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1920 Substance Abuse Testing

1921 Definitions Related to Substance Abuse

1921.1 Chain of Custody

CPS June 2010

The chronological documentation confirming that a drug specimen belongs to the person who was tested and the specimen has not been tampered with en route to the laboratory.

1921.2 Drug Confirmation

CPS June 2010

A drug confirmation is the measurement of the metabolization of a drug by a person's body using a specimen collected from the person. If the drug is present in the person's body at levels high enough to be metabolized, the possibility of accidental or second-hand exposure is ruled out. The confirmation also rules out false positives.

1921.3 Drug Screen

CPS June 2010

A drug screen is any test – whether performed by a caseworker, laboratory, or other facility that conducts screenings – to confirm the existence of a drug in a person's system. A drug screen does not show the level at which a drug is present and therefore cannot be relied on to rule out the possibility of second-hand or accidental exposure.

1921.4 Instant Test (Oral Swab)

CPS June 2010

An instant swab test is a test of a client's oral fluids performed by a caseworker to determine whether the client has used drugs recently. The results may be confirmed by a laboratory, if possible. The results must be confirmed by a laboratory before being presented as evidence in a court hearing.

1922 Eligibility for Substance Abuse Testing

CPS June 2010

Guiding Principle

If a worker has cause to believe, based on credible evidence, that a parent or someone who has direct access to the child has a substance abuse problem, including the abuse of alcohol or marijuana, and that problem threatens the child's safety, the worker must request a drug test for the client.

To request a drug test, see 1951 Children and Adolescents Who Smoke Marijuana, Use Other Drugs, or Drink Alcohol.

Requesting a Drug Test

A worker may request substance abuse testing:

  •  when the worker has cause to believe that a client has a substance abuse problem, based on credible evidence from an intake report, an investigation, comments from collateral sources (such as teachers, neighbors, and family doctors), child safety and risk assessments, family assessments, a drug screening, self-admission from the client, or on-going case monitoring;

  •  when a court orders the testing;

  •  when a safety plan that relates to substance abuse issues is about to end because it no longer appears necessary;

  •  to allow or re-assess family reunification, if the parent has an active substance abuse problem;

  •  to provide motivation for a parent to remain abstinent; or

  •  to encourage participation in substance abuse treatment or aftercare.

The table below shows the tests that may be conducted or ordered for a client by the caseworker or accepted from other sources, and the staff who may approve the orders.

Each region may develop more stringent approval requirements.

Tests Allowed or Accepted

Approving Staff Level

Oral fluid (instant swab test, instant swab test with confirmation, or instant test lab confirmation).

Caseworker or per regional protocol.

Urine

Supervisor or per regional protocol.

(Caseworkers are not permitted to collect urine specimens.)

Hair

Program director or per regional protocol.

Meconium

DFPS does not conduct or purchase meconium tests.

DFPS accepts:

  •  the results of a Hospital Meconium test on a newborn; and

  •  the results of tests conducted in a hospital on the mother of the newborn. (The usual test on the mother is a urine analysis.)

1922.1 Determining Eligibility for Substance Abuse Testing Conducted by a Contracted Laboratory

CPS June 2010

The following clients are eligible for substance abuse testing that is conducted by a laboratory under contract:

Clients Eligible for Testing

Additional Details

Children in open CPS cases, including children in DFPS conservatorship and children who are being placed for adoption, when these services are needed.

Children must not be tested by DFPS caseworkers, unless the child is 10 years old or older and is being investigated as an alleged perpetrator.

The testing of child as an alleged child-perpetrator must be referred to a laboratory.

The parent in open CPS cases, excluding a foster or adoptive parent.

A parent may also be administered an instant swab test by a DFPS caseworker.

Caregivers or kinship family members being assessed to care for a child who is being placed voluntary by the parents rather than by court order (that is, as part of a parental child safety placement).

See:

      4510 Definitions Related to Kinship Care

      2430 Criteria for Parental Child Safety Placements

A caregiver or kinship family member may also be administered an instant swab test by a DFPS caseworker.

The testing is paid for by submitting Form 2054 Service Authorization (located in the IMPACT system).

If child is in DFPS conservatorship, Medicaid does not pay for the testing of the caregiver, family member, or kin.

1922.2 Identifying the Substances That Are Eligible for Testing

CPS June 2010

Laboratory tests are ordered to test for the following substances:

  •  Alcohol

  •  Amphetamines

  •  Cocaine

  •  Opiates

  •  Phencyclidine (PCP)

  •  Cannabinoids (Marijuana)

  •  Barbiturates

  •  Benzodiazepines

  •  Methaqualone (Quaalude; a depressant)

  •  Methadone

  •  Propoxyphene (Darvon; an opioid)

The following drugs are detected in saliva (instant swab tests):

  •  Alcohol

  •  Amphetamine

  •  Cocaine

  •  Codeine

  •  Hydrocodone

  •  Marijuana

  •  Methamphetamine

  •  Morphine

  •  PCP

1922.3 Identifying Laboratory Services for Substance Abuse Testing

CPS June 2010

The laboratory substance abuse tests available by contract must include at least one of the following services:

  •  Urinalysis testing

  •  Hair testing

  •  Oral fluid testing

A caseworker may collect oral fluid from a client in order to perform an instant swab test. The caseworker may be the sole witness to the oral collection and may be part of the chain of custody for instant swab tests only. (See 1921.1 Chain of Custody.)

The laboratory must provide the results of adrug test to DFPS staff only. The lab may not contact clients directly to obtain information or provide results.

1922.4 Referring Clients for Substance Abuse Testing

CPS June 2010

For complete referral instructions, see 8161.1 Active Cases – Authorizing, Extending, or Terminating Direct Services, as referenced in 1922.6 Adding, Extending, Reauthorizing, or Terminating Substance Abuse Services.

1922.5 Authorizing Substance Abuse Testing in IMPACT

CPS June 2010

To authorize substance abuse testing, workers must enter the following details into the IMPACT case management system.

In the IMPACT field …

the caseworker enters …

Category …

Substance Abuse

Service, Service Code

(as applicable) …

79A   (Drug Testing-Urine Analysis)

79B   (Drug Testing-Oral Fluids)

79C   (Drug Testing-Hair Testing)

79D   (Drug Testing-Confirm All Tests)

Unit of Service

One time

Limitations

The caseworker may not submit IMPACT Form 2054 Service Authorization more than once a week for each client.

Stages

The services (tests) listed in the chart above may be provided in the following stages:

  •  Investigation (INV)

  •  Family Preservation (FPR)

  •  Substitute Care (SUB)

  •  Family Substitute Care (FSU)

  •  Family Reunification (FRE)

  •  Adoption (ADO)

1922.6 Adding, Extending, Reauthorizing, or Terminating Substance Abuse Services

CPS June 2010

Workers must follow the procedures in 8161.1 Active Cases – Authorizing, Extending, or Terminating Direct Services:

  •  to authorize additional units of service, or extend or reauthorize substance abuse testing; or

  •  to terminate substance abuse testing before the end date noted on Form 2054 Service Authorization, located in the IMPACT system.

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