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Wednesday, October 7, 2015

Jackson County Commission Work Session, October 5, 2015

Jackson County Courthouse South Side (photo by G. Morgan)

News items of interest for this session: Agenda items 1) Commission employee and retiree insurance plan costs (part 1 video); 7) Jackson County Court Referral and Community Corrections, there is no plan or approval for a plan on file at the county commission office (part 2 video). There is also a question concerning the last audit of the program, which is required annually. For the program to be a Non-profit entity one of the requirements is a 501c3 status; a lack of oversight from a board of directors is also being questioned. A listing of minimum administrative standards as required by the state is posted below. There is a question if the required state administrative standards are met. Code of Alabama 15-18-170 thru 182 covers Community Correction's programs  http://alisondb.legislature.state.al.us/alison/codeofalabama/1975/coatoc.htm
Click on image for an expanded view.

Court Referral Program Requirements may be found at this link under the Administrative Office of the Courts: http://www.alacourt.gov/Sections/CSIT/EducationalPrograms.aspx

My interest became peaked when I interviewed participants in the court referral, so called "out-patient" program, where a counselor at the county corrections referred Family Life Center issued a requirement to "pay homage" to the court system by requiring program participants to write a letter to someone in the court system giving them praise;  examples were given by the counselor which were considered acceptable parties to write this letter of  praise, "Judge, DA or Attorneys," also reported, "When you write the letter there have been examples of the DA, Judge answering back with praise to the letter writer."

There are many questions relating to the health care of individuals submitted for so called "out patient" drug and alcohol program treatment where there is no formal medical evaluation. Calling a program "out patient" care does not make it so, particularly when there is no formal medical oversight by a qualified physician or health care authority. Testing of urine, blood, hair or the evaluation of patients in a health care setting requires qualified health care personnel with oversight from qualified, credentialed health care professionals in a health care setting. Apparently for so called "out patient" drug related rehabilitation cases health care standards are lacking, which does no favors for the patients, or community, in the faux "out patient" care program. 

The State of Alabama requires drug & alcohol counselors to be certified by the Alabama Mental Health Board; there is no requirement for patient care oversight from a health care authority for so called out patient substance abuse care.  http://admh.academy.reliaslearning.com/about-us.aspx 
One example of a corporate drug abuse counseling program with claims to out patient health care, but has no connection to any health care authority or physician performing a professional examination before the so called out patient health care is initiated. http://familylifecenter.ws/laboratory-equipment/ Counselors and programs such as offered at the Family Life Center receive limited oversight from the Alabama Mental Health Board. Unfortunately, mental health care and this board have suffered drastic budget cuts.  
Quote from above Family Life Center link: "We believe that if we have helped our clients become active members of their local self-help group we have achieved our goal." (Self-help groups include Narcotics Anonymous, NA, and Alcoholics Anonymous, AA.)  Nothing is stated about the goal of helping a patient (their word is client) to become a productive member of the community, free from substance abuse following a structured system of recovery guidelines "one day at a time." 

In this case, Substance Abuse Referral programs are specifically connected to the Alabama Department of Corrections via Court Referral and Community Corrections. My concern is the lack of definitive patient/health examinations and health care standards, guidelines and oversight by qualified health care professionals. I believe the resolution may be found in many areas at the local Health Care Authority and/or connected with local public or private hospitals which require specific levels of education, certification and credentialing with oversight from national inspection and accreditation programs; the local Health Care Authority is a member and accredited, http://www.jointcommission.org/about_us/about_the_joint_commission_main.aspx   this insures a high quality of health care in an out-patient or in-patient setting.

 Never should psychiatric or health care treatment of patients, whether substance abuse patients as so called out-patients, or any patient, be conducted without the oversight of qualified, credentialed health care professionals. The question must be asked - how can you call something "out patient" care without patient/health care guidelines and no organized health care oversight?  This is a preliminary report, more to follow. 


Part 1

VIDEO Part 2

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