Substance Abuse Procedures - MD

Best Practices of
Regional Ombudsman Programs

Project Description:  

Developed a model resident compliance agreement and procedures for dealing with severe issues regarding HIV, Alcohol and Drug Abuse (ADA) residents and their non-compliant behavior relative to their medical care.  The Baltimore City Commission on Aging & Retirement Education (CARE) Ombudsman office observed a noticeable increase in calls from Nursing Home Administrators with severe issues of concern regarding HIV, Alcohol and Drug Abuse (ADA) residents and their non-compliant behavior relative to their medical care.  Particular concerns of the Administrators are behavior and medication management and how to initiate emergency measures needed to protect both the resident and staff, such as police intervention and emergency psychiatric evaluation.  These residents usually are verbally abusive to staff and other residents.  When the Administrator and/or Director of Nursing attempt to address behavioral issues with the resident, the resident’s hostility increases.  Alcohol and illegal drugs have become very accessible in the Nursing Home environment.

Impact:

After weeks of monitoring and investigating issues of concern in Baltimore City Nursing Homes, it was determined that a Workshop and/or Conference on HIV and ADA in Long Term Care would be beneficial to the residents and the industry.  The response of a multi-disciplinary core team was overwhelming for a Workshop as soon as possible.  Future Care Corporation and Mariner Health Care both agreed to sponsor the daylong conference in conjunction with CARE. 

A meeting was held on July 9, 1997 at Charles Health Care Center in Baltimore.  This was the kick-off meeting for the PRIME TIME CONFERENCE concerning HIV/ADA: The Changing Face of Long Term Care.

Additional task force participants representing the State Department of Health, law enforcement, State’s Attorney Office, public guardianship program, and an Ethics Committee was included.