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Division/Section Family Support Chapter No./Name 4 – Economic Stability (ES) Part No./Name B – Eligibility Factors Section No./Name B- 1800-FITAP Drug Testing Document No./Name B-1840-FITAP Referral to OBH Effective Date November 15, 2019

1 of 1 I. STATEMENT OF POLICY

If, based on the screening or other reasonable cause, there is a reason to suspect that the recipient is using or is dependent on illegal drugs, refer the recipient to OBH for additional screening which may include urine testing.

II. PROCEDURES

Contact OBH and schedule an appointment for the recipient to receive a formal assessment and possible urine testing and provide the client with a Notice of Appointment for Assessment (OFS DT 3).

Complete the OBH referral form (OFS DT 2).

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Mail the original of the referral form, the DAST 20 (if completed), the release forms (Form DCFS 35/DCFS 35H), a copy of the Notice of Appointment for Assessment (OFS DT 3), and * a copy of the recipient’s photo ID or driver’s license ** to the OBH facility where the recipient's appointment has been scheduled. Mail timely to ensure that it is received before the date of the appointment.

III. FORMS AND INSTRUCTIONS

OFS DT 2 Form / Instructions Referral for Drug Assessment

OFS DT 3 Form / Instructions Notice of Appointment for Assessment

DAST 20 Form / Instructions Drug Use Questionnaire

DCFS 35 Form / Instructions Consent to Release Information (Other than Protected Health Information) Waiver of Confidentiality Form

DCFS 35H Form / Instructions Authorization to Release Protected Health Information

IV. REFERENCES

LAC 67:III.1249

R.S. 46:460.10