107.41 Referral Process for Assessment and Treatment

The CAO must do the following:

Complete the Confidential Drug and Alcohol Referral/Treatment Information form ( PA 1672 ).

Have the person sign the form and the Authorization for Use or Disclosure of Personal Information ( HS 1815 ). Both forms are available on Docushare .

Send the signed PA 1672 , with the appropriate CAO sections completed, to the treatment center. The treatment center completes designated sections on the form and must return it to the CAO within 30 days of the referral date.

If the CAO does not receive the completed PA 1672 within 30 days, it must do the following:

For Community Connections Initiative (CCI) counties: Make a referral to CCI. If CCI does not contact the CAO within 45 days about the referral results, the CAO may send an Advance Notice to close.

For non-CCI counties: Contact the person. After three tries to contact the person, the CAO may send an Advance Notice to close. The CAO must try to reach the person at different times on different days and narrate the details of these attempts.