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Referral Package

Intake Calendar

September 2010

Intake/Referral Information For Addictions Counsellors

You can download our most recent Application for Treatment (Nov/05 update) from the links on the bottom of this page. Please remember that the application must be completed by a counsellor in conjunction with the client. We do not accept self-referrals. The referring counsellor must be committed to a long-term counselling relationship with the client regarding pre- and post-treatment.

Admission Criteria
Couples Admission Criteria
Methadone Program
Medical Criteria
Intake Process
Payment of Fees
Travel to and from RLTC
Spousal Support
Refreshers
Extensions
Progress and Follow-Up
Download Application for Treatment

In addition to the following information, please see these pages as well:

Admission Criteria - return to top

Client must have two weeks (14 full days) from drugs and alcohol prior to admission . No exceptions will be made - clients without the required clean time will be denied intake. Round Lake is not a detox facility.
There will be a five month clean time for all crystal meth users.
Client is 19 years of age or older.
Client has had a minimum of six one-hour (or longer) pre-treatment counselling sessions within the past 3 months with an A&D Counsellor or Referral Worker.
Submission of completed application, including 2-page pre-admission medical, TB results, and any supporting documentation such as probation orders, pre-natal reports, etc.
Round Lake is not under any obligation to accept MCF-mandated or court ordered clients. Clients must recognize that life conflicts (impaired driving, child apprehensioon, etc.) are caused as a result of alcohol and drug use.
Client has no outside interference during the treatment program such as court appearances, MCF case conferences, doctor, dentist, physiotherapist appointments.
The client must not have any upcoming legal issues/court cases. Applicants coming from an institution must reside in a halfway house, recovery house, John Howard Society, or the community a minimum of one month before entering RLTC. Round Lake does not participate in mandated treatment as a condition for release from probation or parole. Delaying pending court dates in an effort to confirm an intake date only delays the intake process; all court dates must be dealt with prior to admission to Round Lake.
RLTC does not accept clients with the following legal conditions: a) Electronic Monitoring, b) Temporary Absence c) 24 Hour Supervision, d) Day Parole, e) all other legal conditions are reviewed on a case by case basis.
A copy of the Probation or Parole Order must be included with the Application for Treatment before the application can be assessed.
Round Lake does not accept known, charged, or convicted sexual offenders.

Couples Admission Criteria - return to top

To be accepted into the RLTC Couples program, the following criteria must be met:

Have a genuine desire to stop using alcohol or drugs, must possess a willingness to work with and explore relationship and family issues.
Possess a willingness and commitment to complete the thirty four or forty one day treatment program, as a couple. The centre may request a written commitment prior to treatment.
To have had a minimum of 2 sessions with referral agent for assessment, screening and readiness to complete an intensive, highly structured couples treatment program.
To have had a minimum of 4 couples sessions with referral agent for couple assessment and grounding of the couple in preparation for couple’s treatment.
A full treatment application form must be submitted by mail and/or facsimile. All questions on the form must be answered fully by the client and his/her referral agent.
A completed medical report must be filled out and signed by a medical practitioner and submitted to RLTC Intake Coordinator by mail and/or facsimile. All medical, dental or other appointments must be taken care of prior to admission.
Clients must be nineteen (19) years old and over and agree to complete the Alcohol and Drug program, in the event that one of the partnerships chooses to leave the Couples program or is dismissed.
The applying couple must have been in a cohabitive relationship for at least 6 months prior to submission of application.
Both clients must not have any upcoming legal issues/court cases, ALL court dates must be dealt with prior to admission to RLTC. Court date interference or any restrictions orders with treatment may result in dismissal from program until resolved. RLTC is not obligated to keep clients who may be mandated to treatment by the courts or other agencies.
Both clients are expected to cooperatively participate and follow our treatment and program guidelines, with the understanding that RLTC is under no obligation to keep a client(s) who does not participate or comply with treatment direction.
Clients on probation or parole must inform the Intake Coordinator as part of the admission process, providing a copy of the probation/parole order and the name, contact information of the probation/parole officer
Both clients must be free from alcohol and drugs for at least three weeks prior to his/her intake date. No exceptions. The purpose of the three week requirement of clean/ sober time for the couples program is to provide a stronger foundation to focus on their relationship issues.

Methadone Program - return to top

Methadone Program

Medical Admission Criteria - return to top

Client must not require acute care or Detox.
The referral worker and client have provided all relevant documents to verify the client's mental stability if the client is dual diagnosis.
The client is clean from all psychoactive medication(s).
Round Lake accepts clients who are in their second trimester of pregnancy. All supporting pre-natal documentation must be submitted with pre-admission medical.
Client is free from all communicable diseases.
All current medications must be listed on the pre-admission medical report. Unsafe/mood-altering /addictive chemicals not listed on the pre-admission medical and brought into treatment will result in client’s discharge from treatment. Please refer to the safe/unsafe meds list included in the application for treatment.
The client is required to have an active medical number. Please ensure the medical number is documented on the application for treatment. Status First Nation’s clients are required to have a current status card to verify their status number for prescription coverage.
For clients receiving income assistance they will need to ensure they have “enhanced” medical coverage while in treatment. Round Lake is not responsible for any additional expenses not covered by the client’s current medical coverage.
Medical exam and TB testing are admissible for 12 months from the date they were administered.

Intake Process - return to top

Please ensure application is complete before sending as this will help to speed up the intake process.
Application can be faxed to the confidential Intake Coordinator fax line at 250-546-3087.
Once the application for treatment is reviewed and the client meets the admission criteria, the Intake Coordinator will contact the referral worker by letter and/or phone to verify client’s admission and intake date. Confirmation letters are sent out by fax two weeks prior to each intake date to allow sufficient time to coordinate travel arrangements to the centre.

Payment of Fees - return to top

First Nations & Inuit Health Branch pays the per diem for all status First Nations and Inuit people. No subsidy application is necessary, simply provide the client's status number on our Application for Treatment. FNIHB will also pay up to $80 for medical examination for status clients.
Métis and Non-Status clients who are currently receiving income assistance are eligible for per diem funding through the Ministry of Human Resources (MHR). The Employment and Assistance Worker can assist the client with travel funds, comfort allowance, and ensure the client has “enhanced” medical coverage.
Clients receiving provincial income assistance are eligible for a comfort allowance of $82.00 or an approved amount. Clients receiving Employment & Assistance Benefits are advised to speak with their worker about this eligibility before arriving at Round Lake.
If the client does not qualify for per diem funding through First Nations & Inuit Health Branch or Ministry of Human Resources he/she can apply for a User Fee Subsidy through the regional ADS office. The approval form needs to be submitted with the complete application.
For per diem funding provided through a First Nations Band or self-payment, full payment must be submitted prior to treatment.
Payment of per diem fees, ALL travel arrangements, comfort allowance, taxi fare, and any additional expenses are to be arranged with the referral worker and/or Employment and Assistance Worker prior to entry to treatment.
Travel moneys are usually supplied by the subsidy funding source; travel arrangements are to be coordinated with the referral worker. First Nations and Inuit Health will not pay return travel costs for clients who do not complete treatment. The client must be prepared to absorb the return travel costs if they leave treatment incomplete or are not accepted due to insufficient clean/sober time.
Please ensure that the Client has been issued their Return Travel prior to attending Treatment. Round Lake does NOT pay for travel.

Travel to and from RLTC - return to top

Bus Destination

The client's destination is Vernon Greyhound Depot. Clients require return bus fare. Taxi Service to Round Lake is $50.00 one-way via Vernon Taxi (250-545-3337). The client will also require the same amount for the return trip after treatment.

Flight Arrangements

The client's destination is Kelowna Airport. Client requires return airfare. Limo Service from Kelowna Airport to Vernon is approximately $24.00 (one way, contact Vernon Airporter). Cab fare from Vernon to Round Lake Treatment Centre is now $50.00 (one way) and is payable to Vernon Taxi (250-545-3337). The same amounts are required for the return trip after treatment. Call (250)542-7574 for current limo rates directly from the airport to RLTC.

Travel monies are usually supplied by the subsidy funding source; travel arrangements are to be coordinated with the referral worker. First Nations and Inuit Health will not pay return travel costs for clients who do not complete treatment. The client must be prepared to absorb the return travel costs if they choose to leave treatment. Round Lake Treatment Centre does not pay for any return travel.

Spousal Support - return to top

Spouse/family member participation is available in the last three weeks of the client's treatment period.
The supporting spouse/family member follows the same admission and booking procedure as the client.
All fees and regulations apply as with the client (refer to payment of fees).
If the spouse/family member has less than 6 months abstinence from alcohol and/or drugs they will be required to attend the complete treatment program.

Refreshers - return to top

Clients are welcome to do a refresher three months (or longer) after they have completed the RLTC program. They must have remained totally abstinent from alcohol and/or drugs from the time they completed the program. If not, they are then welcome to apply to do another complete program when eligible for the funding.
Refreshers are for a three-week period during each treatment cycle.
The referral worker is required to submit a complete and updated Application For Treatment
TB Testing and the pre-admission medical exam are good for one year from the date they were administered.

Extensions - return to top

Round Lake recognizes client’s do not all progress through their treatment program at the same speed and can sometimes require a longer treatment stay beyond the typical 5 or 6 week intake. A client who completes a full treatment program can apply for a 3-week extension in consultation with their primary counselor, A&D Referral Worker, and when eligible for funding.
Clients accepted for an extension are required to leave RLTC premises in between intakes; as the centre does not have a full staff compliment available to provide 24-7 client support (staff may be in training or preparing for the next intake).
Extension costs can include taxi fare to and from the centre, hotel, and meals; these costs must be provided by the client’s funding source. The client can make other suitable arrangements if available. Round Lake does not pay for any extra expenses associated with extension costs.

NOTE: The Intake Coordinator can assist with flexible time frame alternatives for spousal support, refresher and extension clients.

Progress and Follow-Up - return to top

Telephone case conference calls are conducted with the referral worker to review client’s progress.
A written Aftercare plan is prepared at discharge. A discharge conference call is made between the client, primary treatment counselor, and aftercare counselors.
The client's Final Report is mailed to the designated persons identified on the Consent to Release of Confidential Information. A client may change the name of the persons on the consent at any time and it is up to the client to inform their referral worker of the change.
Round Lake conducts post-treatment follow-up with the client at 3 months, 6 months, 1 year and 2 year intervals.

Application for Treatment - Downloads - return to top

Our Most Recent Application for Treatment - NOTE: NEW APPLICATION RELEASED May 2010 - PLEASE MAKE SURE YOU ARE USING THE LATEST VERSION

Any outdated Referral Packages that are submitted will need the "Consent to Attend and Participate in Treatment" and Consent for Release of Confidential Information" (page 12) resubmitted prior to admission.

Available in the following formats (choose your preference):
PDF Format (295KB)
Microsoft Word 2007 (196KB)
Microsoft Word 1997-2003 Compatible (528KB)
Microsoft Works (178KB)

Let us know if you need a different format and we may be able to e-mail one that works for you. E-Mail questions regarding intake or referral to our intake worker at intake@roundlake.bc.ca

We are unable to accept applications through the Internet due to the requirement of having original signatures from the client consenting the release of information. All complete applications are to be sent to our mailing address mentioned in the application (and on our Contact Us page).

Alcohol Screening Test (MAST) / Drug Abuse Screening Test (DAST) / Client Guidelines
Visitor Guidelines / Pre-Treatment Checklist