MAT Member Handbook_09302026

MAT/MOUD MEMBER HANDBOOK

Contact Us

Clinic Phone: 520-202-1786

Address: 380 E. Ft. Lowell Rd. Tucson, AZ 85705

www.CODAC.org

Dosing Hours for Current Members Only Monday — Friday 5:00am — 11:00am (arrive by 10:30am) 1:00pm — 5:00pm (arrive by 4:30pm) Saturday: 7:00am — 10:45am (arrive by 10:15am) * Please note: dosing hours are subject to change. Notification will be posted in the clinic. Standard Office Hours For scheduled appointments, groups and walk-in meetings with the Counselor of the Day: Monday — Friday 5:00am — 5:00pm 24/7 Operations CODAC at 380 is open 24/7, including holidays & weekends, for individuals looking to start treatment for drug or alcohol use (new members). Current members can also call 24/7 with any concerns. Table of Contents Welcome & About CODAC ........................................................ Description of MAT/MOUD Services ................................... Admission into the Program ..................................................... Confidentiality, Medical Records Requests, Patient Portal ............................................................................. CODAC & Member Responsibilities ..................................... About Medications for Opioid Use Disorder .................... About Methadone ................................................................... About Buprenorphine ............................................................ About Naltrexone .................................................................... Naloxone/Narcan ............................................................................ Prescription Drug Policy ............................................................. Take-Home Medication for Methadone Members ....... Other Program Policies ............................................................... Dosing Rules ...................................................................................... Involuntary Discharge .................................................................. Grievance & Appeals .................................................................... Resources ........................................................................................... After-Hours & Crisis Support ................................................... 1 2 3 13 14 15 15 16

CODAC Main Phone Line 520-327-4505 Administrative Offices 4585 E. Speedway Blvd. Tucson, AZ 85712

Medical Records Requests Phone: 520-202-1777 Fax: 520-202-1703 Online: A Medical Records Request Form is available at www.CODAC.org/contact-us.

Genoa Pharmacies

At Cobblestone Court Phone: 520-257-1539 Fax: 520-887-3001 At Speedway Phone: 520-917-0129 Fax: 520-413-4507

After-Hours Support CODAC Safety Zone: 520-202-1950 Community-Wide Crisis Line: 520-622-6000 / 800-796-6762 Solution Zone for Complaints/ Concerns Phone: 520-343-2225

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Welcome to CODAC!

Welcome to CODAC’s Medication Assisted Treatment (MAT) and Medications for Opioid Use Disorder (MOUD) Program. Please read this handbook to learn about important guidelines and rules in this program.

This handbook includes

A description of the program Admission criteria A statement on confidentiality Important program policies and procedures A description of methadone, buprenorphine, naltrexone and naloxone Grievance procedures

Please note: This handbook is a supplement/addition to CODAC’s Member Handbook. For a copy of the CODAC Member Handbook, please ask the front desk.

CODAC envisions a society where everyone lives healthy, productive, caring lives - positively contributing to their communities. Our Vision

Our Mission It is the mission of CODAC to provide tools, support and services to individuals, families and communities so they may live with dignity, free from the harmful effects of mental illness, substance use disorders and trauma.

Our Values

Recovery

Diversity

Acceptance

Respect

Integrity

Creativity

Commitment

CODAC’s integrated health model is a comprehensive, holistic approach to care and wellbeing that focuses on the whole person and family or family of choice. We believe it is important to address the full spectrum of physical, emotional, behavioral, social, spiritual, relational and environmental factors that impact wellness. Integrated Health & Wellness Philosophy

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Description of CODAC MAT/MOUD Services

This program is part of CODAC Health, Recovery & Wellness. All CODAC staff work under a code of ethics that provides guidance for their conduct in accordance with the CODAC mission. CODAC MAT Services opened in 1983 to meet the needs of people who are dependent on opioids in Pima County. Today, we are a comprehensive outpatient treatment center for individuals with substance use disorders and offer Medication Assisted Treatment (MAT) and Medications for Opioid Use Disorder (MOUD). MAT/MOUD Services is a treatment program. To be involved in this program, you must be motivated to stop your opioid use. We work as a team to provide effective and coordinated care to all members. CODAC provides individual and group therapy, case management, peer support, psychiatric services and physical health care (primary care) on-site. CODAC’s MAT/MOUD Program is here to support your goals. While medication makes recovery possible, you must be motivated to change. Services at the MAT/MOUD Clinic Participation in the following services is dependent upon member eligibility, insurance coverage and medical necessity. Medication Assisted Treatment/Medications for Opioid Use Disorder Psychiatric Evaluation & Medication Management Therapy Case Management & Peer Support Primary Care Wellness & Employment Services Coordinating Medical Care & Reviewing Medications In order to provide the best possible care, CODAC reserves the right to coordinate medical and behavioral health services (speak with your doctors) and to withhold a medication dose if a physical health concern is identified. You will be expected to sign Releases of Information (ROIs) with all prescribing doctors. A Medication Profile will also be obtained from the Arizona State Board of Pharmacy.

Presenting to CODAC Under the Influence or Impaired Presenting to the clinic under the influence or impaired will require further discussion prior to medication administration (dosing). Any positive breathalyzer will prevent CODAC from providing you with your medication dose.

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Admission into the Program

To be admitted to CODAC’s MAT/MOUD program, you must be currently using drugs or alcohol or have a recent history of a substance use disorder. You also need to meet state and federal guidelines for admission. You may be denied admission if, in the professional judgment of the clinical/medical staff, you do not meet criteria. If denied admission, you will be referred to appropriate services. The Intake Process During your “Intake” (which is typically the first time you come to CODAC for services), you will meet with staff who will guide you through the following steps: 1.Initial interview with a clinician. 2.Documentation of your substance use and psychosocial history. 3.Creation of an initial treatment plan. 4.A health history, screening, and physical exam with a nurse or medical assistant. 5.When appropriate, prescription of medication and/or induction (start) on a medication. What to Bring to Your First Appointment Your insurance card. If you have AHCCCS insurance, please bring your AHCCCS Identification Card. If you are not on AHCCCS and/or do not have other insurance coverage, please bring paycheck stubs for one month (if you are employed), proof of residence (such as a rent receipt), and anything else that shows that you have significant, regular monthly expenses. Photo identification. List of current medications and dosages.

List of past medications that may or may not have worked for you. Cash, check or credit card to cover copay or fee-for-service charges. Any concerns you have written down since your last appointment.

Cost of Treatment Cost depends on State (AHCCCS) and Federal Substance Use and Treatment Prevention and Treatment Block Grant (SUBG) funding. These funding sources are subject to change and it is expected that you will have a financial screening upon admission, and twice annually (at a minimum), to determine financial eligibility. If you are not already on AHCCCS and do not have other insurance coverage, we are required to help you apply for insurance benefits.

Interpretation If your primary language is not English and you need an interpreter, please tell anyone at CODAC. We want to meet your communication needs. There is no charge for an interpreter. Si su idioma principal no es el inglés y necesita un intérprete, dígaselo a cualquier persona en CODAC. Queremos satisfacer sus necesidades de comunicación. No hay ningún cargo por un intérprete.

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Confidentiality

All records related to substance use treatment are subject to strict confidentiality and non disclosure under Federal laws and 42 CFR Part 2 Federal regulations (42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3 for Federal laws and 42 CFR Part 2 for Federal regulations). Congress states: “Every person having control over or access to patients’ records must understand that disclosure is permitted only under the circumstances and conditions set forth in this section (21 U.S.C. 1175). Records are not made available to investigators for purposes of law enforcement or any other private or public purpose or in any manner not specified under this section.” There are three exceptions to these confidentiality requirements: 1.The member consents in writing. 2.The disclosure is allowed by a court order. 3.The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit or program evaluation purposes. A violation of the Federal law and regulations by a program is a crime. Suspected violations may be reported to the appropriate authorities in accordance with Federal regulations. Federal law and regulations do not protect any information about a crime committed by a member either at the program or against any person who works for the program or about any threat to commit such a crime. Federal law and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities. Due to Federal regulations, any information regarding clinic attendance or program status will not be released to anyone over the phone or in the clinic unless a written release is signed in advance by the member. No information will be released to a spouse without a prior written release. Medical Records Request Members are welcome to request copies of their medical records. To do so, download and complete the Medical Records Request Form at www.CODAC.org/contact-us. Once complete, fax the completed Form to 520-202-1703 or email it to medrecords@codac.org. Questions? Call 520-202-1777. Patient Portal Using the NextGen HealthCare Patient Portal, you can connect with your CODAC healthcare provider 24/7 in a convenient, safe and secure environment. CODAC MAT Services maintains strict confidentiality of member identities and records.

Access resources to improve your health Request an appointment Request prescription refills

Communicate with your CODAC BHMP or PCP Learn about health care diagnoses First time Patient Portal users: Call CODAC at 520-327-4505 to get started.

Visit www.CODAC.org/for-members/ patient-portal/ to log in to the Patient Portal.

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CODAC & Member Responsibilities

We recognize that you are an individual and we will strive to work with you to individualize your treatment. However, you should be aware that there are Federal and State regulations regarding the dispensing of methadone and buprenorphine, which create some necessary rules. Some of these requirements include: 1.Development of a psychosocial history. 2.A full physical examination prior to methadone induction. 3.Ingesting the methadone medication in the presence of medical staff and following appropriate dosing procedures. 4.Submitting to urinalysis (UA) upon request. Urinalysis may be monitored at the discretion of the program staff. 5.Regular contact with your counselor, participation in developing a treatment plan and following through on all agreed upon recovery services and activities. CODAC Responsibilities In addition to responsibilities outlined in CODAC’s Member Handbook, CODAC’s MAT/MOUD program is responsible for providing members engaged in MAT/MOUD services with: An orientation to the program. Convenient hours of operation. Medication on a regularly scheduled basis. Counseling, wellness support, skills training and/or therapy - individual, group and family - services as needed. Referral to other agencies for appropriate services. Coordination of healthcare services. Annual TB test or screening if receiving methadone services. Annual electrocardiogram (EKG) if receiving methadone services. At the discretion of the Medical Director or BHMP, an EKG screening may be performed more frequently based on the member’s methadone dose and cardiac risk profile. Dose alerts may be utilized to notify staff when an EKG is due and to facilitate timely completion of the required EKG. Member Responsibilities In addition to Member Responsibilities outlined in CODAC’s Member Handbook, MAT/MOUD Members are responsible for: Attending scheduled appointments for medication dosing, counseling and therapy. After 3 consecutive days of missed medication dosing, the member will need to meet with their treatment team to determine if re-admission is appropriate or if a referral is needed for a different level of care. Providing urinalyses as scheduled and upon request, which may be monitored at the discretion of the clinic staff. Providing breathalyzers as requested. Advising all outside medical/psychiatric providers of your participation in MAT/MOUD treatment. Coordinating all outside medical care with us. This includes bringing in all prescriptions and signing a release to your outside care providers. You will need to bring in these prescriptions as directed by the staff.

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Member Responsibilities (continued) Notifying CODAC staff if you are admitted to a medical facility and, when returning, providing discharge paperwork. Not providing discharge paperwork may prevent the clinic’s ability to resume your medication dosing. If pregnant, members are responsible for receiving regular prenatal care and informing CODAC staff immediately after learning that you are pregnant so that we can properly manage your medications. Receiving an annual TB test or screening. Receiving an annual EKG. At the discretion of the Medical Director or BHMP, an EKG screening may be performed more frequently based on a member’s methadone dose and cardiac risk profile. Following through with directions from the Medical Director for serious medical problems or contagious diseases. EKG Benefits 1.An EKG (electrocardiogram) is an important safety tool used during methadone treatment to monitor the heart’s electrical activity and identify any cardiac abnormalities. 2.Obtaining an EKG helps providers detect QTc prolongation early, assess individual cardiac risk, and make informed treatment decisions to promote member safety while maintaining the benefits of methadone therapy. Regular monitoring can identify changes before serious complications occur. 3.Failure to obtain an annual or recommended EKG may result in unrecognized cardiac abnormalities and an increased risk of serious complications, including dangerous arrhythmias, syncope, cardiac events, and, in rare cases, death. EKG monitoring is, therefore, an essential component of safe and effective methadone treatment. About Medications for Opioid Use Disorder The FDA has approved specific medications for opioid use disorder: methadone, buprenorphine (Suboxone, Subutex, Brixadi, Sublocade) and naltrexone (Vivitrol). Both methadone and buprenorphine are some of the most highly effective medications in modern medicine. When taken daily, they are shown to prevent the rate of relapse, overdose and death from causes other than overdose by 40-60%! They have also been demonstrated to prevent the transmission of infectious diseases such as HIV and Hepatitis C. Vivitrol is a monthly long-acting injectable medication that can also be used in the treatment of opioid, stimulant and alcohol use disorders. It is unique in that it is an opioid blocker. The daily oral formulation is not approved for the treatment of opioid use disorder (OUD). It is not frequently used in the treatment of OUD as patients must be opiate-free for 10-14 days before starting the medication. It cannot be combined with methadone, suboxone or any other form of opiates. Doing so will precipitate withdrawal.

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About Methadone Methadone is a long-acting, synthetic (“man-made”) opiate. It is taken daily. Unlike buprenorphine, there is no risk in precipitating withdrawal when starting methadone. To be safely started, methadone is prescribed at a low dose and increased slowly under medical supervision. While the dose is being titrated, it is not uncommon to continue to experience cravings and withdrawal. This does not mean that the medication is not working. It just means that you are not yet on a stable dose. As the dose is increased, these symptoms go away. When on a stable dose of methadone, individuals are free from cravings, withdrawal and continued use of their drug of choice and show no signs of sedation. They are able to go about their daily lives free from the negative symptoms of a substance use disorder. Methadone is highly regulated by the DEA when used to treat opioid use disorder. It cannot be sent to a pharmacy and can only be obtained from an Opioid Treatment Program (OTP). As individuals progress in treatment, their level of take-homes is increased accordingly. Methadone is longer acting than fentanyl, heroin or other opioids. An adequate oral dose remains fully effective for 24 hours or longer in stalling the onset of withdrawal. This is why methadone needs to be taken only once instead of several times each day. Effects Methadone should be used with caution and in reduced doses for members who are also receiving other pain medication, tranquilizers, sleeping pills, tricyclic antidepressants and other central nervous system depressants, including alcohol. Decreased breathing, decreased blood pressure, heavy sedation and unconsciousness may otherwise result. PLEASE NOTE: If you are on any other medication, you are required to notify the medical staff. There may be some side effects associated with use of methadone. If you are experiencing any unusual symptoms, please contact the medical staff. Side effects may include swelling of the hands and feet, upset stomach, or irregular menstrual periods. To decrease the possibility of an upset stomach, we suggest that members eat before taking methadone and avoid citrus juices near the time of dosing. While there may be some side effects of methadone treatment, goals that may be achieved while on the program include improvements in:

Mental health Physical health Economic status Social status Improved employability Personal freedom Self-esteem

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About Buprenorphine (Suboxone, Subutex, Brixadi, Sublocade)

Buprenorphine is a synthetic partial opiate. The long-acting injectable forms are given weekly or monthly. The oral formulations are taken daily under the tongue (“sublingually”). It comes in either tablets or films. If taken too soon after use of another opiate, it will cause precipitated withdrawal. Buprenorphine can be sent to a pharmacy like most other medications. Once on a stable dose, members will receive weekly to monthly prescriptions sent to the pharmacy based on provider discretion and will see their BHMP at similar intervals. While it’s a partial opiate, buprenorphine is highly effective as it binds incredibly tightly to the opioid receptors. When on a stable dose of buprenorphine taken daily, the medication blocks the binding of other opiates when relapse occurs, preventing overdose. It is incredibly rare for an adult to overdose on buprenorphine; however, it is important that the medication is safely stored as overdose can occur if ingested by children. Starting on Buprenorphine (suboxone) With the advent of fentanyl, buprenorphine is primarily started via at-home induction. For individuals who want to be on buprenorphine but have had difficulty successfully starting the medication in the past, it may be advised to be admitted to a medically-supervised withdrawal facility (“detox”) to start the medication. Once safely started on buprenorphine in this setting, the individual will return to CODAC for medication management. Please speak with your BHMP regarding further details about starting buprenorphine. Stabilization Phase The second phase of buprenorphine treatment can last from days to weeks. During this time, it is highly recommended that you attend therapy and groups to help in your recovery. Make sure to tell the nurse/BHMP of any withdrawal symptoms or periods when you’re over-sedated (sleepy) so dose adjustments can be made. Maintenance Phase The maintenance phase can last from weeks to months, depending on your individual situation. During this phase, you should be stable on your dose. You should continue to meet with your therapist and attend groups. The focus during this period is counseling, relapse prevention and harm reduction. Other Requirements All members must meet with a BHMP monthly at regularly scheduled intervals. All members are highly recommended to attend groups and individual therapy. CODAC staff can talk with you about groups that are a good fit with your recovery goals.

To view CODAC’s current groups go to www.CODAC.org/ services/groups-classes.

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About Naltrexone

Naloxone (Narcan) for Overdose Reversal Naloxone, sold under the brand name Narcan, is a medication that is used to treat an opiate overdose. In May 2016, HB2355 passed, allowing prescribers to prescribe and distribute Naloxone to individuals at risk for overdose, their friends and family. Prescribers and the person who administers the medication are both protected from certain liabilities. The law also allows people to purchase it directly from the pharmacy without a prescription. Naloxone is available in the lobby of CODAC at 380. Individuals with AHCCCS insurance can also get Naloxone from the Genoa Pharmacy located at our Cobblestone Court treatment site (1075 E. Ft. Lowell Rd. | (520) 257 1539). Naltrexone is a medication approved by the FDA to treat opioid use disorders and alcohol use disorders. It blocks the euphoric and sedative effects of drugs such as heroin, morphine, and fentanyl. Naltrexone is reported to reduce opioid cravings. To reduce the risk of precipitated withdrawal, members are warned to abstain from illegal opioids and opioid medication for a minimum of 7-10 days before starting Naltrexone. There is no abuse or diversion potential with Naltrexone (www.samhsa.gov). Prescription Drug Policy Procedure for Prescription Medication In order to prevent misuse of prescription drugs and to maintain the focus of treatment in counseling, the following guidelines will be followed by all staff: 1.All psychotropic and analgesic medications must be coordinated with the medical staff or designee and logged with medical staff as directed for documentation. 2.All positive urine tests for any controlled substance, without a coordinated prescription, will be considered an unacceptable/”unfavorable” (positive) urine. Acceptable/”favorable” urines are those cases where use of the medication is psychiatrically or medically indicated, and only when coordination with an outside prescribing medical provider occurs. 3.Counseling staff should make every effort to encourage members to only take medications that are necessary and appropriate. When necessary, there may be a consultation between the medical team and the member’s doctor. 4.Take-home privileges and/or medication dosage may be affected if you are on certain medications due to concerns about drug interactions with methadone.

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Take-Home Medication for Methadone Members

Decisions about increased take-home levels are based upon Federal and State regulations and program policies and will be reviewed by the clinical team. Some factors that are taken into consideration are: 1.Your stability in treatment (whether substance use disorders are active or in remission) 2.How regularly you attend appointments 3.Length of time in treatment 4.No serious behavioral problems at the agency 5.Special physical health needs 8.Compliance with prescription drug policy and logging of medications 9.Compliance with policy on diversion, loss or theft of take home medication 10.Stable on psychiatric medication and current coordination with provider of services To receive take-home doses, members must have favorable urinalyses (see urinalysis section). In addition, members may lose the ability to have take-home doses when they no longer meet the above criteria. Breathalyzers and urinalyses positive for illicit drug use, or that are considered unfavorable, may result in partial loss of take-home doses. Ability to receive take-home doses will be reduced one level after each unfavorable urine drug screen. Additional unfavorable urine drug screens may result in daily dosing except for Sundays and holidays. You can get take-home doses again upon stabilization. When you receive take-home bottles, please be aware that this is a potentially dangerous medication prescribed for you only. Take-home medications should be stored in an upright position in a cool, dry place out of the reach of children. A refrigerator is NOT a good place to keep this medication. Additionally, there are State and Federal time frame requirements you need complete before you can take medication home. A federal exception must be made for other circumstances where take-home medication is needed and criteria is not met. Please meet with your Recovery Coach for these requests. Returning Take-Home Bottles: Members must return all used/empty take-home bottles upon their next visit to the site. If you don’t bring back all take-home bottles with the correct name and date, your take-home dosing will be reduced by one level. Diversion CODAC is required by our Federal and State licensure to safeguard all the methadone that our members receive. Any inappropriate use of medication is considered diversion. This includes, but is not limited to, selling your take-home bottles/medication, dual enrollment at another MAT site, uncoordinated prescriptions for methadone from another source, overtaking your buprenorphine, leaving the clinic without swallowing your methadone, and irresponsible loss of take home medication. Due to the seriousness of this concern, any individuals found to be diverting their medication risk losing their treatment. 6.Assurance that take-home medication can be safely stored 7.Hardship experienced in traveling to and from the agency

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Other Program Policies

Loitering Members are expected to leave the premises immediately after dosing unless they have a legitimate purpose to remain on the premises (i.e., counselor or medical appointment or permission of a staff person). Loitering consists of remaining in or around the CODAC building, or on the property of the CODAC building. Continued loitering is grounds for administrative discharge from the program. Involvement of Family or Close Friends in your Treatment Family members, significant others, and close friends can be very important to the success of members in MAT treatment. The people that are close to you can either help or hinder your recovery. It is the goal of our program to involve as many people in your treatment as would be beneficial and only with your permission. Participation by family or close friends can be anywhere from a simple phone call to attendance at one of your appointments. CODAC staff have a wealth of information regarding methadone treatment which can be provided to anyone involved in your treatment. We feel that your treatment can only benefit from others having correct information regarding methadone. Urinalysis Federal and State guidelines require a minimum of 10 urinalyses a year for members on methadone. Urinalyses are performed on all members to test for illicit or inappropriate drug use. Frequency of urinalyses will vary. Urines may be monitored and you may be tested for all the following: opiates, methadone, cocaine, benzodiazepines, amphetamines, barbiturates, marijuana, alcohol and other psychotropic medications as needed. Examples of positive or unfavorable urines are: Urines that test positive for the above with the exception of methadone and buprenorphine if you are prescribed those medications. Urines that are negative for prescribed medications. Urines that are not between 90-100 degrees Fahrenheit. Positive urinalyses from an unfavorable prescription or failure to log prescribed

medications to substantiate prescription. Insufficient amount of urine less than 60 ml. Urines that are screened as diluted by the lab. Leaving the clinic without providing the requested urinalysis.

Members have the right to contest an unfavorable urine drug screen within seven days of providing the sample. Seclusion and Restraint No form of seclusion or restraint is used with any members at CODAC.

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Smoking & Tobacco Use To promote health and maintain a healing environment, CODAC provides a smoke and tobacco free campus for members, staff and visitors. The use of cigarettes, E-cigarettes, vaping devices, cigars, chewing tobacco and snuff are not allowed in any of CODAC’s outpatient or administrative buildings or adjacent to buildings, in parking lots or on the grounds. Smoking at CODAC’s transitional living program is only allowed in designated areas. Drugs and Alcohol on the Premises CODAC provides a drug and alcohol-free environment to its members and staff, therefore no drugs or alcohol are allowed on CODAC property. Legal prescription medications are allowed on site only when they are kept in their original labelled containers, stored appropriately and used as prescribed. Weapons on the Premises No weapons of any kind are allowed on the premises. Carrying a weapon onto company property in violation of CODAC policy will be considered an act of criminal trespass, will be grounds for immediate removal from company property, and may result in prosecution. Pets or Animals on the Premises CODAC welcomes Service Animals on its premises. Individuals with disabilities are allowed to bring their service animals to all areas where patrons are normally allowed to go. An animal in CODAC buildings or on CODAC property (including the parking lots) must meet the following requirements: The animal must be a Service Animal. Service Animals in training are permitted to the same extent as trained service animals under the Arizonans with Disabilities Act (AzDA). A Service Animal is a dog or miniature horse that is individually trained to do work or perform tasks for a person with a disability. The task(s) performed by the Service Animal must be directly related to the person’s disability. A Service Animal must be trained to do work or perform tasks for an individual with a disability, which may include, but are not limited to: Assisting individuals who are blind or have low vision with navigation and other tasks, Alerting individuals who are deaf or hard of hearing to the presence of people or sounds, Providing nonviolent protection or rescue work, Pulling a wheelchair, Assisting an individual during a seizure, Alerting individuals to the presence of allergens, Retrieving items such as medicine or the telephone, Providing physical support and assistance with balance and stability to individuals with mobility disabilities Helping individuals with psychiatric and neurological disabilities by preventing or interrupting impulsive or destructive behaviors. Service animals must be harnessed, leashed or tethered, unless these devices interfere with the service animal’s work or the individual’s disability prevents the use of these devices. In that case, the individual must be able to control the service animal through voice, signal or other effective controls. In situations where it is not obvious that the animal is a Service Animal, staff may ask ONLY (1) Is the animal required because of a disability? and/or (2) What disability-related work or task has the animal been trained to perform?

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Staff may not:

Ask about the individual’s disability. Require the service animal to perform its work or tasks. Ask the individual for a special ID for the service animal.

Ask for any proof that the animal has been certified, trained, or licensed as a Service Animal. Ask the individual to provide proof of vaccinations or license for the Service Animal. Require service animals to wear a vest or any other form of identification gear. Staff should take caution; do not pet the Service Animal without the member’s consent. A Service Animal may only be excluded if the Service Animal is out of control and the handler does not take effective action to control it, or if the Service Animal is not housebroken. All individuals bringing Service Animals on the premises must abide by the above requirements and will be asked to remove their Service Animal from the premises if they do not meet the specific criteria. However, the individual must be allowed to return to the premises without the Service Animal if they wish. The handler is responsible for supervising their Service Animal at all times and for cleaning up after the animal while on CODAC property. A Service Animal handler is liable for any damage done to a public place by the Service Animal or Service Animal in training. Dosing Rules 1.Only members are allowed in the dosing area (with the exception of small children). All others must wait in the front lobby. Children are not permitted at the dosing window; they should stand a reasonable distance away while the member is dosing. 2.Service Animals are permitted. However, they must remain on a leash at all times and must not 4.Members should get a cup and water at the water cooler, and then approach the dosing window. Other containers and/or miscellaneous items are not permitted at the dosing window or on the counter. 5.All hats and sunglasses must be removed prior to entering the dosing area. Nothing may obstruct the face. 6.Members must present picture I.D. every dosing day unless their picture is in the computer dosing system. 7.While at the dosing window, members cannot have anything in their mouth, including gum, food, candy or tobacco. 8.The use of cell phones and any other electronic devices is not permitted in the dosing area. 9.Members will be asked — and required — to speak before and after their dose. 10.Members must verify their dose and clearly sign their name on the signature pad prior to dosing. 11.Members must use water to rinse all methadone from the medication cup to be sure that they get the full dose. 12.Members must leave all dosing containers — including the water cup — in the trash receptacle (tray) provided by the dosing nurse. Nurses have the right to refuse to dose anyone who appears sedated or is exhibiting other inappropriate behaviors. Yelling at program staff will not be tolerated. 13 be aggressive or relieve themselves in the dosing area. 3.No outside food or drink is allowed in the dosing area. For more information, see Policy - Clinical Services No. 137.

Involuntary Discharge

It is the policy of CODAC to provide continuity of care for all members and to encourage members to address all aspects of their substance use. CODAC aims to ensure that members who are on medications through our MAT/MOUD Program are afforded continuity of care in terms of appropriate medical treatment and to ensure that MAT/MOUD services do not reinforce or support destructive patterns of behavior. Involuntary discharge may be implemented at the discretion of medical and clinical staff whenever continued provision of MAT/MOUD treatment is considered to be contrary to the needs of the member, including but not limited to the following: Acts of violence or threats of violence against any staff, contractor, member or visitor of CODAC. Selling, using, possessing, or attempting to procure any illegal drug at the clinic or in its vicinity. Any inappropriate use of the medication (i.e., selling, giving away, uncoordinated prescriptions, double dosing or any attempt to divert or obtain methadone in a way that is not authorized through the program). Verbally abusing staff, contractors, members or visitors or behaving in an unacceptable manner while in the clinic. Continued use of illegal drugs and failure to follow through on recommendations made by the clinical team. Ongoing misuse of alcohol or prescribed medications or use of non-prescribed medications. Excessive absenteeism or failure to meet scheduled appointments. Failure to benefit from treatment as evidenced by lack of progress in achieving program and treatment plan goals. Failure to meet financial obligations. Failure to follow directions from the medical staff concerning treatment for serious medical problems or contagious diseases. Incarceration. Carrying a weapon into the clinic or on CODAC premises. Excessive loitering. Termination Process for Involuntary Discharge Termination from treatment is a team decision requiring approval by the Program Leadership and confirmation of lack of medical complications by the Medical Director. Termination will be accomplished by titrating the member off methadone within a certain period of time and referral to appropriate treatment services. In cases of violence, threatened violence or other serious conditions, a member may be terminated immediately without titration off methadone. Appropriate information regarding termination will be recorded in the member’s record. Incarceration If you get arrested and are incarcerated, be sure to let the institution know you are on methadone. Also, we recommend that you call us as soon as you are released so that plans can be made to readmit you to the MAT/MOUD program. The length of incarceration will determine the procedure for restart. The minimum expectation is that members will need to have an evaluation and screening prior to dosing if they miss three days or more of medication.

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Grievance & Appeals

Procedure for Appealing Denial of Admission, Involuntary Discharge & Other Grievances 1.A copy of the current grievance policy will be given to you to read and sign upon admission. 2.A current copy is always posted in the clinic. Ask your counselor if you have a question. We hope that your participation in the program is successful. 3.If you are having a problem with any aspect of your treatment, it is important that you speak to a member of your treatment team or Program Leadership.

Resources

Community Resources

2-1-1 Arizona: www.211arizona.org Arizona Poison Control: 520-626-6016 Community-Wide Crisis Line: 520-622-6000 Emerge Center Against Domestic Abuse: 1-888-428-0101 National Alliance on Mental Illness (NAMI) of Southern Arizona: 520-622-5582 | www.namisa.org Pima County Health Department TB Clinic: 520-243-8450 Pima County Health Department HIV Counseling & Testing: 520-791-7676 Southern Arizona AIDS Foundation: 520-628-7223 Southern Arizona Center Against Sexual Assault (24/7): 520-327-7273 Theresa Lee Clinic (for STIs): 520-791-7676 12-Step & Support Group Resources Al-Anon Family Groups: www.al-anon.alateen.org Alcoholics Anonymous (24/7): 520-624-4183 | www.AAtucson.org

American Foundation for Suicide Prevention: www.afsp.org AZ Smoker’s Helpline: 520-556-6222 | www.ashline.org Cocaine Anonymous: 520-326-2211 | www.co-anon.org Co-Dependents Anonymous: www.CODA.org Narcotics Anonymous: www.natucson.org Nicotine Anonymous: www.nicotine-anonymous.org Overeaters Anonymous: www.oa.org

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Support After Business Hours & During a Crisis

CODAC’s MAT/MOUD Program is open 24/7 so you can always call us at 520-202-1786.

The Safety Zone is a safe phone number to call when you need additional support outside of CODAC’s normal business hours, but are not in immediate danger to yourself or others. Staff who answer the phone line are CODAC employees. Phone: 520-202-1950 Hours: Call anytime between 5:00 p.m. and 8:00 a.m. and all day on weekends and holidays.

What to Do if You’re Experiencing a Behavioral Health Crisis

Call Pima County’s Community-Wide Crisis Line 520-622-6000 or 1-800-796-6762

The Community-Wide Crisis Line is available 24/7, including holidays. Staff there will help you figure out whether you need to go to the Crisis Response Center, or whether another resource would better meet your needs. The Crisis Response Center (CRC) is for people who are experiencing a behavioral health crisis. You can walk in to the CRC, but it is always better to call the Community-Wide Crisis Line first. The CRC is located at 2802 E. District St., Tucson, AZ 85714 (on the south side of Ajo Way, behind Banner University Medical Center - South Campus). What is a Behavioral Health Crisis? A behavioral health crisis refers to severe emotional distress that might be caused by mental illness or substance use. You might feel out of control and/or worried you might hurt/kill yourself or someone else. If you have an emergency medical problem in addition to your behavioral health crisis, you should call 911 or go to an Urgent Care or hospital emergency department. Other Crisis Hotlines 988 Suicide & Crisis Lifeline | Call or Text 9-8-8 Text TALK to 741741 Warm Line | 520-770-9909 CODAC Safety Zone | 520-202-1950 (non-emergency after-hours support line at CODAC ) SACASA Sexual Assault Crisis Line | 520-327-7273 Trans Lifeline (for transgender individuals) | 877-565-8860

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520-327-4505 | www.CODAC.org

9/2026