MEDICAL SERVICES

The following protocols are presented as a general medical guideline for admission and participation into the program but should not be considered as all-inclusive. Where there is doubt concerning a candidate’s appropriateness for the Black Mountain Substance Abuse Treatment Center for Women (Black Mountain) program, we encourage you to call and consult with the Black Mountain facility about the individual circumstances surrounding the referral. The call could prevent the need for a trip to the facility to pick up a discharged referral.

Medical Staff

Black Mountain provides on-site medical services with a Psychiatric Nurse Practitioner, a Physician, and a Registered Nurse. Primary medical services are offered five days a week. However, medical staff remains on call 24 hours a day and 7 days a week for medical emergencies.

Medical Limitations

Black Mountain is equipped to treat individuals with minor medical problems such as colds, skin rashes, fungal infections etc. and to provide medical services for minor injuries and illnesses which may occur during the individual’s stay. Black Mountain is further equipped to medically manage more serious conditions as long as the resident is on a stabilizing medical regimen upon arriving at the facility. All such referrals will need to be cleared by medical staff prior to admission and should bring a full supply of medications needed for the 90 Days of expected treatment participation. NOTE: Blister packaging with multiple medications cannot be dispensed at BMSATCW. Blister packaging containing any single medication is acceptable.

Three primary areas of concern are taken into consideration in assignment to the facility and are discussed as follows:

1. Debilitating Factors: if a referral has a pre-existing condition that severely limits minimal participation in program activities or requires intense, personal, "around the clock" care or assistance (i.e. hospital care and/or outpatient treatment with follow up.)
   1. Individuals requiring detoxification. Black Mountain does not have a detoxification unit. If there are concerns for acute withdrawal upon arrival to the facility, medical staff will assess and disposition accordingly. Substance withdrawal requiring hospital accommodations and monitoring are not appropriate for assignment to the center; medical staff will consult directly with the Julian F. Keith (JFK) Alcohol and Drug Abuse Treatment Center (ADATC) for treatment / stabilization and direct return back to Black Mountain to continue the program..
   2. In the event medication is needed to control chronic pain, a non-narcotic pain reliever may be provided.
   3. If an individual has a condition requiring hospital care or immediate medical care outside the scope of services provided by Black Mountain (i.e., injuries requiring immediate x-ray, unstable critically high blood pressure, critical heart conditions, etc.), the referral is not appropriate for assignment to the center, it should be noted that such critical conditions will more often be exacerbated by the high stress levels created when one is placed in an intense and highly structured treatment environment.
   4. Individuals with pre-existing appointments with their primary physician or other health care providers should satisfy, postpone or cancel (if medically appropriate) all such appointments before coming to Black Mountain. This is an issue of "managed care" that should be met before or after treatment services have been provided.
2. Stabilization: Individuals arriving at the Center with diagnosed pre-existing medical and/or mental health pathology who are in stable condition with prescribed medicines are, with few exceptions, appropriate for the Black Mountain program. Primary consideration is given to mobility, cognition, coherency and comprehension when an assessment of mental status is made.
   1. Medical staff will continue medical regimens to maintain medical and/or mental health stability as prescribed by the individual’s primary physician after a full assessment has been conducted by the Black Mountain Physician.

      *** Individuals should bring a 90-day supply of all prescription medicines or have refills available***

   2. Special accommodations are made for residents whose medical condition requires a regimen of light duty activities (i.e. residents with a history of heart problems and on glycerin regimen will be given light cleaning duties and exempted from strenuous physical activities).
   3. All individuals are treated with universal precautions. Individuals with known HIV/AID that are current with their labs and clinic visits are appropriate for Black Mountain when in a stabilized condition. Where medical costs (medicines) are high, every attempt will be made to assist these residents with community resources.
   4. Black Mountain does not have a Methadone maintenance program, but will accept individuals on active buprenorphine (Suboxone) or naltrexone treatment.
3. Cost: Black Mountain is a residential community-based substance abuse treatment facility within the Alcoholism and Chemical Dependency Programs Section under the jurisdiction of the Department of Adult Correction. However, medical costs are not assumed by the state for major medical and/or mental health care. Black Mountain is not required to provide extensive, major medical care. All individuals should be aware that vision, dental and major health care problems will not be addressed at the expense of Black Mountain or the State of North Carolina. Residents assessed with such conditions will be discharged and referred for hospital care or back to their primary physician.

   Black Mountain health care protocol and policy is as stated above and further includes or exempts the following:

   1. Physical exams, to include blood work and urinalyses are standard protocol for all residents assigned to Black Mountain and therefore these costs are assumed by the State.
   2. Emergency room services are assumed by the State, in-hospital stays are not. When a resident is admitted to the hospital, she is discharged from Black Mountain and hospital costs are assumed by the resident either through personal or family resources. Individuals at high risk for major medical crisis when placed in a new and stressful environment should not be considered for the Black Mountain program.
   3. Inexpensive prescription medication costs may be assumed by Black Mountain within limits and in certain urgent situations. Residents on large amounts of medicine or medicines with high costs must ensure they bring their supply or have the means to pay for refills (i.e. private insurance, cash, etc.)
   4. All residents with vision and dental care needs will be referred to local community resources at the resident’s expense.
   5. Over-the-counter medicines such as non-aspirin pain relievers, non-alcoholic cough syrup (Robitussin), antacids etc. are provided by the facility.

* Narcotics/Controlled Medications are too numerous to name them all; therefore other medications not on this list may be prohibited. Please contact Black Mountain if you have questions.