Policies

CONTROLLED SUBSTANCE POLICY

(PLEASE READ CAREFULLY) 

The safety and care of our clients is our number one priority!

Controlled substances are prescribed sparingly in this practice in an effort to keep you safe.  They are also highly regulated by the Drug Enforcement Agency (DEA).  Our prescribing of such medications is monitored, and providers are held accountable for prescribing practices. State laws require that additional measures be taken when prescribing controlled substances.  We want our clients to know how seriously we take the prescribing of these types of medications.  

A controlled substance is generally a drug or chemical whose manufacture, possession, or use is regulated by a government, such as illicitly used drugs or prescription medications that are designated by law.

Many of the medications prescribed for ADHD, Anxiety, and Insomnia are drugs that are considered controlled substances.  Some examples in each category include;

ADHD Medications:

• Focalin (Dexmethylphenidate) 
• Ritalin (Methylphenidate)
• Adderall (Dextroamphetamine / Amphetamine) or (Amphetamine Salt Combo)
• Vyvanse

Anxiety Medications:

• Xanax (Alprazolam)
• Ativan (Lorazepam)
• Valium Diazepam) 
• Klonopin (Clonazepam) 
• Tranxene (Clorazepate)

Insomnia Medications:

• Ambien (Zolpidem) 
• Restoril (Temazepam)
• Lunesta (Eszopiclone)
• Belsomra (Suvorexant)
• Sonata (Zaleplon)
• Rozerem (Ramelteon) 

It is the expectation of this practice that the controlled medication will be taken as prescribed and not self-adjusted.  This means you will not increase or decrease your dose or stop taking it without talking to your prescribing provider.  

Self-adjusting prescribed psychiatric medications can be dangerous and can lead to seizures, or death.  Mixing these controlled medications with other substances such as alcohol, narcotics (pain pills), muscle relaxers, or other controlled substances can also lead to death.

Self-adjusting controlled substances will be considered non-compliance. This type of non-compliance will result in discharge from our practice, as it places a huge liability on our ability to safely manage your care.

CONTROLLED MEDICATIONS WILL NOT BE REFILLED EARLY.  It is your responsibility to take them only as prescribed.  Insurances will also not pay for them to be filled early.  Please do not call the office asking for them to be refilled early.

CONTROLLED MEDICATIONS WILL NOT BE REPLACED.  It is your responsibility to make sure that your medication is kept in a secure place to prevent loss or theft.  If you report to our office that your controlled medication(s) has been lost, misplaced or stolen, it will not be replaced.

Monitoring of controlled substances is maintained through the Prescription Drug Monitoring Program.  As is required from providers, we obtain, review, and monitor Prescription Drug Monitoring Programs in various states.  This includes monitoring for multiple controlled substances prescriptions, multiple providers, usage of multiple pharmacies, and any activity that could be suspicious for misuse.  We work closely with pharmacies, as they will often call us if they suspect misuse.

We expect full disclosure from you on any controlled substances you obtain from other sources (even the Emergency Department) while under our care.  If it is identified that this information has been hidden or omitted by you, it is grounds for immediate discontinuation of any controlled substances or any type of medications prescribed by our providers as well as possible immediate dismissal from Palmetto Behavioral Care, LLC.

Changes in your dosages of controlled substances will not occur between scheduled appointments, nor will they be adjusted before your current prescription is due to be refilled.  

If you come to our practice already on controlled substances from another provider, that does not mean that we will automatically assume these same or even similar medications.  Our providers reserve the right to complete their own assessment and make treatment recommendations based on their professional judgment.  Our practice does not prescribe exceedingly high doses of controlled substances and we are not obliged to assume such from other providers.  If it is felt that such a medication could benefit you, you will be tapered down to a dose that is considered safe or placed on another alternative medication that may not be a controlled substance. 

Clients will be asked to obtain either a Urine or Blood drug screen prior to any controlled substance being prescribed.  Random such testing is also obtained at different intervals throughout treatment.  Completion of such screens is ultimately the personal and financial responsibility of the patient these medications are prescribed for.  Such screens help to determine the presence or absence of controlled substances.  Testing negative for prescribed controlled substances or positive for additional controlled or illicit substances not prescribed by our providers will be considered a breach of the controlled substance policy and grounds for immediate discontinuation of the drug prescribed and/or from the practice.

We appreciate your assistance in this matter, as we take this policy very seriously.  These types of drugs are addictive and have a high rate of misuse/abuse.  In addition, many of these medications are intended for short-term use only.  It is our goal to keep you, our client, as safe as possible.

Updated: 5/1/2024

PRESCRIPTIONS AND REFILLS

• Our medication policy is designed with your health and safety as our utmost priority.  We aim to provide you with the highest standard of care in managing your medications effectively.
• Medication Management During Office Visits:  To ensure the best possible care, we kindly request that requests for medication changes and prescription refills be handled during your scheduled office visits.  Please make it a practice to bring your current medication list to each appointment.  Typically, our provider will prescribe medications to cover your needs until your next scheduled visit.  We strongly recommend scheduling your follow-up appointment before leaving your current visit to prevent any interruptions in your medication regimen.
• Frequency of Visits:  The frequency of your visits will determined collaboratively you and your provider.  It depends on factors such as the severity and complexity of your situation, current symptoms, the types of medications prescribed, and the availability of additional support from sources like family, friends, or therapists.  Visits may range from monthly or more frequently initially, until you achieve stability and improved well-being, to quarterly visits once all necessary reports and assessments are up-to-date.  In line with widely accepted community care standards, clients receiving psychotropic mediations must be evaluated by a medical professional at least once every 90 days to continue their medication regimen.  Failure to attend an evaluation within this timeframe may require a follow-up visit to assess medication needs.
• Managing Medication Supply:  We strongly encourage you to keep track of your medication supply to avoid running out.  We do not have the capacity to address emergent medication needs, so planning ahead is essential.
• Requesting Medication Refills:  When requesting medication refills, please ensure you have at least a seven-day supply of medication on hand to prevent any disruptions.  It’s advisable to check with your pharmacy first, as many refills can be authorized with a simple request to your pharmacist.

APPOINTMENTS

• All new patients currently prescribed a controlled substance will require an in-person/office appointment.

• We kindly request a minimum of 24-hour notice for appointment cancellations or rescheduling.  This allows us to allocate the appointment to someone on our waitlist, ensuring efficient care for all.
• Cancellation or No-Show Fee:  Patients who cancel an appointment or fail to attend with less than 24 hour’s notice are subject to a $100  cancellation or no-show fee.  Please be aware that you hold financial responsibility for appointments not rescheduled or canceled with appropriate advance notice. 
• Late Arrival Policy:  Arriving late (more than 10 minutes) for an appointment may lead to cancellation or rescheduling. 

• If you do not show up to your appointment, no medication refills will be provided until you see your provider.   
• In ONE calendar year – after the secondless than 24-hour cancellation, less than 24-hour reschedule, or failure to show up to an appointment you will be placed on a waiting list. You will not be able to self-schedule for three visits.
• A waitlist means you will be scheduled on a day to come in with other wait-listed patients.  You will be worked in between other patients on the schedule.  This will be on a first-come, first served basis. There is no guarantee of how long you will have to wait to be seen.  No refills will be called in until the provider sees you.
• TERMS FOR DISCHARGE FROM THE PRACTICE:  Within one calendar year – FOUR (4) – less than 24 hr cancellations, less than 24 hr rescheduling of your appointment, or failure to show up to your appointment.  Will be grounds for dismissal from the practice with a referral to another practitioner.

DISABILITY FORMS POLICY

As a small practice with limited staff, we have put the following policy in place for the filling out of disability forms.  This can include short, or long-term disability, SSI, attorney forms, and FMLA forms.  

• The client must have been a client of this office for at least 6 months for long-term disability or SSI forms to be completed.  We are happy to provide your medical records, but we will not make the determination if you qualify for long-term disability.

• A client must have completed two visits for short-term or FMLA forms to be completed. 

• Paperwork can take up to 14 days to complete.  It may be completed earlier, but it is done on a first-come-first-served basis.  Please understand it is difficult to rush this process due to the limited staff available to complete these forms.

• Clients must be compliant with ongoing treatment including medications and keeping appointments to have the office continue filling out disability forms.

• Clients must have seen the provider within the last 30 days to submit disability paperwork.

• Blank forms will not be accepted:  At a minimum, the client’s name and date of birth should be filled out on the form prior to submission.

• There is a charge of $25.00 per page to fill out these forms.