A05 - CTS Monthly Report Form

Description

The CTS Report gathers data from the CTS modules in NEO. It includes information on client demographics, supervised consumption visits, overdose events, medical emergency service calls, safety and security, harm reduction services, and wrap-around services. Additionally, the report contains a tab for Federal Reporting, covering Drug Splitting/Sharing, Peer Assistance, and Drug Checking.

Report Tables

CTS Monthly Reporting Form tab

Section B - Total Visits
- Total # of CTS visits this month
- Morning visits: 7am to 11:59am
- Afternoon Visits:12pm to 4:59pm
- Evening Visits: 5pm to 9:59pm
- Overnight Visits:10pm to 2:59am
- 3am to 6:39am
Section C - Non-Identifiable Client Demographics
- Total # of unique clients using the CTS this month by Gender
  - # male clients
  - # female clients
  - # trans clients
  - # other clients
  - # not specified
- Total # of unique clients using the CTS this month by Age
  - # clients under 20
  - # clients 20 to 29 years
  - # clients 30 to 39 years
  - # clients 40 to 49 years
  - # clients 50 to 59 years
  - # clients 60 years or over
  - # clients age unknown
- Total # of new CTS clients using the CTS this month
Section D - Supervised Consumption Visits within the CTS
- Total # of CTS visits for supervised drug consumption this month
- According to the modes of consumption permitted under your Federal exemption, please fill out the following or indicate N/A:
  - Total # of injection consumptions
  - Total # of oral consumptions
  - Total # of intra-nasal consumptions
- Total # of CTS visits where client is consuming the following substances (self-reported at intake)
  - Amphetamine
  - Benzodiazepines
  - Cocaine
  - Crack/cocaine
  - Dilaudid/hydromorphone
  - Fentanyl
  - Heroin
  - Kadian
  - Ketamine
  - Methadone
  - Methamphetamine (crystal meth)
  - Methamphetamine (speed)
  - Morphine
  - Oxycodone/Percocet/OxyNEO
  - Ritalin/methylphenidate
  - Speedball (crystal meth/fentanyl)
  - Speedball (crystal meth/hydromorphone/Dilaudid)
  - Speedball (fentanyl/crack)
  - Speedball/other polysubstance
  - Steroid/testosterone
  - Suboxone/buprenorphine
  - Wellbutrin/bupropion
  - Unspecified Opioid
  - Unspecified Stimulant
  - Unknown
  - Other (list to the right)

Section E - Overdose Events
- Total # of overdoses that occurred in the CTS
- Total # of overdose-related deaths that occurred in the CTS
- CTS staff
  - Total # of overdoses treated solely by CTS staff
  - Total # of overdoses treated solely with oxygen/rescue breathing and/or stimulation by CTS staff
  - Total # of overdoses treated with naloxone by CTS staff (do not include naloxone administered by EMS)
  - Total # of naloxone doses administered by CTS staff
  - Total # of overdoses treated with other interventions not mentioned above and not including calls to
    EMS (please describe in the box below)
- Optional data: # of overdoses treated by CTS staff within the immediate vicinity of the CTS (can be filled after export)
Section F - Medical Emergency Service Calls (non-overdose related)
- Total # of medical-related 911 calls for non-overdose reasons
- Reason for 911 call (non-overdose) (can be filled after export)
- Total (can be filled after export)
- Total # of transports to an emergency department for non-overdose reasons
- Reason for Transport to ED (non-overdose) (can be filled after export)
- Total (can be filled after export)
Section G - Safety and Security
- Total # of times a security staff person assisted with an incident in the CTS (can be filled after report is exported)
- Total # of times a security staff person addressed a security event within the surrounding perimeter of the CTS (can be filled after report is exported)
- Total # of times police were called to the CTS by staff (can be filled after report is exported)
Section H - Harm Reduction Education
- Total # of visits where harm reduction education or information was provided
Section I - Provision of Wrap-Around Services
Section I.1 Addictions Treatment Services
- Total # of unique clients connected to onsite addictions treatment services
- Total # of unique clients connected to each onsite addictions treatment service
  - Addictions counselling services
  - Community treatment
  - Opioid agonist therapy (e.g. methadone, suboxone)
  - Rapid Access Addiction Medicine Clinic
  - Residential treatment
  - Withdrawal management/ detox
  - Other (please describe)
- Other addictions treatment services (not listed above) (can be filled after export)

Federal Reporting tab

Drug Splitting/Sharing

- Total number of visits
- Number of unique clients
- Number of new clients
Overdose events
- Non-fatal
- Fatal
- Number of overdose events requiring naloxone

Peer Assistance

- Total number of visits
- Total number of consumptions
- Number of unique clients
- Number of new clients
Drugs consumed
- Cocaine
- Crack
- Methampetamine
- Amphetamine
- Heroin
- Fentanyl
- Oxycodone/Percocet/OxyNEO
- Morphine
- Hydromorphone/Dilaudid
- Unspecified opioid
- Speedball
- Other substances*
- Unknown/not specified
Overdoses events
- Non-fatal
- Fatal
- Number of overdoses events requiring naloxone
- EMS service called
- Other medical emergencies
- Law enforcement calls
Client data
- Male
- Female
- Other
Number of clients in each age range per visit
- Under 20
- 20-29
- 30-39
- 40-49
- 50-59
- 60+
- Unknown/Not specified
Referrals
- Referrals to services provided with the SCS
- Referrals to services provided onsite (outside SCS)**
- Referrals to services provided offsite

Drug Checking

Client test outcome
- Pre-Consumption | Post-Consumption
  - As Expected
  - Unexpected
  - Inconclusive

Content

Space Tools

Description

Report Tables

Federal Reporting tab

Parameters

Filters

Sub-reports