So, I got a small update from the agency caseworker, who'd managed to reach the county caseworker on the phone and had also talked with the supervisor of the county caseworker.
BioMom did indeed fail the drug test, although her reasons for taking the medication seem to vary depending on who is hearing the story. (That is, BioMom told me one reason, the drug counselor claimed she told her another one. Someone is supposed to be following up on a third possible story involving an emergency room visit.) What it boils down to, though, is that the reason is unimportant. BioMom was told at the beginning of this drug counseling program that she could not take this medication. Period, the end. So, when she failed the test, she was told (again) that it does not matter if someone writes her a prescription for it, she cannot take it. Ever. And if she really is in severe pain and is talking to a medical professional about help for it, she needs to Tell Them that she has a history of abusing that particular medication and ask if there are other options.
This program apparently allows her one failed test. She's had it now, so if she fails another one, they will kick her out of the program. If she gets kicked out of the program, she is done; she cannot complete her case plan without completing a drug rehab program and the programs are too full for another one to take on someone who has just been kicked out for failing 2 screenings while enrolled.
I don't know a whole lot about drug rehab or about how these programs work. But the caseworker said something that gave me pause. She said she felt that BioMom needs inpatient services, not outpatient. But that this particular program bases their decisions about the level of services needed entirely on the self-reporting of the addict. So, if BioMom understated her frequency/type/amount/whatever of drug use during the intake screening, she may not be getting the level of intensive programming she needs to succeed.
I understand that the rehab program doesn't necessarily have a lot of other reliable ways to judge the addict's level of need -- are they supposed to assume the patient is lying? -- but it seems to me that there should be some way to allow for the possibility. For example, in BioMom's case, it seems to me that the response to one failed drug screen (this early!) should not be "don't do it again", but "hmm, maybe we've underestimated the program you should be in, let's reconsider putting you in an inpatient program." I don't know much about addiction, either, to be honest, so maybe I'm off base and the fact that the addict won't admit their level of addiction at the beginning means they aren't ready to be helped at all. The agency caseworker said that some programs are better than others -- I got the impression that this isn't one of the better ones.
The county caseworker had a staffing in which she requested and received permission to begin filing for TPR. (Didn't take long for her tune to change on that idea!) The next step is for a TPR hearing date to be set. When one is set, it will be subject to change (or cancellation) based on the progress on the case plan. That is, if BioMom gets her act together now and starts moving on the case plan before the TPR hearing date (whenever that might be), the TPR paperwork might just sit in a desk drawer and not get filed with the court at all. But, if she doesn't.....