Licensed Vocational Nurse

Salary Range: 32.98 to 39.42 (Currency: USD) (Pay period: per-hour-wage)

KEY RESPONSIBILITIES

Responsibilities include, but are not limited to, the following:  

Medication Administration & Dispensing 

Administer MOUD and other medications by approved routes, including injections and vaccines, per provider orders, state and federal regulations, and clinic protocols.

Administer OTP medication and, where permitted by state law, dispense it in the dispensary (see California Scope of Practice)

Independently verify the patient, active order, medication, dose, and documentation before every administration or dispensing.

Perform focused pre-dose safety screening and observations within LVN scope and approved protocols, including identification of possible intoxication, sedation, respiratory compromise, or other contraindications; hold or defer medication when required by approved protocols, immediately notify the RN or authorized prescribing practitioner, and document findings, actions, and disposition. Comprehensive nursing assessments, independent triage, and care planning remain the responsibility of the RN or authorized provider.

Document and escalate withheld, delayed, missed, or refused doses to the prescribing provider per protocol.

Prepare, label, verify, and release take-home doses only as ordered; take-home eligibility, dose changes, and prescribing are determined by the OTP Medical Director or an authorized OTP practitioner under 42 CFR Part 8 and the program's written delegation framework.

Maintain accurate medication administration and dispensing records, perpetual inventory records, and controlled-substance accountability documentation in accordance with applicable DEA requirements, including 21 CFR Parts 1304 and 1306, state regulations, and approved OTP procedures; immediately report discrepancies, initiate required reconciliation and escalation procedures, document unresolved discrepancies before shift handoff, and never defer escalation of an unresolved discrepancy to the next shift

Deliver authorized medication doses when assigned (for example, doses for patients in custody; in California, only after documented site-specific compliance approval of the dose preparation, release, and transfer process), following chain-of-custody, security, storage, and transport procedures under approved OTP policy, DEA requirements, and state rules; document each transfer of custody and report any delay, loss, or discrepancy immediately.

Submit referrals for specialty care (for example, prenatal, infectious disease, and primary care), follow up for continuity of care, and assist with patient transfers into or out of the program.

Patient Care & Clinical Support 

Collect and report patient data, including vital signs, withdrawal scores (e.g., COWS/CIWA), and health history; comprehensive assessments, triage decisions, and care plans are completed by the RN or provider with LVN input.

Perform point-of-care testing, specimen collection, and TB skin testing per clinic policy and state scope.

Report abnormal and critical results to the provider immediately and document follow-up as assigned.

Assist providers with examinations and routine procedures.

Reinforce patient education on MOUD, overdose prevention, and naloxone as directed.

Recognize and respond to medical emergencies, including opioid overdose.

Care Coordination, Documentation & Compliance 

Submit referrals for specialized care and follow up on attendance; assist with patient transfers into and out of the program.

Order medical supplies, maintain inventory, and record use per regulations; maintain the dispensing room and medical equipment.

Maintain complete, accurate, and timely EHR documentation, including medication and dosing records.

Comply with HIPAA, 42 CFR Part 2, 42 CFR Part 8, state nursing regulations, and accreditation standards.

Participate in huddles, case conferences, and quality improvement initiatives.

Fulfill mandatory reporting obligations under California law and the Indian Child Protection and Family Violence Prevention Act, and follow clinic procedures for reporting suspected abuse or neglect.

Other duties as assigned within LVN scope of practice and clinic policy.

QUALIFICATIONS

Required Qualifications

Graduate of an accredited vocational or practical nursing program

Active, unrestricted California LVN license (Board of Vocational Nursing and Psychiatric Technicians)

Minimum 1 year of clinical nursing experience

Active American Heart Association (AHA) Basic Life Support (BLS) certification

Continuing education as required by the board of licensure.

Ability to successfully complete employment-related background screening, occupational health requirements, and any legally permissible drug screening, consistent with applicable federal, state, and tribal laws and clinic policy

Ability to provide health clearance and tuberculosis (TB) clearance.

Valid driver's license, current auto insurance, and an acceptable driving record, as medication delivery may be assigned.

Preferred Qualifications 

California: BVNPT-recognized IV therapy and blood withdrawal certification (Business and Professions Code § 2860.5; 16 CCR §§ 2542–2547.5)

1+ years of experience in an OTP or substance use disorder setting

Active American Heart Association (AHA) ACLS

Experience working with tribal health programs or multicultural communities.

Bilingual fluency in English and Spanish or a language native to the community served

SKILLS

The ideal candidate embodies the following:

• Precision in medication administration, record-keeping, and controlled substance handling
• Strong observation, crisis intervention, and de-escalation skills
• Empathetic listening and cultural humility
• Ability to stay calm and professional in high stress situations
• Commitment to patient dignity, confidentiality, and safety