Treatment data and restricted listings
Whether you are seeking help for yourself, a friend, a family member, or someone you know, finding the right treatment for a substance problem or addiction can be overwhelming and confusing. There are many in the field who are working tirelessly every day to address the things that are contributing to this fact. And there are numerous people and places out there who stand ready to help you. Our hope is to connect you with those that have your best interests at heart and can help you move from anxiety and fear to stability and hope.
How addiction treatment resource data is verified and published
The treatment resources made available through Capacitype applications are either submitted by authenticated users (organizations and the general public) or are published by the Capacitype Data Team (Data Team) which manages mapping activities throughout the U.S.
Starting in November 2017, the Data Team adopted a revised set of guidelines for verifying and publishing treatment resource data.
In accordance with these guidelines, an initial data set of resources for substance abuse and addiction treatment was retrieved from the Behavioral Health Treatment Services Locator which is managed by the Substance Abuse and Mental Health Services Agency (SAMHSA) Center for Behavioral Health Statistics and Quality (CBHSQ). The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is retrieved from facility responses to SAMHSA's National Survey of Substance Abuse Treatment Services (N-SSATS) and National Mental Health Services Survey (N-MHSS). New facilities that have completed an abbreviated survey and met all the eligibility qualifications are added monthly. While the Locator offers the most comprehensive directory of addiction treatment programs in the country there are limitations to this information. For example, contact information may not be accurate and service listings do not include any evaluation on the quality of care.
Eligible substance abuse and addiction treatment facilities must meet at least one of the criteria below:
- Licensure/accreditation/approval to provide substance abuse treatment from the state substance abuse agency (SSA) or a national treatment accreditation organization (e.g., The Joint Commission, CARF, NCQA, etc.)
- Staff who hold specialized credentials to provide substance abuse treatment service.
- Authorization to bill third-party payers for substance abuse treatment services using an alcohol or drug client diagnosis
In an effort to better assist people in finding and accessing quality care, an initial dataset of treatment resources was retrieved by the Data Team in November 2017 and reviewed for accuracy of contact information and self-reported Licenses, Certifications, and Accreditations (LCAs).
There are 9 possible LCAs that a treatment facility can report, of which 7 qualify for publication to Capacitype applications. From the initial data set, 91.65% of the treatment facilities found in the Locator indicated at least one qualifying LCA. These qualifying facilities were included in a revised data set of resources for substance abuse and addiction treatment.
Specifically, 3 of the 7 qualifying LCAs were considered to be high-quality: Commission on Accreditation of Rehabilitation Facilities (CARF), Council on Accreditation (COA), and The Joint Commission on Accreditation of Healthcare Organizations (The Joint Commission). Each of these national accreditations have documented standards that reflect industry expertise, require self-evaluation surveys and site surveys, have stipulated review and decision processes, and have an annual reporting requirement for accreditation maintenance.
Treatment facilities that have reported one or more of these high-quality accreditations can be identified within Capacitype applications by selecting the accreditation provider from the Group listing.
The remaining 4 of the 7 qualifying LCAs reflect treatment resources that are licensed under State-specific rules and regulations. Based on a 2012 report from The National Association of State Alcohol and Drug Abuse Directors (NASADAD), a majority of states give the responsibility for licensing or certifying substance use disorder programs to the agency responsible for the federal Substance Abuse Prevention and Treatment Block Grant. Some of these are distinct-purpose agencies, while others are broader agencies with additional responsibilities such as mental health and developmental disabilities. These responsible agencies are referred to as the Single State Authority, or SSA, and the NASADAD Directory of SSAs can be accessed here. Of note, in some States, program licensure/certification is the responsibility of separate licensing Agencies/Bureaus that exercise oversight of a range of health providers, including substance abuse treatment facilities.
The revised data set of resources for substance abuse and addiction treatment was further compared to validated submissions from the general public, available directories from accreditation providers, and processes applied for verifying websites and phone numbers.
The resulting final data set of resources for substance abuse and addiction treatment has been published for access through online applications. This baseline dataset continues to be updated and modified based on public feedback and qualification improvement processes that are being implemented annually.
Efforts are ongoing by the Data Team to create relationships with groups and organizations that are actively working to identify and credential high-quality and effective treatment programs and services in the U.S. The intention is to continue evolving guidelines for publication through partnerships that support refinements to the initial verification processes.
Capacitype applications do allow for public feedback on all resource listings. Each submission is reviewed by the Data Team and may result in a resource being unpublished or designated as unverified. Online applications may also include mapping tools that allow individuals and groups to submit resources that they feel may be of benefit to those who are seeking care and support in their communities.
Notice on call center operators and lead generator websites for addiction treatment programs and services
As a component of the guidelines for verifying and publishing treatment resource data, Capacitype maintains a list of restricted websites and addiction treatment providers that engage in lead generation activities which include suspected patient brokering and deceptive marketing practices. Given concerns over potential patient brokering and addiction treatment fraud initiated by certain websites and participating call centers, a sweep of all database records is conducted weekly to ensure no records match restricted websites or providers. If found, those records are immediately unpublished and flagged for review.
Starting August 2018, the list of restricted websites and addiction treatment providers has been expanded to include the List of Excluded Individuals/Entities (LEIE) from the Office of Inspector General (OIG), U.S. Department of Health & Human Services. The OIG has the authority to exclude individuals and entities from Federally funded health care programs pursuant to section 1128 of the Social Security Act (Act) (and from Medicare and State health care programs under section 1156 of the Act) and maintains a list of all currently excluded individuals and entities called the List of Excluded Individuals/Entities (LEIE). Anyone who hires an individual or entity on the LEIE may be subject to civil monetary penalties (CMP). A listing of entities that appear on the database within the last 10 years are restricted from publication to applications using Capacitype data services.
Inquiries regarding restricted call center operators and lead generator websites can be directed to firstname.lastname@example.org.
How to identify and select quality addiction treatment programs and services
A primary goal of providing treatment resource data is to help you find the right starting point. With hundreds of treatment programs and services potentially available in your area, it can be challenging to assess which programs and services offer the highest quality or best fit of care.
Experts at the Recovery Research Institute have compiled a comprehensive list of 11 indicators of effective treatment to help guide you or your loved one to high-quality addiction treatment and increase recovery success. A summary of those indicators are provided for reference.
Importantly, this summary is not meant to replace any advice from a health professional. We suggest that you use this information when contacting identified programs and services. You may need to contact numerous programs in order to find the right one for you or your loved one. (Retrieved: November 20, 2017)
The 11 Indicators of Effective Treatment
1. Screening and assessment practices
Finding effective help for an alcohol or other drug use disorder begins with reliable and valid screening for a range of substance use disorders and related conditions, as well as any physical or mental health conditions. This is followed by more comprehensive assessment of substance use history and related disorders, medical history, psychiatric history, your family and social network, and assessment of available recovery resources (recovery capital). These services help uncover the many interrelated factors affecting your life and readiness to change. A careful and comprehensive assessment can help prevent missing aspects in your treatment plan or minimizing important aspects of your life, such as trauma or chronic pain.
2. A comprehensive, integrated treatment approach
Treatment programs should incorporate comprehensive approaches that directly address any co-occurring psychiatric disorders as well as other medical concerns, or otherwise connect you to needed services. Treating the whole person will improve the likelihood of substance use disorder recovery and remission.
3. Emphasis on continuing care for treatment and recovery support
Continuing care provides essential recovery-specific social support and necessary recovery support services after you leave or transition away from the initial phase of treatment. Treatment programs that strongly emphasize this continuing care aspect will provide more than just phone numbers or a list of people to call, but instead, will provide connections to community resources, on-going health care providers, peer-support groups, and recovery residences. This ‘warm hand-off’ or personalized introduction to potential peers and resources in the recovery community can produce substantially better outcomes.
4. A dignified and respectful environment
Treatment programs should have the type of environment that you would expect from any medical service or patient care facility. You don’t need palm trees and luxury mattresses, but you should expect a clean, bright, cheerful, and comfortable facility. Creating a respectful and dignified environment can be particularly important for treating addiction, because those suffering from substance use disorders often feel as if they’ve lost their self-respect and dignity. A respectful environment helps you regain it.
5. Treatment involves significant other and/or family members
Engaging significant others and loved ones in treatment increases the likelihood that you will stay in treatment and that treatment gains will be sustained after it has ended. Techniques that clarify family roles, reframe behavior, teach management skills, encourage monitoring and boundary setting, create intervention plans, and identify community services can all help strengthen the entire family system and help family members cope with, and adapt to, the changes that occur in recovery.
6. Strategies to engage and retain
Dropout from addiction within the first month of care is around 50% nationally. Dropout leads to worse outcomes, so it is vital to employ strategies to enhance engagement and retention. These include creating an atmosphere of mutual trust through clear communication and transparency of program rules, regulations, and expectations. Treatment programs can also strive to retain by providing client-centered, empathic, counseling that works to build strong patient-provider relationships. Some programs also provide motivational incentives to reward you for continued attendance and abstinence.
7. Evidence-based and evidence-informed practices
Not surprisingly, treatment programs that deliver services founded on scientific research and principles and that are delivering available “best practices” tend to have better outcomes. In addition to psychological interventions, these should include accessibility to FDA approved medications for addiction (e.g., buprenorphine/naloxone, methadone, naltrexone/depot naltrexone, acomprosate) as well as psychotropic medication for other types of psychiatric conditions (e.g., SSRIs etc.).
8. Qualified Staff, ongoing training, and adequate staff supervision
Having multi-disciplinary staff (e.g., addiction, medicine, psychiatry, spirituality) can help you uncover and address a broad array of needs that can aid addiction recovery and improve functioning and psychological well-being. Staff with graduate degrees, and adequate licensing or board certification in these specialty areas are indicators of high quality programs. Be sure to look for clinical supervision and team meetings that should take place at least once or twice a week for outpatient programs and three to five times a week for residential and inpatient programs.
9. Personalized approaches that include specialized populations, gender and cultural competence
Drawing from an individualized comprehensive screening and assessment, treatment programs should treat everyone as individuals and attend to their needs accordingly. One size does not fit all, and neither does one treatment approach work for every individual. Quality treatment programs identify the potentially different needs of men and women, adolescents versus adults, and those from different minority communities (e.g. LGBT) or cultural backgrounds, and use that knowledge to create treatment and recovery plans that address specific needs and acknowledge available strengths and recovery resources.
10. Measurement of program performance and during-treatment outcomes
A further indicator of quality treatment is having reliable, valid measurement systems in place to track your response to treatment. Similar to regular assessment of blood pressure at each health check-up for treating hypertension, addiction treatment programs should collect “addiction and mental health vital signs” in order to monitor the effectiveness or ineffectiveness of the individualized treatment plan and adjust accordingly when needed. Without any kind of standardized metrics, it is difficult to document and demonstrate progress.
11. External accreditation from nationally recognized quality monitoring agencies
Accreditation from external regulatory organizations such as the Commission on Accreditation of Rehabilitation Facilities (CARF); Council on Accreditation (COA); and, The Joint Commission on Accreditation of Healthcare Organizations (The Joint Commission); and other programs licensed by State agencies are required to offer minimum levels of evidence-based care. These licensing and accreditation requirements serve as quality assurance that a treatment program is incorporating a certain level of evidence-based care in its model and is open to auditing of its clinical care.