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Staying Informed: Trends in the Staying Informed: Trends in the Addiction Profession Addiction Profession Christopher C. Campbell, NAADAC Director of Government Relations Donald P. Osborn, NAADAC President Shirley Beckett Mikell, NAADAC Director of Certification and Education

Staying Informed: Trends in the Addiction Profession

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Staying Informed: Trends in the Addiction Profession. Christopher C. Campbell , NAADAC Director of Government Relations Donald P. Osborn , NAADAC President Shirley Beckett Mikell , NAADAC Director of Certification and Education. Presented By. Obtaining CE Credit. - PowerPoint PPT Presentation

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Page 1: Staying Informed: Trends in the Addiction Profession

Staying Informed: Trends in the Staying Informed: Trends in the Addiction ProfessionAddiction Profession

Christopher C. Campbell, NAADAC Director of Government Relations

Donald P. Osborn, NAADAC President

Shirley Beckett Mikell, NAADAC Director of Certification and Education

Page 2: Staying Informed: Trends in the Addiction Profession

Presented By

Page 3: Staying Informed: Trends in the Addiction Profession

The education delivered in this webinar is FREE to all professionals.

2 CEs are FREE to NAADAC members and AccuCare subscribers who attend this webinar. Non-members of NAADAC or non-subscribers of AccuCare receive 2 CEs for $25.

If you wish to receive CE credit, you MUST download, complete and submit the “CE Quiz” that is located at:

www.myaccucare.com/webinars

www.naadac.org/education

A CE certificate will be emailed to you within 30 days.

Successfully passing the “CE Quiz” is the ONLY way to receive a CE certificate.

Obtaining CE Credit

Page 4: Staying Informed: Trends in the Addiction Profession

Learn about the Affordable Care Act (ACA) and how it impacts the addiction profession;

Learn about the new national scopes of practice for the addiction profession; and

Understand the importance of maintaining your license or credential.

Question and Answer session at the end of the program.

Webinar Objectives

Page 5: Staying Informed: Trends in the Addiction Profession

The Affordable Care Act (ACA): What It Means for the Addiction

Profession

Christopher Campbell

NAADAC Director of Government Relations

Page 6: Staying Informed: Trends in the Addiction Profession

Affordable Care Act

The new health reform law, signed by President Obama in March 2010, significantly enhances access to healthcare, including

prevention and treatment services for substance use disorders.

Page 7: Staying Informed: Trends in the Addiction Profession

• The passage of the Patient Protection and Affordable Care Act (ACA) ensures that the role of behavioral health in the overall healthcare system will change

• Now, it is more important than ever to know how healthcare reform will affect your role and the role of States, behavioral healthcare providers, and consumers

The Affordable Care Act (ACA): What It Means for the Addiction Profession

Page 8: Staying Informed: Trends in the Addiction Profession

• Key points to keep in mind:

1. The work is really just beginning

2. Going to learn as we go

3. Keep an eye on your state (more later)

• Need to continue advocacy efforts in order to assure beneficial programs are funded year in and year out!

The Affordable Care Act

Page 9: Staying Informed: Trends in the Addiction Profession

• In 2008, 23.1 million Americans age 12 and older needed treatment for a substance use problem, and yet only 2.3 million – one in ten – received care at a specialty treatment center

• Many of those who do not receive, but could benefit from, treatment do not have health insurance or other means to pay for it

• By helping more people get the care they need, the ACA, when fully implemented in 2014, will go a long way toward closing the “treatment gap”

Background

Page 10: Staying Informed: Trends in the Addiction Profession

The Affordable Care Act (ACA), signed into law by President Obama in March 2010, expands health insurance coverage to 32 million Americans, guaranteeing that 95 percent of Americans will be covered.

• Expands Medicaid for all individuals under 133% of the federal poverty level

• Creates State Health Insurance Exchanges to help newly insured and those with individual and small group coverage to purchase affordable policies (large buying club)

• Provides credits & subsidies up to 400% of the federal poverty level to help individuals and families purchase insurance

The Affordable Care Act: Coverage Expansion

Page 11: Staying Informed: Trends in the Addiction Profession

• Under the new law, services such as screening, early intervention, treatment, and recovery support for patients with substance use disorders will be provided in the same manner and in the same, primary care settings as services for any other illness

• The change will bring needed help to many as it also increases awareness that drug dependence is a chronic, treatable disease

The Affordable Care Act

Page 12: Staying Informed: Trends in the Addiction Profession

In 2014: 32 Million More Americans Will Be Covered

HIEs/Subsidies

Commercia

l

In

sura

nce

Medicaid

6-10 Million with M/SUDs

~5m

SUDs

Page 13: Staying Informed: Trends in the Addiction Profession

• Of the 32 million currently uninsured Americans who will receive health insurance under the ACA, about 5 million meet medical diagnostic criteria for a substance use disorder (6-10 Million with M/SUDs )

• These Americans will receive insurance coverage to help pay for substance use treatment

The Affordable Care Act

Page 14: Staying Informed: Trends in the Addiction Profession

Insurers will no longer be able to deny coverage based on pre-

existing medical conditions, such as substance use disorders.

The Affordable Care Act

Page 15: Staying Informed: Trends in the Addiction Profession

• Individuals and small businesses will have access to affordable coverage through a new competitive private health insurance market through state-based Health Insurance Exchanges

• Plans offered through the Exchanges are required to cover mental health and substance use disorder services and must meet the “parity” requirements of the Wellstone-Domenici Mental Health Parity Act of 2008

The Affordable Care Act

Page 16: Staying Informed: Trends in the Addiction Profession

• In 2014, Medicaid eligibility will be expanded for families or individuals with incomes up to 133 percent of Federal poverty guidelines. Many newly eligible beneficiaries will receive substance use services

• Participation in Medicaid will help more patients gain access to traditional healthcare benefits, such as medications and behavioral therapies in the treatment of addiction

The Affordable Care Act

Page 17: Staying Informed: Trends in the Addiction Profession

By 2014: 6.3 million individuals newly covered by Medicaid will be in need of behavioral

health services

4.2 million individuals newly covered by private insurance will be in need of behavioral health services

About 5 million will meet medical diagnostic criteria for a substance use disorder

$30 billion in Medicaid funding annually for substance abuse services

$7 billion annually in private healthcare contributions for substance abuse services

How Do These Numbers Break Down?

Page 18: Staying Informed: Trends in the Addiction Profession

More people (approx. 32 million) will have insurance coverage

Demand will rise for qualified and well-trained addiction professionals

Medicaid will play a bigger role in paying for substance use treatment services

Focus on primary care & coordination with specialty care

Major emphasis on home & community-based services; less reliance on institutional care

Theme: preventing diseases & promoting wellness

Focus on quality rather than quantity of care

Impact of Affordable Care Act

Page 19: Staying Informed: Trends in the Addiction Profession

How can the addiction workforce meet this new demand for services?

• Integration of services with other professionals who are trained and educated in SUDs treatment

• Help from the Department of Labor (DOL)

• SUD Counseling is now a “distressed profession”

• (DOL) is working with ONDCP on new effort that would recruit and train 60,000 new counselors over the next decade

• Would require $500 million over 4 years, which ONDCP is highly supportive of

• But…the budget is an issue…

What Does This Mean for the Addiction Profession?

Page 20: Staying Informed: Trends in the Addiction Profession

• A major change for the workforce will come in the form of primary care/behavioral health integration

There is a big push to integrate more services into primary care settings (i.e., Primary Care/BH Integration), and this includes substance use disorder treatment and prevention

• As a result, primary care settings may be seeking to have counselors on staff

• Also, treatment programs should expect an increase in referrals from these primary care settings

Integration

Page 21: Staying Informed: Trends in the Addiction Profession

• It will be incumbent on the professionals in these fields to collaborate, and ideally work together to develop a clinical model of best practices

• This will include developing integration budgets, and designing implementation plans

• In short, the profession will need to be proactive

Integration

Page 22: Staying Informed: Trends in the Addiction Profession

• The ACA establishes a National Prevention Council, led by the Surgeon General, with substance use disorders as a national priority for the Council’s report to Congress (ONDCP will serve as a member of the Council)

• Mental health and behavioral health are listed as high priority areas in the new law’s National Workforce Commission section

Workforce Development

Page 23: Staying Informed: Trends in the Addiction Profession

In addition, the ACA provides:

Funding for residencies for behavioral health included with other disciplines

Loan repayment programs

Push towards more national certification standards

Push towards re-licensure and re-certification

Workforce Development

Page 24: Staying Informed: Trends in the Addiction Profession

Title V of the ACA establishes several new workforce development programs and defines which health professionals

are eligible for such programs.

Workforce Development

Page 25: Staying Informed: Trends in the Addiction Profession

Title V of ACA provides funding for

scholarships and loan repayment programs, for certain healthcare professionals, including substance abuse prevention and treatment providers, in the areas of the country that need them most, such as rural areas and

inner cities.

Workforce Development

Page 26: Staying Informed: Trends in the Addiction Profession

Certain substance abuse counselors may qualify for these

programs under the definition of “mental health service professionals” as defined in the ACA:

“MENTAL HEALTH SERVICE PROFESSIONAL.—The term ‘mental health service professional’ means an individual with a graduate or postgraduate degree from an accredited institution of higher education in psychiatry, psychology, school psychology, behavioral pediatrics, psychiatric nursing, social work, school social work, substance abuse disorder prevention and treatment, marriage and family counseling, school counseling, or professional counseling.”

Workforce Development

Page 27: Staying Informed: Trends in the Addiction Profession

NOTE: The definition of “Mental Health Professional” applies only to Title V programs in the ACA. It extends no further

The federal government does not- and will not- dictate the education or credentials for a civilian profession

Professionals who meet these requirements can qualify for loan repayment programs established by the legislation

It is important to note that the masters degree/no master’s degree issue only applies to one’s ability to qualify for programs under Title V of the ACA. The ability to practice one’s profession does not hinge on this distinction

States will continue to determine who may qualify to practice (i.e., licensure or certification)

Workforce Development

Page 28: Staying Informed: Trends in the Addiction Profession

• For Medicaid reimbursement, the Center for Medicare & Medicaid Services defers to states to define qualified providers

• The state sends its guidelines to the Federal Center for Medicare Services, which are almost always accepted without question or review

• State guidelines are more important than ever, as federal reimbursement will go to the professionals that the state recognizes as qualified to provide services

• The federal government has not set any standards of practice for substance use disorder counselors, nor will they

Workforce Development

Page 29: Staying Informed: Trends in the Addiction Profession

In short…

licensure, and in many states certification, is more important than ever, because recognition by the state as to who is

recognized as a substance use treatment and prevention professional will almost certainly play a role in who may provide services that are reimbursed by the federal government

Standards

Page 30: Staying Informed: Trends in the Addiction Profession

• It’s an ongoing process

• The state still plays a critical role, and the federal role, in terms of the profession, is not as large as you think

• Be ready to work with others in the health community on integration of services

The Affordable Care Act

Page 31: Staying Informed: Trends in the Addiction Profession

• When the Affordable Care Act is fully implemented in 2014, individuals and small businesses will have access to health care coverage through a new competitive private health insurance market – state-based Health Insurance Exchanges  

• States are already taking their first steps toward 2014 when Health Insurance Exchanges will be operational

How to Get Involved in ACA Implementation at the State Level

Page 32: Staying Informed: Trends in the Addiction Profession

• Many of those activities have been funded by the $49 million in Exchange planning grants awarded by the U.S. Department of Health and Human Services (HHS) in July of 2010

• States applied to use those grants for a number of important planning activities, including research to understand their insurance markets, efforts to obtain the legislative authority to create Exchanges, and steps to establishing the governing structures of Exchanges

How to Get Involved in ACA Implementation at the State Level

Page 33: Staying Informed: Trends in the Addiction Profession

• It is critical that as your state moves forward with the planning and implementation of its Health Insurance Exchange in 2014, that your Association be “at the table,” either by connecting with the organization in your state charged with HIE implementation, or with your Single State Authority (SSA)

• These organizations need to hear from the addiction professionals in their states

How to Get Involved in ACA Implementation at the State Level

Page 34: Staying Informed: Trends in the Addiction Profession

Resources – NAADAC has the following resources available on the web site (www.naadac.org) to assist in your efforts:

• State Health Insurance Exchange Contact Information, and

• Directory of Single State Agencies (SSA) for Substance Abuse Services

How to Get Involved in ACA Implementation at the State Level

Page 35: Staying Informed: Trends in the Addiction Profession

NAADAC encourages you to use these resources to connect with your state’s HIE and/or SSA to see what you can learn, how you submit your recommendations as an Association, and how you can advocate on behalf of the addiction profession in your state

How to Get Involved in ACA Implementation at the State Level

Page 36: Staying Informed: Trends in the Addiction Profession

• Health information technology is essential to the transformation of the health care delivery system and the promotion of preventive care and patient self-care

• Both the American Recovery and Reinvestment Act Affordable Care Act contain incentives for providers to adopt Electronic Health Records (EHRs) and will drive integration of services, allowing for greater benefits from and need for the adoption of HIT

Health Information Technology (HIT) and the ACA

Page 37: Staying Informed: Trends in the Addiction Profession

Some facts:

• Of 175 substance abuse treatment programs surveyed, 20 percent had no information systems, e-mail, or even voicemail1

• On average, information technology (IT) spending in behavioral health care and human services organizations represents 1.8 percent of total operating budgets—compared with 3.5 percent of the total operating budgets for general health care services2

• Fewer than half of behavioral health and human services providers possess fully implemented clinical electronic record systems2

1 McLellan, A. T., Carise, D., & Kleber, H. D. (2003). Can the national addiction treatment infrastructure support the public’s demand for quality care? Journal of Substance Abuse Treatment, 25, 117–121.

2 Centerstone Research Institute. (2009, June). Behavioral Health/Human Services Information Systems survey. National Council for Community Behavioral Health Care. Retrieved March 25, 2011, from http://www.thenationalcouncil.org/galleries/policy-file/HIT%20Joint%20Survey%20Exec%20Summary.pdf

Health Information Technology (HIT)

Page 38: Staying Informed: Trends in the Addiction Profession

• According to HHS Secretary Kathleen Sebelius, “Electronic health records will provide major technological innovation to our current health care system by allowing doctors to work together to make sure patients get the right care at the right time.”

• She has described patient privacy in HIT as “our top priority.”

Health Information Technology (HIT)

Page 39: Staying Informed: Trends in the Addiction Profession

• In the past, the specialty behavioral health system has often operated independently from the broader health system and differed in the type and scope of information technology used

• SAMHSA is working to increase access to HIT so that Americans with behavioral health conditions can benefit from these innovations (one of SAMHSA’s Eight Initiatives)

Health Information Technology (HIT) and SAMHSA

Page 40: Staying Informed: Trends in the Addiction Profession

SAMHSA is focusing on HIT in general and EHRs specifically to ensure that behavioral

health is integrated in to the Nation’s broader health system

Health Information Technology (HIT) and SAMHSA

Page 41: Staying Informed: Trends in the Addiction Profession

• Generalized adoption of behavioral health HIT requires the involvement of the behavioral health workforce

• Not only must the various treatment settings addressing substance use disorders—such as substance use disorder treatment programs—implement EHR systems, their staff must be trained to function within an EHR environment and to adapt to HIT

Health Information Technology (HIT) and the Workforce

Page 42: Staying Informed: Trends in the Addiction Profession

• Included in ARRA legislation passed in 2009 is the Health Information Technology for Economic and Clinical Health (HITECH) Act, also known as HITECH

• HITECH provides funding to establish programs to improve health care quality, safety and efficiency through promotion of HIT and private and secure health information exchange

• Medicare and Medicaid (CMS) to offer incentive payments for “meaningful use” of certified EHR technology

Health Information Technology and HITECH

Page 43: Staying Informed: Trends in the Addiction Profession

Centers of Medicare and Medicaid (CMS) issued final regs in July 2010:

• Defined the meaningful use requirements (objectives) that providers must meet through use of certified EHR technology in order to qualify for the payments 

• Identified the standard criteria for the certification of EHR technology (so eligible professionals and hospitals may be assured that the systems they adopt are capable of performing the required functions to meet meaningful use)

What is “Meaningful Use?”

Page 44: Staying Informed: Trends in the Addiction Profession

What are CMS Incentive Programs for Meaningful Use?

Medicare Medicaid

Can participate as soon as the federal program launchesCan participate once state offers the program (check with your state for expected launch date)

Can receive up to $44,000.00 in incentives, and up to $48,400.00 if practicing in a Health Provider Shortage Area

Can receive up to $63,750.00 in incentives

Required to demonstrate meaningful use of certified EHR technology every year to qualify for payment

Can qualify for payment for adopting, implementing, upgrading or demonstrating meaningful use of certified EHR technology in first participation year. Required to demonstrate meaningful use in each subsequent year to qualify for payment

Must participate by the second year to receive the maximum incentive payment

Must participate by 2016 to receive the maximum incentive payment

Page 45: Staying Informed: Trends in the Addiction Profession

Who is Eligible for CMS Incentives?

Medicare Medicaid

Eligible hospitals

Acute Care, Critical Access

Eligible hospitals

Acute Care, Critical Access and Children’s Hospitals

Eligible Professionals (EPs)

Doctors of Medicine, Osteopathy, Dental, Podiatric Medicine, Optometry, Chiropractor

Eligible Professionals (EPs)

PhysiciansNurse Practitioners (NPs), Certified Nurse-Midwives (CNMs), DentistsPhysician Assistants (PAs)

Page 46: Staying Informed: Trends in the Addiction Profession

Do I Have to Adopt the Use of EHRs?

• No penalty – the incentive program is voluntary

• Medicare may adjust payments in 2015

• Medicaid will not adjust any payments

Page 47: Staying Informed: Trends in the Addiction Profession

• Currently incentives contained in HITECH do not apply to most behavioral health, including SUD professionals, unless certain EPs (physicians, nurse) are on staff

• However……

What About Behavioral Health Treatment?

Page 48: Staying Informed: Trends in the Addiction Profession

• On March 10th, Senator Sheldon Whitehouse (D-RI) introduced S. 539, the Behavioral Health Information Technology Act of 2011

Bill would extend health information technology assistance

included in the HITECH Act to behavioral health, mental health, and substance abuse professionals and facilities

Similar to legislation introduced last year by Reps. Kennedy/Murphy

Behavioral Health Information Technology Act of 2011

Page 49: Staying Informed: Trends in the Addiction Profession

The Future of Education for Addiction Professionals

Don Osborn, MAC, ICAC, CCS

President of NAADAC

Page 50: Staying Informed: Trends in the Addiction Profession

Where We Are Now

• Addictions Counseling (AC) lacks a standardized curriculum

• Few programs exist beyond Associates Degrees

• Existing programs lack consistency of hours, content, or learning outcomes

Page 51: Staying Informed: Trends in the Addiction Profession

Concerns

• Without academic standards, AC viewed as unorganized and baseless profession

• Ethical issues

• No defined theoretical orientation or treatment methodology

Page 52: Staying Informed: Trends in the Addiction Profession

History of the Field

• Lack of treatment methods, competency

• Allied profession limitations with addiction

Social Workers

Psychologists

• Professional vs. non-professional

Page 53: Staying Informed: Trends in the Addiction Profession

History of the Field (cont.)

• Academic preparation of allied professions

• Undergraduate/graduate programs

• Body of knowledge skill and practice

• AC none

Page 54: Staying Informed: Trends in the Addiction Profession

History of the Field (cont.)

• Recovering vs. non-recovering

• 1975 National Association of Alcohol and Drug Abuse Counselors (NAADAC)

Membership

Certification exam

• Education/training

Workshops

Conferences

Two year college courses

Page 55: Staying Informed: Trends in the Addiction Profession

History of the Field (cont.)

• Process addictions

Gambling, eating disorders, sexual addiction

• Diagnostic and Statistical Manual (DSM) and Managed Health Care

• Ill-equipped workforce

• Resistance to educational standards

• Personal experience only is needed

Page 56: Staying Informed: Trends in the Addiction Profession

Current Need

• 23.2 million need treatment

• Only 2.4 million received treatment

• Need 5,000 new Addictions counselors a year

to meet need (NIDA,

2009)

Page 57: Staying Informed: Trends in the Addiction Profession

Composition of Addiction Workforce

• Recovering vs. non-recovering

• Academic degree not required

• Masters required in allied mental health profession (Bissel & Royce, 1994)

• Some states only required high school diploma or certification

Page 58: Staying Informed: Trends in the Addiction Profession

Training

• AAMFT, ACA, NASW, APA saw addiction as secondary diagnosis

• Addiction Counselors have degrees in something other than addictions

• Needs of multi-service agencies professionals in assessment, family counseling, treatment planning, and relapse prevention in addictions

(VonSteen, Vacc & Strickland, 2008)

Page 59: Staying Informed: Trends in the Addiction Profession

Training (cont.)

• School counselors are frontline providers. No academic preparation in addictions.

(Sink, 2005; Mason, 1997; Palmer & Ringwalt, 1988)

• Low level of addictions training in higher education

• Lack of consistent prerequisites, curriculum, course content (Selin & Svanum, 1981)

Page 60: Staying Informed: Trends in the Addiction Profession

Ethics, Supervision and Recommendations

• Lack of academic standards, competencies, knowledge, and skill development present ethical concerns (e.g., confidentiality, scope of practice, and dual relationships)

• Only 14 states require ethics training

• CFR 42 Confidentiality of Alcohol and Drug Abuse Patient Record Code

Page 61: Staying Informed: Trends in the Addiction Profession

• Traditional/Recovering vs. Nontraditional/Non Recovering

• Traditional/Recovering

12 step; disease model; little, if any, education; workshops; conferences

• Nontraditional/Non Recovering

Research to service, theory, treatment protocols

Education – degree requirements

Ethics, Supervision and Recommendations

Page 62: Staying Informed: Trends in the Addiction Profession

Standardized Curriculum: Scopes of Practice

Don Osborn, MAC, ICAC, CCS

President of NAADAC

Page 63: Staying Informed: Trends in the Addiction Profession

Standardized Scopes of Practice

Model Scopes of Practice and Career Ladder for Substance Use Disorder Counselors

Download now or later at: www.myaccucare.com/webinars

Page 64: Staying Informed: Trends in the Addiction Profession

• Category 4: Independent Clinical Substance Use Disorder Counselor/Supervisor

• Category 3: Clinical Substance Use Disorder Counselor

• Category 2: Substance Use Disorder Counselor

• Category 1: Associate Substance Use Disorder Counselor

• Substance Use Disorder Technician

Standardized Scopes of Practice

Page 65: Staying Informed: Trends in the Addiction Profession

Category 4: Independent Clinical Substance Use Disorder Counselor/Supervisor

Practice of Independent Clinical Substance Use Disorder Counselor/Supervisor:

Typically has a Masters or other post graduate degree

Is licensed to practice independently

Page 66: Staying Informed: Trends in the Addiction Profession

Category 4: Independent Clinical Substance Use Disorder Counselor/Supervisor

The scope of practice for Independent Clinical Substance Use Disorder Counselor/Supervisor can include:

1. Clinical evaluation, including screening, assessment, and diagnosis of Substance Use Disorders (SUDs) and Co-Occurring Disorders (CODs)

2. Treatment Planning for SUDs and CODs, including initial, ongoing, continuity of care, discharge, and planning for relapse prevention

3. Referral

4. Service Coordination and case management in the areas of SUDs and CODs

5. Counseling, therapy, trauma informed care, and psycho-education with individuals, families, and groups in the areas of SUDs and CODs

6. Client, Family, and Community Education

7. Documentation

8. Professional and Ethical Responsibilities

9. Clinical supervisory responsibilities for all categories of SUD Counselors

Page 67: Staying Informed: Trends in the Addiction Profession

Category 4: Independent Clinical Substance Use Disorder Counselor/Supervisor

• Can practice under the auspice of a licensed facility, within a primary care setting, or as an independent private practitioner.

• It is the responsibility of the Independent Clinical Substance Use Disorder Counselor/Supervisor to seek out clinical supervision and peer support.

Page 68: Staying Informed: Trends in the Addiction Profession

Category 3: Clinical Substance Use Disorder Counselor

Practice of Clinical Substance Use Disorder Counselor:

Typically has a Masters or other post graduate degree

Depending on the jurisdiction, persons in this position either have not attained their license, or the license is restricted to practice only under supervision of a Category 4 Independent Clinical Substance Use Disorder Counselor/Supervisor.

Page 69: Staying Informed: Trends in the Addiction Profession

The scope of practice for Clinical Substance Use Disorder Counselor can include:

1. Clinical evaluation, including screening, assessment, and diagnosis of Substance Use Disorders (SUDs) and Co-Occurring Disorders (CODs)

2. Treatment Planning for SUDs and CODs, including initial, ongoing, continuity of care, discharge, and planning for relapse prevention

3. Referral

4. Service Coordination and case management in the areas of SUDs and CODs

5. Counseling, therapy, trauma informed care, and psycho-education with individuals, families and groups in the areas of SUDs and CODs

6. Client, Family, and Community Education

7. Documentation

8. Professional and Ethical Responsibilities

9. Clinical supervisory responsibilities for categories Levels 1 and 2 as well as Substance Use Disorder Technicians.

Category 3: Clinical Substance Use Disorder Counselor

Page 70: Staying Informed: Trends in the Addiction Profession

The Substance Use Disorder Counselor 3 can only practice under the auspice of a

licensed facility, within a primary care setting, and under clinical supervision of a Clinical

Substance Use Disorder Counselor 4.

Category 3: Clinical Substance Use Disorder Counselor

Page 71: Staying Informed: Trends in the Addiction Profession

Substance Use Disorder Counselor – The Scope of Practice for the category of those with a Bachelor’s degree includes the following activities with clinical supervision of a Clinical Substance Use Disorder Counselor or other state approved supervisor:

1. Clinical evaluation, including diagnostic impression or Screening, Brief Intervention, and Referral to Treatment Referral (SBIRT)

2. Treatment Planning for SUDs and CODs, including initial, ongoing, continuity of care, discharge, and planning for relapse prevention

3. Referral

4. Service Coordination and case management for SUDs and CODs

5. Counseling, therapy, trauma informed care, and psycho-education with individuals, families, and groups

6. Client, Family, and Community Education

7. Documentation

8. Professional and Ethical Responsibilities

9. Clinical supervisory responsibilities for all categories of SUD Counselors

Category 2: Substance Use Disorder Counselor

Page 72: Staying Informed: Trends in the Addiction Profession

The Substance Use Disorder Counselor 2 can only practice under the auspice of a

licensed facility, within a primary care setting, and under the clinical supervision of Clinical

Substance Use Disorder Counselor/Supervisor or Clinical Substance

Abuse Counselor.

Category 2: Substance Use Disorder Counselor

Page 73: Staying Informed: Trends in the Addiction Profession

Associate Substance Use Disorder Counselor –The Scope of Practice for the category of those with an Associate’s degree include the following activities with clinical supervision from a Clinical Substance Abuse Counselor or state approved supervisor and/or administrative supervision of a Substance Abuse Counselor:

1. Diagnostic impression, and Screening, Brief Intervention, Referral to Treatment (SBIRT)

2. Monitor treatment plan/compliance

3. Referral

4. Service Coordination and case management for SUD

5. Psycho-educational counseling of individuals and groups

6. Client, Family, and Community Education

7. Documentation

8. Professional and Ethical Responsibilities

Category 1: Associate Substance Use Disorder Counselor

Page 74: Staying Informed: Trends in the Addiction Profession

The Associate Substance Use Disorder Counselor can only practice under the auspice of a licensed

facility or a primary care setting, and under the clinical and/or administrative supervision of an Independent

Clinical Substance Use Disorder Counselor/Supervisor and a Clinical Substance Use Disorder Counselor or the administrative oversight of

the Substance Use Disorder Counselor.

Category 1: Associate Substance Use Disorder Counselor

Page 75: Staying Informed: Trends in the Addiction Profession

Substance Use Disorder Technician – The Scope of Practice for the category of those with a high school diploma or a GED include the following activities with clinical supervision from a Clinical Substance Abuse Counselor/Supervisor, Clinical Substance Abuse Counselor or state approved supervisor and/or administrative supervision of a Substance Abuse Counselor:

1. Diagnostic impression, and Screening, Brief Intervention, Referral to Treatment (SBIRT).

2. Monitor treatment plan/compliance

3. Referral

4. Service Coordination and case management for SUD

5. Psycho-educational counseling of individuals and groups

6. Client, Family, and Community Education

7. Documentation

8. Professional and Ethical Responsibilities

Substance Use Disorder Technician

Page 76: Staying Informed: Trends in the Addiction Profession

The Substance Use Disorder Technician can only practice under the auspice of a licensed facility or a primary care setting, and under the clinical and/or

administrative supervision of Clinical Substance Use Disorder Counselor/Supervisor, Clinical Substance Abuse Counselor, or the administrative oversight of

the Substance Use Disorder Counselor.

Substance Use Disorder Technician

Page 77: Staying Informed: Trends in the Addiction Profession

Standardized Scopes of Practice

Model Scopes of Practice and Career Ladder for Substance Use Disorder Counselors

Download now or later at: www.myaccucare.com/webinars

Page 78: Staying Informed: Trends in the Addiction Profession

The Importance of Maintaining Your Credential/License

Shirley Beckett Mikell, NCAC II, SAP

NAADAC Director of Certification & Education

Page 79: Staying Informed: Trends in the Addiction Profession

Protection of the profession

Protection of your clients/patients

Protection of your colleagues

Protection of your agency

Protection of your practice

The Importance of Maintaining Your Professional Standing

Page 80: Staying Informed: Trends in the Addiction Profession

What is an Addiction Professional Credentialing Program?

Addiction credentialing program =

an organized system of baseline requirements that must be met in

order for a professional to practice within a given field

Page 81: Staying Informed: Trends in the Addiction Profession

What is an Addiction Licensing Board?

Established to:

• Enforce effective Substance Use Disorder practice

• Determine adequate practice standards

• Protect the public

• Develop and maintain performance standards

• Ensure safety of the public

• Act on ethical complaints

Page 82: Staying Informed: Trends in the Addiction Profession

Licensure Boards

• 12 State - Substance Use Disorders Licensing Boards

• 51 State – Substance Use Disorders Credentialing Boards

• 9 National Credentialing Boards

• Available in every state and territory

• Similar criteria, requirements and standards

• State Boards recognized within each state

Page 83: Staying Informed: Trends in the Addiction Profession

Accepted Credential Standards

Should meet national criteria

Should have specific educational requirements

Should have specific skills set

Should require clinical supervisory over site

Should require renewal at least every 2 years

Page 84: Staying Informed: Trends in the Addiction Profession

Obtaining the National Credential for Addiction

Professionals

Shirley Beckett Mikell, NCAC II, SAP

Director of Certification and Education

Page 85: Staying Informed: Trends in the Addiction Profession

Certification Opportunities

The NCC has 5 national credentials for addiction professionals:

• Basic or Entry Level (BAC)

• National Certified Addiction Counselor (NCAC I)

• National Certified Addiction Counselor (NCAC II)

• Master Addiction Counselor (MAC)

• Nicotine Dependence Specialist (NDS)

Page 86: Staying Informed: Trends in the Addiction Profession

Basic or Entry Level

Current state certification/licensure as an alcohol and/or drug abuse counselor.

Two years full-time or 4,000 hours of supervised experience as an alcohol and/or drug abuse counselor.

200 contact hours of education and training in alcoholism and drug abuse or related counseling subjects, including 6 hours of ethics training and 6 hours of HIV/AIDS training.

Passing score on the Basic Level written examination within 4 years of application.

Page 87: Staying Informed: Trends in the Addiction Profession

NCAC I Requirements

Current state certification/licensure as an alcohol and/or drug abuse counselor.

Three years full-time or 6,000 hours of supervised experience as an alcohol and/or drug abuse counselor.

270 contact hours of education and training in alcoholism and drug abuse or related counseling subjects, including 6 hours of ethics training and 6 hours of HIV/AIDS training.

Passing score on the NCAC I written examination within 4 years of application.

Page 88: Staying Informed: Trends in the Addiction Profession

NCAC II Requirements

A Bachelor's level college degree from a regionally accredited institution of higher learning.

Current state certification/licensure as an alcohol and/or drug abuse counselor.

Five years full-time or 10,000 hours of supervised experience as an alcohol and/or drug abuse counselor.

450 contact hours of education and training in alcoholism and drug abuse or related counseling subjects, including 6 hours of ethics training and 6 hours of HIV/AIDS training.

Passing score on the NCAC II written examination within 4 years of application.

Page 89: Staying Informed: Trends in the Addiction Profession

MAC Requirements

Master's Degree in the healing arts or related field with in-depth subjects applicable to the alcohol and drug abuse treatment arena, by a regionally accredited institution of higher learning.

Current state certification/licensure in alcohol and/or drug abuse counseling or a related healing art.

500 contact hours of specific alcohol and drug abuse counseling training.

Three years full-time or 6,000 hours of supervised experience, two years or 4,000 hours of which is post master's degree.

Passing score on the MAC written examination within 4 years of application.

Page 90: Staying Informed: Trends in the Addiction Profession

Nicotine Dependence Specialist

Current license or certification in the helping profession (i.e. nursing, respiratory therapy and pharmacy) or teaching certificate or alcohol and other drug certification

270 contact hours of education and training in the health care profession

85 hours or more of specific nicotine dependence training and validated testing

3 years full-time or the equivalent employment in the helping profession

Passing score on the NDS written examination

Page 91: Staying Informed: Trends in the Addiction Profession

Specialty Opportunities

The NCC also offers 4 specialty opportunities that allow nationally certified addiction counselors to demonstrate their knowledge base in a particular area of expertise:

• Substance Abuse Professional (SAP)

• Adolescent Specialist Endorsement (ASE)

• Conflict Resolution in Recovery Certificate

• Spiritual Caregiving to Help Addicted Persons and Families Certificate

Page 92: Staying Informed: Trends in the Addiction Profession

Credential Crosswalk

National Certified

Addiction Counselor (Basic Level)

National Certified Addiction Counselor

(NCAC I)

National Certified Addiction Counselor

(NCAC II)

Master Addiction Counselor (MAC)

Nicotine Depedence Specialist (NDS)

Prerequisite: Employment in a

substance use disorder program or treatment facility at

intern or novice level

Must possess a current state license or certification as a

substance abuse counselor from an

accepted state credential

Must possess a current state license or certification as a

substance abuse counselor from an

accepted state credential

Must possess a current state license or certification as a

substance abuse counselor from an

accepted state credential OR current

state license in a healing art (e.g. LPC, LCSW, nurse, etc.)

Must possess a current state license or certification in the

health care profession from an

accepted state credential

Degree

Required:

High school diploma or equivalent

High school diploma or equivalent

Bachelor’s degree with an emphasis in counseling addicted

clients

Master’s degree in a healing art or related

field with an emphasis in

counseling addicted clients

No requirement

Approved Education

&

Training:

125 contact hours of education and

training in AODA counseling subjects, including 6 hours of

HIV/AIDS and 6 hours of ethics

270 contact hours of education and

training in AODA counseling subjects, including 6 hours of

HIV/AIDS and 6 hours of ethics

450 contact hours of education and

training in AODA counseling subjects, including 6 hours of

HIV/AIDS and 6 hours of ethics

500 contact hours of education and

training in specific AODA counseling

subjects, including 6 hours of HIV/AIDS and 6 hours of ethics

270 contact hours of education and

training in the health care profession,

including 85 hours of specific tobacco education and

training

Experience:

2,000 hours/1 year full-time supervised

experience in AODA counseling

6,000 hours/3 years full-time supervised

experience in AODA counseling

10,000 hours/5 years full-time supervised

experience in AODA counseling

6,000 hours/3 years full-time experience

in AODA counseling, 2 years post-master’s

degree

6,000 hours/3 years of employment in a

health care profession

Page 93: Staying Informed: Trends in the Addiction Profession

More Information

For more information about national certification, please visit:

www.naadac.org/certification

Page 94: Staying Informed: Trends in the Addiction Profession

Please feel free to ask questions!

1001 N. Fairfax Street., Ste. 201Alexandria, VA 22314

phone: 703.741.7686/800.548.0497 fax: 703.741.7698/800.377.1136

[email protected]

Misti Storie: [email protected]

1016 Leavenworth Street Omaha, NE 68102

phone: 402.341.8880 fax: 402.341.8911

www.myaccucare.com [email protected]

Emily Haverty: [email protected]

Thank You for Participating!

Page 95: Staying Informed: Trends in the Addiction Profession

Providing solutions to improve the quality of life for communities by helping addictions professionals excel in their field through the use of information technology.

Visit us today! Call: (800) 324-7966Click: www.MyAccuCare.com

Clinical Administrative

Outcome Reporting

Billing

Page 96: Staying Informed: Trends in the Addiction Profession

The education delivered in this webinar is FREE to all professionals.

2 CEs are FREE to NAADAC members and AccuCare subscribers who attend this webinar. Non-members of NAADAC or non-subscribers of AccuCare receive 2 CEs for $25.

If you wish to receive CE credit, you MUST download, complete and submit the “CE Quiz” that is located at:

www.myaccucare.com/webinars

www.naadac.org/education

A CE certificate will be emailed to you within 30 days.

Successfully passing the “CE Quiz” is the ONLY way to receive a CE certificate.

Obtaining CE Credit

Page 97: Staying Informed: Trends in the Addiction Profession

July 14, 2011 - Integrating Co-occurring Disorders: An Introduction to What Every Addiction Counselor Needs to Know

August 18, 2011 - Strategies for Successful Test Taking

September 15, 2011 - Your Voice Counts: Advocacy and the NAADAC Political Action Committee

October 13, 2011 - Conflict Resolution for Clients and Professionals

November 17, 2011 - What's Next in Your Career? Recap and Highlights from the NAADAC Workforce Conference

December 15, 2011 - Clinical Supervision: Keys to Success

Register at: www.naadac.org/education or www.myaccucare.com/webinars

Upcoming Webinars 2011

Page 98: Staying Informed: Trends in the Addiction Profession

Alcohol SBIRT: Integrating Evidence-based Practice Into Your Practice

Medication Assisted Recovery: What Every Addiction Professional Needs to Know

Build Your Business With the Department of Transportation Substance Abuse Professional (SAP) Qualification

Working with NAADAC to Express Your Professional Identity

Screening, Brief Intervention and Referral to Treatment (SBIRT)

Medicaid Expansion 2014 and Preparing to Bill for Medicaid

Understanding NAADAC’s Code of Ethics

Archived webinars located at: www.naadac.org/education or www.myaccucare.com/webinars

Archived Webinars

Page 99: Staying Informed: Trends in the Addiction Profession

1001 N. Fairfax Street., Ste. 201Alexandria, VA 22314

phone: 703.741.7686/800.548.0497 fax: 703.741.7698/800.377.1136

[email protected]

Misti Storie: [email protected]

1016 Leavenworth Street Omaha, NE 68102

phone: 402.341.8880 fax: 402.341.8911

www.myaccucare.com [email protected]

Emily Haverty: [email protected]

Thank You for Participating!

Christopher C. Campbell - [email protected]

Donald P. Osborn - [email protected]

Shirley Beckett Mikell - [email protected]