Staying Informed: Trends in the Addiction Profession

1
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
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Presented By
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Obtaining CE Credit

• 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.

4
Webinar Objectives

• 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.

5
The Affordable Care Act (ACA) What It Means for
the Addiction Profession

• Christopher Campbell
• NAADAC Director of Government Relations

6
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.

7
The Affordable Care Act (ACA) What It Means for
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

8
The Affordable Care Act

• Key points to keep in mind
• The work is really just beginning
• Going to learn as we go
• 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!

9
Background

• 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

10
The Affordable Care Act Coverage Expansion

• 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

11
The Affordable Care Act

• 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

12
In 2014 32 Million More Americans Will Be Covered
HIEs/ Subsidies
Commercial Insurance
Medicaid
5m SUDs
6-10 Million with M/SUDs
13
The Affordable Care Act

• 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

14
The Affordable Care Act

• Insurers will no longer be able to deny coverage
  based on pre-existing medical conditions, such as
  substance use disorders.

15
The Affordable Care Act

• 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

16
The Affordable Care Act

• 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

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How Do These Numbers Break Down?

• 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

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Impact of Affordable Care Act

• 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

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What Does This Mean for 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
• Butthe budget is an issue

20
Integration

• 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

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Integration

• 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

22
Workforce Development

• The ACA establishes a National Prevention
  Council, led by the Surgeon General, with
  substance use disorders as a national priority
  for the Councils 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 laws National
  Workforce Commission section

23
Workforce Development

• 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

24
Workforce Development

• Title V of the ACA establishes several new
  workforce development programs and defines which
  health professionals are eligible for such
  programs.

25
Workforce Development

• 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.

26
Workforce Development

• 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.

27
Workforce Development

• 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 masters degree issue only applies to
  ones ability to qualify for programs under Title
  V of the ACA. The ability to practice ones
  profession does not hinge on this distinction
• States will continue to determine who may qualify
  to practice (i.e., licensure or certification)

28
Workforce Development

• 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

29
Standards

• 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

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The Affordable Care Act

• Its 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

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How to Get Involved in ACA Implementation at the
State Level

• 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

32
How to Get Involved in ACA Implementation at the
State Level

• 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

33
How to Get Involved in ACA Implementation at the
State Level

• 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

34
How to Get Involved in ACA Implementation at the
State Level

• 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

35
How to Get Involved in ACA Implementation at the
State Level

• NAADAC encourages you to use these resources to
  connect with your states 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

36
Health Information Technology (HIT) and the ACA

• 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

37
Health Information Technology (HIT)

• 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 budgetscompared 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 publics demand for
  quality care? Journal of Substance Abuse
  Treatment, 25, 117121.
• 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/p
  olicy-file/HIT20Joint20Survey20Exec20Summary.p
  df

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Health Information Technology (HIT)

• 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.

39
Health Information Technology (HIT) and SAMHSA

• 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
  SAMHSAs Eight Initiatives)

40
Health Information Technology (HIT) and SAMHSA

• SAMHSA is focusing on HIT in general and EHRs
  specifically to ensure that behavioral health is
  integrated in to the Nations broader health
  system

41
Health Information Technology (HIT) and the
Workforce

• Generalized adoption of behavioral health HIT
  requires the involvement of the behavioral health
  workforce
• Not only must the various treatment settings
  addressing substance use disorderssuch as
  substance use disorder treatment
  programsimplement EHR systems, their staff must
  be trained to function within an EHR environment
  and to adapt to HIT

42
Health Information Technology and HITECH

• 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

43
What is Meaningful Use?

• 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)

44
What are CMS Incentive Programs for Meaningful
Use?
Medicare Medicaid
Can participate as soon as the federal program launches Can 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
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Who is Eligible for CMS Incentives?
Medicare Medicaid
Eligible hospitals Acute Care, Critical Access Eligible hospitals Acute Care, Critical Access and Childrens Hospitals
Eligible Professionals (EPs) Doctors of Medicine, Osteopathy, Dental, Podiatric Medicine, Optometry, Chiropractor Eligible Professionals (EPs) Physicians Nurse Practitioners (NPs), Certified Nurse-Midwives (CNMs), Dentists Physician Assistants (PAs)
46
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

47
What About Behavioral Health Treatment?

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

48
Behavioral Health Information Technology Act of
2011

• 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

49
The Future of Education for Addiction
Professionals

• Don Osborn, MAC, ICAC, CCS
• President of NAADAC

50
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

51
Concerns

• Without academic standards, AC viewed as
  unorganized and baseless profession
• Ethical issues
• No defined theoretical orientation or treatment
  methodology

52
History of the Field

• Lack of treatment methods, competency
• Allied profession limitations with addiction
• Social Workers
• Psychologists
• Professional vs. non-professional

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History of the Field (cont.)

• Academic preparation of allied professions
• Undergraduate/graduate programs
• Body of knowledge skill and practice
• AC none

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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

55
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

56
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)

57
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

58
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)

59
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)

60
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

61
Ethics, Supervision and Recommendations

• 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

62
Standardized Curriculum Scopes of Practice

• Don Osborn, MAC, ICAC, CCS
• President of NAADAC

63
Standardized Scopes of Practice

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

Download now or later at www.myaccucare.com/webin
ars
64
Standardized Scopes of Practice

• 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

65
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

66
Category 4 Independent Clinical Substance Use
Disorder Counselor/Supervisor

• The scope of practice for Independent Clinical
  Substance Use Disorder Counselor/Supervisor can
  include
• Clinical evaluation, including screening,
  assessment, and diagnosis of Substance Use
  Disorders (SUDs) and Co-Occurring Disorders
  (CODs)
• Treatment Planning for SUDs and CODs, including
  initial, ongoing, continuity of care, discharge,
  and planning for relapse prevention
• Referral
• Service Coordination and case management in the
  areas of SUDs and CODs
• Counseling, therapy, trauma informed care, and
  psycho-education with individuals, families, and
  groups in the areas of SUDs and CODs
• Client, Family, and Community Education
• Documentation
• Professional and Ethical Responsibilities
• Clinical supervisory responsibilities for all
  categories of SUD Counselors

67
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.

68
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.

69
Category 3 Clinical Substance Use Disorder
Counselor

• The scope of practice for Clinical Substance Use
  Disorder Counselor can include
• Clinical evaluation, including screening,
  assessment, and diagnosis of Substance Use
  Disorders (SUDs) and Co-Occurring Disorders
  (CODs)
• Treatment Planning for SUDs and CODs, including
  initial, ongoing, continuity of care, discharge,
  and planning for relapse prevention
• Referral
• Service Coordination and case management in the
  areas of SUDs and CODs
• Counseling, therapy, trauma informed care, and
  psycho-education with individuals, families and
  groups in the areas of SUDs and CODs
• Client, Family, and Community Education
• Documentation
• Professional and Ethical Responsibilities
• Clinical supervisory responsibilities for
  categories Levels 1 and 2 as well as Substance
  Use Disorder Technicians.

70
Category 3 Clinical Substance Use Disorder
Counselor

• 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.

71
Category 2 Substance Use Disorder Counselor

• Substance Use Disorder Counselor The Scope of
  Practice for the category of those with a
  Bachelors degree includes the following
  activities with clinical supervision of a
  Clinical Substance Use Disorder Counselor or
  other state approved supervisor
• Clinical evaluation, including diagnostic
  impression or Screening, Brief Intervention, and
  Referral to Treatment Referral (SBIRT)
• Treatment Planning for SUDs and CODs, including
  initial, ongoing, continuity of care, discharge,
  and planning for relapse prevention
• Referral
• Service Coordination and case management for SUDs
  and CODs
• Counseling, therapy, trauma informed care, and
  psycho-education with individuals, families, and
  groups
• Client, Family, and Community Education
• Documentation
• Professional and Ethical Responsibilities
• Clinical supervisory responsibilities for all
  categories of SUD Counselors

72
Category 2 Substance Use Disorder Counselor

• 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.

73
Category 1 Associate Substance Use Disorder
Counselor

• Associate Substance Use Disorder Counselor The
  Scope of Practice for the category of those with
  an Associates 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
• Diagnostic impression, and Screening, Brief
  Intervention, Referral to Treatment (SBIRT)
• Monitor treatment plan/compliance
• Referral
• Service Coordination and case management for SUD
• Psycho-educational counseling of individuals and
  groups
• Client, Family, and Community Education
• Documentation
• Professional and Ethical Responsibilities

74
Category 1 Associate Substance Use Disorder
Counselor

• 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.

75
Substance Use Disorder Technician

• 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
• Diagnostic impression, and Screening, Brief
  Intervention, Referral to Treatment (SBIRT).
• Monitor treatment plan/compliance
• Referral
• Service Coordination and case management for SUD
• Psycho-educational counseling of individuals and
  groups
• Client, Family, and Community Education
• Documentation
• Professional and Ethical Responsibilities

76
Substance Use Disorder Technician

• 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.

77
Standardized Scopes of Practice

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

Download now or later at www.myaccucare.com/webin
ars
78
The Importance of Maintaining Your
Credential/License

• Shirley Beckett Mikell, NCAC II, SAP
• NAADAC Director of Certification Education

79
The Importance of Maintaining Your Professional
Standing

• Protection of the profession
• Protection of your clients/patients
• Protection of your colleagues
• Protection of your agency
• Protection of your practice

80
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

81
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

82
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

83
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

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Obtaining the National Credential for Addiction
Professionals

• Shirley Beckett Mikell, NCAC II, SAP
• Director of Certification and Education

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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)

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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.

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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.

88
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.

89
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.

90
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

91
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

92
Credential Crosswalk
93
More Information

• For more information about national
  certification, please visit
• www.naadac.org/certification

94
Please feel free to ask questions!
Thank You for Participating!
1016 Leavenworth Street Omaha, NE 68102 phone
402.341.8880 fax [phone] www.myaccucare.com
info_at_orionhealthcare.com Emily Haverty
ehaverty_at_orionhealthcare.com
1001 N. Fairfax Street., Ste. 201 Alexandria, VA
22314 phone [phone].548.0497 fax
703.741.7698/800.377.1136 www.naadac.org naadac_at_na
adac.org Misti Storie misti_at_naadac.org
95
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 [phone] Click
www.MyAccuCare.com
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96
Obtaining CE Credit

• 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.

97
Upcoming Webinars 2011

• 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

98
Archived Webinars

• 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 NAADACs Code of Ethics
• Archived webinars located at www.naadac.org/educa
  tion or www.myaccucare.com/webinars

99
Thank You for Participating!
Christopher C. Campbell - chris_at_naadac.org Donald
P. Osborn - dposborn_at_hotmail.com Shirley Beckett
Mikell - shirley_at_naadac.org
1016 Leavenworth Street Omaha, NE 68102 phone
402.341.8880 fax [phone] www.myaccucare.com
info_at_orionhealthcare.com Emily Haverty
ehaverty_at_orionhealthcare.com
1001 N. Fairfax Street., Ste. 201 Alexandria, VA
22314 phone [phone].548.0497 fax
703.741.7698/800.377.1136 www.naadac.org naadac_at_na
adac.org Misti Storie misti_at_naadac.org