What happens when a mandate for accreditation is on the horizon or comes through?

If your organization is impacted by either a Federal, State or Association mandate, it is important to get in front of it early so you don’t get caught in the crunch-which can happen when hundreds of organizations try to get accredited at the same time

How Accreditation Supports Recovery Principles

The national accrediting bodies have been among the moving forces in the integration of the recovery model into the care, treatment and services for people with mental health and/or substance use disorders. Recovery principles can now be seen throughout behavioral health standards of accrediting bodies as well as the outlined expectations that an organization will demonstrate conformance/compliance to these standards. And, the integration makes sense – this model not only complements the more traditional model of medication and “talk” therapies, but also expands the focus to include the person’s own goals and strengths and empowers them to be actively involved in the process.

The US Substance Abuse and Mental Health Administration (SAMHSA) has also integrated the recovery model in their publications, requirements for certified community-based behavioral health clinics, training materials, and grants. To that end – they’ve developed the Working Definition of Recovery. Several of the guiding principles shown here are addressed in the accrediting bodies’ standards.

Accrediting bodies’ implementation of such a model involves workforce training so that staff can fully understand and embody the organization’s philosophy, thus permeating service delivery to positively impact the recovery of the people served.  In addition, the accreditation survey process itself supports the recovery principles. Surveyor(s) not only review written documents, but also observe interactions amongst staff at all levels and persons served and share their observations with the organization. This external survey can confirm, enhance, and strengthen the organization’s intent and commitment to recovery principles

While accreditation as a whole supports the recovery model, below are specific examples of ways in which accreditation and the recovery model intersect:

Person-Driven – An individualized plan of care, treatment, and services based on the needs, strengths and abilities, preferences/expectations and goals of each person being provided care, treatment or services is a core accreditation requirement. “Boiler plate” plans that repeat over and over the same information for each person served will result in survey findings (unsatisfactory conformance/noncompliance with standards) and the need for correction to achieve full accreditation. Furthermore, it’s an expectation that an accredited organization actively involve the person served in identifying their needs and preferences for aftercare and, as much as possible, making choices about where, type, and by whom.

Holistic – The needs of the person in relation to various life domains, such as physical health and housing, are addressed in case management/care coordination standards (assessment of the person’s needs and assistance in meeting these identified life domain needs). Since access to routine and needed physical health care can be a challenge for those who need it, the accrediting bodies offer options for the integration/coordination of physical health care. Health Home standards have been established to facilitate successful integration of physical health care with an organization’s traditional behavioral health programs.

Culture and Respect – Accreditation standards emphasize that the person served encounters respect in all aspects of their care, treatment, or service experience and this is reflected in the organization’s policies, procedures, rules, and expectations as well as the rights and responsibilities of the person served. Standards clearly emphasize that service delivery is provided by staff in an atmosphere of respect and understanding and sensitivity to cultural values, beliefs, and preferences.

Trauma – The approach of the accrediting bodies to trauma centers around their screening and assessment, planning and delivery of services, and workforce training standards. Standards require a screening and assessment process to identify people whose lived experiences either currently and/or in the past may have included trauma(s). Also, organizations need to demonstrate that the impact of trauma on the person served is considered in the planning and delivery of care, treatment, or services.

Peer Support – Peer support services are an important component of the recovery model. These services are part of the plan of care, treatment, or services, and are provided by trained individuals who share similar lived experiences with mental health and substance use challenges. Accrediting bodies not only recognize the utilization of this type of service by mental health and substance use treatment providers, but also have developed standards addressing the integration of these services into the planning of care with the active involvement of the person served.

The accrediting bodies require written plans, policies, or procedures promoting these recovery principles to form a framework for implementation and a communication to staff and people served of the philosophy, beliefs, and values of an organization.

For more information on the recovery model and/or how accreditation can benefit your organization, visit AccreditationGuru.com.

 

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Accreditation – A Solid Foundation for a CCBHC

The Certified Community Behavioral Health Clinic (CCBHC) model has seen rapid uptake in the last decade because it improves the quality of life for individuals with behavioral health needs. It does this by improving community-based access to behavioral healthcare, regardless of an individual’s ability to pay, which is important. Studies have shown that, in the U.S., one in five adults have a mental illness, but fewer than half received treatment in the past year. In addition, individuals with behavioral health needs often have poor physical health outcomes due to a lack of physical health care access, so the CCBHC model integrates and coordinates physical health services for this population. In order to meet this mission, CCBHCs receive enhanced Medicaid funding that allows them to provide more services as well as services that are not always reimbursed, like community outreach and partnerships.

In 2002, eight community mental health clinics formed the first CCBHC pilot. The number of CCBHCs has now grown to over 400 operating in 40 states. More states are considering adopting this model now that the program has gone nationwide. “Certified Community Behavioral Health Clinics help connect Americans to easy-to-access, comprehensive mental health and substance use disorder treatment and supports in their own communities,” said Miriam E. Delphin-Rittmon, Ph.D., the U.S. Health and Human Services Assistant Secretary for Mental Health and Substance Use and the leader of SMAHSA.

But becoming a CCBHC can be complex. Agencies may need to expand services and hours, hire staff, and determine how and where to integrate physical health care into their operations so they have the capabilities they need to meet the qualifications. CCBHCs are nonprofit organizations or units of a local government behavioral health authority, including tribal government. They must directly provide (or contract with partner organizations to provide) nine types of services, with an emphasis on the provision of 24-hour crisis care and substance use disorder treatment, use of evidence-based practices, care coordination with local primary care and hospital partners, and integration with physical health care.

Some of the key expectations for certified community behavioral health clinics are closely aligned with the accreditation requirements of the national accrediting bodies. These include:

  • Advancing integration of behavioral and physical health care
  • Coordination of care, treatment and services through care coordination/case management
  • Delivering services based on individualized plan of care/treatment by well-trained, competent staff who match culturally/linguistically to the population(s) served
  • Providing patient-centered, trauma-informed, recovery-oriented best practices in their care, treatment and services
  • Enhancing quality to improve outcomes for individuals served
  • Collecting, reporting, and tracking data
  • Continuous quality improvement.

Because national accreditation requirements contain standards of care for addressing these same CCBHC criteria, achieving and maintaining accreditation with Accreditation Association for Ambulatory Health Care (AAAHC) CARF International (CARF), Council on Accreditation (COA), or the The Joint Commission can provide a solid foundation for a  behavioral health care clinic’s journey as a CCBHC. Through compliance with accreditation requirements, organizations will have a roadmap to follow for addressing many key CCBHC components. These areas are then assessed by surveyors/reviewers during on-site or virtual site visits, providing validation of good practices and potential feedback that can generate further enhancements.

Recognizing this solid foundation, SAMHSA encourages accreditation for a CCBHC by an appropriate, nationally recognized organization such as AAHC, CARF, COA, or The Joint Commission. SAMHSA’s intent for a CCBHC is to improve access to and quality of mental health and addiction care, treatment and services for all persons in need. This intent is reflected in the mission of each of the national accrediting bodies: AAAHC, CARF, COA, and The Joint Commission.

Accreditation Guru has experts who can provide consulting to assist organizations throughout the CCBHC accreditation/reaccreditation process. Recently, AG was proud to partner with BestSelf Behavioral Health, a CCBHC, in their achievement of accreditation through COA. BestSelf provides outpatient, integrated behavioral and physical health care using evidence-based practices. Its programs and services include education and vocational supports, mobile mental health and substance use disorder services, homeless outreach and housing, community and school-based programs, and coordination with law enforcement and medical, mental health and child protection professionals. “COA accreditation has allowed BestSelf to focus on quality and maintain best practices as well as operate our Opioid Treatment Program,” says Rebecca S. Steffen LCSW-R, Vice President of Quality Improvement & Accreditation.

We would love to discuss your clinic’s accreditation needs, click here to contact us.

  1. The National Council for Mental Wellbeing, CCBHC Success Center, 2021 Impact Report, https://www.thenationalcouncil.org/wp-content/uploads/2021/08/2021-CCBHC-Impact-Report.pdf?daf=375ateTbd56 (October, 2021)
  2. National Alliance on Mental Illness, Certified Community Behavioral Health Clinics, https://www.nami.org/Advocacy/Policy-Priorities/Improving-Health/Certified-Community-Behavioral-Health-Clinics (October, 2021)
  3. The National Council for Mental Wellbeing, CCBHC Success Center CCBHC Overview, Success Center, CCBHC Overview, https://www.thenationalcouncil.org/ccbhc-success-center/ccbhcta-overview (October, 2021)
  4. Substance Abuse and Mental Health Services Administration, Criteria for the Demonstration Program to Improve Community Mental Health Centers and to Establish Certified Community Behavioral Health Clinics https://www.samhsa.gov/sites/default/files/programs_campaigns/ccbhc-criteria.pdf (October, 2021)

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Telehealth – One Size May Not Fit All!

As the COVID-19 pandemic has evolved, technology-based service delivery – “Telehealth” (aka Teletherapy or Telemedicine) has quickly become a necessary mode of service delivery for behavioral health providers. One study reports that using telehealth for substance use disorder care has increased 1,400% during COVID. The tremendous uptick over such a short time necessitated a “learn as you deliver” approach for many providers. Now, eighteen months into the pandemic, providers are trying to transition into a new normal and evaluating whether they should offer online, in-person, or hybrid services. Lessons learned from the quick adoption of telehealth for behavioral health care indicate “one mode does not fit all”.

What will be the best mode of service delivery in the future?

In terms of patient satisfaction, it may be a mix. A Vista Research Group study indicates that patients receiving both face-to-face and telehealth treatment consistently rated their satisfaction more highly than those receiving only in-person care. “I see a tremendous variance in staff and clients’ perceptions, experiences, and value assessment of behavioral health telehealth service deliver,” says David G. Branding, PhD, CEO, JAMHI Health and Wellness, Inc.

Yet Behavioral Health Business reports that a market research study polled individuals receiving tele-behavioral health services and showed the majority – 84% – wanting to continue. Reasons for continuing virtual services include the convenience, lack of need to travel, and more comfortable surroundings at home. Carol Smith, one of Accreditation Guru’s CARF accreditation experts, says, “The organizations that I am working with report increased accessibility for their clients due to services being delivered virtually.”

But not everyone has equal access to, or comfort with, telehealth technology, per a RAND corporation study. “While the increased use of telehealth was widespread, some groups of Americans reported using the services less often than others,” said Dr. Shira H. Fischer, lead author and a physician researcher at RAND, a nonprofit research organization.  “If telehealth use is going to remain high, we need to ensure quality of access, particularly for behavioral health care where education, age, and gender were all associated with levels of use.”

Indeed, behavioral health providers are hearing mixed reactions to continuing telehealth. As Colorado Behavioral Healthcare providers transition back to in-person service delivery, they are receiving mixed feedback. “Some staff and clients want to continue with virtual services, while other staff and clients want face-to-face services,” says Doyle Forrestal, Chief Executive Officer of Colorado Behavioral Healthcare Council

As organizations adapt service delivery modes to changing environmental conditions, critical factors to consider are efficacy, client satisfaction, and accessibility. Dave Branding reminds agencies that no matter what mode(s) of service delivery are used, services must always be person-centered.

Accreditation Guru can provide knowledgeable, experienced, and efficient consulting for ay behavioral health organization on the path to (re)accreditation, regardless of your chosen service delivery.

We’d love to hear from you! Reach out to us for more information.

Sources

  1. LexisNexis Risk Solutions, 2021 Mental Health Report Validates Surge in Mental Health Telehealth Visits During pandemic, healthcaredive.com (May 20, 2021).
  2. Conti, Joanna, Why Were Patients Dissatisfied with Telehealth-Only Addiction Treatment? vista-research-group.com (July 22, 2021).
  3. Coward, Kyle, 84% of Americans Want to Continue Getting Mental Health Care Via Telehealth Post Pandemic, BHbusiness.com (July 8, 2021).
  4. Fischer, Shira H., MD, Use of Telehealth Jumped as Pandemic Shutdown Begun, Use is Highest for Mental Health Services, Rand.org (January 11, 2021).

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Joining Google, Facebook Now Requires That Addiction Treatment Centers Acquire Certification to Advertise on Its Site

Last year, Google barred advertisements from appearing in search results for addiction treatment centers in the United States. Starting last month, however, the company allowed centers with LegitScript Addiction Treatment Certification to run ads on its platform.

Now, Facebook recently announced that it will also require that addiction treatment centers achieve certification before they are approved to advertise on its properties, including Instagram and Messenger. LegitScript, a verification and monitoring service for online pharmacies, charges $995 for initial certification and $1,995 for annual vetting.

Google and Facebook’s advertising restrictions stemmed from complaints about addiction centers that targeted people suffering from addiction, offering sub-par clinical services to the highest bidder or making out-of-state recommendations solely to collect a referral fee. Other disreputable addiction treatment centers inflate staff qualifications and engage in improper billing.

Still, it is important to remember that certification represents a lower standard than accreditation. There is no need to rely on random internet searches to find reputable addiction treatment providers: just determine if a given organization is nationally accredited by an independent accrediting agency.

To earn national accreditation, an external panel of experts conducts thorough on-site scrutiny of addiction and human services organizations to ensure that they adhere to the rigorous guidelines and criteria set by the nationally recognized accrediting bodies. The initial process takes up to a year of preparation and organizations must reapply for accreditation every three or four years to maintain the designation.

National accreditation provides independent third-party validation of an organization’s quality of care. Addiction treatment centers and other human service organizations usually tout this status on their websites. Reputable treatment providers can also be found directly on the accrediting bodies’ websites, including The Joint Commission (formerly JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF) and the Council on Accreditation (COA).

LegitScript’s certification applies to “any website, application, or merchant that provides information about in-person drug or alcohol addiction treatment, or facilitates in-person or online drug or alcohol treatment, other than at a private residence or non-clinical setting.” Recovery residences that “do not provide clinical services or addiction treatment, provide or purport to provide a cooperative living environment in a non-commercial location (a private residence or similar setting), and are not part of a larger treatment program offered by an addiction treatment provider, are not eligible for certification.”

Read more about the crackdown on addiction treatment advertising online here