Tag Archives: Ethics

Tag Archives: Ethics


Marvin Ventrell - NAATP Executive Director - National Association of  Addiction Treatment Providers
Marvin Ventrell
Executive Director
National Association of Addiction Treatment Providers

23 Million Americans suffer from addiction. An estimated 10% get the specialized care they need. Compare this to diabetes where an estimated 87% receive specialized care. Addiction is a disease and addiction treatment is a health care service. It is plain to see we have a serious health care gap between addiction treatment and need, and the need is great.

Unlike most healthcare, government funding is the primary source of payment for addiction care and that funding is woefully inadequate. Private insurance doesn’t adequately close the gap. It pays about 40% of medical care generally but only about 10% of addiction care. While parity law and addiction as an essential healthcare benefit have the potential to close that gap, we are not there yet.

Accessing appropriate treatment, therefore, is a considerable challenge. We who work in the field know what appropriate treatment, for the appropriate level of care, looks like, and where to find it. However, identifying treatment that is both high quality and attainable is a serious problem for both the typical consumer and even the payer.

good healthcare is never easy but for most conditions, consumers follow a sensible path. We seek the advice of trusted professionals who work in the field. We inquire with those who have experienced the condition. We ask our primary healthcare provider for a referral. We contact our insurer to find out what services are covered.

Consumers searching for addiction care frequently do not follow this path and are prone to falling into a web of marketing deception. Rather than focusing on appropriate health care criteria, the consumer can be lured toward flashy amenities, false promises, and economic bargains. These are not sensible healthcare selection criteria. It is alarming to think that a lifesaving healthcare selection would be influenced by luxury accommodations and whether the facility has a pool or is near the beach.

NAATP - National Association of  Addiction Treatment Providers

Addiction treatment is confusing and misunderstood to the consumer. We even have a confusing name for it: rehab. (The term rehab is both inaccurate and minimizes the gravity of the disease. It is time we stopped using it.) Further, the consumer or the consumer’s loved ones are typically operating in crisis and are vulnerable to deception.

So, the consumer turns to the internet. The landscape for finding treatment is dominated by the internet, which is dominated by Google, which is itself a function of marketing and the aggregation of consumer identity and behavior. The system is not built to help the consumer find the best care. It is built to help the advertiser direct the consumer.

The internet is frequently the source of manipulation and deception conducted by a minority of treatment providers and treatment brokers. Google AdWords can be dominated by unscrupulous marketers. Numerous other predatory web practices are designed to deceive the consumer. The AdWords game became so dangerous to the consumer that Google agreed to suspend that source of considerable income for the time being. NAATP is currently working with Google to develop a plan to reintroduce AdWords, accompanied by certain safeguards against deceptive practices.

Online treatment directories to the rescue! Not so fast. Such private directories can be of limited value to the consumer and can be misleading. They may be merely disguised advertising tools for one or more treatment centers or treatment brokers. Despite listing many other programs, frequently without permission, and presenting as independent resources, they still direct the consumer to call a specific 800 number where “caring professionals” are available. These directories are not, as some have suggested, analogous to the phonebook yellow pages, nor are they the Yelp of treatment. The buying and selling of patient leads can also be facilitated by online directories (remember, this is an identity aggregation system), a practice prohibited by the NAATP Code of Ethics. Additionally, the consumer must beware of so called treatment program rankings. Such rankings are not a recognized practice in the field.

The consumer may also find itself visiting a website that purports to be a treatment educational resource but is, itself, designed to aggregate identities and market certain treatment programs to them. Some such sites can be operated by a single program while not clearly branded with the program’s identity.

The government, through the Substance Abuse and Mental Health Services Administration (SAMHSA), has produced an online repository of mental health and addiction services. It is a large repository that contains approximately 13,000 addiction treatment service entities. It is an important and useful repository of information, particularly for professionals working in the field, researchers, and policy-makers. In its depth and selection criteria, it may not be the most useful tool for the consumer to narrow and select care.

Good consumerism requires discernment based on objective criteria. To aid the consumer and payer in this process, NAATP has produced a guide to treatment program selection. We encourage the consumer and the professional to read and use this guide in the process of selecting addiction treatment. We further encourage treatment providers themselves to review this guide and ask themselves whether they meet the conditions set forth.

Continue Reading NAATP Executive Director’s Article on Treatment Program Discernment

Read the NAATP Guide to Choosing Treatment

Access the NAATP Addiction Industry Directory


Read about Cumberland Heights’ Code of Ethics and learn about 12 Questions to Ask Before You Choose an Addiction Treatment Program written by Cumberland Heights CEO Jay Crosson.

Ethics, Best Practices and Effective Strategies Training by AMSymposium for Executives, Admissions and Marketing professionals.

WHEN:    April 18 – 19 from 8:00 a.m. – 5:30 p.m. each day
WHERE: Cumberland Heights River Road Campus – in the FLC Auditorium
COST:     $399 (includes admission both days, 12 CE’s, breakfast and lunch both days)

REGISTER HERE

NASHVILLE PRESENTERS

BECK GEE-COHEN
BECK GEE-COHEN
CANDACE BRUCE
CANDACE BRUCE
DEREK DALEY
DEREK DALEY
ELIZABETH IRIAS
ELIZABETH IRIAS
GREG ROSENBAUM
GREG ROSENBAUM
HOLLY DANIELS
HOLLY DANIELS
ILANA ZIVKOVICH
ILANA ZIVKOVICH
KELLY FARRELL
KELLY FARRELL
MARK OERTHER
MARK OERTHER
ROBBIN MOONEY
ROBBIN MOONEY
RUTHANN RIGBY
RUTHANN RIGBY

Medication-Assisted Treatment (MAT)

The addiction industry is changing at a rapid rate, especially with the national opioid crisis. For the second year in a row the centers for disease control lowered the average life expectancy for U.S. citizens, due in large part to the number of overdose deaths from opioids. Here are trending topics to be aware of in addiction treatment.

Medication-Assisted Treatment (MAT)

MAT is the use of FDA- approved medications to provide treatment of substance use disorders in combination with counseling and behavioral therapies. Two commonly used medications are buprenorphine and naltrexone. As an abstinence based recovery center, Cumberland Heights prefers the use of naltrexone for a set period of time – usually a year – and then to transition patients off.

Ethics in the Treatment Industry

Ethics in the Treatment Industry

Due to the national opioid crisis the treatment industry has become a lucrative market for many private investors. So much so practices surrounding the recruitment of patients online have become more than suspect. To combat this Google recently stopped showing all AdWords for search terms like “drug addiction” and “alcohol treatment.”

Cumberland Heights CEO Jay Crosson sits on the ethics committee formed by the National Association of Addiction Treatment Providers (NAATP) to draft ethics requirements for treatment providers. NAATP hopes the new ethics guidelines will help patients and their families make better decisions when assessing and choosing a treatment provider.

The Cumberland Heights board of directors recently adopted a Code of Ethics. You can read about our deep commitment to the ethical implementation of addiction treatment and the principles we follow below.

At Cumberland Heights we are members of the National Association of Addiction Treatment Providers, accredited by the Joint Commission and licensed by the Tennessee Department of Mental Health and Substance Abuse Services.

 

As a promise to the people we serve, Cumberland Heights implements the following ethical practices:

  1. Our marketing efforts are based on awareness and engagement. We believe education is more valuable than fear. We use original content and never participate in predatory web practices. Our alumni have become our number one referral source because we provide quality care to our patients and continually cultivate relationships with them.
  2. In an effort to provide the best care possible, our goal is to thoroughly assess patients and their families as soon as possible. We employ exclusionary criteria to ensure our treatment program will meet the needs of entering patients. If a need is outside our scope of clinical excellence, we will help patients be placed in a reputable program suitable for their situation. We do not purchase or sell patient referrals.
  3. Relationships matter. We believe the entire family benefits from participation in the recovery process. There is no cost to our family program. We encourage all family members to get the education and support they need to begin recovery from addiction.
  4. We are transparent with our financial arrangements. We do not employ hidden fees. Our pricing is posted on our website. Our financial advisors are available to discuss out of pocket costs and estimates based on length of stay. Our financial forms are explicit. We refund any overpayments back to those who paid them and do not assess any admission or non-refundable deposits. You get what you pay for.
  5. Fiscal responsibility. To our donors we pledge to be good stewards with their gifts, applying them to their intended purposes. As a nonprofit, we are audited annually by outside certified public accountants and are subject to rigorous board oversight.
  6. Safe and loving environment. We strive to provide a quiet serene environment for recovery to take root. Our food is excellent and the various campuses are clean and well maintained. We treat patients and families with dignity and respect.
  7. The ultimate act of trust is when a clinician or referent asks us to provide care for their client. We will endeavor to collaborate with them to provide what is in the patient’s best interest throughout the continuum of treatment.
  8. We seek to hire the best people who are committed to our mission of recovery. Our clinicians also adhere to professional codes of ethics. We are not perfect. We try to take care of each other in order to provide better care for the people we serve, but if patients or their families have concerns we employ a Quality Management team built to monitor and improve our services. They may be contacted by calling (615) 352-1757 or emailing qm@cumberlandheights.org.
  9. We are committed to providing lifetime recovery opportunities to patients who complete our program. Patients are invited to a peer support aftercare group. We offer fellowship opportunities through our alumni services office. We have hundreds come back home to our annual staff and alumni picnic as well as monthly alumni activities.
  10. We are committed to abstinence based recovery. Recovery Care Advocates meet with patients during treatment and follow-up with them during the first year after discharge to guide their journey of recovery.

Again, we are committed to creating an environment where the people we serve can depend on us for the best treatment possible. Because we hope to strengthen our industry’s standard for treatment, Cumberland Heights has also adopted the National Association of Addiction Treatment Providers Code of Ethics.

Ethical Decision Making: Understanding and Coping with Dilemmas

WHO: April Mallory, LCSW, MAC and Sheri Lozier-Bentley, LCSW
WHAT: Ethical Decision Making: Understanding and Coping with Dilemmas
WHERE: Cumberland Heights (River Road Campus) in the FLC Auditorium
WHEN: 1:00PM – 4:00PM

Objectives:

Upon completion of this session, participants will be able to:

  1. Understand ethical codes across disciplines – history, evolution, relevance, and importance to practice
  2. Recognize ethical challenges in practice
  3. Identify, critically analyze, and utilize resources to assist in ethical decision making

Ethical Decision Making: Understanding and Coping with Dilemmas

Google Curtails Addiction-Related Advertising – And Cumberland Heights believes it's a Good ThingGoogle recently sent a shock wave through the addiction industry when it eliminated advertising for many addiction-related search terms it determined were ripe for fraud.

I join many in our industry in applauding this decision. Here is the statement by the National Association of Addiction Treatment Professionals (NAATP).

I’ve been involved in a number of quality initiatives with NAATP and other industry associations the last few years. One of our priorities has been the rise of disreputable and even fraudulent marketing that is preying on vulnerable people and their families.

The most egregious violators are third-party companies who collect leads online and sell them to treatment centers. They do not have treatment facilities and have no vested interest in the treatment outcome. They are not members of the national organizations like NAATP, accredited by the Joint Commission or licensed by state bodies.

They only care about finding potential patients who have insurance so they can sell them for the highest amount to the highest bidders.

These companies have mastered online marketing, including Google AdWords and SEO, and, in many markets, have taken market share from reputable treatment centers.

I believe Google’s action will have a profound effect on these companies.

This may sound like a strong statement, but no reputable treatment center should ever purchase leads from third-party aggregators. Human beings suffering from the disease of addiction have complex problems and deserve more than being a line on a spreadsheet.

I’d be remiss if I didn’t mention that Cumberland Heights also uses AdWords to find potential patients. It’s necessary in today’s market where lots of private investment is rushing to cash in on the $35 billion addiction industry.

At the same time, we want to make sure we use AdWords the right way. I’m proud of our leadership for recently adopting a Code of Ethics, the first line of which reads:

Our marketing efforts are based on awareness and engagement. We believe education is more valuable than fear. We use original content and never participate in predatory web practices. Our alumni have become our number one referral source because we provide quality care to our patients and continually cultivate relationships with them.

Since our founding in 1966, Cumberland Heights has been a place of hope and healing. Our Code of Ethics and marketing will always reflect these principles, the way our founders would have wanted.


Jay Crosson, CEO of Cumberland Heights

Jay Crosson is the CEO at Cumberland Heights, a nonprofit alcohol and drug-addiction treatment center in Nashville, Tennessee. Cumberland Heights was established more than 50 years ago and Crosson’s experience there has spanned half that time.

Jay is a member of the board for the National Association of Addiction Treatment Providers (NAATP), and is chair of the ethics committee.

Jay is a grateful recovering alumnus of Cumberland Heights. His personal experience of treatment at Cumberland Heights and the transformative power of the 12 Steps shape his leadership principles today.

Original Article By: MICHAEL CORKERY, NY Times
Date: SEPT. 15, 2017

As drug addiction soars in the United States, a booming business of rehab centers has sprung up to treat the problem. And when drug addicts and their families search for help, they often turn to Google.

Google Sets Limits on Addiction Treatment Ads, Citing Safety

But prosecutors and health advocates have warned that many online searches are leading addicts to click on ads for rehab centers that are unfit to help them or, in some cases, endangering their lives.

This week, Google acknowledged the problem — and started restricting ads that come up when someone searches for addiction treatment on its site. “We found a number of misleading experiences among rehabilitation treatment centers that led to our decision,” Google spokeswoman Elisa Greene said in a statement on Thursday.

Google has taken similar steps to restrict advertisements only a few times before. Last year it limited ads for payday lenders, and in the past it created a verification system for locksmiths to prevent fraud.

In this case, the restrictions will limit a popular marketing tool in the $35 billion addiction treatment business, affecting thousands of small-time operators.

Google Sets Limits on Addiction Treatment Ads, Citing Safety

“This is a bold move by one of the world’s biggest companies, saying people’s lives are more important than profit,” said Greg Williams, co-founder of Facing Addiction, a nonprofit group that is an advocate for people struggling with addiction.

Many rehab centers, a large number of which are clustered in warm climates like Florida, Arizona and California, rely on Google searches to attract patients from across the country. Their strategy often included buying an ad that would come up when someone searched for phrases like “drug rehab” or “alcohol treatment centers.”

Google Sets Limits on Addiction Treatment Ads

As of this week, Google has stopped selling ads related to those searches, although it may lift the restriction if it can find a way to weed out misleading advertisements.

Search ads for addiction treatment are lucrative. Treatment providers, in some cases, have been willing to pay $70 per ad click, according to an analysis that Mr. Williams’ group conducted and presented to Google executives.

But the payoff for those clicks can be significant. Addicts who sign up for 30 days of residential treatment can bring in tens of thousands of dollars from private insurance.

The crucial, if unwitting, role that Google has played in the treatment industry exposes the deep flaws in how drug addicts are cared for in America. Despite the rapid growth in the number of addiction cases — and the Trump Administration’s declaration that the opioid crisis is a national emergency — the treatment industry remains a hodgepodge of upstart businesses, with only a few well-known providers.

What constitutes treatment is also all over the map, from yoga and equine therapy to daily doses of medication. And unlike other serious illnesses, like cancer or heart disease, where a physician typically refers the patient for treatment, many addicts and their families look for help on the internet.

That has made Google one of the largest referral sources for treating a disease that affects millions of Americans. And the companies willing to the pay the most for ads are the one that addicts are most likely to see on their search.

But ad-driven searches, according to advocates and law enforcement officials, have not always led patients to the best care. In some cases, they have found that patients are being duped, a phenomenon Google on Thursday acknowledged.

Last December, a Florida grand jury released a report detailing abuses in the state’s addiction treatment industry, which is centered around Palm Beach County. Among the findings, the grand jury zeroed on the problems with how some of the shoddy programs were being marketed online.

One witness, according to the grand jury report, described how “online marketers use Google search terms to essentially hijack the good name and reputation of notable treatment providers only to route the caller to the highest bidder.”

Another common trap: Addicts search Google for a rehab program close to their home, but they will click on an ad for a referral service pitching treatment in another state. The referral service then collects a fee, if they signed up.

Google’s restrictions were cheered by health officials, who have called for more medically based treatment. “People don’t always know what good treatment is,” said Dr. Vivek Murthy, who was surgeon general in the Obama Administration and published a oft-cited report last year that warned of the nation’s addiction crisis. “I am glad Google took steps to prevent the spread of these false ads.”

In targeting the ads for addiction treatment, Google consulted with experts including Mr. Williams, who himself has been in recovery for many years. He said he began discussions with Google executives around the time that Dr. Murthy released his report.

Mr. Williams said that he had explained to Google that his own experience trying to buy ads from the company had illustrated how the process of finding information about addiction treatment online was providing people with unreliable information. Mr. Williams said he discovered this when his group received a grant from Google that would help him buy ads promoting a website providing information about community based treatment — and found he couldn’t compete.

Buying ads on Google involves bidding to place your ad at the top of the search results when a user types in words relevant to your product or service. But Mr. Williams found that the bid prices for words related to treatment had gotten so expensive that his group couldn’t pay as much as the for-profit treatment providers. Some of those treatment providers, Mr. Williams told Google, were not only misleading, they had been charged with crimes.

In a series of phone calls and a meeting in Washington, D.C., Mr. Williams presented the company his research. He highlighted that some of the biggest buyers of ad words related to treatment had been accused of misdeeds related to insurance fraud and sexual assault.

“We stumbled upon this issue organically,” said Mr. Williams. “And they heard us out.”


A version of this article appears in print on September 15, 2017, on Page B5 of the New York edition with the headline: In Rare Move, Google Imposes New Limits on Addiction Treatment Ads, Citing Safety.

When I was discharged from Cumberland Heights I knew one thing for certain…treatment may have been complete, but recovery was just beginning. Today, there are many ways I’m active in my recovery and one of the most rewarding is what I’m able to do for others. Service work is an integral part of what keeps me sober one day at a time. Each simple act keeps me out of my own head long enough to focus on another individual or group’s recovery. I’m not seeking recognition, only trying to make someone else’s journey in sobriety a little easier. And while focusing on someone else, something magical happens…people begin to recover together.

With this in mind, here are 10 ways to be of service to others in recovery:

1) Sponsorship – Becoming a sponsor is the ultimate way one person suffering from addiction can help another. A sponsor gives his or her time; meeting sponsees to help them work the steps, to ferret out the root causes of his or her addiction, and develop a deeper relationship with a Higher Power of their understanding.

2) Be a sober contact – Newly recovering people are always encouraged to get as many phone numbers as they can so they’ll have plenty of people to call when they’re triggered to use or drink. Being the person on the other end of the call can save a life.

3) Take meetings to detox units – I’ll never forget the first message of recovery, strength and hope I heard was in a detox unit at a local hospital. Providing this vital area of service work, you can inspire hope in someone about a program with the potential to change their life for the better.

4) Chair 12-Step meetings – A certain amount of responsibility comes along with steering the ship at a 12-Step meeting. The chair passes out the readings, and often, chooses the topic of discussion. This role serves every person attending.

5) Attend business meetings – Each home group has a meeting set aside to discuss financial details: bills for rent, items needed for purchase such as soft drinks; and the collections to pay for expenses. This is a good way to serve the home group.

6) Greet people – Making someone feel welcome in a 12-Step meeting is a wonderful way to give back. Shaking hands, taking an interest in a newcomer, offering a smile or a friendly hello can be the one thing someone needed to hear to come back to another meeting.

7) Clean up – Each month my home group assigns someone to clean up our meeting place. Wiping off tables, sweeping floors and cleaning up the facility to keep it nice for our meetings is one way to get out of ourselves and help others.

8) Offer transportation to meetings – In recovery finding our way to meetings is our responsibility. However, some provide rides as service work. I was blessed enough to have someone who helped me get to meetings when I couldn’t drive.

9) Participate in fundraising – A clubhouse where I got sober recently held a yard sale. Providing clothing, tagging items or volunteering time at an event like this are all ways to provide service work.

10) Host sober activities – A common complaint among someone new in recovery is that they don’t know how to have fun without substances. Hosting an event for sober people to have a bonfire, barbecue, movie night, canoe or camping trip; or just a gathering to walk together downtown is more helpful than you might realize.


10 Ways to be of Service to Others in RecoveryKatrina Cornwell is a case manager at Cumberland Heights, a motivational speaker, blogger and three-time, first-place award winner in the annual Tennessee Press Association contest.

In her presentations, she speaks about her addiction to drugs and alcohol and how those habits led to a drunk driving accident which killed a man in October 2009.

12 Questions to Ask Before You Choose an Addiction Treatment Program The initial fear and devastation a family experiences when a loved one is diagnosed with a life-threatening or chronic disease can be overwhelming and confusing. Many people will turn to their family physician for treatment recommendations and information about the disease. Families will also consult relatives, friends, clergy or survivors for support or to find out where they received effective treatment. But this isn’t common with addiction. The stigma surrounding the disease of addiction is so prevalent families often turn to the anonymity of the internet to seek help for their loved one sometimes leading them into unsavory treatment schemes.

These searches and schemes are contributing to growing unethical practices in addiction treatment where corrupt treatment providers are preying on unsuspecting and uneducated families in crisis. This recent news story aired on Sunday Night with Megyn Kelly on NBC illustrates more accurately the current environment:

However, these issues don’t begin and end in one Florida town. With the click of a button these unethical practices reach into the living rooms of any family suffering from addiction. Searches on the internet for common terms like “rehab” and “addiction” are filled with treatment directories listing dozens of facilities in your region. These directories sell themselves as placement specialists with their 800 number prominently displayed all over the “unbiased” website. These directories often use reputable treatment centers’ names and images without permission. When the number is called someone posing as the reputable center’s staff, after little discovery, will quickly refer the caller to an alternative facility. What families don’t know is the referred facility is paying hundreds to thousands of dollars for that call. This is another form of patient brokering.

It’s difficult for families to make informed health care decisions while their loved one is being persuaded away from effective treatment programs into fraudulent ones. So how do families educate themselves against unethical practices? The best first step is to consult a trusted family physician, therapists, clinicians, the local recovery community and clergy for treatment recommendations. When you discover a program you’re interested in visit their website and call their direct number. Do NOT rely on a call center. And finally, educate yourself on what to look for in a trustworthy recovery program.

The following questions may be helpful when seeking a reputable recovery program:

  1. How long has the program been in operation? Providers in operation over 10 years typically aren’t seeking quick profits.
  2. Is the program licensed by the state?
  3. Is the program accredited by the Joint Commission, an independent, nonprofit which certifies health care organizations and programs in the United States, or the Commission on Accreditation of Rehabilitation Facilities (CARF), an international nonprofit accreditor of health and human services?
  4. Is the program a part of the national trade organization for addiction treatment? Are they contributing to the community, including taking the NAATP ethics pledge which has been in place for five years?
  5. Is the program In Network or Out of Network? For-profit or Nonprofit? While not all Out of Network or For-profit providers are bad it’s nearly impossible to be dishonest from a billing standpoint if you’re In Network with insurance payers.
  6. How frequently does the program perform lab testing like urine drug screens? Does the program have financial ownership or receive incentives from the lab company?
  7. Does the program have a family component or family participation? Is there an extra charge for this service?
  8. What levels of care does the program provide?
  9. Does the program have placement criteria? Do they refer patients to alternative facilities when they don’t fall into their area of expertise? What are those criteria?
  10. Does the program offer airline tickets, free rent or other inducements? Offers of free rent or other benefits may be evidence of illegal patient brokering or in some states fraudulent inducement.
  11. Does the program have a strong alumni base? Do they offer alumni services such as Aftercare?
  12. If seeking a sober home, are referral fees paid to the sober home from a treatment center if residents enroll at that center? If so, it suggests the presence of an illegal kickback scheme.

It is absolutely possible to recover life from addiction. I’m living proof. That’s why the information gathered while seeking treatment is the most important research done for the benefit of someone struggling with addiction. We see the miracle of recovery every day at Cumberland Heights, but it’s important to keep your eyes open and make certain you’re well informed when making decisions which will set the trajectory for your loved one’s life from this point forward.

Follow this link for more coverage and additional resources to assist in your addiction treatment research.


Jay Crosson, CEO of Cumberland Heights

Jay Crosson is the CEO at Cumberland Heights, a nonprofit alcohol and drug-addiction treatment center in Nashville, Tennessee. Cumberland Heights was established more than 50 years ago and Crosson’s experience there has spanned half that time.

Jay is a member of the board for the National Association of Addiction Treatment Providers (NAATP), and is chair of the ethics committee.

Jay is a grateful recovering alumnus of Cumberland Heights. His personal experience of treatment at Cumberland Heights and the transformative power of the 12 Steps shape his leadership principles today.


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