Arizona Drug Treatment Centers: Ten Questions You Should Ask When Considering a Treatment Center for Alcoholism and Drug Addiction

Q. Does the State Behavioral Health board, or other State agency license your treatment center?

A. States have licensing agencies that oversee behavioral health facilities. Some states (Arizona is one) do not require licenses for “halfway” houses thus there are no standards enforced or monitored by the State. The quality of a halfway house in Arizona depends upon the owner’s commitment to recovery. A license means the facility meets minimum standards to protect the client. A license says nothing about the quality of the program or staff.

Q. What are the credentials of the staff that work with the client?

A. Credentials are important. States vary in the credentialing nomenclature. Arizona uses “LISAC” (Licensed Independent Substance Abuse Counselor). This designation indicates the professional has met a standard established by the State. Not all counselors are licensed in substance abuse. Some facilities have “counselors” who are recent graduates of their program.

Other credentials are more obvious, but you should still ask about them. These include: M.D., N.M.D., PsyD., PhD., MSW, LCSW, R.N., M.Ed. and more. Be sure the staff is qualified and licensed.

Q. What are the staffing hours?

A. This question lets you know if there is 24/7 staff “on-premises” or staff “on-duty”. “On duty” means a staff is awake and present in the facility. “On-premises” means that a staff is on-site, but not necessarily on-duty (awake). Most facilities have a house manager on-site at all times, that does not mean that the house manager is awake and on-duty 24/7. Make sure there is someone is always awake and on-duty, every hour of every day.

Q. How many clinical hours does each client receive each week?

A. This varies according to the level of care. Residential 28-day facilities generally have a high level of clinical services. Extended care facilities usually have less than a residential one and a transitional facility normally have less than an extended care facility. Most halfway houses have none.

Clinical care means therapeutic care such as individual and group therapy. These services should be delivered by a licensed and credentialed professional, but that’s not always the case. At some facilities an intern with little training and who may have a year or two of sobriety delivers clinical services. Interns work under the supervision of a licensed professional, but even this may be misleading. The licensed professional who “supervises” the intern may have no direct interaction with the client.

Extended Care programs vary in the number of clinical hours offered per client per week. You need to know how many clinical hours you, or your loved one, will receive each week, and by whom. To cut costs, some facilities use interns or a senior resident, often with two years or less of sobriety, to lead group therapy.

Q. What is the client-to-staff ratio?

A. If there is not enough staff to deliver services and programs and/or to adequately supervise all clients, your quality of care may suffer. A good ratio is 1 staff for every 10 clients during normal “awake” periods. A better ratio is one staff for every eight clients.

Q. What are the monthly fees for the program and what do they include/exclude?

A. Fees vary widely for the same levels of care. Some fees cover tuition and exclude counseling, housing and transportation. Some fees are all-inclusive and include counseling, prescriptions, groceries, transportation and personal money for sundries. High fees do not necessarily equate to better care. Be sure you know what is included and what is excluded. A facility with “affordable” rates may have hidden charges. Get the facts first.

Q. Are there admission fees/deposits/etc.?

A. Most facilities have admission fees. Be sure to ask what is included and what the intake process is. For instance, does the fee include a bio/social/psych assessment? Are UA (drug testing) and BAC (blood alcohol) tests included? Are the client’s belongings searched upon entry? Are the client’s belongings inventoried?

Q. Are there refunds for admission or monthly fees?

A. As a general rule; fees are non-refundable except in the event of a no-show for admittance. Even then, some facilities offer no refunds for any reason. Once admitted, there is normally a no-refund policy to avoid “treatment shopping” wherein the client moves from one facility to another, against staff advice.

Q. Does the facility have commercial insurance? If so, what coverage do they have and what are the limits? Ask for an insurance certificate.

A. Any legitimate treatment facility has commercial coverage that includes: fire and other perils, general liability, property coverage, professional liability, medical payments, and commercial auto. Ask them for a copy of their insurance certificate.

Q. Is insurance accepted as payment, or is it private pay?

A. Sometimes a private pay program is less expensive as fees are paid in which helps cash flow. Companies who accept insurance for payment may wait weeks or months for payment from the insurance provider, which may negatively impact cash flow.

There is another reason why some facilities do not accept insurance for payment: To avoid managed care traps. Many insurance companies dictate the level of care and length of stay. Treatment providers who are private pay are free to design a program that is relevant to the client’s needs rather than adhering to a managed care standard. The client may be better off paying up front and then submitting a statement to their insurance company for reimbursement. Most services are eligible for reimbursement. Check with your insurance provider first.

Summary You are about to make one of the most important decisions of your life, or the life of someone you love. Make sure your questions are answered completely. There are more questions one should ask, so, if you can, take a tour of the facility and meet the staff and clinicians. Do not be fooled by a “cool” website or expensive brochures. Like any business, management and staff change over time, so a facility that had an excellent reputation two years ago may not have one today. Take your time and do your homework before you write a check.

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