Chapter 4

Facility Characteristics and Services

This chapter describes key characteristics of facilities and programs in 2004. Facilities are described in terms of operation, that is, the type of entity responsible for the operation of the facility: private non-profit; private for-profit; or government—local, county, or community; State; Federal; or tribal. They are also described in terms of the facility’s primary focus: substance abuse treatment services, mental health services, a mix of mental health and substance abuse treatment services, general health care, and other.

Facility Operation and Primary Focus

Table 4.1. Overall, 62 percent of facilities reported that providing substance abuse treatment services was their primary focus of activity. Slightly more than one-quarter (26 percent) of all facilities considered a mix of mental health and substance abuse treatment services to be their primary focus. Eight percent of all facilities reported the provision of mental health services as their primary focus, while 2 percent had a primary focus of general health care.

Private organizations were more likely to regard provision of substance abuse treatment services as their primary focus (64 percent of non-profit organizations and 63 percent of for-profit organizations) than government-operated facilities (51 percent to 59 percent). Tribal, local, and State government-operated facilities were more likely to have a primary focus of a mix of mental health and substance abuse treatment services (between 30 percent and 38 percent) than private for-profit facilities (28 percent), private non-profit facilities (25 percent), or Federal government-operated facilities (21 percent). The Federal government had the largest proportion of facilities (19 percent) that reported a general health care focus. The large number of facilities operated by the Department of Veterans Affairs (VA) greatly influenced this—among facilities operated by the VA, most of which were hospital-based,1 30 percent reported a focus on general health care.

Type of Care Offered

Tables 4.2a and 4.2b. Outpatient treatment was the most widely available type of care, offered by 81 percent of all facilities. Outpatient treatment was most likely to be available in facilities operated by the Federal government (97 percent), private for-profit organizations (92 percent), and facilities operated by tribal governments (94 percent). Outpatient services were most likely to be available in facilities providing a mix of mental heath and substance treatment services, at 91 percent.

Regular and intensive outpatient care were offered by 72 percent and 42 percent of all facilities, respectively. Fourteen percent of all facilities provided outpatient day treatment or partial hospitalization programs.

Outpatient detoxification was offered at 10 percent of facilities. Outpatient detoxification was most likely to be offered by facilities operated by the Federal government (34 percent), largely because 43 percent of VA-operated facilities provided outpatient detoxification. Outpatient detoxification was also relatively widely available in private for-profit organizations (16 percent) and facilities operated by tribal governments (15 percent).

Outpatient methadone maintenance was offered at 7 percent of facilities. Outpatient methadone maintenance was most likely to be offered by facilities operated by private for-profit organizations (13 percent). Outpatient methadone maintenance was also relatively widely available in facilities operated by the Federal government (10 percent), largely because 17 percent of VA-operated facilities provided outpatient methadone maintenance.

Non-hospital residential treatment was offered by 27 percent of all facilities. Non-hospital residential treatment was most likely to be available in facilities operated by private non-profit organizations (35 percent), and in facilities focusing on the provision of substance abuse treatment services (35 percent).

Non-hospital residential long-term treatment (more than 30 days) was offered by 22 percent of all facilities. Eleven percent offered non-hospital residential short-term care (30 days or less), and 7 percent offered non-hospital residential detoxification.

Hospital inpatient treatment was offered by 8 percent of facilities. Hospital inpatient treatment was most likely to be available in facilities operated by Federal and State governments (27 percent and 13 percent, respectively). Hospital inpatient treatment was available at 46 percent of facilities with a general health care focus, and at 17 percent of facilities focused on the provision of mental health services.

Hospital inpatient detoxification was offered by 6 percent of all facilities, and hospital inpatient treatment by 5 percent of all facilities.

Client Substance Abuse Problem Treated

Table 4.3. Almost all facilities (94 percent) had clients in treatment for both alcohol and drug abuse on March 31, 2004. More than 80 percent each had clients in treatment for abuse of drugs alone (82 percent) and for abuse of alcohol alone (81 percent). These proportions were relatively constant across facility operation categories and by the primary focus of the facility. Clients with alcohol abuse alone were treated in 96 percent of Federal government-operated facilities, and in 93 percent of facilities with a general health care focus.

Facility Size

Table 4.4. The median number of clients in substance abuse treatment at a facility on March 31, 2004, was 40. Facility size varied by type of care offered. In facilities offering outpatient care, the median number of clients was 46. However, this represented a range by type of outpatient care, from a median of 2 clients in outpatient detoxification to 30 clients in regular outpatient care and 210 clients receiving outpatient methadone maintenance. In facilities offering non-hospital residential care, the median number of clients in treatment on March 31, 2004, was 19. In hospital inpatient facilities, the median number of clients was 8.

Government-operated facilities were generally larger than private for-profit or private non-profit facilities. Facilities operated by the Federal government had a median of 60 clients in treatment on March 31, 2004. This was due to the large number of clients in treatment at VA facilities, which had a median of 99 clients in treatment on that date.

The median number of clients also varied according to primary focus of the facility. In facilities with a primary focus on the provision of substance abuse treatment services, the median number of clients in treatment was 45. In contrast, facilities focused on the provision of mental health services had a median of 22 clients in treatment.

Table 4.5. Facilities with a primary focus on the provision of substance abuse treatment services tended to be larger than other facilities. Some 23 percent of these facilities had 120 or more clients in treatment on March 31, 2004. In contrast, only 7 percent of facilities focused on the provision of mental health services were that large, and 38 percent had fewer than 15 clients in treatment on that date. Facilities with a general health care focus also tended to be smaller, with 33 percent having fewer than 15 clients in treatment on March 31, 2004.

Facility Capacity and Utilization Rates

Facilities were asked to report non-hospital residential and hospital inpatient beds designated for substance abuse treatment. Utilization rates were calculated by dividing the number of non-hospital residential or hospital inpatient clients by the number of non-hospital residential or hospital inpatient designated beds. Because substance abuse treatment clients may also occupy non-designated beds, utilization rates may be more than 100 percent.

Table 4.6. Some 3,346 facilities reported having 104,860 non-hospital residential beds designated for substance abuse treatment. On March 31, 2004, 92 percent of all non-hospital residential beds designated for substance abuse treatment were in use.2 Utilization rates ranged from 79 percent in non-hospital residential facilities operated by tribal governments to 111 percent in non-hospital residential facilities operated by the Federal government. Facilities focused on the provision of a mix of substance treatment and mental health services had a utilization rate of 99 percent.

Table 4.7. Some 832 facilities reported having 13,138 hospital inpatient beds designated for substance abuse treatment. On March 31, 2004, 91 percent of all hospital inpatient beds designated for substance abuse treatment were in use.3 Utilization rates ranged from 77 percent in hospital inpatient facilities operated by local governments to 105 percent in hospital inpatient facilities operated by State governments. Facilities focused on general health care and on the provision of mental health services had utilization rates of 99 percent and 98 percent, respectively.

Figure 9 and Tables 4.6 and 4.7 show the distribution of the facility-level utilization rates separately for non-hospital residential and hospital inpatient beds. Facilities with non-hospital residential beds had generally higher utilization rates than facilities with hospital inpatient beds. Fifty percent of facilities with non-hospital residential beds had utilization rates of 91 to 100 percent. Only 29 percent of facilities with hospital inpatient beds had utilization rates in that range, and 20 percent had utilization rates of 50 percent or less. About 14 percent of hospital inpatient facilities and 9 percent of non-hospital residential facilities had utilization rates over 100 percent.
 

Figure 9
Non-Hospital Residential and Hospital Inpatient Utilization Rates:
March 31, 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS), 2004.

Programs or Groups for Specific Client Types

Facilities may offer treatment programs or groups designed to address the specific needs of specific client types. These client types include adolescents, clients with co-occurring mental health and substance abuse disorders, persons with HIV or AIDS, gays or lesbians, and pregnant or postpartum women. Special programs or groups may also be offered for adult women, for adult men, and for seniors or older adults. Many facilities offer treatment for persons arrested while driving under the influence of alcohol or drugs (DUI) or driving while intoxicated (DWI), as well as for other criminal justice clients.

In response to concerns about over-reporting of special programs or groups, the survey question was revised in 2003 to distinguish between those facilities that accepted specific client types and those facilities that had specially designed programs or groups for each client type. Although the number and proportion of facilities offering programs or groups for each of the specified client types decreased in 2003 in comparison with previous years, the numbers from the 2003 and 2004 surveys are believed to be a more accurate representation of the number of facilities providing special programs for the specific client types.

Tables 4.8a and 4.8b. These tables indicate the proportions of facilities that accept each client type into treatment. Most facilities accepted most client types. Acceptance ranged from 81 percent accepting pregnant or postpartum women to 95 percent accepting gays or lesbians and persons with HIV or AIDS. Adolescents were the exception—they were accepted as clients in only 50 percent of facilities.

Tables 4.9a and 4.9b. These tables indicate the proportions of facilities that offered specially designed substance abuse treatment programs or groups exclusively for specific client types. Overall, 82 percent of facilities offered special programs or groups directed at a specific client type. This proportion was fairly consistent across operating organizations, with the exception of the Federal government, where less than two-thirds (65 percent) of facilities had programs or groups designed for specific client types. Facilities focused on general health care also had a relatively low availability of such programs (65 percent), as did facilities focused on the provision of mental health services (72 percent).

Adolescents

Thirty-one percent of facilities offered programs or groups for adolescents. The highest proportions of adolescent programs were found in facilities operated by tribal governments (56 percent) or local governments (36 percent). Programs or groups for adolescents were available in 42 percent of facilities whose focus was the provision of a mix of mental health and substance abuse treatment services.

Clients with co-occurring disorders

Overall, 35 percent of all facilities provided programs or groups for clients with co-occurring mental health and substance abuse disorders. These services were most likely to be provided in government-operated facilities. They were offered in 50 percent of State-operated facilities, 44 percent of local government-operated facilities, and 41 percent of Federally-operated facilities.

Facilities whose focus was the provision of a mix of mental health and substance abuse treatment services or of mental health services alone were most likely to offer programs or groups for clients with co-occurring disorders, at 51 percent and 47 percent, respectively.

Criminal justice clients

Twenty-seven percent of all facilities provided programs or groups for criminal justice clients other than DUI/DWI offenders. (Facilities treating incarcerated persons only were excluded from this report; see Chapter 1.) These services were most likely to be provided in facilities operated by local governments (31 percent).

Persons with HIV or AIDS

Eleven percent of facilities offered programs or groups for persons with HIV or AIDS. Facilities operated by State governments were most likely to offer such programs (15 percent). Among facilities focused on provision of general health care, 15 percent offered programs or groups for persons with HIV or AIDS, as did 12 percent of facilities focused on providing substance abuse treatment services.

Gays or lesbians

Special programs or groups for gays or lesbians were available in 5 percent of all facilities. They were most likely to be offered in facilities operated by tribal governments (8 percent) and in private for-profit facilities (7 percent). Seven percent of facilities whose primary focus was provision of a mix of mental health and substance abuse treatment services had programs for gays and lesbians.

Seniors or older adults

Seven percent of all facilities provided programs or groups for seniors or older adults. Facilities most likely to have this type of program were tribal and Federal government-operated facilities and private for-profit facilities (15 percent, 10 percent, and 8 percent, respectively). Nine percent of facilities focused on provision of a mix of mental health and substance abuse treatment services had programs or groups for seniors or older adults, as did 8 percent each of facilities whose focus was general health care or mental health services.

Adult women

Special programs or groups for adult women were offered in 30 percent of all facilities. These were most likely to be available in tribal, local, and State government-operated facilities (38 percent, 37 percent, and 36 percent, respectively). Similarly, 34 percent of facilities focused on provision of substance abuse treatment services had programs or groups for adult women.

Pregnant or postpartum women

Programs or groups for pregnant or postpartum women were offered by 14 percent of all facilities. These programs were most likely to be available in local, State, or tribal government-operated facilities (21 percent, 18 percent, and 18 percent, respectively). Among facilities focused on the provision of substance abuse treatment services, 17 percent offered programs or groups for pregnant or postpartum women.

Adult men

Special programs or groups for adult men were available in 23 percent of all facilities. Tribal government facilities were the most likely to have programs or groups for adult men (28 percent). Similarly, about one-quarter (27 percent) of facilities focused on provision of substance abuse treatment services had programs or groups for adult men.

DUI/DWI offenders

Special programs or groups for DUI/DWI offenders were offered by 31 percent of all facilities. Almost half (46 percent) of private for-profit facilities had such programs, as did 41 percent of tribal government-operated facilities. Programs or groups for DUI/DWI offenders were most likely to be offered by facilities providing a mix of mental health and substance abuse treatment services (39 percent).

Services Offered

Facilities were asked about the types of services they offered. Services were grouped into six broad categories. (See Appendix A, the 2004 N-SSATS Questionnaire, Question 10, for specific services within each category.)

The majority of facilities offered one or more of the specific services in each category, although the availability of services varied somewhat by facility operation and primary focus. Differences were most apparent in pharmacotherapies, testing, transitional services, and other services.

Tables 4.10a and 4.10b. At least one of the assessment services was available in 95 percent of all facilities. The availability of substance abuse assessment and diagnosis differed little by facility operation. However, mental health assessment and diagnosis was more readily available in Federal, State, and local government-operated facilities (66 percent, 54 percent, and 52 percent, respectively) than in facilities operated by other entities.

Substance abuse therapy and counseling services, offered by 99 percent of all facilities, differed little by facility operation. Pharmacotherapies, available in 26 percent of all facilities, were more readily available in Federal and State government-operated facilities (68 percent and 37 percent, respectively) and in private for-profit facilities (33 percent) than in facilities operated by other entities.

Testing services were available in 85 percent of all facilities. Good availability of a wide range of tests was most frequently found in State and Federal government-operated facilities, and least likely to be found in private for-profit and tribal government facilities. Similarly, facilities operated by private for-profit organizations were less likely than facilities operated by other entities to offer any of the specific transitional or other services.

Tables 4.11a and 4.11b. The overall availability of assessment services (95 percent) differed little by facility focus. However, mental health assessment and diagnosis was far more readily available in facilities focused on provision of mental health services, a mix of mental health and substance abuse treatment services, and general health care (93 percent, 82 percent, and 80 percent, respectively) than in facilities primarily providing substance abuse treatment services (19 percent).

The overall availability of substance abuse therapy and counseling services (99 percent) differed little by primary focus. Pharmacotherapies, available in 26 percent of all facilities, were more readily available in facilities focused on provision of general health care (56 percent) or a mix of mental health and substance abuse treatment services (28 percent) than in facilities primarily providing substance abuse treatment services (24 percent) or mental health services (22 percent).

Testing services were available in 85 percent of all facilities, and good availability of a wide range of tests was found in facilities whose focus was general health care (97 percent of these facilities offered testing) and least likely to be found in facilities focused on providing mental health services (61 percent). Similarly, facilities focused on providing mental health services were less likely than other facilities to offer many of the specific transitional and other services.

Services in Sign Language for the Hearing Impaired and in Languages Other than English

Table 4.12. Substance abuse treatment services in sign language for the hearing impaired were offered in 29 percent of all facilities. Facilities operated by local and State governments were most likely to offer these services (43 percent and 35 percent, respectively), followed by private non-profits (32 percent).

Substance abuse treatment services in languages other than English were provided in 47 percent of all facilities. Facilities operated by local governments were most likely, at 57 percent, to provide these services.

Substance abuse treatment services in languages other than English could be provided by staff counselors, on-call interpreters, or both. Of the facilities offering these services, 43 percent reported that the services were provided by staff counselors only. Thirty-nine percent used only on-call interpreters, and 18 percent used both staff counselors and on-call interpreters. Private for-profit organizations were most likely to use staff counselors only (54 percent), and State, local, and Federal government-operated facilities were most likely to use on-call interpreters only (55 percent, 46 percent, and 44 percent, respectively). Facilities with a focus on the provision of substance abuse treatment services were the most likely to use staff counselors only (49 percent), while those whose focus was the provision of mental health services, general health care, or a mix of mental health and substance abuse treatment services were most likely to use on-call interpreters only (58 percent, 45 percent, and 44 percent, respectively).

Among facilities using staff counselors to provide substance abuse treatment services in languages other than English, Spanish was the most commonly reported language, provided in 26 percent of all facilities. Treatment services in American Indian/Alaska Native languages were offered in 1 percent of facilities overall. However, 35 percent of facilities operated by the Indian Health Service and 27 percent of facilities operated by tribal governments offered these services.

Payment Options

Tables 4.13a and 4.13b. Cash or self-payment and private insurance were the most widely accepted forms of payment for substance abuse treatment (accepted by 90 percent and 67 percent of facilities, respectively). Medicaid was accepted by more than half of all facilities (52 percent). State-financed health insurance, Federal military insurance, and Medicare were each accepted by about one-third of all facilities (35 percent, 34 percent, and 33 percent, respectively).

A sliding fee scale for substance abuse treatment charges was used by 64 percent of all facilities. More than half (54 percent) of all facilities offered treatment at no charge to eligible clients who could not pay, and 4 percent provided treatment at no charge to all clients.

The type of payment accepted varied considerably by facility operation and primary focus. Facilities operated by local and State governments had relatively high proportions of acceptance of a wide range of payment options. They were most likely to use a sliding fee scale (82 percent and 72 percent, respectively), and to offer treatment at no charge to eligible clients who could not pay (71 percent and 76 percent, respectively). However, while 7 percent of State-operated facilities provided treatment at no charge to all clients, only 3 percent of facilities operated by local governments did so.

Facilities operated by the Federal government were the most likely to accept Federal military insurance (68 percent), but the least likely to accept other public payment sources such as Medicare, Medicaid, or other State-financed health insurance (17 percent, 15 percent, and 12 percent, respectively), or to use a sliding fee scale (17 percent).

Other than Federally-operated facilities, private for-profit facilities were the least likely to accept Medicaid (33 percent), State-financed health insurance (26 percent), and Medicare (25 percent). They were less likely to use a sliding fee scale (51 percent) than most other entities and less likely than all other entities or to provide treatment at no charge to eligible clients who could not pay (25 percent). Treatment at no charge for all clients was provided by less than 1 percent of private for-profit facilities. In contrast, 28 percent of facilities operated by tribal governments provided treatment at no charge to all clients, and 83 percent provided treatment at no charge to eligible clients who could not pay.

Facilities focused on the provision of substance abuse treatment services were less likely than other facilities to accept payment options other than cash or self-payment—58 percent accepted private health insurance, 44 percent accepted Medicaid, 28 percent accepted other State-financed health insurance, 23 percent accepted Federal military insurance, and 20 percent accepted Medicare.

Facility Licensing, Certification, or Accreditation

Facilities were asked whether they were licensed, certified, or accredited by various organizations. These included the State substance abuse agency, State mental health department, State public health department or board of health, hospital licensing authority, or other State/local agency or organization. Also included were accreditation organizations: the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Rehabilitation Accreditation Commission (CARF), the National Committee for Quality Assurance (NCQA), and the Council on Accreditation for Children and Family Services (COA).

Tables 4.14a and 4.14b. Overall, 95 percent of all facilities reported that they were licensed, certified, or accredited by one or more agencies or organizations. Most facilities (81 percent) named the State substance abuse agency, 33 percent listed the State mental health department, and 31 percent listed the State public health department/board of health. Accreditation by JCAHO was reported by 24 percent of facilities, but accreditation by CARF, COA, or NCQA was relatively rare (15 percent, 5 percent, and 2 percent, respectively).

Thirteen percent of all facilities reported licensing, certification, or accreditation by a State or local agency or organization that was not specifically included in the N-SSATS questionnaire.

Tables 4.15a and 4.15b. Accreditation by JCAHO was highest in facilities offering hospital detoxification or hospital treatment (86 percent and 77 percent, respectively) and in facilities offering outpatient day treatment/partial hospitalization (46 percent). However, JCAHO accreditation was also relatively high for facilities offering outpatient detoxification (37 percent), and outpatient methadone maintenance (32 percent). Accreditation by CARF was highest among facilities offering outpatient methadone maintenance (57 percent) and relatively high among facilities offering outpatient detoxification (32 percent).

Facility Funding

Facilities were asked several questions about sources of funding, including whether the facility had agreements or contracts with managed care organizations for the provision of substance abuse treatment services, and whether the facility received Federal, State, or local government funds for the provision of substance abuse treatment.

Table 4.16. Approximately half of all facilities (49 percent) reported that they had agreements or contracts with managed care organizations for the provision of substance abuse treatment services. In general, government-operated facilities were less likely to have such agreements or contracts than were privately-operated facilities (between 15 percent and 39 percent, compared to 51 percent for private for-profit organizations and 52 percent for private non-profit organizations). Facilities providing a mix of mental health and substance abuse treatment services were most likely to have agreements or contracts with managed care organizations (59 percent), while facilities providing general health care were the least likely to have managed care agreements or contracts (39 percent).

Almost two-thirds (64 percent) of all facilities received Federal, State, or local government funds for the provision of substance abuse treatment services. Not surprisingly, government-operated and private non-profit organizations were more likely to receive these funds than were private for-profit facilities (between 65 percent and 90 percent, compared to 27 percent for private for-profit organizations).

Client Outreach

Facilities were asked several questions about client outreach, including whether the facility operated a hotline responding to substance abuse problems, whether it had Internet access, and whether it had a web site providing information about its substance abuse treatment programs.

Table 4.17. Twenty-three percent of all facilities reported that they operated a hotline responding to substance abuse problems. Hotlines were most likely to be operated by local and State government-operated facilities (39 percent and 33 percent, respectively). Higher proportions of hotline operation were reported by facilities providing mental health services or a mix of mental health and substance abuse treatment services (33 percent each) than by facilities reporting another primary focus.

Almost all facilities (91 percent) reported that they had access to the Internet. More than half of all facilities (57 percent) had web sites providing information about their substance abuse treatment programs. These were most common among facilities operated by private non-profit organizations (65 percent). They were less common among facilities operated by private for-profit organizations or by Federal or tribal government-operated facilities (44 percent, 36 percent, and 27 percent, respectively).

Facilities with Opioid Treatment Programs (OTPs)

Opioid Treatment Programs (OTPs) are certified by the Substance Abuse and Mental Health Services Administration to provide medication-assisted therapy in the treatment of opioid addiction. Currently, methadone and buprenorphine are the only opioid medications approved for the treatment of opioid addiction.

Table 4.18. OTPs were available at 1,070 (8 percent) of all substance abuse treatment facilities on March 31, 2004 [Table 2.3]. Forty-three percent of OTPs were operated by private for-profit organizations, compared to 26 percent of all substance abuse treatment facilities [Table 4.1]. More than half (55 percent) of all OTPs provided both maintenance and detoxification. Thirty-five percent provided maintenance only, and 10 percent provided detoxification only.

Facilities with OTPs were likely to be dedicated entirely or almost entirely to medication-assisted therapy. Nearly two-thirds (65 percent) of facilities certified as OTPs reported that all of the clients in treatment on March 31, 2004, were receiving either methadone or buprenorphine. (In 29 percent of the remaining facilities, some but not all clients in treatment on March 31, 2004, were receiving methadone or buprenorphine; in 5 percent, no clients in treatment on March 31, 2004, were receiving either medication.)4 Overall, 88 percent of clients in treatment on March 31, 2004, in facilities with OTPs were receiving methadone or buprenorphine. This proportion was highest (96 percent) in private for-profit facilities and in facilities focused on the provision of substance abuse treatment services (91 percent).

Of the 241,688 clients receiving one of the two medications approved for the treatment of opioid addiction, more than 99 percent were receiving methadone and only 727 (less than 1 percent) were receiving buprenorphine.

Tables 4.19a and 4.19b. Facilities with OTPs were most likely to offer outpatient treatment (91 percent), followed by hospital inpatient treatment (11 percent) and residential treatment (10 percent). Outpatient methadone maintenance was offered in 84 percent of facilities with OTPs, and outpatient detoxification in 54 percent. Outpatient methadone maintenance was offered in 94 percent of Federal government-operated facilities with OTPs in 93 percent of private for-profit facilities with OTPs. Outpatient detoxification was offered in 67 percent of private for-profit facilities with OTPs and in 66 percent of Federal government-operated facilities with OTPs. Federal government-operated facilities with OTPs offered the widest range of types of care. In addition to those named above, 94 percent offered regular outpatient care, 78 percent offered intensive outpatient care, 47 percent offered hospital inpatient detoxification, 44 percent offered outpatient day treatment/partial hospitalization, and 40 percent offered some type of residential treatment.

Tables 4.20a and 4.20b. Overall, 99 percent of facilities with OTPs reported that they were licensed, certified, or accredited by one or more agencies or organizations. Most facilities with OTPs (88 percent) named the State substance abuse agency, 49 percent listed the State public health department/board of health, and 24 percent listed the State mental health department. Accreditation by JCAHO was higher among facilities with OTPs than among facilities overall (39 percent, compared to 24 percent [Table 4.14b]), as was accreditation by CARF (52 percent, compared with 15 percent). Accreditation by COA and NCQA was higher among facilities with OTPs than among facilities overall, but was still relatively low (3 percent and 4 percent, respectively). Twenty-two percent of facilities with OTPs reported licensing, certification, or accreditation by a State or local agency or organization that was not specifically included in the N-SSATS questionnaire, as compared to 13 percent of all facilities combined. Accreditation by JCAHO was highest in facilities with OTPs that offered hospital treatment or hospital detoxification (91 percent and 89 percent, respectively) and in facilities with OTPs that offered short-term residential treatment (77 percent) or outpatient day treatment/partial hospitalization (72 percent). JCAHO accreditation was relatively low for facilities with OTPs that offered outpatient methadone maintenance (33 percent) or outpatient detoxification (31 percent). Conversely, accreditation by CARF was highest among these types of care, at 60 percent of facilities with OTPs that offered outpatient detoxification and 58 percent of facilities with OTPs that offered outpatient methadone maintenance.


1 Of the 185 facilities operated by the VA, 160 (86 percent) reported that they were located in or operated by a hospital [data not shown].

2 Non-hospital residential utilization rates are based on a subset of 3,059 facilities that reported for themselves alone and that reported numbers greater than zero for both designated beds and clients.

2 Hospital inpatient utilization rates are based on a subset of 552 facilities that reported for themselves alone and that reported numbers greater than zero for both designated beds and clients.

4 Percentages sum to less than 100 percent because of rounding.

[To Tables]