Chapter 4

Facility Characteristics and Services

Facility Operation and Primary Focus
Type of Care Offered
Client Substance Abuse Problem and Diagnosed Co-occurring Mental Disorders
Facility Size
Facility Capacity and Utilization Rates
Services Provided
Clinical/Therapeutic Approaches
Programs or Groups for Specific Client Types
Services in Sign Language for the Hearing Impaired and in Languages Other than English
Detoxification Services
Client Outreach
Facility Licensing, Certification, or Accreditation
Facility Standard Operating Procedures
Payment Options
Facility Funding
Facilities with Opioid Treatment Programs
Counseling Services Offered by Facilities
Facility Smoking Policy

This chapter outlines key characteristics of facilities and programs in 2011.

Facility Operation and Primary Focus

Table 4.1. Facilities were asked to designate the type of entity responsible for the operation of the facility. They were also asked to designate the facility’s primary focus of activity.

  • The proportions of all facilities by facility operation were:9
    • Private non-profit organizations
    • Private for-profit organizations
    • Local, county, or community governments
    • State governments
    • Federal government10
    • Tribal governments
  • The proportions of all facilities by primary focus were:
    • Substance abuse treatment services
    • Mix of substance abuse treatment and mental heath services
    • Mental health services
    • General health care
    • Other and unknown focus

 
57 percent
31 percent
5 percent
3 percent
3 percent
2 percent
 
59 percent
32 percent
6 percent
1 percent
1 percent


9 Percentages do not sum to 100 percent because of rounding.
10 Data for the Federal agencies specified in the survey (the Department of Veterans Affairs, the Department of Defense, the Indian Health Service, and other unspecified Federal agencies) are detailed in the tables.

Type of Care Offered

Table 4.2b. Type of care offered was made up of three broad categories (outpatient, residential [non-hospital], and hospital inpatient), each with several subcategories. A facility could offer more than one type of care. The proportions of all facilities offering the different types of care were:11

  • Outpatient treatment
    • Regular outpatient care
    • Intensive outpatient treatment
    • Outpatient day treatment/partial hospitalization
    • Outpatient detoxification
    • Outpatient methadone maintenance
  • Residential (non-hospital) treatment
    • Long-term treatment (more than 30 days)
    • Short-term care (30 days or fewer)
    • Detoxification
  • Hospital inpatient treatment
    • Detoxification
    • Treatment

81 percent
75 percent
44 percent
12 percent
9 percent
9 percent
26 percent
21 percent
13 percent
6 percent
5 percent
5 percent
4 percent

Almost three quarters (74 percent) of private non-profit facilities provided outpatient care and more than one third (34 percent) provided residential (non-hospital) care. In contrast, 91 percent of private for-profit facilities provided outpatient care and 13 percent provided residential non-hospital) care.


11 Facility percentages sum to more than 100 percent because a facility could provide more than one type of care.

Client Substance Abuse Problem and Diagnosed Co-occurring Mental Disorders

Table 4.3. Facilities were asked to estimate the proportions of clients in treatment for both alcohol and drug abuse, for alcohol abuse only, and for drug abuse only. They were also asked to estimate the proportion of clients with diagnosed co-occurring substance abuse and mental disorders.

Facility Size

Table 4.4. Facility size is defined by the number of clients in substance abuse treatment. The median number of clients in substance abuse treatment at a facility on March 31, 2011 was 42 clients.

    • Outpatient treatment
      • Regular outpatient care
      • Intensive outpatient treatment
      • Outpatient day treatment/partial hospitalization
      • Outpatient detoxification
      • Outpatient methadone maintenance
    • Residential (non-hospital) treatment
      • Long-term treatment (more than 30 days)
      • Short-term treatment (30 days or fewer)
      • Detoxification
    • Hospital inpatient treatment
      • Treatment
      • Detoxification

50 clients
28 clients
12 clients
3 clients
1 clients
200 clients
20 clients
16 clients
9 clients
4 clients
10 clients
7 clients
5 clients

Table 4.5. Facilities were sorted into five size groups based on the total number of clients in treatment on March 31, 2011. The smallest facilities were defined as having fewer than 15 clients and the largest as having 120 clients or more.


12 The median number of clients for the main categories of type of care (outpatient, residential, and hospital inpatient) can be greater than the median for any of the subcategories because a facility can provide more than one subcategory of the main types of care.

Facility Capacity and Utilization Rates

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

Figure 7
Residential (Non-Hospital) and Hospital Inpatient Utilization Rates: March 31, 2011

Bar chart comparing Residential (Non-Hospital) and Hospital Inpatient Utilization Rates: March 31, 2011

SOURCE: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services
Administration, National Survey of Substance Abuse Treatment Services (N-SSATS), 2011.


13 Residential (non-hospital) utilization rates are based on a subset of 3,058 facilities that reported for themselves alone and that reported numbers greater than zero for both designated beds and clients.
14 Hospital inpatient utilization rates are based on a subset of 476 facilities that reported for themselves alone and that reported numbers greater than zero for both designated beds and clients.

Services Provided

Tables 4.8 and 4.9. Facilities were asked about the types of services they provided. Services were grouped into the five broad categories shown below.

Clinical/Therapeutic Approaches

Table 4.10. Facilities were asked to indicate whether they used any of 12 specific clinical/therapeutic approaches.

Programs or Groups for Specific Client Types

Table 4.11b. Facilities were asked about the provision of treatment programs or groups specially designed for specific client types. Overall, 80 percent of facilities offered at least one special program or group to serve a specific client type.

  • The proportions of facilities providing special programs or groups were:
    • Clients with co-occurring mental and substance abuse disorders
    • Adult women
    • Persons arrested for DUI or DWI
    • Adolescents
    • Adult men
    • Other criminal justice clients15
    • Pregnant or postpartum women
    • Persons with HIV or AIDS
    • Seniors or older adults
    • Lesbian, gay, bisexual, or transgender (LGBT) clients

 
36 percent
32 percent
29 percent
28 percent
25 percent
24 percent
13 percent
8 percent
6 percent
5 percent


15 Facilities treating incarcerated persons only were excluded from this report; see Chapter 1.

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

Table 4.12b. Facilities were asked about the provision of substance abuse treatment services in sign language for the hearing impaired. They were also asked if treatment was provided in languages other than English, if this treatment was provided by a staff counselor or by an on-call interpreter, and in what languages staff counselors provided treatment.

Detoxification Services

Table 4.13. Facilities that provided detoxification services were asked to indicate whether or not they detoxified clients from specified substances, and whether or not medication was routinely used during detoxification.

  • The proportions of facilities providing detoxification from the following specific substances were:
    • Opiates
    • Alcohol
    • Benzodiazepines
    • Cocaine
    • Methamphetamines
    • Other substances
  • Medications were routinely used during detoxification in 77 percent of the facilities providing detoxification services.

 
84 percent
67 percent
59 percent
54 percent
53 percent
12 percent

Client Outreach

Tables 4.14 and 4.8. Facilities were asked whether or not they had a website providing information about their substance abuse treatment programs.

Facility Licensing, Certification, or Accreditation

Facilities were asked to report licensure, certification, or accreditation by specified agencies or organizations. These included the State substance abuse agency, State mental health department, State department of health, hospital licensing authority, the Joint Commission, CARF, NCQA, COA, and other State or local agency or organization.16

    • State substance abuse agency
    • State department of health
    • State mental health department
    • CARF
    • Joint Commission
    • Hospital licensing authority
    • Another State or local agency or other organization
    • COA
    • NCQA

83 percent
42 percent
37 percent
23 percent
19 percent
7 percent
6 percent
5 percent
3 percent

      • Joint Commission
      • State department of health
      • Hospital licensing authority
      • NCQA

79 percent
68 percent
58 percent
10 percent


16 Joint Commission: formerly JCAHO (Joint Commission on Accreditation of Healthcare Organizations); CARF: formerly Commission on Accreditation of Rehabilitation Facilities; NCQA: National Committee for Quality Assurance; and COA: Council on Accreditation.

Facility Standard Operating Procedures

Table 4.17b. Facilities were asked to indicate whether or not they followed specified practices as part of their standard operating procedures. All the standard practices listed were used by two thirds or more of all facilities.

    • Required continuing education for staff
    • Regularly scheduled case review with a supervisor
    • Periodic client satisfaction surveys
    • Periodic client drug testing
    • Periodic utilization reviews
    • Case review by an appointed quality assurance committee
    • Outcome follow-up after discharge

98 percent
95 percent
92 percent
86 percent
86 percent
72 percent
69 percent

Payment Options

Table 4.18b. Facilities were asked to indicate whether they accepted specified types of payment or insurance for substance abuse treatment. They were also asked about use of a sliding fee scale and if they offered treatment at no charge to clients who could not pay.

    • Cash or self-payment
    • Private health insurance
    • Medicaid
    • State-financed health insurance
    • Medicare
    • Federal military insurance

90 percent
64 percent
57 percent
39 percent
33 percent
33 percent


17 Access to Recovery vouchers were available only in AK, AZ, CA, CO, CT, DC, FL, HI, IA, ID, IL, IN, LA, MI, MO, MT, NJ, NM, OH, OK, RI, TN, TX, WA, WI, and WY. See table 6.19a for number of facilities accepting ATRs by State.
18 Through a contract, tribes can receive the money that the Indian Health Service (IHS) would have used to provide direct health services for tribal members. Tribes can use these funds to provide directly, or through another entity, a broad range of health services. This option was part of P.L. 93-638 and is commonly known as "638 contracting."

Facility Funding

Table 4.19. Facilities were asked if they received Federal, State, or local government funds or grants to support their substance abuse treatment programs.

Facilities with Opioid Treatment Programs

Opioid Treatment Programs (OTPs) are certified by SAMHSA 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.

Counseling Services Offered by Facilities

Facility Smoking Policy

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