Neither the federal government nor state regulatory authorities has much control over the legal, but unethical, practices of some treatment programs—such as saying that insurance will pay when it probably won’t, and taking kickbacks for referrals, as Addiction Professional’s recent series shows. Unless the program is funded by federal or state dollars, there is little that government entities can do if the program isn’t breaking the law.
But there are some ways that family members, even those who are desperately trying to find a treatment center in a hurry, can protect themselves. In Florida, the Department of Children and Families (DCF; the agency that licenses substance abuse treatment programs) has a complaints database that prospective patients and their family members can access. Over the last three years, 186 complaints have been recorded in the Substance Abuse Licensure Information System, according to Chris Weller, statewide substance abuse licensure policy coordinator for DCF’s Substance Abuse and Mental Health Program Office.
“I get these phone calls quite a bit,” says Weller, referring to inquiries from family members trying to find out about a treatment program. Unfortunately, all too often the calls come in after the patient already has been admitted, he says.
“They are researching the provider after they sent a family member there.” Weller says. “They were in a hurry, and now the patient is there, and they get the first bill and say, ‘What am I into here?’”
When he gets these calls, Weller goes “into the statewide licensure database, and I tell them what information we have about the program.” The database has a “complaint log tool” where people can file complaints. Before those complaints officially go into the database, DCF looks into them to avoid the problem of sham complaints, says Weller. Only when complaints are verified are they put into the database, he says.
Of course, there are potential ethical lapses in a program that patients would not know about, such as when a program accepts or pays a kickback for a referral. Of all the complaints filed in Florida, there has been only one about that specific issue in the past three years. Nevertheless, anyone—including another treatment program—can file a complaint.
The complaint database isn’t published, but is available to anyone who has a query about a specific program, says Weller. “The media could get information about it,” he says. “If it’s in the database, it’s public.”
Out of state
One of the problems affecting Florida is that so many people from out of state go there for treatment—Weller says nobody knows exactly how many, particularly on the private side. Other states may have more generous insurance benefits, and Florida locations can boast of beautiful oceanside real estate (at least on the Internet—what the actual facility looks like may differ).
Housing presents another issue. The sober home industry has taken off in Florida, often with a major gray area between it and treatment in terms of Internet marketing. However, DCF does not license sober homes, and would shut them down if they were promoting themselves as treatment programs.
While there is a move for more regulation of sober homes, with a bill currently before the state legislature, it would take 65 additional full-time equivalent employees to license all of these homes, says Kathy Goltry, policy and planning chief with the state’s Substance Abuse and Mental Health Program Office.
One reason for the sober home explosion in the state is the real estate collapse of several years ago, says Goltry. “There are relatively expensive high-end properties that have been available, some in gated communities, and people have set up sober houses,” she says. “What has brought it to people’s attention is that the neighbors believe there are unsavory characters loitering outside on the porches, catcalling, and so on.”