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Accreditation takes on added importance

June 29, 2016
by Rebecca Flood
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When I was considering leaving Seabrook House, a subacute state-licensed and accredited specialty hospital, to come to New Directions for Women, a social recovery state-licensed and non-accredited treatment center, I knew I would not work for a non-accredited organization. So, during my first two years here, we worked on preparing our center for accreditation. New Directions had existed for almost 31 years without it, and now we were one of a handful of accredited centers in all of Orange County, Calif. Why is that important?

Accreditation is the national and international gold seal for behavioral health organizations that lets you know that the facility has applied countless standards of care to its services and systems. It allows you to compare facilities on equal footing, regardless of where they are located. Whether they’re in a different state, or even in a different country, the same standards are applied in every accredited organization. On a higher level of standard than licensing, accreditation is “a visible demonstration to those you serve, their families, your staff, and community of your organization’s ongoing commitment to safe, high quality care, treatment or services.”

Whereas the process of accreditation is standardized nationally and internationally, the process and requirements for certification and licensing vary from state to state, as do models of care. Some states require only a room and board license for sober livings, and some states have no requirements at all for sober livings. California does not require any licensing or certification to operate a sober living house with six or fewer people in it. In some countries, there may not be any standards at all for sober livings or treatment centers.

All accreditation processes require the facilities to be licensed by their state in good standing for the services they’re accredited for and to conduct follow-up with the patients they serve. This includes outcome data, internal requirements, safety levels, high-level documentation of the services offered, and confirmation that evidence-based best practices are in place. In addition, staff members are required to hold the proper credentials for delivering the levels of care they’re providing.

The two most widely held national and international accreditations for rehabilitation treatment centers and other behavioral health organizations are The Joint Commission (formerly referred to as the Joint Commission on Accreditation of Healthcare Organizations or JCAHO) and CARF (formerly referred to as the Commission on Accreditation of Rehabilitation Facilities). Their accreditations apply to hospitals, treatment centers, nursing homes, physical rehabilitation centers, partial day services, retirement centers, disability facilities, developmental group homes, and group services that provide medical, psychiatric, developmental, and health care diagnoses.

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I fear the value of accreditation is beginning to be eroded. I know of facilities with horrid conditions that have been given the Gold Seal. They cram far too many people into far too little space, they have people with 2 months or less sobriety working for them (and working ungodly hours at that). They have "managers" who are using in their housing (one even died as a result). And, with a 3 year window before they can expect to be visited again, the odds of this changing anytime soon are slim at best. It seems as though the Gold Seal is now being handed out like candy and the true value for those of us who decide to do it right is being diminished by this.

If this is the "standard" we are being held to, it is a very low standard indeed.

Interesting observation, Lyle. It seems that national organizations are prioritizing the importance of accreditation as a critical marker of quality for consumers and families. That goal certainly can't be achieved if there is any doubt that the process is sufficiently rigorous. I invite our readers to join this conversation and share their observations about accreditation standards.

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Rebecca Flood

Executive Director/CEO of New Directions for Women

Rebecca Flood

@NDFW

http://www.newdirectionsforwomen.org/

In more than 3 decades of experience in the health care industry, Becky Flood has demonstrated...