Should the National Association of Addiction Treatment Providers (NAATP) use educational opportunities to promote more ethical behavior in the treatment industry, or should it take a more activist role by formally fielding complaints about its members and closely policing their activities?
On the opening day of the association's annual conference in Charlotte, N.C., members of NAATP's Ethics Committee discovered that many attendees of a workshop session would like NAATP to assume a more aggressive role than it is currently comfortable taking. But committee chair Bobby Ferguson, CEO of Jaywalker Lodge in Colorado, assured the group that NAATP will take member feedback seriously and will potentially revisit its position within a year.
In revising and updating the association's Code of Ethics in recent months, the NAATP panel also considered codifying a set of procedures for enforcing compliance and processing complaints about members' business practices. But the committee ultimately decided instead to publish the updated code, now available on the NAATP website, without a monitoring component formally spelled out.
In the coming months NAATP will shine the spotlight on ethics issues by appearing at several professional forums, including a panel at the National Conference on Addiction Disorders (NCAD) this August, and then see if the attention to the issue spurs feedback about ethics problems in the field.
Ferguson did say that new and renewing members of the provider association will have to sign off on the ethics code, as well as demonstrate that they carry the appropriate licenses for operation. The question of how and whether to police adherence to the code's mandates will remain open for discussion within the association.
Under the leadership of NAATP president and CEO Michael E. Walsh, promoting ethical conduct in the industry has become a front-burner issue at the association. NAATP's recent activity has occurred against the backdrop of intense scrutiny of the broader treatment field in the trade and popular press.
Ferguson said in his May 18 workshop talk that a number of factors are intensifying competition in the field—and therefore the temptation to engage in questionable practices such as paying for referrals or making misleading comments to families about the extent of their insurance coverage. Provider consolidation and the emergence of more start-up ventures are among the driving factors, he said.
At the same time, social media has made it easier for consumers and families to sound off against or praise a treatment center in a very public way. It also therefore becomes easier for a competing center to enter these comments under the guise of consumer feedback, Ferguson emphasized.
To illustrate the lengths to which some providers will go to get a leg up on the competition, Ferguson said he had heard at this week's conference that one vendor in attendance surreptitiously stuffed its brochure into copies of a book from a competitor also in attendance.
The NAATP Code of Ethics includes sections governing how members handle issues around treatment, management, facilities and marketing. Examples of provisions include, under treatment, “Continuing care (or 'aftercare') services are considered essential to the continuum of care,” and, under management, “Fee structures are made available to the public.”
The code's marketing provisions bar the offering of any financial rewards or substantive gifts for patient referrals, and prohibit any predatory competitive activity on the part of members.
Some attendees in the workshop audience indicated that providers that see unethical behavior in the field already have other methods of recourse, such as by reporting the activity to state licensing boards. But while states such as Texas have successfully cracked down on some questionable practices, states such as California and Florida have seen regulatory agencies decimated by budget cuts, leaving them largely unable to strike back against treatment center practices that give the entire treatment field a bad name.