Staying Informed: Trends in the
Addiction Profession
Christopher C. Campbell, NAADAC Director of Government Relations
Donald P. Osborn, NAADAC President
Shirley Beckett Mikell, NAADAC Director of Certification and Education
Presented By
Obtaining CE Credit
 The education delivered in this webinar is FREE to all professionals.
 2 CEs are FREE to NAADAC members and AccuCare subscribers who
attend this webinar. Non-members of NAADAC or non-subscribers of
AccuCare receive 2 CEs for $25.
 If you wish to receive CE credit, you MUST download, complete and
submit the “CE Quiz” that is located at:
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 A CE certificate will be emailed to you within 30 days.
 Successfully passing the “CE Quiz” is the ONLY way to receive a CE
certificate.
Webinar Objectives
 Learn about the Affordable Care Act (ACA) and how it impacts
the addiction profession;
 Learn about the new national scopes of practice for the
addiction profession; and
 Understand the importance of maintaining your license or
credential.
Question and Answer session at the end of the program.
The Affordable Care Act (ACA):
What It Means for the Addiction
Profession
Christopher Campbell
NAADAC Director of Government Relations
Affordable Care Act
The new health reform law, signed by President Obama in March
2010, significantly enhances access to healthcare, including
prevention and treatment services for substance use disorders.
The Affordable Care Act (ACA): What It
Means for the Addiction Profession
• The passage of the Patient Protection and
Affordable Care Act (ACA) ensures that the role of
behavioral health in the overall healthcare system
will change
• Now, it is more important than ever to know how
healthcare reform will affect your role and the role of
States, behavioral healthcare providers, and
consumers
The Affordable Care Act
• Key points to keep in mind:
1. The work is really just beginning
2. Going to learn as we go
3. Keep an eye on your state (more later)
• Need to continue advocacy efforts in order to
assure beneficial programs are funded year in and
year out!
Background
• In 2008, 23.1 million Americans age 12 and older needed
treatment for a substance use problem, and yet only 2.3
million – one in ten – received care at a specialty treatment
center
• Many of those who do not receive, but could benefit from,
treatment do not have health insurance or other means to pay
for it
• By helping more people get the care they need, the ACA,
when fully implemented in 2014, will go a long way toward
closing the “treatment gap”
The Affordable Care Act: Coverage
Expansion
The Affordable Care Act (ACA), signed into law by President Obama in
March 2010, expands health insurance coverage to 32 million Americans,
guaranteeing that 95 percent of Americans will be covered.
•
Expands Medicaid for all individuals under 133% of the federal poverty level
•
Creates State Health Insurance Exchanges to help newly insured and those
with individual and small group coverage to purchase affordable policies
(large buying club)
•
Provides credits & subsidies up to 400% of the federal poverty level to help
individuals and families purchase insurance
The Affordable Care Act
• Under the new law, services such as screening, early
intervention, treatment, and recovery support for patients
with substance use disorders will be provided in the same
manner and in the same, primary care settings as services
for any other illness
• The change will bring needed help to many as it also
increases awareness that drug dependence is a chronic,
treatable disease
In 2014: 32 Million More Americans
Will Be Covered
HIEs/
Subsidies
~5m
SUDs
6-10 Million with M/SUDs
The Affordable Care Act
• Of the 32 million currently uninsured Americans who
will receive health insurance under the ACA, about 5
million meet medical diagnostic criteria for a
substance use disorder (6-10 Million with M/SUDs )
• These Americans will receive insurance coverage to
help pay for substance use treatment
The Affordable Care Act
Insurers will no longer be able to
deny coverage based on preexisting medical conditions, such
as substance use disorders.
The Affordable Care Act
• Individuals and small businesses will have access to
affordable coverage through a new competitive private
health insurance market through state-based Health
Insurance Exchanges
• Plans offered through the Exchanges are required to cover
mental health and substance use disorder services and
must meet the “parity” requirements of the WellstoneDomenici Mental Health Parity Act of 2008
The Affordable Care Act
• In 2014, Medicaid eligibility will be expanded for families
or individuals with incomes up to 133 percent of Federal
poverty guidelines. Many newly eligible beneficiaries will
receive substance use services
• Participation in Medicaid will help more patients gain
access to traditional healthcare benefits, such as
medications and behavioral therapies in the treatment of
addiction
How Do These Numbers Break Down?
By 2014:
 6.3 million individuals newly covered by Medicaid will be in need of behavioral
health services
 4.2 million individuals newly covered by private insurance will be in need of
behavioral health services
 About 5 million will meet medical diagnostic criteria for a substance use disorder
 $30 billion in Medicaid funding annually for substance abuse services
 $7 billion annually in private healthcare contributions for substance abuse
services
Impact of Affordable Care Act
 More people (approx. 32 million) will have insurance coverage
 Demand will rise for qualified and well-trained addiction professionals
 Medicaid will play a bigger role in paying for substance use treatment services
 Focus on primary care & coordination with specialty care
 Major emphasis on home & community-based services; less reliance on
institutional care
 Theme: preventing diseases & promoting wellness
 Focus on quality rather than quantity of care
What Does This Mean for the Addiction
Profession?
How can the addiction workforce meet this new
demand for services?
• Integration of services with other professionals who are trained and
educated in SUDs treatment
• Help from the Department of Labor (DOL)
• SUD Counseling is now a “distressed profession”
• (DOL) is working with ONDCP on new effort that would recruit and
train 60,000 new counselors over the next decade
• Would require $500 million over 4 years, which ONDCP is highly
supportive of
• But…the budget is an issue…
Integration
•
A major change for the workforce will come in the form of primary
care/behavioral health integration

There is a big push to integrate more services into primary care settings
(i.e., Primary Care/BH Integration), and this includes substance use
disorder treatment and prevention
•
As a result, primary care settings may be seeking to have counselors
on staff
•
Also, treatment programs should expect an increase in referrals from
these primary care settings
Integration
• It will be incumbent on the professionals in these fields
to collaborate, and ideally work together to develop a
clinical model of best practices
• This will include developing integration budgets, and
designing implementation plans
• In short, the profession will need to be proactive
Workforce Development
• The ACA establishes a National Prevention Council,
led by the Surgeon General, with substance use
disorders as a national priority for the Council’s report
to Congress (ONDCP will serve as a member of the
Council)
• Mental health and behavioral health are listed as high
priority areas in the new law’s National Workforce
Commission section
Workforce Development
In addition, the ACA provides:
 Funding for residencies for behavioral health included
with other disciplines
 Loan repayment programs
 Push towards more national certification standards
 Push towards re-licensure and re-certification
Workforce Development
Title V of the ACA establishes several
new workforce development programs
and defines which health professionals
are eligible for such programs.
Workforce Development
Title V of ACA provides funding for
scholarships and loan repayment programs,
for certain healthcare professionals, including
substance abuse prevention and treatment
providers, in the areas of the country that
need them most, such as rural areas and
inner cities.
Workforce Development
 Certain substance abuse counselors may qualify for these
programs under the definition of “mental health service
professionals” as defined in the ACA:
“MENTAL HEALTH SERVICE PROFESSIONAL.—
The term ‘mental health service professional’ means an individual with a
graduate or postgraduate degree from an accredited institution of higher
education in psychiatry, psychology, school psychology, behavioral
pediatrics, psychiatric nursing, social work, school social work,
substance abuse disorder prevention and treatment, marriage and
family counseling, school counseling, or professional counseling.”
Workforce Development
 NOTE: The definition of “Mental Health Professional” applies only to Title V
programs in the ACA. It extends no further
 The federal government does not- and will not- dictate the education or
credentials for a civilian profession
 Professionals who meet these requirements can qualify for loan repayment
programs established by the legislation
 It is important to note that the masters degree/no master’s degree issue
only applies to one’s ability to qualify for programs under Title V of the ACA.
The ability to practice one’s profession does not hinge on this distinction
 States will continue to determine who may qualify to practice (i.e., licensure
or certification)
Workforce Development
•
For Medicaid reimbursement, the Center for Medicare & Medicaid Services
defers to states to define qualified providers
•
The state sends its guidelines to the Federal Center for Medicare
Services, which are almost always accepted without question or review
•
State guidelines are more important than ever, as federal reimbursement
will go to the professionals that the state recognizes as qualified to provide
services
•
The federal government has not set any standards of practice for
substance use disorder counselors, nor will they
Standards
In short…
licensure, and in many states certification, is
more important than ever, because
recognition by the state as to who is
recognized as a substance use treatment and
prevention professional will almost certainly
play a role in who may provide services that
are reimbursed by the federal government
The Affordable Care Act
• It’s an ongoing process
• The state still plays a critical role, and the
federal role, in terms of the profession, is not
as large as you think
• Be ready to work with others in the health
community on integration of services
How to Get Involved in ACA
Implementation at the State Level
• When the Affordable Care Act is fully implemented in
2014, individuals and small businesses will have
access to health care coverage through a new
competitive private health insurance market – statebased Health Insurance Exchanges
• States are already taking their first steps toward 2014
when Health Insurance Exchanges will be operational
How to Get Involved in ACA
Implementation at the State Level
• Many of those activities have been funded by the $49
million in Exchange planning grants awarded by the U.S.
Department of Health and Human Services (HHS) in July
of 2010
• States applied to use those grants for a number of
important planning activities, including research to
understand their insurance markets, efforts to obtain the
legislative authority to create Exchanges, and steps to
establishing the governing structures of Exchanges
How to Get Involved in ACA
Implementation at the State Level
• It is critical that as your state moves forward with the
planning and implementation of its Health Insurance
Exchange in 2014, that your Association be “at the table,”
either by connecting with the organization in your state
charged with HIE implementation, or with your Single
State Authority (SSA)
• These organizations need to hear from the addiction
professionals in their states
How to Get Involved in ACA
Implementation at the State Level
 Resources – NAADAC has the following resources
available on the web site (www.naadac.org) to
assist in your efforts:
• State Health Insurance Exchange Contact Information, and
• Directory of Single State Agencies (SSA) for Substance
Abuse Services
How to Get Involved in ACA
Implementation at the State Level

NAADAC encourages you to use these
resources to connect with your state’s HIE
and/or SSA to see what you can learn,
how you submit your recommendations as
an Association, and how you can
advocate on behalf of the addiction
profession in your state
Health Information Technology (HIT) and
the ACA
• Health information technology is essential to the
transformation of the health care delivery system and the
promotion of preventive care and patient self-care
• Both the American Recovery and Reinvestment Act
Affordable Care Act contain incentives for providers to adopt
Electronic Health Records (EHRs) and will drive integration
of services, allowing for greater benefits from and need for
the adoption of HIT
Health Information Technology (HIT)
Some facts:
•
Of 175 substance abuse treatment programs surveyed, 20 percent had
no information systems, e-mail, or even voicemail1
•
On average, information technology (IT) spending in behavioral health
care and human services organizations represents 1.8 percent of total
operating budgets—compared with 3.5 percent of the total operating
budgets for general health care services2
•
Fewer than half of behavioral health and human services providers
possess fully implemented clinical electronic record systems2
McLellan, A. T., Carise, D., & Kleber, H. D. (2003). Can the national addiction treatment infrastructure support the public’s demand for quality care? Journal of Substance
Abuse Treatment, 25, 117–121.
2 Centerstone Research Institute. (2009, June). Behavioral Health/Human Services Information Systems survey. National Council for Community Behavioral Health Care.
Retrieved March 25, 2011, from http://www.thenationalcouncil.org/galleries/policy-file/HIT%20Joint%20Survey%20Exec%20Summary.pdf
1
Health Information Technology (HIT)
• According to HHS Secretary Kathleen Sebelius,
“Electronic health records will provide major
technological innovation to our current health care
system by allowing doctors to work together to
make sure patients get the right care at the right
time.”
• She has described patient privacy in HIT as “our
top priority.”
Health Information Technology (HIT) and
SAMHSA
• In the past, the specialty behavioral health system has often
operated independently from the broader health system and
differed in the type and scope of information technology used
• SAMHSA is working to increase access to HIT so that
Americans with behavioral health conditions can benefit from
these innovations (one of SAMHSA’s Eight Initiatives)
Health Information Technology (HIT)
and SAMHSA
SAMHSA is focusing on HIT in general and
EHRs specifically to ensure that behavioral
health is integrated in to the Nation’s
broader health system
Health Information Technology (HIT)
and the Workforce
• Generalized adoption of behavioral health HIT requires
the involvement of the behavioral health workforce
• Not only must the various treatment settings addressing
substance use disorders—such as substance use
disorder treatment programs—implement EHR
systems, their staff must be trained to function within an
EHR environment and to adapt to HIT
Health Information Technology and
HITECH
• Included in ARRA legislation passed in 2009 is the Health
Information Technology for Economic and Clinical Health
(HITECH) Act, also known as HITECH
• HITECH provides funding to establish programs to improve
health care quality, safety and efficiency through promotion
of HIT and private and secure health information exchange
• Medicare and Medicaid (CMS) to offer incentive payments
for “meaningful use” of certified EHR technology
What is “Meaningful Use?”
Centers of Medicare and Medicaid (CMS) issued final
regs in July 2010:
• Defined the meaningful use requirements (objectives) that
providers must meet through use of certified EHR
technology in order to qualify for the payments
• Identified the standard criteria for the certification of EHR
technology (so eligible professionals and hospitals may be
assured that the systems they adopt are capable of
performing the required functions to meet meaningful use)
What are CMS Incentive Programs for
Meaningful Use?
Medicare
Medicaid
Can participate as soon as the federal program launches
Can participate once state offers the program (check with your
state for expected launch date)
Can receive up to $44,000.00 in incentives, and up to
$48,400.00 if practicing in a Health Provider Shortage Area
Can receive up to $63,750.00 in incentives
Required to demonstrate meaningful use of certified EHR
technology every year to qualify for payment
Can qualify for payment for adopting, implementing, upgrading
or demonstrating meaningful use of certified EHR technology
in first participation year. Required to demonstrate meaningful
use in each subsequent year to qualify for payment
Must participate by the second year to receive the maximum
incentive payment
Must participate by 2016 to receive the maximum incentive
payment
Who is Eligible for CMS Incentives?
Medicare
Medicaid
Eligible hospitals
Eligible hospitals
Acute Care, Critical Access
Acute Care, Critical Access and Children’s
Hospitals
Eligible Professionals (EPs)
Eligible Professionals (EPs)
Doctors of Medicine, Osteopathy, Dental,
Podiatric Medicine, Optometry, Chiropractor
Physicians
Nurse Practitioners (NPs), Certified NurseMidwives (CNMs), Dentists
Physician Assistants (PAs)
Do I Have to Adopt the Use of EHRs?
• No penalty – the incentive program is voluntary
• Medicare may adjust payments in 2015
• Medicaid will not adjust any payments
What About Behavioral Health Treatment?
• Currently incentives contained in HITECH
do not apply to most behavioral health,
including SUD professionals, unless certain
EPs (physicians, nurse) are on staff
• However……
Behavioral Health Information Technology
Act of 2011
• On March 10th, Senator Sheldon Whitehouse (D-RI) introduced
S. 539, the Behavioral Health Information Technology Act of 2011

Bill would extend health information technology assistance
included in the HITECH Act to behavioral health, mental
health, and substance abuse professionals and facilities

Similar to legislation introduced last year by Reps.
Kennedy/Murphy
The Future of Education for
Addiction Professionals
Don Osborn, MAC, ICAC, CCS
President of NAADAC
Where We Are Now
• Addictions Counseling (AC) lacks a standardized
curriculum
• Few programs exist beyond Associates Degrees
• Existing programs lack consistency of hours,
content, or learning outcomes
Concerns
• Without academic standards, AC viewed as
unorganized and baseless profession
• Ethical issues
• No defined theoretical orientation or treatment
methodology
History of the Field
• Lack of treatment methods, competency
• Allied profession limitations with addiction
 Social Workers
 Psychologists
• Professional vs. non-professional
History of the Field (cont.)
• Academic preparation of allied professions
• Undergraduate/graduate programs
• Body of knowledge skill and practice
• AC none
History of the Field (cont.)
• Recovering vs. non-recovering
• 1975 National Association of Alcohol and Drug Abuse
Counselors (NAADAC)
 Membership
 Certification exam
• Education/training
 Workshops
 Conferences
 Two year college courses
History of the Field (cont.)
• Process addictions
 Gambling, eating disorders, sexual addiction
• Diagnostic and Statistical Manual (DSM) and
Managed Health Care
• Ill-equipped workforce
• Resistance to educational standards
• Personal experience only is needed
Current Need
• 23.2 million need treatment
• Only 2.4 million received treatment
• Need 5,000 new Addictions counselors a year
to meet need
(NIDA, 2009)
Composition of Addiction Workforce
• Recovering vs. non-recovering
• Academic degree not required
• Masters required in allied mental health profession
(Bissel & Royce, 1994)
• Some states only required high school diploma or
certification
Training
• AAMFT, ACA, NASW, APA saw addiction as secondary
diagnosis
• Addiction Counselors have degrees in something other than
addictions
• Needs of multi-service agencies professionals in assessment,
family counseling, treatment planning, and relapse prevention
in addictions
(VonSteen, Vacc & Strickland, 2008)
Training (cont.)
• School counselors are frontline providers. No academic
preparation in addictions.
(Sink, 2005; Mason, 1997; Palmer & Ringwalt, 1988)
• Low level of addictions training in higher education
• Lack of consistent prerequisites, curriculum, course
content
(Selin & Svanum, 1981)
Ethics, Supervision and Recommendations
• Lack of academic standards, competencies,
knowledge, and skill development present ethical
concerns (e.g., confidentiality, scope of practice,
and dual relationships)
• Only 14 states require ethics training
• CFR 42 Confidentiality of Alcohol and Drug Abuse
Patient Record Code
Ethics, Supervision and Recommendations
• Traditional/Recovering vs. Nontraditional/Non
Recovering
• Traditional/Recovering
 12 step; disease model; little, if any, education; workshops;
conferences
• Nontraditional/Non Recovering
 Research to service, theory, treatment protocols
 Education – degree requirements
Standardized Curriculum:
Scopes of Practice
Don Osborn, MAC, ICAC, CCS
President of NAADAC
Standardized Scopes of Practice
Model Scopes
of Practice and
Career Ladder
for Substance
Use Disorder
Counselors
Download now or later at: www.myaccucare.com/webinars
Standardized Scopes of Practice
• Category 4: Independent Clinical Substance Use Disorder
Counselor/Supervisor
• Category 3: Clinical Substance Use Disorder Counselor
• Category 2: Substance Use Disorder Counselor
• Category 1: Associate Substance Use Disorder Counselor
• Substance Use Disorder Technician
Category 4: Independent Clinical Substance
Use Disorder Counselor/Supervisor
Practice of Independent Clinical Substance
Use Disorder Counselor/Supervisor:
 Typically has a Masters or other post
graduate degree
 Is licensed to practice independently
Category 4: Independent Clinical Substance
Use Disorder Counselor/Supervisor
The scope of practice for Independent Clinical Substance Use Disorder
Counselor/Supervisor can include:
1. Clinical evaluation, including screening, assessment, and diagnosis of Substance Use
Disorders (SUDs) and Co-Occurring Disorders (CODs)
2. Treatment Planning for SUDs and CODs, including initial, ongoing, continuity of care,
discharge, and planning for relapse prevention
3. Referral
4. Service Coordination and case management in the areas of SUDs and CODs
5. Counseling, therapy, trauma informed care, and psycho-education with individuals,
families, and groups in the areas of SUDs and CODs
6. Client, Family, and Community Education
7. Documentation
8. Professional and Ethical Responsibilities
9. Clinical supervisory responsibilities for all categories of SUD Counselors
Category 4: Independent Clinical Substance
Use Disorder Counselor/Supervisor
• Can practice under the auspice of a licensed
facility, within a primary care setting, or as an
independent private practitioner.
• It is the responsibility of the Independent Clinical
Substance Use Disorder Counselor/Supervisor
to seek out clinical supervision and peer support.
Category 3: Clinical Substance Use
Disorder Counselor
Practice of Clinical Substance Use Disorder Counselor:

Typically has a Masters or other post graduate
degree

Depending on the jurisdiction, persons in this
position either have not attained their license, or
the license is restricted to practice only under
supervision of a Category 4 Independent Clinical
Substance Use Disorder Counselor/Supervisor.
Category 3: Clinical Substance Use
Disorder Counselor
The scope of practice for Clinical Substance Use Disorder Counselor can include:
1.
Clinical evaluation, including screening, assessment, and diagnosis of Substance Use
Disorders (SUDs) and Co-Occurring Disorders (CODs)
2.
Treatment Planning for SUDs and CODs, including initial, ongoing, continuity of care,
discharge, and planning for relapse prevention
3.
Referral
4.
Service Coordination and case management in the areas of SUDs and CODs
5.
Counseling, therapy, trauma informed care, and psycho-education with individuals,
families and groups in the areas of SUDs and CODs
6.
Client, Family, and Community Education
7.
Documentation
8.
Professional and Ethical Responsibilities
9.
Clinical supervisory responsibilities for categories Levels 1 and 2 as well as Substance
Use Disorder Technicians.
Category 3: Clinical Substance Use
Disorder Counselor
The Substance Use Disorder Counselor 3
can only practice under the auspice of a
licensed facility, within a primary care setting,
and under clinical supervision of a Clinical
Substance Use Disorder Counselor 4.
Category 2: Substance Use Disorder
Counselor
Substance Use Disorder Counselor – The Scope of Practice for the category of those with
a Bachelor’s degree includes the following activities with clinical supervision of a Clinical
Substance Use Disorder Counselor or other state approved supervisor:
1. Clinical evaluation, including diagnostic impression or Screening, Brief Intervention, and
Referral to Treatment Referral (SBIRT)
2. Treatment Planning for SUDs and CODs, including initial, ongoing, continuity of care,
discharge, and planning for relapse prevention
3. Referral
4. Service Coordination and case management for SUDs and CODs
5. Counseling, therapy, trauma informed care, and psycho-education with individuals, families,
and groups
6. Client, Family, and Community Education
7. Documentation
8. Professional and Ethical Responsibilities
9. Clinical supervisory responsibilities for all categories of SUD Counselors
Category 2: Substance Use Disorder
Counselor
The Substance Use Disorder Counselor 2
can only practice under the auspice of a
licensed facility, within a primary care setting,
and under the clinical supervision of Clinical
Substance Use Disorder
Counselor/Supervisor or Clinical Substance
Abuse Counselor.
Category 1: Associate Substance Use
Disorder Counselor
Associate Substance Use Disorder Counselor –The Scope of Practice for the category
of those with an Associate’s degree include the following activities with clinical
supervision from a Clinical Substance Abuse Counselor or state approved supervisor
and/or administrative supervision of a Substance Abuse Counselor:
1. Diagnostic impression, and Screening, Brief Intervention, Referral to Treatment (SBIRT)
2. Monitor treatment plan/compliance
3. Referral
4. Service Coordination and case management for SUD
5. Psycho-educational counseling of individuals and groups
6. Client, Family, and Community Education
7. Documentation
8. Professional and Ethical Responsibilities
Category 1: Associate Substance Use
Disorder Counselor
The Associate Substance Use Disorder Counselor can
only practice under the auspice of a licensed facility or
a primary care setting, and under the clinical and/or
administrative supervision of an Independent Clinical
Substance Use Disorder Counselor/Supervisor and a
Clinical Substance Use Disorder Counselor or the
administrative oversight of the Substance Use
Disorder Counselor.
Substance Use Disorder Technician
Substance Use Disorder Technician – The Scope of Practice for the category of
those with a high school diploma or a GED include the following activities with
clinical supervision from a Clinical Substance Abuse Counselor/Supervisor, Clinical
Substance Abuse Counselor or state approved supervisor and/or administrative
supervision of a Substance Abuse Counselor:
1.
Diagnostic impression, and Screening, Brief Intervention, Referral to Treatment
(SBIRT).
2.
Monitor treatment plan/compliance
3.
Referral
4.
Service Coordination and case management for SUD
5.
Psycho-educational counseling of individuals and groups
6.
Client, Family, and Community Education
7.
Documentation
8.
Professional and Ethical Responsibilities
Substance Use Disorder Technician
The Substance Use Disorder Technician can only
practice under the auspice of a licensed facility or a
primary care setting, and under the clinical and/or
administrative supervision of Clinical Substance Use
Disorder Counselor/Supervisor, Clinical Substance
Abuse Counselor, or the administrative oversight of
the Substance Use Disorder Counselor.
Standardized Scopes of Practice
Model Scopes
of Practice and
Career Ladder
for Substance
Use Disorder
Counselors
Download now or later at: www.myaccucare.com/webinars
The Importance of Maintaining
Your Credential/License
Shirley Beckett Mikell, NCAC II, SAP
NAADAC Director of Certification &
Education
The Importance of Maintaining Your
Professional Standing
 Protection of the profession
 Protection of your clients/patients
 Protection of your colleagues
 Protection of your agency
 Protection of your practice
What is an Addiction Professional
Credentialing Program?
Addiction credentialing program =
an organized system of baseline
requirements that must be met in
order for a professional to practice
within a given field
What is an Addiction Licensing Board?
Established to:
• Enforce effective Substance Use Disorder practice
• Determine adequate practice standards
• Protect the public
• Develop and maintain performance standards
• Ensure safety of the public
• Act on ethical complaints
Licensure Boards
• 12 State - Substance Use Disorders Licensing
Boards
• 51 State – Substance Use Disorders Credentialing
Boards
• 9 National Credentialing Boards
• Available in every state and territory
• Similar criteria, requirements and standards
• State Boards recognized within each state
Accepted Credential Standards
 Should meet national criteria
 Should have specific educational requirements
 Should have specific skills set
 Should require clinical supervisory over site
 Should require renewal at least every 2 years
Obtaining the National
Credential for Addiction
Professionals
Shirley Beckett Mikell, NCAC II, SAP
Director of Certification and Education
Certification Opportunities
The NCC has 5 national credentials for addiction
professionals:
• Basic or Entry Level (BAC)
• National Certified Addiction Counselor (NCAC I)
• National Certified Addiction Counselor (NCAC II)
• Master Addiction Counselor (MAC)
• Nicotine Dependence Specialist (NDS)
Basic or Entry Level
 Current state certification/licensure as an alcohol and/or drug
abuse counselor.
 Two years full-time or 4,000 hours of supervised experience as an
alcohol and/or drug abuse counselor.
 200 contact hours of education and training in alcoholism and drug
abuse or related counseling subjects, including 6 hours of ethics
training and 6 hours of HIV/AIDS training.
 Passing score on the Basic Level written examination within 4
years of application.
NCAC I Requirements
 Current state certification/licensure as an alcohol and/or drug abuse
counselor.
 Three years full-time or 6,000 hours of supervised experience as an
alcohol and/or drug abuse counselor.
 270 contact hours of education and training in alcoholism and drug
abuse or related counseling subjects, including 6 hours of ethics
training and 6 hours of HIV/AIDS training.
 Passing score on the NCAC I written examination within 4 years of
application.
NCAC II Requirements

A Bachelor's level college degree from a regionally accredited
institution of higher learning.

Current state certification/licensure as an alcohol and/or drug abuse
counselor.

Five years full-time or 10,000 hours of supervised experience as an
alcohol and/or drug abuse counselor.

450 contact hours of education and training in alcoholism and drug
abuse or related counseling subjects, including 6 hours of ethics
training and 6 hours of HIV/AIDS training.

Passing score on the NCAC II written examination within 4 years of
application.
MAC Requirements
 Master's Degree in the healing arts or related field with in-depth
subjects applicable to the alcohol and drug abuse treatment arena,
by a regionally accredited institution of higher learning.
 Current state certification/licensure in alcohol and/or drug abuse
counseling or a related healing art.
 500 contact hours of specific alcohol and drug abuse counseling
training.
 Three years full-time or 6,000 hours of supervised experience, two
years or 4,000 hours of which is post master's degree.
 Passing score on the MAC written examination within 4 years of
application.
Nicotine Dependence Specialist

Current license or certification in the helping profession (i.e. nursing,
respiratory therapy and pharmacy) or teaching certificate or alcohol and
other drug certification

270 contact hours of education and training in the health care profession

85 hours or more of specific nicotine dependence training and validated
testing

3 years full-time or the equivalent employment in the helping profession

Passing score on the NDS written examination
Specialty Opportunities
The NCC also offers 4 specialty opportunities that allow
nationally certified addiction counselors to demonstrate
their knowledge base in a particular area of expertise:
• Substance Abuse Professional (SAP)
• Adolescent Specialist Endorsement (ASE)
• Conflict Resolution in Recovery Certificate
• Spiritual Caregiving to Help Addicted Persons and
Families Certificate
National Certified
Addiction Counselor
(NCAC I)
National Certified
Addiction Counselor
(NCAC II)
Master Addiction
Counselor(MAC)
Nicotine Depedence
Specialist (NDS)
Employm ent in a
substance use
disorder program or
treatm ent facility at
intern or novice
level
Must possess a
current state license
or certification as a
substance abuse
counselor from an
accepted state
credential
Must possess a
current state license
or certification as a
substance abuse
counselor from an
accepted state
credential
Must possess a
current state license
or certification as a
substance abuse
counselor from an
accepted state
credential OR current
state license in a
healing art (e.g. LPC,
LCSW, nurse, etc.)
Must possess a
current state license
or certification in the
health care
profession from an
accepted state
credential
Degree
Required:
High school
diplom a or
equivalent
High school
diplom a or
equivalent
BachelorÕs degree
with an emphasis in
counseling addicted
clients
MasterÕs degree in a
healing art or related
field with an
emphasis in
counseling addicted
clients
No requirem ent
Approved Education
&
Training:
125 contact hours of
education and
training in AODA
counseling subjects,
including 6 hours of
HIV/AIDS and 6
hours of ethics
270 contact hours of
education and
training in AODA
counseling subjects,
including 6 hours of
HIV/AIDS and 6
hours of ethics
450 contact hours of
education and
training in AODA
counseling subjects,
including 6 hours of
HIV/AIDS and 6
hours of ethics
500 contact hours of
education and
training in specific
AODA counseling
subj ects, including 6
hours of HIV/AIDS
and 6 hours of ethics
270 contact hours of
education and
training in the health
care profession,
including 85 hours of
specific tobacco
education and
training
2,000 hours/1 year
full-time supervised
experience in
AODA counseling
6,000 hours/3 years
full-time supervised
experience in
AODA counseling
10,000 hours/5 years
full-time supervised
experience in
AODA counseling
6,000 hours/3 years
full-time experience
in AODA counseling,
2 years post-masterÕs
degree
6,000 hours/3 years
of employm ent in a
health care
profession
Prerequisite:
National Certified
Addiction Counselor
(Basic Level)
Experience:
Credential Crosswalk
More Information
For more information about national
certification, please visit:
www.naadac.org/certification
Thank You for Participating!
Please feel free to ask questions!
1001 N. Fairfax Street., Ste. 201
Alexandria, VA 22314
phone: 703.741.7686/800.548.0497
fax: 703.741.7698/800.377.1136
www.naadac.org
naadac@naadac.org
Misti Storie: misti@naadac.org
1016 Leavenworth Street
Omaha, NE 68102
phone: 402.341.8880
fax: 402.341.8911
www.myaccucare.com
info@orionhealthcare.com
Emily Haverty:
ehaverty@orionhealthcare.com
Providing solutions to improve the quality of life for communities by
helping addictions professionals excel in their field through the use of
information technology.
Clinical
Administrative
Outcome
Reporting
Billing
Visit us today!
Call: (800) 324-7966
Click: www.MyAccuCare.com
Obtaining CE Credit
 The education delivered in this webinar is FREE to all professionals.
 2 CEs are FREE to NAADAC members and AccuCare subscribers who
attend this webinar. Non-members of NAADAC or non-subscribers of
AccuCare receive 2 CEs for $25.
 If you wish to receive CE credit, you MUST download, complete and
submit the “CE Quiz” that is located at:
 www.myaccucare.com/webinars
 www.naadac.org/education
 A CE certificate will be emailed to you within 30 days.
 Successfully passing the “CE Quiz” is the ONLY way to receive a CE
certificate.
Upcoming Webinars 2011

July 14, 2011 - Integrating Co-occurring Disorders: An Introduction to What
Every Addiction Counselor Needs to Know

August 18, 2011 - Strategies for Successful Test Taking

September 15, 2011 - Your Voice Counts: Advocacy and the NAADAC Political
Action Committee

October 13, 2011 - Conflict Resolution for Clients and Professionals

November 17, 2011 - What's Next in Your Career? Recap and Highlights from
the NAADAC Workforce Conference

December 15, 2011 - Clinical Supervision: Keys to Success
Register at: www.naadac.org/education or www.myaccucare.com/webinars
Archived Webinars
 Alcohol SBIRT: Integrating Evidence-based Practice Into Your Practice
 Medication Assisted Recovery: What Every Addiction Professional Needs to Know
 Build Your Business With the Department of Transportation Substance Abuse
Professional (SAP) Qualification
 Working with NAADAC to Express Your Professional Identity
 Screening, Brief Intervention and Referral to Treatment (SBIRT)
 Medicaid Expansion 2014 and Preparing to Bill for Medicaid
 Understanding NAADAC’s Code of Ethics
Archived webinars located at: www.naadac.org/education or
www.myaccucare.com/webinars
Thank You for Participating!
Christopher C. Campbell - chris@naadac.org
Donald P. Osborn - dposborn@hotmail.com
Shirley Beckett Mikell - shirley@naadac.org
1001 N. Fairfax Street., Ste. 201
Alexandria, VA 22314
phone: 703.741.7686/800.548.0497
fax: 703.741.7698/800.377.1136
www.naadac.org
naadac@naadac.org
Misti Storie: misti@naadac.org
1016 Leavenworth Street
Omaha, NE 68102
phone: 402.341.8880
fax: 402.341.8911
www.myaccucare.com
info@orionhealthcare.com
Emily Haverty:
ehaverty@orionhealthcare.com