NAATP Code of Ethics - 2014 A common sense approach to "mission vs. margin" in the fast-changing environment of addiction treatment

1. NAATP Annual Conference – May 18, 2014
Bob Ferguson, Ethics Committee Chairman
NAATP Code of Ethics
A common sense approach to
balancing “mission vs. margin”
in the ever-evolving landscape
of addiction treatment.

2. Addiction Treatment at the Ethical Crossroads…
Who is policing what is being promised on the Internet, as well as by the
call centers interwoven into the marketing strategies of treatment providers?
Who comes between the desperate family and the treatment provider, to
guarantee that treatment is valid and likely to produce a good outcome?
• Paying bounties for referrals.
• Large gifts to interventionists with whom a program works.
• Insurance “bait and switch” when reimbursements are very low.
• Call centers sharing patient info among treatment centers.
• Kickbacks to and from toxicology labs and treatment facilities.
• Billing the patient for proprietary nutrient supplements.
• Promising a cure.
NAATP Code of Ethics

3. Environmental challenges facing today’s leaders
• Shifting payer mix – managed care, out of network, private pay
• Consolidation via mergers & acquisition
• Industry growth via start-ups, increased competition
• Uncertainty around ACA and Parity Act and inclusion of residential as an “essential
service.”
• Impact of social media – emergence of the visible and vocal consumer
• Emergence of online/direct to consumer marketing: “Caveat Emptor”
NAATP Code of Ethics

4. Source: American Marketing Association
https://archive.ama.org/Archive/AboutAMA/Pages/Statement%20of%20Ethics.aspx
Ethical Values
American Marketing Association
Respect – to acknowledge the basic human dignity of all stakeholders.
Transparency – to create a spirit of openness in marketing operations.
Honesty – to be forthright in dealings with customers and stakeholders.
Responsibility – to accept the consequences of our marketing decisions and strategies.
Fairness – to balance justly the needs of the buyer with the interests of the seller.

5. Guiding Principals for NAATP Code of Ethics
• A “common sense” document that is evolving and dynamic
• The ethics conversation as a process, not an event.
• Create a forum for discussion and debate – i.e. leadership versus enforcement?
• Membership organization versus an accrediting agency
NAATP Code of Ethics

6. “What is moral is what you feel good after; what is immoral is
what you feel bad after.”
- Ernest Hemingway

7. Benchmark Study – May, 2013
• Educational Consultants – IECA http://www.iecaonline.com
• Therapeutic Schools & Programs – NATSAP www.natsap.org
• Professional Chaplains – ACP http://www.professionalchaplains.org
• Chiropractors – ACA http://www.acatoday.org
• Doctors of Acupuncture – AAOM http://www.aaaomonline.org
• Midwives – NACPM http://www.nacpm.org
Examine, compare and identify:
1. Mission, Vision and Values
2. Criteria for Membership
3. Code of Ethics
4. Enforcement of Standards of Practice
5. Handling of Complaints
NAATP Code of Ethics

8. NAATP Code of Ethics

9. …Just as personal responsibility
and accountability are
underscored in treatment for the
recovery process, NAATP
treatment providers shall assume
such responsibility and
accountability in their provision of
treatment services, in their
management practices, in their
staff relationships, in their
relationships with other publics,
and in their marketing.
NAATP Code of Ethics

10. Treatment
• Specific admission and referral criteria are developed and adhered to for every
level of service provided.
• Quality treatment services are provided that appropriately meet the physical,
emotional, social and spiritual needs of the patient and family.
• Treatment programs enhance the dignity and protect the human and legal rights
of the patient and family.
• Continuing care (or “aftercare”) services are considered essential to the continuum
of care.
NAATP Code of Ethics

11. Management
• Governing authority clearly states organizational goals and objectives
• Staff members who subscribe to the professional standards of their respective
fields provide interdisciplinary team treatment.
• Treatment facilities develop relationship with other health care providers to assure
they are an integral part of a community’s health care services system.
• Fee structures are made available to the public.
• Treatment facilities do not discriminate against any person for any services
provided on the basis of race, creed, sex or national origin.
• Treatment facilities recognize that ongoing internal evaluation of care is essential.
NAATP Code of Ethics

12. Facilities
• All applicable local, sate and federal life safety, occupational safety, health and
fire codes are met.
• When a facility serves the handicapped, they are assured accessibility and
maneuverability.
• The treatment facility’s environment enhances the human dignity and rights
of patients.
• Positive community relationships are developed and nurtured.
• There is cultivation of good relationships and communications with related public
and private agencies, associations, and institutions.
NAATP Code of Ethics

13. Marketing
Financial rewards for patient referrals:
No financial rewards or substantive gifts are offered for patient referrals.
Treatment providers may refer families or individuals to a variety of treatment or
recovery support professionals, including interventionists; continuing care providers;
monitoring agencies; and/or referral sources that offer services to patients prior to or
after outpatient or residential treatment.
However, in no case should treatment providers make payment or compensation to
these individuals or organizations in exchange for patient referrals – neither in the form
of direct payment, consulting contracts, large gifts, nor other forms of remuneration or
compensation.
NAATP Code of Ethics

14. Marketing
Deceptive advertising or marketing practices:
Treatment providers will not engage in deceptive or misleading advertising or
marketing practices.
NAATP members and member organizations will provide information in their
advertising; on their websites; and in their collateral marketing materials about the
general location of their facility or facilities; the credentials of their staff; and the
length of stay in their programs.
In addition NAATP members and member organizations will not utilize any form of
false or misleading advertising; will not engage in “patient brokering;” will not exploit
patients and or families, particularly for the purpose of promoting their programs; and
will not engage in competitive practices that are unduly predatory and/or destructive to
a collaborative marketplace.
NAATP Code of Ethics

15. Marketing
Exposing Clients’ Identities for Marketing Purposes
Treatment providers will not exploit their clients’ rights to privacy for the
purpose of promoting or marketing their programs.
NAATP members and member organizations hold sacred the shared value of our
patients’ rights to privacy. Clients’ identities may not be revealed by a treatment
provider – neither in the form of photographic images, video images, media coverage,
nor in marketing testimonials – at any time during the client’s engagement in treatment.
NAATP Code of Ethics

16. “…is filled with disturbing
accounts of seriously addicted
people getting very limited
care at exhaustive costs and
with uncertain results - but in
my experience, they are
accurate accounts.”
A. Thomas McLellan, PhD -
Introduction to Inside Rehab
NAATP Code of Ethics

17. NAATP Code of Ethics

18. NAATP Code of Ethics

19. NAATP Code of Ethics

20. Complaints Policy and Procedure – Draft Language
Complaints charging members of NAATP with unethical behavior or practices shall
be investigated, processed, and resolved in accordance with procedures…
1. Seek informal resolution between parties first
2. Formal written complaint to NAATP Ethics Committee Chair
3. NAATP will notify respondent within 10 days
4. Ethics Committee must determine if there is “probable cause” to investigate
5. All parties notified, investigation conducted by Ethics Committee
6. Ethics Committee submits findings to Board of Directors
7. Respondent may request appearance at next Board of Directors meeting
8. Board of Directors makes final decision and notifies all parties.
NAATP Code of Ethics

21. Complaints, Enforcement, Accountability
• Ethical complaints:
• Forwarded to member organization CEO
• Complainant referred to State Licensing +/or Accrediting Agency
• Member Accountability:
• Proof of valid and current state licensure; new members & renewals
• Member sign off on Code of Ethics; new members & renewals
NAATP Code of Ethics

22. Looking ahead…
1. Revise, adopt, and disseminated an update Code of Ethics
1. Communicate with NAATP members and consumers
• Prominent placement on NAATP website
• Information session at NAATP annual conference
• Email blast to NAATP members
• Media release to consumer and trade media
2. Education and leadership for NAATP members
• Provide ethics panels at future conferences (i.e. NCAD and NAATP)
• Ethics column in quarterly newsletter
• Bring gray areas into sharper focus through debate and discussion
NAATP Code of Ethics

23. NAATP Annual Conference – May 18, 2014
Bob Ferguson, Ethics Committee Chairman
NAATP Code of Ethics
A common sense approach to
balancing “mission vs. margin”
in the ever-evolving landscape
of addiction treatment.