NASADAD Letter to Congress regarding
Faith-based Addiction Programs
NASADAD
sent a letter to Congress asking them to not support language in a
Community Renewal Bill that allows the Secretary of DHHS to exempt any
faith-based treatment counselor from state licensing requirements.
July 13, 2000
Dear Senator or Representative:
On behalf of the National Association of State Alcohol and Drug Abuse
Directors (NASADAD), I am writing to oppose sections of Title IV of S.
2779, the American Community Renewal and New Markets Act or the House
companion bill. Language in this section related to the licensure of
substance abuse professionals would amend authorities of the Substance
Abuse and Mental Health Services Administration (SAMHSA) under Title V
of the Public Health Service Act and override the authority of States to
govern basic health care standards for substance abuse treatment
professionals within their jurisdiction. NASADAD represents the concerns
of State Alcohol and Drug Abuse Directors who administer the $4 billion
public alcohol and drug prevention and treatment system.
The Title IV (Faith Based Substance Abuse Treatment) finds that
"establishing formal educational qualifications for counselors
and other personnel in drug treatment programs may undermine the
effectiveness of such programs" and that " formal
educational requirements may hinder or prevent the provision of needed
drug treatment services." Of great concern is a provision that
allows the Secretary of Health and Human Services to require a State to
waive their educational qualifications for substance abuse professionals
if the "State has failed to demonstrate empirically that the
educational qualifications in question are necessary to the operation of
a successful program."
Faith Based Providers Are Welcome and Utilized
States welcome and currently use a wide range of faith-based
providers and counselors to provide substance abuse prevention and
treatment services. Faith based providers have been and will continue to
be a key component of the health network utilized by States that
provides services to prevent and treat alcohol and drug addiction.
NASADAD worked closely with Chairman Frist, Member of the Senate Labor
and Human Resources Committee, and the Administration to assure the
inclusion of Charitable Choice language in S. 976, the bill to
reauthorize the Substance Abuse and Mental Health Services
Administration.
Research and Practice
However, changes proposed in Title IV of S. 2779 are in conflict with
the research findings of the National Institute on Drug Abuse (NIDA)
which classifies drug abuse as a brain disease and recognizes that
effective drug and alcohol abuse treatment must have both medical and
behavioral therapy components, in addition to a broad array of social
support services. Both NIDA and the National Drug Control Strategy,
formulated by the Office of National Drug Control Policy, call for
science-based principles and program accountability for substance abuse
treatment services. Limited governmental resources are best provided to
providers and individuals who have the training and education to conduct
programs that are consistent with established knowledge, based on
scientific principles, and capable of demonstrating outcomes through
rigorous evaluation. All providers and programs seeking Federal or State
dollars should be expected to embrace these recognized principles and
standards.
State Approval Of Practitioners Is Essential
Responsibility for certification of facilities and individuals
providing substance abuse services has traditionally and appropriately
resided with the States. Every State certifies or licenses substance
abuse facilities and counselors in a manner similar to the process used
for other health facilities or professionals.
Just as faith-based hospitals and physicians must meet accepted
standards so should faith-based substance abuse treatment facilities and
professionals. The State licensure/certification system helps to protect
consumers from individuals who provide inappropriate or sub-standard
care as well as assures effective treatment.
Core Competencies
There is a strong national consensus around core competencies that a
substance abuse practitioner must demonstrate in order for them to be
effective. These competencies can only be achieved through education,
training, and supervised experience. As is the case for other health
care professionals, States have evolved a process to ensure that those
standards of competency are met. In no other health care profession has
Federal legislation been proposed that would force States to abandon
established qualifications for practitioners.
The specific individual skill sets and areas of knowledge required to
effectively treat alcoholism and drug addiction are broadly accepted and
applicable to all treatment settings and philosophies. This includes
treatment provided in facilities affiliated with religious
organizations. Demonstrated competency in those skill sets and subject
areas form the basis for alcohol and other drug counselor certification
within specific States and for the reciprocity of professional
certification between States. The recognized core competencies are: