Florida House Bill 823 and Florida Senate Bill 1138, both which sought to curb abuses in marketing practices in the Substance Use Disorder field, both died in their respective Appropriations Committee today.
Both bills rightfully sought to place the onus on treatment providers to ensure that their sources of client referrals were both legitimate and did not further take advantage of the generally uninformed treatment consumer.
I believe that marketing and delivering patients to treatment remains the #1 issue in this industry.
Unlike hospitals which are awarded a Certificate of Need and Necessity (CON) by AHCA (Agency for Health Care Administration), treatment centers are allowed to open anywhere and anytime, notwithstanding a lack of demonstrable need, resulting is various overconcentration of facilities.
This overconcentration has caused an unnatural shift in marketing economics where consumers cannot readily discern quality service providers nor the quality of the services being delivered.
Cynically, between the continued failure to fund informed regulators, combined with the intentional low funding for FARR by the State of Florida for 2016, we believe that a framework is being established to lobby Congress that “local government’s hands are tied; they have tried everything; the ADA and FHA need to be modified.” Those in power get the right to write the history books, I suppose.
The reality is, nothing could be further from the truth when it comes to the ability of local governments to rein in the abuses in the SUD treatment and housing industry.
The law in this field has been abundantly clear – any law that only affects a protected class is lawful so long as that law is intended to further protect that very same class.
In this instance, stronger marketing laws to create a fair and level playing field are an absolute, unequivocal must. It’s like sports and performance enhancing drugs – if there is no fairness in the game, then only those with money who elect to cheat will win. And then, we all lose.
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On that point, the New York Times recently wrote a story entitled “Centers To Treat Eating Disorders Are Growing, And Raising Concerns.”
Many SUD treatment providers have recognized the correlation, particularly in women, between eating disorders and SUD.
As the NYT writes:
“In an ever-expanding industry, some worry that the residential programs are taking advantage of vulnerable patients….. Their websites show peaceful scenes — young women relaxing by the ocean or caring for horses in emerald pastures — and boast of their chefs and other amenities. One center sends out invitations to a reception with cocktails and hors d’oeuvres. Another offers doctors and therapists all-expense-paid trips to visit and experience their offerings, including yoga classes. Several employ staff who call mental health professionals, saying they would love to have lunch. The marketing efforts by these for-profit residential care centers are aimed at patients with eating disorders and the clinicians who treat them. The programs have proliferated in recent years, with some companies expanding across the country.”
“n the companies’ rush to expand, they argue, quality of treatment may be sacrificed for profit. And they question whether the spa like atmosphere of some programs is so comfortable that it fosters dependency.”
“ ‘For the most part, the people who are running and working in these programs believe they’re doing the right thing,’ said Dr. Angela Guarda, the director of the eating disorders program at the Johns Hopkins Hospital in Baltimore.”
“ ‘But it’s a slippery slope,’ she said. ‘Money can cloud your view.’ ”
“Many eating disorders specialists agree that some patients require the supervision of residential programs and benefit from the treatment. But studies showing the programs’ effectiveness are scant, Dr. Guarda and other experts said. The methods of the handful of studies that exist have been criticized.”
“ ‘The effect of these clinician inducements, which are aimed at building a program’s patient referral base, may not be fully recognized by the professionals they target,’ ” wrote Dr. Attia and her colleagues, who included Dr. Guarda.”
Several industry representatives said that while they had not seen the journal article, they agreed that more data on patient outcomes and stricter standards were needed.”

