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It’s Time to Shift Behavioral Healthcare in Florida to the Healthcare Regulators

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at March 25, 2016

Again, hats off to Vendome Healthcare Media and their publications, Behavioral Healthcare, and Addiction Professional, for constantly staying engaged in current affairs affecting our industry. Please consider patronizing these publications and attending their conferences – in modern journalism, advertising only goes so far, and a fair, independent press is essential, particularly as we try to tell the true story about Substance Use Disorder and the see the faces and hear the voices of those going through their own recovery pathways.

Behavioral Healthcare Editor-in-Chief Julie Miller writes again about a September 4, 2012 (!) report from the State of California Senate Rules Committee (which continues to apparently fall on deaf ears) entitled: “Rogue Rehabs: State failed to police drug and alcohol homes, with deadly results.”

“The report, ‘Rogue Rehabs,’ from the California Senate Office of Oversight and Outcomes noted that the department in charge of regulating treatment facilities ‘consistently failed to catch life-threatening problems, and when it did, neglected to follow up to assure that dangerous practices stopped.’ It went on to outline the details of several patient deaths in treatment facilities, including the death that prompted the case against [American Addiction Centers].”

Our takeaway: Not to throw the Florida Department of Children and Families (DCF) under the bus, but here in Florida we have a child welfare agency which is underpaid and understaffed yet singularly responsible to regulate and govern a multi-billion dollar healthcare industry, not to mention a behavioral healthcare industry, all of which is simultaneously intertwined with housing policy and the de-stigmatization of mental health issues.

Not so coincidentally, the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) just released a report entitled: “Some Florida Childcare Centers Did Not Always Comply with State Health and Safety Licensing Requirements,” finding that although DCF or county conducted the required inspections at the four providers that were reviewed”

“This onsite monitoring did not ensure that providers that received funds from the Child Care and Development Fund complied with State licensing requirements related to the health and safety of children. Although one provider complied with staff and child record requirements, all four of the providers that we visited did not comply with the physical conditions requirements, two providers did not comply with staff record requirements, and two providers did not comply with child record requirements…. The instances of noncompliance at all four providers occurred because the State licensing agency and county did not ensure that the providers took proactive steps to remain compliant with the minimum State licensing requirements related to the health and safety of children.”

As I have said over and over again, if we thoroughly regulate treatment providers and ensure consistency in treatment outcomes, Recovery Residences naturally fall into line.  But we can’t do that with DCF being the warden.

Recovery Residences fail when they are used primarily as the location to warehouse patients for future treatment. Recovery Residences alone do not and cannot (currently) be paid via insurance. For me, that’s like saying insurance will pay for your surgery but you have to pay for the post-op recovery room out of pocket.  As a result, Recovery Residences have tended to attract the wrong kind of business person and operator.

Meanwhile, AHCA (the Florida Agency for Health Care Administration) and the Florida Department of Health vigorously regulate all other forms of health care businesses, yet exclude this one because we claim it is “behavioral” healthcare, as if the mind and body are not connected by neurons and blood vessels.  That makes all the more reason to regulate it. Make sure it’s done right. It’s important. We know what the side effects are of unregulated treatment providers which tend to be abusive Recovery Residences.  But, like California, our entire nation appears to reject the notion that it takes all of us to pay appropriately for the regulation of such care, to ensure all of these people (who are always people we know and/or are related to) are appropriately taken care, by a well-run regulatory body that allows the marketplace to do what it does best, under rules to avoid victimization.  We simply do not want to admit that our national addiction to drugs has more to do with our culture of pain avoidance than moral failing. No one is immune.

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