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Your ParticipationWebinar Housekeeping

This webinar contains intermediate to advanced accreditation information

3© 2019 The Joint Commission. All Rights Reserved.

Yvonne RockwoodAssociate Director

Behavioral Health & Human Services Program, The Joint Commission

[email protected]

Accreditation forThe Changing Face of Addiction

Treatment

The Joint Commission

Peter VanceField DirectorBehavioral Health & Human Services Program, The Joint CommissionSurveyor Management & Development,Accreditation & Certification Operations [email protected]

mailto:[email protected]



Today’s Agenda

1. Introducing The Joint Commission2. MAT, OTP & OBOT - Overview3. New Addiction Treatment Standards4. Accreditation Resources & Tools5. Questions

The Joint Commission Background


Accrediting Behavioral Health Care Organizations since 1969

The Joint Commission


Accreditation is the process of inviting outside experts to conduct a review of your organization to validate and improve the safety and quality of care, treatment and services.

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What is Accreditation?


− Increases credibility by demonstrating the organization’s commitment to quality and safety

− Improves operations by standardizing processes and providing a management outline for leadership

− Supports a culture of excellence through continuous improvement and integration of data into daily operations

− Reduces risk and improves emergency management by integrating risk reduction activities into daily operations

− Helps expand reimbursement options and referrals and helps improve standing with payors

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What Will Accreditation Do For Your Organization?


To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.

Our Mission All people experience

the safest, highest quality, best-value health care across all settings.

Our Vision

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Mission and VisionBased on Oakbrook, IL (Chicago)


•Behavioral Health Care•Community Health Centers•Home Care Agencies•Hospitals•Laboratory Services•Medical Group Practices•Nursing Care Centers•Radiology/MRI Centers•Sleep Centers

Over 23,000 Health Care

Organizations Accredited

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Reputation Across the Continuum of Health Care


− Oldest and largest accrediting body in Behavioral Health Care

− Widely respected as the "Gold Standard" in BHC

− Providing accreditation across a broad range of settings/services

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Non Profit38%

For-Profit40%

Other22%

Over 3,300 Organizations11,000 + Locations

Non Profit For Profit Other

Reputation inBehavioral Health & Human Services

− Over 3,300 Accredited Organizations− Over 11,700 sites− 38% not-for-profit− 40% for profit− 22% governmental agencies/facilities


National Level Recognition:•Federally deemed by SAMHSA as an approved provider of

opioid treatment program accreditation •Approved as a national accreditor of QRTPs for the Family

First Prevention Act (FFPSA)

State Level Recognition:•Approved accreditor for state requirements or regulatory

relief by 250 distinct administrative agencies within all 50 states and the District of Columbia

•Certified Behavioral Health Homes in 15 States www.jointcommission.org/BHCS

Recognition inBehavioral Health & Human Services

http://www.jointcommission.org/BHCS

OTP, MAT, and OBOT


Opioid Treatment Program

Federally certified programs that use FDA approved medications, including methadone, in combination with counseling and behavior therapies.

Office-Based Opioid Treatment

Outpatient Opioid Use Disorder (OUD) treatment program typically using buprenorphine and other non-methadone medications in combination with addiction therapies and has no requirement to be federally certified.

Medication Assisted Treatment

Essentially the same as OBOT, but usually refers to a prescriber with a DATA 2000 waiver prescribing FDA approved medications for OUD and has no requirement to be federally certified. Medication Assisted Treatment may also refer to treating Alcohol Use Disorder.

OTP, MAT, and OBOTHow do they Differ?


Product DEA Schedule Treatment Settings

Methadone II OTP

Buprenorphine (Subutex) III Physician office, OTP, or other healthcare setting

Buprenorphine-naloxone (Suboxone) III Physician office, OTP, or

other healthcare setting

Naltrexone Not scheduledPhysician office, OTP, or any substance abuse treatment program

FDA Approved Drugsfor OUD Treatment


− Any time methadone is being used to treat opiate addiction whether for detoxification or maintenance. (Exception: 72-hour rule, Title 21 CFR Part 1306.07(b))

− When a federally certified licensed independent practitioner exceeds the limit for the number of patients, they are prescribing buprenorphine to treat opiate addiction. (30/100/275)

− When providing buprenorphine in a detoxification program from the program's own pharmacy (i.e. residential, hospital).

− Federal certification allows a licensed independent practitioner to prescribe buprenorphine products for up to 30 patients at a time in the first year of certification, and then for up to 100 patients at a time thereafter.

When to Seek OTP Accreditation


− Qualified licensed independent practitioners allowed to dispense or prescribe specifically approved Schedule III, IV, and V narcotic medications for the treatment of opioid addiction in various treatment settings

− Accreditation not required− Patient limits 30-100-275− Goal – to bring treatment of addiction

back to the primary care provider− All OBOT physicians must complete the

training in the use of buprenorphine required by the Drug Addiction Treatment Act 2000 (DATA 2000)

Office Based Opioid Treatment (OBOT)

Requirements to receive a federal waiver:

•Current State license•Valid DEA registration number•Qualified by training and/or

certification•At 275 patient limit there are

additional requirements*

New & Revised Joint Commission Substance Use

Disorder Treatment Standards


− New SUD Standards are effective July 1st, 2020− The Standards

1. CTS.02.02.09, EPs 5 (revised) and 15 NEW EP2. CTS.02.03.07 EPs 1, 2 and 7 (all revised)3. CTS.02.03.13, EP 1 NEW STANDARD4. CTS.02.03.15 EPs 1, 2 and 3 NEW STANDARD5. CTS.03.01.03 EP 28 NEW EP6. CTS.04.03.35 EPs 5 (revised) and 8 NEW EP7. CTS.06.02.01 EP 4 (revised)8. LD.04.02.03 EP 10 NEW EP

New & Revised Substance UseDisorder Treatment Standards


New and Revised Standards Overview − Some standards, previously only applicable to the

OTP service are now more widely applicable:− Individual rights while collecting urine drug

specimens−OTP providers as well as MAT providers must

have staff trained in withdrawal management and CPR

−Providing referrals for on-going care when individual discontinues MAT


− New standard to promote best practices around urine drug screening−Rationale−Documentation−Staff training

New and Revised Standards Overview – Urine Drug Testing


− Creating and initiating a care plan as soon as possible upon entry into treatment.

New and Revised Standards Overview – Care Plan


− Transparency with the charges that the individual served will be responsible for prior to them entering a program.

New and Revised Standards Overview – Cost Transparency


− Revised existing addiction treatment assessment requirements to include all aspects of a multidimensional assessment, such as method of acquiring substance, readiness to change, and living situation while in recovery

− A new standard requiring addiction treatment programs to use an evidence-based multidimensional assessment (e.g., ASAM, LOCUS) to place individuals in the appropriate level of care

New and Revised Standards Overview – Level of Care


− Surveyors will be able to use the evidence-based process the organization has in place to survey the level(s) of care they provide

New and Revised Standards Overview – Level of Care

Accreditation Resources


− R3 Report− 2020 Free Webinars & Webinar Replays− Joint Commission Suicide Prevention Portal− JCR Paid Webinar Series (Breakfast Briefings)− Joint Commission Annual BHC Conference − SAMHSA− AATOD

Resources

See Handouts Section for .pdf of new/revised standards

https://www.jointcommission.org/standards/r3-report/r3-report-issue-25-enhanced-substance-use-disorders-standards-for-behavioral-health-organizations/

https://www.jointcommission.org/resources/news-and-multimedia/webinars#f:setting_type=%5Bbehavioral%20health%20care%5D

https://www.jointcommission.org/en/resources/patient-safety-topics/suicide-prevention/

https://store.jcrinc.com/behavioral-health-care-and-human-services-accreditation-on-demand-webinar-series/?_ga=2.73242837.733378850.1595995381-1312486642.1563463407

https://store.jcrinc.com/behavioral-health-care-conference-live-virtual-october-28-30-2020/?_ga=2.182106337.733378850.1595995381-1312486642.1563463407

https://www.samhsa.gov/

http://www.aatod.org/


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Julia Finken, RN, BSN, MBA, CPHQExecutive [email protected]

Colette Bukowski, MA, LPCC-SAssociate Director [email protected]

Darrell Anderson, BAManager- [email protected]

Yvonne Rockwood, MBA/MHA CPHQAssociate Director [email protected]

Tiffany Holloway, MBAManager - [email protected]

Eastern Region Western Region

Behavioral Health Care AccreditationBusiness Development Team






Questions?Thank You

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