Integrated care that aims to treat the whole person, including addiction, mental health and primary care needs, is changing the landscape of healthcare. These changes are ushering in a new era for addictions professionals. The New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) is committed to ensuring that all of its services fully recognize and respond to the needs of those in or seeking recovery from Substance Use Disorders (SUDs). Sustaining recovery from SUD goes beyond treatment and abstinence to the lifelong process of improved health, wellness, quality-of-life and continued reintegration with family and community. NYS OASAS is adapting a new model of patient care, one that addiction professionals will have to embrace and be trained in to ensure that quality care is delivered and indeed services that address the needs of the whole person are provided.
The New Behavioral Health Workforce: Changing with the Times
The medical field is constantly evolving and the addictions field is changing right along with it. To that end, the Credentialed Alcoholism and Substance Abuse Counselor (CASAC) job task analysis is updated on a regular basis. The most recent CASAC competencies included knowledge and skills related to screening, identification, integration and referral for co-occurring mental and physical health problems. Additionally, OASAS certifies a total of 89 CASAC certificate programs statewide, 56 Colleges/Universities and 33 Community Based Education programs, to offer a standardized 350 Hour Curriculum of SUD specific education. In addition to Addiction Counseling programs OASAS also certifies Bachelors, Masters and Doctoral programs in Psychology, Social Work, Mental Health Counseling and Marriage and Family Therapy to ensure that students receive addiction specific coursework and work experience that is not currently required for these disciplines. This prepares clinicians working toward NYS licensure to gain both mental health and addiction competencies that can be used in OASAS programs and other counseling and healthcare settings to provide integrated treatment.
There is also a fellowship opportunity for those individuals who are currently enrolled in or entering their second year of a Master’s Program that is also certified by OASAS as a CASAC Certificate Program. The fellowship is offered by the National Association of Addiction Professionals (NAADAC) and awards up to $20,000 toward tuition fees for those students who are currently, or committed to, working with minority populations and/or transition age youth. More information about this opportunity can be found at: http://www.naadac.org/nmfp-ac-eligibility-application-process.
Additionally, medical professionals will need to embrace further educational and experiential opportunities to learn more about SUDs. OASAS currently requires that all Medical Directors in OASAS certified programs also be Board Certified in Addictions. There will also be a need for additional Certified Addiction Registered Nurses and Nurse Practitioners to serve on the multi-disciplinary teams that treat clients in OASAS programs. This is important because individuals with co-occurring substance, mental health and/or physical conditions will need to have care that addresses all of their illnesses simultaneously without inadvertently making one or more worse due to lack of understanding of the interactions of the treatments being provided.
Fortunately, this has been foreseen for some time. In 2012, a study found that the implementation of the Affordable Care Act in 2014 would result in a significant increase in the need for professionals who are able to care for individuals with SUDs in a variety of managed healthcare settings [Vital Signs: Taking the Pulse of the Addiction Treatment Profession- Addiction Technology Transfer Center Network, 2012]. The same study also acknowledges the constant changes in technology and recognizes the importance of SUD treatment practitioners making sure they stay up to speed, building their computer and web-based technology skills.
More than Medicine: Skills to ‘Manage Care’ Needed
While the focus remains on the care and interest of the patient, there are other aspects changing in our field right now. Managed care is altering the landscape in which healthcare is delivered. Now that health insurance plans or health care systems are coordinating the provision, quality and cost of care for its enrolled members, addictions professionals need to know more and understand the principles of these payer systems. They will want to have a more comprehensive understanding of insurance and insurance companies to better understand how to work with payers, providers, patients and their families with regard to levels of care, reintegration and reimbursement.
Shortage in the Workforce: Building Our Ranks
The new age of the addictions field is in dire need of professionals. A recent survey found that retention continues to be an ongoing challenge for SUD treatment facilities. According to respondents, the average staff turnover rate is 18.5 percent [Vital Signs: Taking the Pulse of the Addiction Treatment Profession- Addiction Technology Transfer Center Network, 2012]. Additionally, the Bureau of Labor Statistics has indicated that the Substance Abuse and Behavioral Disorder Counselor category is growing at a much faster than average rate nationally at 22% for the years 2014-24. But efforts are underway to attract more interested and compassionate individuals into the field and current addictions professionals can help. There are several paths to take for anyone interested in pursuing a career in addictions. If you or someone you know is interested in working to address addictions in individuals, families and/or communities, head to www.nysoasas.ny.gov and click on Credentialing. There, you’ll find valuable information including eligibility requirements for Credentialed Alcoholism Substance Abuse Counselor (CASAC), Credentialed Problem Gambling Counselor (CPGC) or Credentialed Prevention Professional (CPP) and Credentialed Prevention Specialist (CPS). As stated above, the educational requirements for these credentials can be earned as part of an Associate’s, Bachelor’s, Master’s or Doctoral program in Psychology, Social Work or Counseling that are listed at this link: http://www.oasas.ny.gov/training/providers.cfm?providerType=CASAC-350.
Our community based CASAC certificate programs also offer opportunities for those that may already have degrees or are not seeking a degree at this time. Many second career individuals, who are retiring from one career and looking to continue to make a difference in people’s lives, are also taking advantage of these programs and the demand for new addiction counselors. Additionally, OASAS also approves two organizations to offer the Certified Recovery Peer Advocate certification for those individuals who are interested in serving those with SUDs in a peer capacity. Peer Advocates can work in OASAS programs or for agencies that are approved to offer Home and Community Based Services (HCBS) to individuals who qualify as members of Health and Recovery Programs (HARPs). More information on the OASAS approved Peer Advocate certification can be found at: www.oasas.ny.gov/recovery/PeerServices.cfm.
Education is not limited to those looking to get started in the addictions field. NYS OASAS is encouraging current professionals to expand their knowledge through ‘Learning Thursdays.’ This program is designed to provide those already working in the profession new, current evidence-based information to help ensure the delivery of the best clinical practice. The courses are free and strives to improve the lives of clients in prevention, treatment and recovery services. To register to receive Learning Thursday information visit www.oasas.ny.gov/LT/index.cfm. OASAS also offers in-person Regional Learning Opportunities which can be found at: www.oasas.ny.gov/workforce/training/oasastraining.cfm and a list of free online courses at: http://www.oasas.ny.gov/workforce/training/FreeLDO.cfm, all of which are approved for those seeking to satisfy the continuing education requirements necessary to renew an OASAS credential.
Current professionals can also do more to help fill the shortage in the addictions workforce. They can be mentors and role models, inspiring others to join the fold. We need a workforce that reflects our great nation, with professionals of all ages and from diverse backgrounds. All must be able to work together in this new, integrated setting.