National Credentials: Why They Are Important

1. National Credentials:Why They Are Important Kathryn Benson, NCAC II, SAP Chair, NCC AP

2. What is an Addiction Professional Credentialing Program? An addiction credentialing program is an organized system of baseline requirements that must be met in order for a professional to practice within a given field

3. Benefits of Certification Professionalization of the field of substance use disorders Proven method by which addiction professionals are recognized Constant actualization of skills and knowledge of addiction professionals Clients verification that persons offering treatment services are competent, skilled and knowledgeable It improves overall quality of services

4. What is an Addiction Licensing Board Established to: Enforce effective Substance Use Disorder practice Determine adequate practice standards Protect the public Develop and maintain performance standards Ensure safety of the public Act on ethical complaints

5. Licensure Boards 15 State - Licensing Board for Substance Use Disorders 51 State – Substance Use Disorder Credentialing Boards Nine National Credentialing Boards -Available to in every state and territory -Similar criteria, requirements, standards -State Boards recognized within each state

6. Accepted Credential Standards Should meet national criteria Should have specific educational requirements Should have specific skills set Should require clinical supervisory over site Should require renewal at least every 2 years

7. Overview of the Behavioral Health Workforce

8. Need and Demand for Behavioral Health Services Integration of Substance Use Disorders practitioners as a specialty profession is essential Recognition that SUD Professionals have supported the medical, mental health and other behavioral health professionals is paramount to integrated care.

9. Need and Demand for Behavioral Health Services Acceptance that the SUD Professional has emerged into a full fledged profession

10. A Specialty Profession Substance Use Disorders is a specialty profession requiring: Specific training and education Specific skill sets Core competencies and knowledge Practice experience

11. A Specialty Profession This profession has its own Core competencies Scopes of practice Career ladder Standard of Ethics

12. Scopes of Practice The activities of a counselor within the Substance Use Disorder profession are based on the practice dimensions outlined in TAP 21 and include the following: 1. Clinical Evaluation 2. Treatment Planning 3. Referral 4. Service Coordination 5. Counseling

13. Scopes of Practice 6. Client, Family, and Community Education 7. Documentation 8. Professional and Ethical Responsibility

14. Scopes of Practice Category 4: Independent Clinical Substance Use Disorder Counselor/Supervisor Category 3: Clinical Substance Use Disorder Counselor Category 2: Substance Use Disorder Counselor Category 1: Associate Substance Use Disorder Counselor Substance Use Disorder Technician

15. The Substance Use DisorderTreatment Workforce • Full-time Employees • Part-time Employees • Contracted Employees • Administrative Staff • Prevention Specialists • Nurses • Intervention Specialist • Mental Health Counselors • Psychologists • Physicians • Social Workers • Criminal Justice Workers • Clinical Supervisors • Psychiatrists • Peer Recovery Coaches

16. Work Force Placements Private and Public ( local, state, federal and international) Prevention and Treatment Schools ( elementary, secondary and post secondary) Higher Education(Professors, Researchers

17. Under Representation of Minorities in Behavioral Health Workforce • Although minorities make up approximately 30% of the U.S. population, they currently account for only • 24.3% of all psychiatrists, • 5.3% of psychologists, • 20% of counselors, • 8.5% of marriage and family therapists, • 4.9% of school psychologists, and • 9.8% of psychiatric nurses (Duffy et al., 2004).

18. Certificants by Race

19. Eliminating Disparities • Although minorities are a growing percentage of the nation’s population, they continue to be underrepresented in the behavioral health field. • We need to attract more minorities to the behavioral health workforce.

20. Eliminating Disparities, Cont. • Only 10.4% of those (12 and older) who needed treatment for a drug or alcohol use problem in 2007 received it at a specialty facility. • We need to expand access to underserved areas and populations with culturally appropriate services and treatment.

21. Certificants by Age

22. Certificants by Certification/Licensure

23. Certificants by Work Setting

24. Challenges Inadequate college/ university specific education/preparation Lack of ability to obtain student loan and loan forgiveness Inadequate supervision Licensing/credentialing requirements vary from state to state Inadequate salaries

25. Challenges Continued 1. Acceptance of career ladder that is tied to scopes of practice 2. Reduce stigma for patients & professionals 3. Minority recruitment 4. Adding addictions professionals to national Service Health Core 5. Promotion & Recognition at the agency and state level to enhance recruitment 6. Resources for one-stop treatment cent

26. Challenges Continued 7. Training with technology transfer for Evidence Based Practices 8. Salary & Benefit enhancement 9. Outcome and monitoring systems for agency Programs (computerized & software support) 10. Increase funding at the state level 11. Increase funding at the agency level

27. Overcoming Challenges Building Capacity for HBCU, HIS, and Tribal, PBS/PBI by providing technical assistance in increasing degree programs Offer both on-line and traditional courses and degrees Provide regional leadership conferences for faculty and students in the field.

28. Overcoming Challenges Cont. Provide regional curriculum development workshops through the use of technology (webinars) in developing curricula, training workshops, etc. Incorporation of Core Competencies in current Syllabi Incorporation of evidence-based and emerging best practices into course syllabi

29. Overcoming Challenges Cont. Incorporation of infusion into non-substance abuse /mental health offerings in all curricula Integration of HIV/AIDS and substance abuse (relationship of alcohol and other drug use and mental health to HIV/AIDS) in curriculum development

30. Overcoming Challenges, Cont. Research and compilation of a database on the licensure process for each State Research and compilation of a database on the certification process for each State Research and compilation of a database that matches national accreditation body requirements with State requirements

31. Overcoming Challenges, Cont. Provide training assistance opportunities for faculty and practitioners ready to take licensure and/or certification examinations in substance abuse, including mock examinations, refresher courses, and assistance with completing applications

32. Overcoming Challenges, Cont. Creation of a database of employment opportunities, cooperative agreement availability, and substance abuse internship opportunities at the national and State levels and with community- and faith-based organizations serving substance abuse and behavior health agencies

33. Overcoming Challenges, Cont. Expose students to strong mentors and career opportunities in behavioral health.

34. SAMHSA Response: Minority Fellowship Program (MFP) • SAMHSA program supported by all three centers, CSAT, CSAP, CMHS. • Purpose: to facilitate the entry of ethnic minority students into mental health careers and increase the number of psychologists, psychiatric nurses, psychiatrists, and social workers trained to teach, administer, and provide direct mental health and substance abuse services to ethnic minority groups.

35. SAMHSA Response (CSAT) • 207 grantees who target African American/Black populations: • Minority AIDS Initiative: Targeted Capacity Expansion- HIV/AIDS and HIV/AIDS Outreach • Addiction Treatment – Homeless (AT-HM) • Young Offenders Reentry Program (YORP)

36. SAMHSA Response, CSAT, Cont. Access to Recovery (ATR) Treatment Drug Courts (TDC) Pregnant & Postpartum Women (PPW) Recovery Community Support Program (RCSP) Screening, Brief Intervention & Referral to Treatment (SBIRT)

37. HISTORY OF THE CERTIFICATION PROCESS IN THE UNITED STATES

38. History of Certification People working in the addiction counseling profession wanted their skills and knowledge to be acknowledged and obtain professional recognition for their work. A voluntary certification process began in the early 1970s. Certification procedures and eligibility were established by independent professional boards.

39. History of Certification The US government began in the late 1970s to include requirements for persons to demonstrate that they held and had obtained credentials to practice within the facilities receiving Federal funds. Until the 1980s, this was a voluntary process, and presently in 5 states, the voluntary status remains. Nevertheless, treatment facilities within those states require their personnel to be licensed. Different states establish different eligibility requirements for certification or licensing.

40. THE NATIONAL CERTIFICATION COMMISSION (NCC)

41. NationalCertificationCommissionforAddictionProfessionals(NCC AP) Under the banner of NAADAC, the Association for Addiction Professionals, the National Certification Commission for Addiction Professionals (NCC Ap) operates as an independent body for all matters involving the Association’s alcohol and drug abuse counselor certification and specialty endorsement opportunities at the national/international level.

42. National Certification Commission (NCC) The NAADAC/NCC AP is building the profession by ensuring high standards of excellence for certification/licensure and by providing quality continuing education.

43. History of the NCC AP Established in 1990 under the auspices of NAADAC, The Association for Addiction Professionals The NCC AP has independent autonomy in the development and promulgation of our standards for testing, including: who qualifies for the exams content administration scoring Appeals Development of new Credential Products

44. Mission of the NCC AP The purposes and benefits of the NCC AP’s national certifications are: to focus on the individual counselor and to provide a formal indicator of the current knowledge and competence at the national level; to provide a national standard that is generally higher than the state requirements and encourages professionals to continue to learn for the sake of their clients;

45. Mission (cont.) to afford a means of establishing, measuring, and monitoring the requirements for knowledge in the profession; and to provide assistance to employers, health care providers, educators, government entities, labor unions, other practitioners, and the public in the identification of quality counselors who have met the national competency standards.

46. Certification Opportunities The NCC AP instituted three credentials for alcoholism and drug abuse counselors: National Certified Addiction Counselor (NCAC I) National Certified Addiction Counselor (NCAC II) Master Addiction Counselor (MAC)

47. NCAC I Requirements Current state certification/licensure as an alcohol and/or drug abuse counselor. Three years' full-time or 6,000 hours of supervised experience as an alcohol and/or drug abuse counselor. 270 contact hours of education and training in alcoholism and drug abuse or related counseling subjects, including 6 hours of ethics training and 6 hours of HIV/AIDS training. Passing score on the NCAC I written examination within 4 years of application.

48. NCAC II Requirements A Bachelor's level college degree from a regionally accredited institution of higher learning. Current state certification/licensure as an alcohol and/or drug abuse counselor. Five years full-time or 10,000 hours of supervised experience as an alcohol and/or drug abuse counselor. 450 contact hours of education and training in alcoholism and drug abuse or related counseling subjects, including 6 hours of ethics training and 6 hours of HIV/AIDS training. Passing score on the NCAC II written examination within 4 years of application.

49. MAC Requirements Master's Degree in the healing arts or related field with in-depth subjects applicable to the alcohol and drug abuse treatment arena, by a regionally accredited institution of higher learning. Current state certification/licensure in alcohol and/or drug abuse counseling or a related healing art. 500 contact hours of specific alcohol and drug abuse counseling training. Three years full-time or 6,000 hours of supervised experience, two years or 4,000 hours of which is post master's degree. Passing score on the MAC written examination within 4 years of application.