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In the Streets

By: Richard Buckman

In the Streets puts the spotlight on recovery housing, issues surrounding it and its crucial transitory step in the continuum of recovery.

Is Recovery Coaching Driven by Economics?

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Jul 04, 2011
As I delve deeper into the topic of recovery coaching, let me make clear that I approach it with a heavy dose of cynicism. Although the developments in recent years appear to be good additions to the recovery support network on the surface, I have been concerned since the onset about an “unspoken” plan to shift the economic burden of addiction treatment and recovery away from government agencies and insurers and into the realm of volunteers or low-paid peers. I suspect the covert master plan includes government and insurers getting out of the arena of addiction altogether.

At a Friends of Recovery-New York board meeting last year, a member shared that there had been contact from Value Options, which was the managed care group for New York State's Empire Plan. They were seeking to contract with recovery coaches to work with members with addiction issues. When we explored the rate they were seeking to offer for coaches, surprise! They were seeking the services for free.

New York Medicaid has contracted with some “peer-bridgers” to work with dual-focus clients utilizing a fee-for-service model but these arrangements have yet to be incorporated into the traditional addiction-treatment circles.

To Cost-Cutters, The Choice Is Obvious

Now let’s see. Would a cost-conscious, dollar-driven, managed-care case rep authorize outpatient treatment two or three times per week or instead refer them to AA and a recovery coach as the plan-included benefit? The answer would seem more then obvious.

What about the potential impact on the treatment programs?

On Long Island this year, we have seen the proposed elimination of deficit funding and the de-funding of several programs due to lack of units of service (client contacts), as  well as renewed talk—all but certain to happen—of combining the New York State Office of Alcoholism and Substance Abuse Services (OASAS) with the Office of Mental Health (OMH)

In addition, as a New York State Credentialed Alcohol and Substance Abuse Counselor (CASAC), the other concern I have is the potential loss of counseling jobs for addiction care professionals—and even some social workers, perhaps—by a watering-down or blurring of territory.

Isn't That What Sponsors Do?
The term Recovery Coach itself has flipped many a belly and raised eyebrows among Twelve Steppers and addiction-treatment clinicians alike. “What kind of nonsense is this?” they say. “Isn’t this the stuff that a sponsor does, or maybe an addiction counselor?” Many of them express disbelief that such a service is something that people can get paid to do. They recall the inherent nobility of Twelfth Step work—reaching out and helping others—as something they have been taught to do.

Despite the controversy, however, the concept is growing, the training expanding and the idea is being embraced in ever-widening circles.

Next: Recovery Coach training: What could that be?

» Read about Richard here.

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