Running a Quality Methadone Program

methadone76Not all methadone programs are the same. While regulations do exist that govern the operation of methadone clinics, the standard of quality & care will most definitely vary from one clinic to another. At the core of every reputable, high-level methadone clinic is genuine dedication to the consumer patient.

All clinics have a business component in which revenue is a major consideration. Sometimes clients will complain "Oh, it's all about the money with them." In reality, a clinic's revenue must be an important ongoing consideration. In fact, it's that way throughout all of health care in America. The true bottom line is being able to remain open & to offer a valuable service. Without revenue, this will not happen.

For-profit clinics, and non-profit clinics, both have an important task. And that is to provide a quality treatment service to their clients who have suffered with a debilitating opioid addiction. Good quality clinics will maintain an acceptable counselor to client ratio so that the counselor is available to meet with clients and to assist them with planning & the processing of important treatment issues pertaining to their recovery.

In North Carolina, the maximum client caseload ratio is 50 clients for every 1 counselor. This is often a very challenging ratio in that 50 active clients, each with his or her own unique needs, will keep a single counselor enormously busy. Add in heavy documentation requirements and the counselor will be in a near perpetual state of dancing & juggling in order to get things done by the end of the day. Many clinics are aware of this and will consequently set a more manageable counselor to client ratio like 35 clients for every counselor. This allows for better quality of care although it can negatively affect a clinic's revenue, and particularly so when clients do not make sessions that equate to billable revenue for the clinic.

Clinics invariably develop a reputation within the local community based on their internal policies and their treatment of clients over time. Important aspects of a quality methadone program include:

  • Caring staff who treat clients with respect
  • Qualified treatment staff who receive ongoing clinical supervision
  • Program staff who communicate clearly
  • Well-developed internal policies & procedures for running the program
  • Knowledgeable medical and clinical personnel who work together as a unit
  • A treatment & recovery focus that emphasizes skill-building and goal setting
  • Accountability measures are in place for both clients & staff
  • Clients have defined rights and a process for airing concerns/grievances
  • A clear safety orientation exists that underlies all key clinical decisions
  • Do not readily prescribe/allow benzodiazepines, and take active measures to ensure that clients are achieving progress in recovery

Running a quality methadone program is a complex, multi-faceted endeavor requiring the careful attention & effort of individual team members. Each person on the team contributes to, or detracts from, the overall quality of the clinic's operation (and reputation).

It goes without saying that most methadone clinics require organization and dedication in order to deliver good services to their consumers. Moving from average to good to great … is a process that evolves with practice & time. To be a great clinic should be the aspiration of every clinic. We owe this to our consumers.