National Survey of SubstanceAbuse Treatment Services(N-SSATS), 2003United States Department of Health andHuman Services. Substance Abuse andMental Health Services Administration.Office of Applied StudiesQuestionnaireis sponsored by

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SummaryThe National Survey of Substance Abuse Treatment Services (N-SSATS) is designed tocollect information from all facilities in the United States, both public and private, thatprovide substance abuse treatment. N-SSATS provides the mechanism for quantifyingthe dynamic character and composition of the United States substance abuse treatmentdelivery system. The objectives of N-SSATS are to collect multipurpose data that can beused to assist the Substance Abuse and Mental Health Services Administration(SAMHSA) and state and local governments in assessing the nature and extent ofservices provided and in forecasting treatment resource requirements, to updateSAMHSA's Inventory of Substance Abuse Treatment Services (I-SATS), to analyzegeneral treatment services trends, and to generate the National Directory of Drug andAlcohol Abuse Treatment Programs and its online equivalent, the Substance AbuseTreatment Facility Locator. Data are collected on topics including ownership, servicesoffered (assessment, therapy and counseling, pharmacotherapies, testing, transitional,ancillary), primary focus (substance abuse, mental health, both, general health, and other),hotline operation, methadone/LAAM dispensing, languages in which treatment is provided, typeof treatment provided, number of clients (total and under age 18), numberof beds, types of payment accepted, sliding fee scale, special programs offered, facilityaccreditation and licensure/certification, and managed care agreements.

UniverseAll 17,787 active treatment facilities on the Inventory of Substance Abuse Treatment Services (ISATS) at a point six weeks prior to the survey reference date of March 31, 2003. Facilities addedby state substance abuse agencies or discovered during the first three weeks of the survey werealso included in the survey universe.Data TypeSurvey dataData SourceMail questionnaire, telephone interview, and Web-based surveyAdditional Information for Study 04099http://datafiles.samhsa.govStudy CitationWe appreciate the appropriate citation for study documentation obtained fromSAMHDA. The study description for this study includes a suggested bibliographiccitation for the data.

8437-810U.S. Department of Health and Human ServicesFORM APPROVED:OMB No. 0930-0106APPROVAL EXPIRES: 12/31/2005See OMB burden statement on back coverNational Survey ofSubstance Abuse Treatment Services(N-SSATS)March 31, 2003Substance Abuse and Mental Health Services Administration (SAMHSA)PLEASE REVIEW THE FACILITY INFORMATION PRINTED ABOVE.CROSS OUT ERRORS AND ENTER CORRECT OR MISSING INFORMATION.CHECK ONE Information is complete and correct, no changes neededAll missing or incorrect information has been correctedPrepared by Mathematica Policy Research, Inc.

PLEASE READ THIS ENTIRE PAGE BEFORECOMPLETING THE QUESTIONNAIREINSTRUCTIONS Most of the questions in this survey ask about “this facility.” By “this facility” we mean the substanceabuse treatment facility or program listed on the front cover. If you have any questions about howthe term “this facility” applies to your facility, please call 1-888-324-8337. Please answer ONLY for the facility printed on the cover, unless otherwise specified in thequestionnaire. Return the completed questionnaire in the envelope provided. Please keep a copy for your records. If you have any questions or need additional blank forms, contact:MATHEMATICA POLICY RESEARCH, INC.1-888-324-8337If you prefer, you may complete this questionnaire online. See the pink flyer enclosed in yourquestionnaire packet for the Internet address and your unique user name and password. If youneed more information, call the N-SSATS hotline at 1-888-324-8337.Important InformationAsterisked questions. Information from asterisked (Ý) questions will be published inSAMHSA’s National Directory of Drug and Alcohol Abuse Treatment Programs and will beavailable online at, SAMHSA’s Substance AbuseTreatment Facility Locator.Mapping feature in Locator. Complete and accurate name and address information isneeded for the online Treatment Facility Locator so it can correctly map the facility location.Eligibility for Directory/Locator. Only facilities approved by their State substance abuseoffice will be listed in the National Directory and online Treatment Facility Locator. Your StateN-SSATS representative can tell you if your facility is State-approved. For the name andtelephone number of your State representative, call the N-SSATS hotline at 1-888-324-8337or go to and click on “DASIS Contacts” then “N-SSATSContacts by State.”

SECTION A: FACILITYCHARACTERISTICS*2.What is the primary focus of this facility?MARK ONE ONLYSection A asks about characteristics of individual facilities andshould be completed for only the facility listed on the frontcover.1 Substance abuse treatment services2 Mental health services31.Which of the following substance abuse servicesare offered by this facility, that is, the facilitynamed on the front cover? Mix of mental health and substance abusetreatment services (neither is primary)4 General health care5 Other (Specify:)MARK “YES” OR “NO” FOR EACHYES1.Intake, assessment, or referral. 1 0 2.Detoxification . 1 0 3.Substance abuse treatment(services that focus on initiatingand maintaining an individual’srecovery from substance abuseand on averting relapse) . 1 0 Halfway house or othertransitional housing. 1 0 4.5.1a.1b.1c.NOOther substance abuse services(such as administrative orpreventive services) . 1 0 Yes0 NoMARK ONE ONLY Yes0 No1 A private for-profit organization2 A private non-profit organization3 State government43a.SKIP TO Q.4 Local, county, or communitygovernment5 Tribal government6 Federal governmentSKIP TO Q.6(PAGE 2)Which federal government agency?MARK ONE ONLYSKIP TO Q.2Did you answer “yes” to detoxification inquestion 1 above?1Is this facility operated by . . . Did you answer “yes” to substance abusetreatment in question 1 above?13.1 Department of Veterans Affairs2 Department of Defense3 Indian Health Service4 Other (Specify:SKIP TO Q.6(PAGE 2))SKIP TO Q.2Did you answer “yes” to halfway house or othertransitional housing in question 1 above?4.Is this a private solo practice, that is, an officewith a single practitioner or therapist?1 YesSKIP TO Q.32 (PAGE 10)1 Yes0 NoSKIP TO Q.37 (PAGE 10)0 No*SEE IMPORTANT NOTICE ON INSIDE FRONT COVER.1

5.Is this facility affiliated with a religiousorganization?1 Yes0 No8.Does this facility operate a hotline that respondsto substance abuse problems? A hotline is a telephone service that providesinformation, referral, or immediate counseling,frequently in a crisis situation. If this facility is part of a group of facilities thatoperates a central hotline to respond to substanceabuse problems, you should mark “yes.” DO NOT consider 911 or the local police number ahotline for the purpose of this survey.6.Is this facility a jail, prison, or other organizationthat provides treatment exclusively forincarcerated persons?1 Yes0 No1 Yes0 NoSKIP TO Q.9*8a. Please enter the hotline telephone number(s)below.HOTLINE TELEPHONE NUMBER(S)7.7a.Is this facility located in, or operated by, ahospital?1 Yes0 NoSKIP TO Q.8What type of hospital?*9.MARK ONE ONLY1 General hospital (including VA hospital)2 Psychiatric hospital3( ) - ext.2.( ) - ext.What telephone number(s) should a potentialclient call to schedule an intake appointment?INTAKE TELEPHONE NUMBER(S) Other specialty hospital, for example,alcoholism, maternity, etc.(Specify:1.)1.( ) - ext.2.( ) - ext.2*SEE IMPORTANT NOTICE ON INSIDE FRONT COVER.

10.Which of the following services are provided bythis facility at this location?*11. Does this facility operate an Opioid TreatmentProgram (OTP) at this location? MARK ALL THAT APPLYAssessment Services12 Comprehensive substance abuse assessmentor diagnosis Comprehensive mental health assessment ordiagnosis (for example, psychological orpsychiatric evaluation and testing)Opioid Treatment Programs are certified by theSubstance Abuse and Mental Health ServicesAdministration, Center for Substance AbuseTreatment, to use opioid drugs such asmethadone and LAAM in the treatment ofopiate (narcotic) addiction.1 Yes0 NoPLEASE REVIEW THE OTP NUMBER(FORMERLY THE FDA NUMBER) ONTHE FRONT COVER AND UPDATE IFINCORRECT OR MISSING.Substance Abuse Therapy and Counseling34567 Family counselingGroup therapy, not including relapse preventionIndividual therapyRelapse prevention groupsAftercare counselingPharmacotherapies8910 Antabuse Naltrexone Buprenorphine (Subutex, Suboxone)Testing (Include testing service even if specimenis sent to outside source for chemical analysis.)11121314151617 Breathalyzer or other blood alcohol testingDrug or alcohol urine screeningScreening for Hepatitis BScreening for Hepatitis CHIV testingSTD testingTB screeningTransitional Services18192021 Assistance with obtaining social services(for example, Medicaid, WIC, SSI, SSDI) Discharge planning Employment counseling or training Assistance in locating housingOther Services2223242526272829 Case management services Child care Domestic violence—family or partner violenceservices (physical, sexual, and emotionalabuse) HIV or AIDS education, counseling, or support Outcome follow-up after discharge Transportation assistance to treatment Acupuncture Residential beds for clients’ childrenSKIP TO Q.12*11a. Is the Opioid Treatment Program at this location amaintenance program, a detoxification program,or both?MARK ONE ONLY1 Maintenance program2 Detoxification program3 Both*11b. Are ALL of the substance abuse clients at thisfacility currently in the Opioid TreatmentProgram?1 Yes0 No*12. Does this facility offer a special program forDUI/DWI or other drunk driver offenders? Mark “yes” if this facility serves only DUI/DWIclients OR if this facility has a special DUI/DWIprogram.1 Yes0 NoSKIP TO Q.13 (PAGE 4)*12a. Are ALL of the substance abuse treatmentclients at this facility DUI/DWI or other drunkdriver offenders?1 Yes0 No*SEE IMPORTANT NOTICE ON INSIDE FRONT COVER.3

*13. Does this facility provide substance abusetreatment services in sign language (for example,American Sign Language, Signed English, orCued Speech) for the hearing impaired? 14.Mark “yes” if either a staff counselor or anon-call interpreter provides this service.1 Yes0 No*15. This question has two parts. Column A asksabout the types of clients accepted into treatmentat this facility. Column B asks whether thisfacility offers specially designed treatmentprograms or groups for each type of client.Column A: For each type of client listed below:Indicate whether this facility accepts these clients intotreatment at this location.Column B: For each “yes” in Column A: Indicateif this facility offers a specially designed substanceabuse treatment program or group exclusively for thattype of client at this location. Does this facility provide substance abusetreatment services in a language other thanEnglish? Mark “yes” if either a staff counselor or anon-call interpreter provides this service.1 Yes0 NoFor example, if this facility accepts adolescentsfor treatment but does not have a speciallydesigned program or group just for adolescents,mark YES in Column A and NO in Column B. Ifthis facility accepts adolescents and has a specialprogram or group just for adolescents, mark YESin both Columns A and B.MARK “YES” OR “NO” FOR EACHSKIP TO Q.15ACLIENTS ACCEPTEDIN TREATMENTYES NO*14a. In what other language(s) is substance abusetreatment offered at this facility?0 1 0 Clients with co-occurringmental and substanceabuse disorders . 1 0 1 0 Criminal justice clients(other than DUI/DWIclients) . 1 0 1 0 Persons with HIV orAIDS . 1 0 1 0 5.Gays or lesbians. 1 0 1 0 6.Seniors or older adults . 1 0 1 0 7.Pregnant or postpartumwomen . 1 0 1 0 8.Women . 1 0 1 0 9.Men. 1 0 1 0 programs or groups forother types of clients . 1 0 MARK ALL THAT APPLY3.1 Hopi3 Navajo2 Lakota4 Yupik54. Other American Indian orAlaska Native language(Specify:)Other Language(s):6 Arabic12 Korean7 Chinese13 Polish8 Creole14 Portuguese9 French15 Russian10 German16 Spanish11 Hmong17 Vietnamese18 Other language (Specify:YES NO1. Adolescents . 1 2.American Indian or Alaska Native:BSPECIALLY DESIGNEDPROGRAM OR GROUP10. Specially designed(Specify:))4*SEE IMPORTANT NOTICE ON INSIDE FRONT COVER.

*16. Does this facility offer HOSPITAL INPATIENTsubstance abuse services at this location?1 Yes0 No*18. Does this facility offer OUTPATIENT substanceabuse services at this location?SKIP TO Q.171 Yes0 NoSKIP TO Q.19*18a. Which of the following OUTPATIENT substanceabuse services are offered?MARK “YES” OR “NO” FOR EACHYES*16a. Which of the following HOSPITAL INPATIENTsubstance abuse services are offered?MARK “YES” OR “NO” FOR EACHYES1.Outpatient detoxification . 1 0 2.Outpatient methadone orLAAM maintenance . 1 0 Outpatient day treatment orpartial hospitalization program(20 or more hours per week) . 1 0 Intensive outpatient treatment(defined as a minimum of2 hours per day on 3 or moredays per week) . 1 0 Regular outpatient treatment(fewer hours per week thanintensive) . 1 0 NO1.Inpatient detoxification . 1 0 2.Inpatient treatment . 1 0 3.4.5.*17. Does this facility offer RESIDENTIAL (nonhospital) substance abuse services at thislocation?1 Yes0 No*19. Does this facility use a sliding fee scale?1 YesSKIP TO Q.18The Directory/Locator will explain thatsliding fee scales are based on incomeand other factors.DO YOU WANT THE AVAILABILITY OF ASLIDING FEE SCALE PUBLISHED IN THEDIRECTORY/LOCATOR?10*17a. Which of the following RESIDENTIAL substanceabuse services are offered?MARK “YES” OR “NO” FOR EACHYESNO1.Residential detoxification . 1 0 2.Residential short-term treatment(30 days or less) . 1 0 Residential long-term treatment(more than 30 days). 1 0 3.NO Yes0 No No*19a. Does this facility offer treatment at no charge toclients who cannot afford to pay?1 YesThe Directory/Locator will explain thatpotential clients should call the facility forinformation on eligibility.DO YOU WANT THE AVAILABILITY OF FREECARE FOR ELIGIBLE CLIENTS PUBLISHEDIN THE DIRECTORY/LOCATOR?10 Yes0 No No*SEE IMPORTANT NOTICE ON INSIDE FRONT COVER.5

SECTION B: CLIENT COUNTINFORMATION*20. Which of the following types of payments areaccepted by this facility for substance abusetreatment?MARK “YES,” “NO,” OR “DON’T KNOW” FOR EACHDON’TYES NO KNOW1.Cash or self-payment. 1 0 -1 2.Medicare . 1 0 -1 3.Medicaid. 1 0 -1 A State-financed health insuranceplan other than Medicaid (for example,State children’s health insuranceplan (SCHIP) or high riskinsurance pools). 1 0 -1 Federal military insurance suchas TRICARE or Champ VA . 1 0 -1 6.Private health insurance . 1 0 -1 7.No payment accepted (freetreatment for ALL clients). 1 0 -1 Other . 1 0 -1 4.5.8.IMPORTANT: Questions in Section B ask about differenttime periods, e.g., March 31, 2003, and the 12-month periodending on March 31, 2003. Please pay special attention tothe date specified in each question.23.24.(Specify:)Did this facility offer substance abuse treatmentor detoxification services on March 31, 2003?1 Yes0 NoSKIP TO Q.32 (PAGE 10)The next questions ask about the number ofclients in treatment at this facility on March 31,2003. Please check the option below that bestdescribes how client counts will be reported inthis questionnaire. We would prefer to get this information separatelyfor this facility. However, if this facility is part of anorganization with multiple facilities or sites thatprovide substance abuse treatment, and data cannotbe separated, it is acceptable to report the combinedcounts of multiple facilities. If you have any questions on how to proceed, pleasecall the N-SSATS hotline at 1-888-324-8337.MARK ONE ONLY121.Does this facility receive any public funds suchas federal, state, county, or local governmentfunds for substance abuse treatment programs? Do not include Medicare, Medicaid, or federalmilitary insurance.1 Yes0 No23 This questionnaire will includeclient counts for this facilityaloneSKIP TO Q.25 (PAGE 7) This questionnaire will includeclient counts for this facilitycombined with other facilitiesin the organizationSKIP TO Q.25 (PAGE 7) Client counts for this facilitywill be reported in anotherfacility’s questionnaire24a. Whom should we contact for client countinformation? Please record all of the information requested.CONTACT PERSON22.6Does this facility have agreements or contractswith managed care organizations for providingsubstance abuse treatment services?1 Yes0 NoPHONE NUMBERFACILITY NAMECITY/STATE*SEE IMPORTANT NOTICE ON INSIDE FRONT COVER.SKIP TOQ.32(PAGE 10)

RESIDENTIAL (NON-HOSPITAL)HOSPITAL INPATIENT(RESPOND FOR MARCH 31, 2003)(RESPOND FOR MARCH 31, 2003)25.On March 31, 2003, did any patients receiveHOSPITAL INPATIENT substance abuse servicesat this facility?1 Yes0 NoSKIP TO Q.2625a. On March 31, 2003, how many patients receivedthe following HOSPITAL INPATIENT substanceabuse services at this facility?26.On March 31, 2003, did any clients receiveRESIDENTIAL (non-hospital) substance abuseservices at this facility?1 Yes0 NoSKIP TO Q.27 (PAGE 8)26a. On March 31, 2003, how many clients received thefollowing RESIDENTIAL substance abuse servicesat this facility? COUNT a client in one service category only,even if the client received both services. COUNT a client in one service category only,even if the client received multiple services. DO NOT count codependents, parents, otherrelatives, friends (that is, “collaterals”), or othernon-treatment clients. DO NOT count codependents, parents, otherrelatives, friends (that is, “collaterals”), or othernon-treatment clients.PROVIDE A NUMBER OR MARK “NONE” FOR EACHPROVIDE A NUMBER OR MARK “NONE” FOR EACHNUMBER1.Inpatient detoxification2.Inpatient treatmentNUMBERNONE or orHOSPITAL INPATIENTTOTAL BOX1.Residential detoxificationor 2.Residential short-termtreatment (30 days or less)or Residential long-termtreatment (more than30 days)or 3.25b. How many of the patients from the HOSPITALINPATIENT TOTAL BOX were under the age of 18?PROVIDE A NUMBER OR MARK “NONE”NONENumber under age 18 or NONERESIDENTIALTOTAL BOX26b. How many of the clients from the RESIDENTIALTOTAL BOX were under the age of 18?PROVIDE A NUMBER OR MARK “NONE”NONE25c. How many of the patients from the HOSPITALINPATIENT TOTAL BOX received methadoneor LAAM dispensed at this facility? Number under age 18 or26c. How many of the clients from the RESIDENTIALTOTAL BOX received methadone or LAAMdispensed at this facility?Include clients who received these drugs fordetoxification or maintenance purposes. PROVIDE A NUMBER OR MARK “NONE” FOR EACHNUMBER1.Methadone2.LAAM PROVIDE A NUMBER OR MARK “NONE” FOR EACHNONE or or25d. On March 31, 2003, how many of the hospitalinpatient beds at this facility were specificallydesignated for substance abuse treatment?Include clients who received these drugs fordetoxification or maintenance purposes.NUMBER1.Methadone2.LAAMNONE or or26d. On March 31, 2003, how many of the residentialbeds at this facility were specifically designatedfor substance abuse treatment?PROVIDE A NUMBER OR MARK “NONE”PROVIDE A NUMBER OR MARK “NONE”NUMBERNUMBERNONEor NONEor 7

27b. How many of the clients from the OUTPATIENTTOTAL BOX were under the age of 18?OUTPATIENT(RESPOND FOR THE MONTH OF MARCH 2003)27.PROVIDE A NUMBER OR MARK “NONE”During the month of March 2003, did any clientsreceive OUTPATIENT substance abuse services atthis facility?1 Yes0 NoNONENumber under age 18 orSKIP TO Q.28 (PAGE 9)27c. How many of the clients from the OUTPATIENTTOTAL BOX received methadone or LAAMdispensed at this facility?27a. As of March 31, 2003, how many active clientswere enrolled in each of the followingOUTPATIENT substance abuse services at thisfacility? Active outpatient clients are individuals who:(1) were seen at this facility for a substance abusetreatment or detox service at least once duringthe month of March 2003AND(2) were still enrolled in treatment as of March 31,2003. COUNT a client in one service only, even if theclient received multiple services.DO NOT count codependents, parents, otherrelatives, friends (that is, “collaterals”), or othernon-treatment clients.ENTER A NUMBER OR MARK “NONE” FOR EACHNUMBEROutpatient detoxificationor 2.Outpatient methadoneor LAAM maintenanceor Outpatient day treatment orpartial hospitalization (20 or morehours per week)or 4.5.Intensive outpatient treatment(defined as a minimum of2 hours per day on 3 or moredays per week)or Regular outpatient treatment(fewer hours per week thanintensive)or OUTPATIENTTOTAL BOX8NONE1.3. Include clients who received these drugs fordetoxification or maintenance purposes.PROVIDE A NUMBER OR MARK “NONE” FOR EACHNUMBERNONE1.Methadoneor 2.LAAMor 27d. The number you recorded in the OUTPATIENTTOTAL BOX (question 27a) represents clientsenrolled in outpatient substance abuse treatmentat this facility on March 31, 2003. Consideringstaff resources available during the month ofMarch 2003, did this facility have the capacity toaccommodate a larger outpatient enrollment onMarch 31, 2003?1 Yes0 NoGO TO Q.28 (PAGE 9)27e. Considering the available staff resources, howmany additional clients could have been enrolledin outpatient substance abuse treatment at thisfacility on March 31, 2003? Use the worksheetbelow to calculate your response.OUTPATIENT CAPACITYMINUS NUMBER FROMOUTPATIENT TOTAL BOXADDITIONAL OUTPATIENTSTHAT COULD HAVE BEENENROLLED IN TREATMENTON MARCH 31, 2003

HOSPITAL INPATIENT, RESIDENTIAL,AND OUTPATIENT30.(RESPOND FOR DATES SPECIFIED IN EACH QUESTION)28.Approximately what percent of all substanceabuse treatment clients enrolled at this facilityon March 31, 2003, were being treated for . . .How many facilities are included in the clientcounts reported in questions 25 through 29?1 Only this facility2 This facility plus othersIf no substance abuse clients were enrolled onMarch 31, 2003, check here AND SKIP TO Q.291.Abuse of both alcoholand drugs%2.Alcohol abuse only%3.Drug abuse only%TOTAL%SKIP TO Q.31ENTER TOTAL NUMBER OFFACILITIES BELOW (INCLUDETHIS FACILITY):NUMBER OFFACILITIESWhen we receive your questionnaire, we will contact youfor a list of the other facilities included in your clientcounts.If you prefer, attach a separate piece of paper listing thename and location address of each facility included in yourclient counts.Please continue with Question 31.THIS SHOULD TOTAL 100%.IF NOT, PLEASE RECONCILE.31.For which of the numbers you just reported didyou provide actual client counts and for which didyou provide your best estimate? 29.In the 12 months beginning April 1, 2002 andending March 31, 2003, how many admissions forsubstance abuse treatment did this facility have?Count every admission and re-admission in this12-month period. If a person was admitted3 times, count this as 3 admissions. FOR OUTPATIENT CLIENTS, consider anadmission as the initiation of a treatment episode.IF DATA FOR THIS TIME PERIOD are notavailable, use the most recent 12-month periodfor which you have data.NUMBER OF SUBSTANCEABUSE ADMISSIONS IN12-MONTH PERIODMark “N/A” for any type of care not provided by thisfacility on March 31, 2003.MARK “ACTUAL,” “ESTIMATE,” OR “N/A” FOR EACHACTUAL ESTIMATE N/A1.2.3.4.Hospital inpatient clientcounts (Q.25a, Pg. 7) . 1 2 0 Residential clientcounts (Q.26a, Pg. 7) . 1 2 0 Outpatient clientcounts (Q.27a, Pg. 8) . 1 2 0 12-month admissions(Q.29) . 1 2 0 PLEASE TURN TO BACK COVER TO COMPLETE SECTION C: GENERAL INFORMATION9

SECTION C:GENERAL INFORMATION33.Section C should be completed for only this facility.32.Does this facility have Internet access?1 Yes0 No*34. Does this facility have a Web site or Web pagewith information about the facility’s substanceabuse treatment programs?Does this facility or program have licensing,certification, or accreditation from any of thefollowing organizations? Only include facility-level licensing, accreditation,etc., related to the provision of substance abuseservices. Do not include general business licenses, fire

Treatment Facility Locator. Mapping feature in Locator. Complete and accurate name and address information is needed for the online Treatment Facility Locator so it can correctly map the facility location. Eligibility for Directory/Locator