Let's begin, as the story typically does, with the client. More specifically the route at which the client becomes the broker:
It begins with a client. Client comes into treatment, typically via a predatory marketer/alumni from a specific treatment facility. Client comes in with marketer/alunmi, goes through the program, and eventually graduates the program. The day of graduation the owners of the center decide to hire this client and is now an employee with a constructed title Ie - alumni services rep, marketer, recovery specialist. This individual is responsible for monitoring graduating individuals from said program. As soon as he hears of someone relapsing he ropes them back into the same facility. This begins one aspect of the revolving door.
It begins with a client. Client comes into treatment, graduates the program. The day of graduation the owners of the center decide to hire this client and is now an employee with a constructed title Ie - alumni services rep, marketer, recovery specialist. This individual is responsible for monitoring graduating individuals from said program. As soon as he hears of someone relapsing he ropes them back into the same facility. This begins one aspect of the revolving door.
If said facility is at max capacity this is when the “head for head” concept comes from. The spawn of brokering exists here. The original client (alumni rep/marketer/recovery specialist) will continue monitoring graduates for relapse. They then will look at neighboring facilities or facilities a few states over ie - florida or California. This then begins the head for head transfers/trafficking of humans. The unwritten rule is if one facility sends one client , the receiving facility owes sending facility. That goes on and on with various facilities. Commission structure exists here. The rep sending clients in need, will get a base salary, and x amount of money based on clients sent/received. Typically the x amount is in a bonus structure.
Marketers will also get kick backs from the receiving facility. To me knowledge in the tri state area it was $500 per client.
In summary, marketers are profiting off of the clients via brokering to addiction centers across state lines. Modeling the treatment center they work for. ie - owners, private equity - no direct wholesome concern for positive efficacy - more focus on human capital. Repetitive motifs of profits over people.
Marketers and out reach servicing providers, even alumni of programs, will often make quotes on, and market, false efficacy studies. This can happen in person, or via the phone as call centers are typically created to enhance this process to generate more influx of clients to said treatment centers (cold calling).
Many facets here need to be extrapolated: firstly, the stigma of these efficacy studies. There are so many arenas where falsities are involved. Most treatment facilities will have their alumni and marketing staff, cold call former clients to check in at specific intervals of time. ie - 3 days, 5 days, 2 weeks, 1 month post discharge. These "efficacy studies" are done in order to gauge progress of the client via simple phone assessment with little to no cross-referencing. Questions like "are you still sober, are you going to meetings, how many meetings a week are you going to, do you have a sponsor, are you willing for us to be in touch with your sponsor, etc." are included. From this "data" alumni and marketers create percentages for longevity of sobriety. This is simply phase one of the falsity. The next phase is when the percentages are reviewed by the higher ups of the facility, owners, more often than not, will ask for alumni or other staff to apply "positive skews" to the data. Manipulating for a higher percentage that they can advertise and market. More often than not, the figure 80% efficacy, is often applied to and marketed on pamphlets and websites of these types of facilities. Accrediting organizations DO NOT do their due diligence, they simply sign off their stamp of approval.
Speaking on accreditation bodies; there are tow main accreditation bodies for substance abuse treatment: JCAHO and CARF. Both of which sit in the non profit sector and are renowned nationally for going to treatment centers, evaluating them, and granting them accreditation. New in the running is a for profit known as Shatterproof. Shatterproof is a private for profit variation of JCAHO and CARF.
In laymen's terms, having accreditation in this sector, at this stage, is pretty much paying a golf membership to say that a facility is part of an organization. JCAHO, CARF, and Shatterproof all have each facility that is accredited pay them a nominal fee annually, with Shatterproof being the most expensive of the three. This allots for the facility to then publicize their accreditation, which society will then see, and automatically assume esteem. What I have found is that even if the facility holds accreditation with JCAHO, CARF, potentially even Shatterproof, and are under investigation, these accreditation bodies do little to nothing in removing their accreditation.
Further up the chain, on another level and discuss state regulatory bodies like the department of drug and alcohol programming, have oversight on facilities, but typically only have their sights on facilities during the opening phase. Meaning, in order to get credentialed, most representatives from the state level will only come into the facility to see how it operates, and evaluates upon opening. Thereafter, there are minimal checks or follow ups.
For more details please feel free to listen to something I wrote up on my reflections and recorded: