October 2009; Philadelphia: Widespread implementation of quality-improving NQF treatment standards took a major step forward September 24 when TRI hosted an implementation workshop attended by representatives of 25 states.

The one-day workshop addressed adoption of the NQF standards in state-funded treatment systems. Representatives of five states presented on small-scale, NQF-implementation pilots already attempted. Much of the rest of the workshop was spent identifying issues and barriers that states must overcome for them to promote incorporation of the standards in their systems.

For years, researchers, policy makers and practitioners have embraced the continuum of care, cross-agency model for delivery of substance abuse treatment services. Reconfiguring the publicly-funded delivery system, most of it regulated by the states and much not structured consistent with that model, has been a significant issue, however. Publication in 2007 of the NQF standards premised on a full continuum of care and linked service model was widely hailed by the field but implementation issues have remained daunting.

Mady Chalk, Ph.D. of TRI saw evidence that state policy makers are ready to begin incorporating the NQF standards, even if they need more help and technical assistance. “When 25 states are represented at an implementation meeting, and seven more are interested, request project materials, but are unable to physically attend, it tells me the states are ready to take essential steps toward systems of care that cover the entire treatment continuum, including linkages to other agencies,” she said, “particularly when the national economy makes this time ripe for lower-cost infrastructure-building.” Dr. Chalk and Richard Rawson, Ph.D. of UCLA are leading a national dissemination/implementation project for the NQF standards.

Funding permitting, next steps involve getting more help to states, possibly through peer-led learning communities based on common approaches to adapting, disseminating, or piloting NQF standards. A webinar and webcast will be developed for members of such major national associations as ASAM, State Associations of Addiction Services, National Council for Community Behavioral Health Care, and others, and a workshop for some western states may also be conducted. Developing evaluation models that measure outcomes from NQF-related pilots is also a priority, according to Chalk.