Staffing Patterns In State Chemical Dependency
Staffing Patternsin Washington State Chemical DependencyTreatment Facilities:Trends Over a 15‐Year PeriodPrepared forJohn Taylor, M.A.C.Acting DirectorDivision of Alcohol and Substance AbuseHealth and Recovery Services AdministrationWashington State Department of Social and Health ServicesPrepared byFelix Rodriguez, Ph.D.The Edward R. Murrow College of CommunicationWashington State UniversityDecember 2008
Staffing Patterns in Washington State Chemical Dependency Treatment Facilities
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesContentsContents. 3Acknowledgments. 6Executive Summary . 7Background . 7Key Findings . 7All Full‐Time Equivalent (FTE) Staff. 7FTE Staff with Chemical Dependency Professional (CDP) Certification. 8Counselors. 8Counselor Trainees . 8Counselor Supervisors . 9Administrators . 9The Staffing Pattern Survey . 11Purpose of the Survey. 11Methodology. 11Organization of the Findings. 12All Full‐Time Equivalent (FTE) Staff . 13Number of FTE Staff in Contract and Non‐Contract Treatment Facilities . 15FTE Staff by Race/Ethnicity . 15White FTE Staff. 15African American FTE Staff . 16Hispanic FTE Staff. 16Native American FTE Staff . 17Asian/Pacific Islander FTE Staff. 17Minority FTE Staff Compared to Minority CD Patients. 18Female FTE Staff. 18FTE Staff by Disability Status. 19FTE Staff by Multilingual Ability . 19Focus on Chemical Dependency Professionals (CDPs). 21Number of FTE Staff with CDP Certification . 23Proportion of All FTE Staff with CDP Certification. 23CDP‐Certified FTE Staff by Job Title . 24CDP‐Certified FTE Staff by Gender. 24CDP‐Certified FTE Staff by Race/Ethnicity . 253
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesContentsCDP‐Certified FTE Staff by Disability Status and Multilingual Ability . 25Counselors. 27Number of Counselors in Contract and Non‐Contract Treatment Facilities . 29Counselors by Race/Ethnicity . 29White Counselors. 29African American Counselors. 30Hispanic Counselors . 30Native American Counselors. 31Asian/Pacific Islander Counselors . 31Minority Counselors Compared to Minority CD Patients. 32Female Counselors. 32Counselors with Disabilities . 33Counselors with Multilingual Abilities . 33Counselors with CDP Certifications . 34Number of CDP‐Certified Counselors . 34Proportion of CDP‐Certified Counselors . 34Counselor Trainees . 35Number of Counselor Trainees in Contract and Non‐Contract Treatment Facilities . 37Counselor Trainees by Race/Ethnicity . 37White Counselor Trainees. 37African American Counselor Trainees . 38Hispanic Counselor Trainees. 38Native American Counselor Trainees . 39Asian/Pacific Islander Counselor Trainees. 39Female Counselor Trainees. 40Counselor Trainees with Disabilities. 40Counselor Trainees with Multilingual Abilities . 41Counselor Supervisors . 43Number of Counselor Supervisors in Contract and Non‐Contract Treatment Facilities . 45Counselor Supervisors by Race/Ethnicity . 45White Counselor Supervisors. 45African American Counselor Supervisors. 46Hispanic Counselor Supervisors. 46Native American Counselor Supervisors. 47Asian/Pacific Islander Counselor Supervisors. 474
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesContentsFemale Counselor Supervisors. 48Counselor Supervisors with Disabilities. 48Counselor Supervisors with Multilingual Abilities . 49Counselor Supervisors with CDP Certifications . 49Administrators . 51Number of Administrators in Contract and Non‐Contract Treatment Facilities . 53Administrators by Race/Ethnicity . 53White Administrators. 53African American Administrators . 54Hispanic Administrators. 54Native American Administrators . 55Asian/Pacific Islander Administrators. 55Female Administrators. 56Administrators with Disabilities. 56Administrators with Multilingual Ability. 57Administrators with CDP Certifications . 57References. 59Appendix A: Source Tables . 61Appendix B: The Staffing Pattern Survey . 775
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesAcknowledgmentsEvery three years since 1991, the Division of Alcohol and Substance Abuse (DASA) hasadministered the Staffing Pattern Survey to monitor changes in key demographic characteristicsof staff employed in chemical dependency (CD) treatment facilities across Washington State. Ihave directed the surveys that were conducted in 2000, 2003, and most recently in 2006.Many individuals deserve recognition for making a contribution to the administration ofthe 2006 Staffing Pattern Survey and the preparation of this statewide report. Credit goesprimarily to Washington State CD treatment providers who willingly gave their time tocomplete and return the surveys.At DASA, my appreciation goes to Doug Allen who served as Director from 2006 until2008, and John Taylor, Acting Director, for their continuing support of the survey. For manyyears, the survey has benefited from the guidance given by Toni Krupski, Administrator ofEvaluation and Quality Assurance (EQA) until 2006. I am grateful to Alice Huber, currently EQAAdministrator, for reviewing this report, for her stimulating questions, and for showing greatpatience in seeing this report finalized. Beverly Smith has my fullest admiration for heradministrative and proof reading skills. MaryLou Blocker and Kasey Leonard offered muchneeded help with the mailing as they have done in previous surveys.Joan Sharp of Action Data Services deserves praises for coding the survey responses andfor her excellent work on double data entry. Thank you so much, Joan.Felix Rodriguez, Ph.D.6
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesExecutive SummaryBackgroundAs a matter of policy, the Division of Alcohol and Substance Abuse (DASA) periodicallyassesses the representation of ethnic minorities, women, persons with disabilities, and personswith multilingual skills on the staff of certified chemical dependency treatment (CD) facilities inWashington State. Supporting the focus on cultural competency coming from the SubstanceAbuse and Mental Health Services Administration (SAMHSA), DASA recognizes that treatmentprograms whose staff reflects the backgrounds and experiences of minority groups will bebetter able to serve their needs. Toward this end, DASA conducts the Staffing Pattern Surveyevery three years to collect information that would help identify, on a statewide level,disparities in the representation of minority groups on the staff of CD treatment agencies andto develop policies to redress them. This report highlights the results of the latest surveyconducted in 2006 and presents staffing pattern trends in CD treatment facilities over thecourse of fifteen years. The results compare contracting agencies (those that receive publicfunding), with non‐contracting agencies (those that are privately funded). The report uses onefull‐time equivalent (FTE) as the unit of analysis, rather than persons, in order to adjust for thefact that not every staff was employed full‐time.Key FindingsAll Full‐Time Equivalent (FTE) Staff In 2006, African Americans accounted for 8 percent of FTEs in contracting facilities,Hispanics 7 percent, Native Americans 6.3 percent, and Asian/Pacific Islanders 3.9 percent. The proportion of minority FTE staff in contract facilities, 25.2 percent, approximated theproportion of minority patients admitted to publicly funded treatment in 2006, 27.4percent. In 2006, women comprised 67.2 percent of all FTEs in contracting facilities; persons withdisabilities 28.9 percent, and persons with multilingual skills 10.7 percent. Among multilingual staff, the most common language spoken other than English wasSpanish. The proportion of African American FTE staff in contract facilities increased from 5.5percent in 2000 to 8 percent in 2006; in non‐contract facilities, the proportion declinedfrom 6.6 percent to 4.7 percent during the same time interval. The proportion of FTE staff with disabilities in contract facilities declined from over 35percent in 1991‐1997 to about 30 percent in 2000‐2006.7
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesExecutive SummaryFTE Staff with Chemical Dependency Professional (CDP) Certification Considering contract and non‐contract facilities together, the total number of FTE staff witha chemical dependency professional certification (CDP) dropped from 2,014 in 2000 to1,632 in 2006, a decline of 19 percent. Between 1994 and 2003, more than 50 percent of all FTE staff in contract facilities wereCDP‐certified; the proportion declined to 47.1 percent in 2006. In 2006, 69 percent of CDP‐certified staff in contract and 44.2 percent in non‐contractfacilities worked as counselors. In 2006, 85.5 percent of CDP‐certified FTEs in non‐contract facilities were White comparedto 77.9 percent in contract facilities.Counselors In 2006, contract facilities employed 80 percent of the total number of counselors incertified chemical dependency treatment facilities. The total number of CDP‐certified counselors in contract and non‐contract facilities declinedfrom 1,272 in 2000 to 1,011 in 2006, a drop of 20.5 percent. In 2006, the proportion of minority counselors in contract facilities, 22.1 percent, was lowerby 5.3 percentage points than the proportion of minority patients admitted to publiclyfunded treatment, 27.4 percent. In 2006, 46 percent of counselors with multilingual skills spoke Spanish.Counselor Trainees The total number of counselor trainees in contract and non‐contract facilities increased 224percent from 163 in 1997 to 528 in 2006. The proportion of White counselor trainees in contract and non‐contract facilities remainedabove 70 percent over the course of 15 years. In contract facilities, the proportion of counselor trainees with disabilities has steadilydropped from 54 percent in 1994 to 35.5 percent in 2006; in non‐contract facilities itdeclined from 50 percent to 29.1 percent during the same period.8
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesExecutive SummaryCounselor Supervisors Since 1997, the proportion of White counselor supervisors in contract facilities hasfluctuated between 71 percent and 83 percent, while in non‐contract facilities, theproportion has varied between 77 percent and 93 percent. In non‐contract facilities, the proportion of African American counselor supervisors rosefrom 3.2 percent in 2000 to 8 percent in 2006. Historically, contract facilities have employed proportionately more female counselorsupervisors than contract facilities, but they were almost at parity in 2006.Administrators Over the course of 15 years, more than 80 percent of administrators in both contract andnon‐contract facilities have been White, except in 2006 when the proportion of Whiteadministrators in contract facilities declined to 78.4 percent. In non‐contract facilities the proportion of African American administrators dropped from6.7 percent in 2000 to 2.8 percent in 2006, but grew from 1.3 percent to 5.4 percent incontract facilities during the same period. Over the course of 15 years, contract facilities employed proportionately more femaleadministrators than non‐contract facilities, 53.3 percent on average compared to 48percent in non‐contract facilities.9
Staffing Patterns in Washington State Chemical Dependency Treatment Facilities10
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesThe Staffing Pattern SurveyPurpose of the SurveyThe Division of Alcohol and Substance Abuse (DASA) is the single state agency (SSA)responsible for planning and delivery of chemical dependency (CD) treatment andsubstance abuse prevention services in Washington State. DASA provides these servicesthrough contracts with county governments, Native American tribes, and non‐profit serviceproviders.DASA works with partner agencies and providers to ensure the delivery of quality CDtreatment and substance abuse prevention services. It manages the Substance Abuse andPrevention Treatment grant that Washington State receives under the auspices of theSubstance Abuse and Mental Health Services Administration (SAMHSA) of the U.S.Department of Human and Health Services (DHHS). In support of SAMHSA’s promotion ofcultural competency, DASA recognizes that treatment programs whose staff reflects thebackgrounds and experiences of minority groups will be better able to meet their needs.DASA therefore has made it a policy to periodically assess changes in the staffing of certifiedCD treatment facilities in Washington State with respect to gender, ethnicity, disabilitystatus, and multilingual skills.DASA conducts the Staffing Pattern Survey tri‐annually to collect information thatwould help identify disparities in the representation of minority groups on the staff of CDtreatment programs statewide. Results from the survey are used to inform new policies anddevelop corrective action plans if needed. This report highlights the findings from the mostrecent survey conducted in 2006 and shows trends in the staffing patterns of CD treatmentagencies in Washington State over the course of 15 years. It also presents in a specialsection the most recent information on the number and characteristics of full‐timeequivalent (FTE) staff with chemical dependency professional (CDP) certification.MethodologyEvery three years since 1991, DASA sends the Staffing Pattern Survey to directors ofall the certified chemical dependency treatment facilities in Washington State. The surveyasks directors to list the positions or job titles, not names of persons, in their respectiveagency, and to provide for each position the following information: average number ofhours worked per week; certification status i.e., whether or not the staff member is achemical dependency professional (CDP); gender; race or ethnicity; disability status;multilingual ability; and language other than English spoken by employees identified asmultilingual. For the purpose of the survey, persons with disabilities included staffrecovering from chemical dependency. As the following table shows, the survey responserate has been over 90 percent, except in 1997 when it was 85 percent. The current surveyreflects 98 percent participation of all certified treatment facilities in the state.11
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesThe Staffing Pattern SurveyStatewide Staffing Pattern SurveyFacility Response Rate by Survey Year, 1991‐2006Survey Year199119941997200020032006Number r onseRate(%)929685999898This report compares trends in staffing patterns between contract and non‐contractfacilities. Contract facilities receive state or federal funds through a contract with DASA orthrough a county sub‐contract; non‐contract facilities do not. Following the procedure used inthe previous surveys, the data are weighted on the full‐time equivalency rate (FTE) since theaverage number of hours that employees work per week varies across positions. An FTEwas calculated as the reported average number of hours an employee worked per weekmultiplied by 52 weeks and divided by 2088 hours.Organization of the FindingsThe report begins with findings for all FTE staff followed by separate sections oncounselors, counselor trainees, counselor supervisors, and administrators. The tables inAppendix A show all the results for each survey year and are the source of the charts found inthe report. The survey instrument and definition of terms used in the survey can be found inAppendix B.12
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesAll Full‐T ime Equivalent (FTE) Staff13
Staffing Patterns in Washington State Chemical Dependency Treatment Facilities14
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesAll Full‐Time Equivalent (FTE) StaffNumber of FTE Staff in Contract and Non‐Contract TreatmentFacilitiesNumber of Full‐Time Equivalent (FTE) Staff in Contract and Non‐Contract Treatment Facilities by Year of 320061,000The total number of FTEs in contractand non‐contract facilities has grownfrom 3,559 in 1991 to 4,772 in 2006,generally in line with the populationincrease in the state over that periodof time. However, the percentage ofFTEs employed as counselors andCDPs has declined; the percentage ofFTEs employed as trainees hasincreased.019911994Source: Tables 1a and 1b, Appendix A.In 2006, four out of five FTEs incertified chemical dependencytreatment facilities in WashingtonState were in contract facilities.FTE Staff by Race/EthnicityWhite FTE StaffPercent of White FTE Staff in Contract and Non‐ContractTreatment Facilities by Year of 200020032006Source: Tables 1a and 1b, Appendix A.15Both contract and non‐contractfacilities experienced a decline in theproportion of White FTE staffbetween 1991 and 2006, althoughthe drop was greater in contractfacilities with nine percentage pointsthan in non‐contract facilities withfive percentage points.The proportion of White FTE staffemployed in non‐contract facilitiesremained over 80 percent during the15‐year period.
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesAll Full‐Time Equivalent (FTE) StaffAfrican American FTE StaffExcept in 2000, contract facilitiesemployed proportionately moreAfrican American FTE staff than non‐contract facilities.Percent of African American FTE Staff in Contract and Non‐Contract Treatment Facilities by Year of e: Tables 1a and 1b, Appendix A.Between 2000 and 2006, contractfacilities increased their proportion ofAfrican American FTE staff from 5.5percent to 8.0 percent; in non‐contract facilities, the proportiondeclined from 6.6 percent to 4.7percent.Hispanic FTE StaffPercent of Hispanic FTE Staff in Contract and Non‐ContractTreatment Facilities by Year of e: Tables 1a and 1b, Appendix A.16Results indicate an increasingproportion of Hispanic FTE staff inboth contract and non‐contractfacilities, although contract facilitieshave consistently employed a higherproportion of Hispanic staff than non‐contract facilities. In contractfacilities, the proportion of HispanicFTE staff rose from 3.7 percent in1991 to 7 percent in 2006. In non‐contract facilities the level rose from1.2 percent to 4.6 percent.
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesAll Full‐Time Equivalent (FTE) StaffNative American FTE StaffPercent of Native American FTE Staff in Contract andNon‐Contract Treatment Facilities by Year of SurveyContractNon‐Contract1086.96.55.7 3Contract facilities have employedproportionately more NativeAmerican FTE staff than non‐contractfacilities and have done soconsistently over the course of 15years. Contract facilities have seenthe level of Native American FTE stafffluctuate between 4.4 percent and6.9 percent, but non‐contractfacilities have seen continuing declinesince 1994.2006Source: Tables 1a and 1b, Appendix A.Asian/Pacific Islander FTE StaffThe proportion of Asian/PacificIslander FTE staff employed in bothcontract and non‐contract facilitiesstayed below 4 percent over thecourse of 15 years.Percent of Asian/Pacific Islander FTE Staff in Contract and Non‐Contract Facilities by Year of .8 2.62.6 2.7199720002.32.31.601991199420032006Source: Tables 1a and 1b, Appendix A.17The proportion of Asian/PacificIslander FTE staff in contract facilitiesrose from 2.6 percent in 2000 to 3.9percent in 2006, while in non‐contract facilities the proportionremained near 2.5 percent duringthe same period.
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesAll Full‐Time Equivalent (FTE) StaffMinority FTE Staff Compared to Minority CD PatientsOverall, the percentage of minorityFTE staff in contract facilitiesapproximated the percentage ofminority patients admitted to publiclyfunded treatment in 2006. *Comparing the Percentage of Minority FTE Staff in ContractFacilities in 2006 to the Percentage of Minority PatientsAdmitted to Publicly Funded Treatment in CY2006 byRace/EthnicityMinority FTEsMinority CD Patients504025.2 A comparison between non‐contractfacility staff and patients is notpossible since DASA does not haveaccess to patient records in non‐contract facilitiesSource: Table 7, Appendix A.Female FTE StaffPercent of Female FTE Staff in Contract and Non‐ContractFacilities by Year of SurveyContractNon‐Contract1008062.6 62.163.9 62.31991199464.967.561.06066.859.060.867.263.0The proportion of female FTE staff incontract facilities remained at nearlythe same level of about 67 percentbetween 2000 and 2006. In non‐contract facilities, the proportionincreased from 59 percent in 2000 to63 percent in 2006.402001997200020032006Source: Tables 1a and 1b, Appendix A.*Data on minority patients in contracting facilities were obtained from the Division of Alcohol and SubstanceAbuse Treatment Analyzer (DASA‐TA). The DASA‐TA is a Web‐based application designed to monitor treatmentoutcomes for publicly funded CD patients in Washington State. It uses data from DASA’s management informationsystem, the Treatment and Assessment Report Generation Tool (TARGET).18
Staffing Patterns in Washington State Chemical Dependency Treatment FacilitiesAll Full‐Time Equivalent (FTE) StaffFTE Staff by Disability StatusContract and non‐contract facilitiesemployed nearly similar proportionsof FTE staff with disabilities, except in1991 and 1997 when contractfacilities had proportionately moreFTE staff with disabilities than non‐contract facilities.Percent of FTE Staff with Disabilities in Contract andNon‐Contract Facilities by Year of SurveyContractNon‐Contract10080604036.2 36.335.837.327.627.430.3 30.132.1 29.528.9 30.8200020032006200199119941997Source: Tables 1a and 1b, Appendix A.Within contract facilities, theproportion of FTE staff withdisabilities declined from over 35percent in 1991‐1997 to about 30percent in 2000‐2006.FTE Staff by Multilingual AbilityPercent of Multilingual FTE Staff in Contract and Non‐ContractFacilities by Year of SurveyContractNon‐Contract504030In contract facilities, the proportionof multilingual FTE staff stayedbetween 10 percent and 12 percentover the course of 15 years. In non‐contract facilities, the level fluctuatedbut increased from 8.3 percent in2000 to 11 percent in 2006.20109.611.56.79.111.59.610.38.
FTE Staff with Chemical Dependency Professional (CDP) Certification Considering contract and non‐contract facilities together, the total number of FTE staff with a chemical dependency professional certification (CDP) dropped from 2,014 in 2000 to 1,632 in
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