Case Identification Number
Control: Completes 1=phone 2=mail 9=web
Census State FIPS codes label
Blk A. Location Addr: County
NCHS 2006 1=Most urban 6=Least urban
NCHS 1990 1=Most urban 6=Least urban
Blk A. Location Addr: MSA/PMSA Code (1990)
Blk A. Location Addr: MSA/PMSA Code (2000)
Added: Census Region
Added: Census Division
Offered Intake/Ass'mnt/Refer'l
Offered Detox
Offered SA Tx
Any other SA services offered
Detox from alcohol
Detox from benzodiazepines
Detox from cocaine
Detox from methamphetamines
Detox from opiates
Detox from other substances
Routinely detox with medications
Primary focus SA Tx/MH/Mix/GH
Ownership
Federal Government Agency
Solo practice
Affiliated w/religious organization
Located in/operated by hospital
Hospital Type
Assessment screening substance abuse
Assessment screening mental health
Assessment comprehensive SA
Assessment mental health
Screening tobacco use
Assessment outreach
Assessment interim services
Testing blood/alcohol
Testing drug/alcohol urine screen
Testing Hepatitis B
Testing Hepatitis C
Testing HIV
Testing STD
Testing TB screen
Transitional Discharge Plan
Transitional Aftercare
Ancillary Services Case Management
Ancillary Social Skills
Ancillary Mentoring/Peer Support
Ancillary Child Care
Ancillary Assist. Social Services
Ancillary Employment
Ancillary Housing Assist
Ancillary Domestic Violence
Ancillary Intervention HIV
Ancillary HIV/AIDS Edu
Ancillary Hepatitis Edu
Ancillary Health Edu
Ancillary Substance Abuse Edu
Ancillary Transportation Assistance
Ancillary Mental Health Svcs
Ancillary Acupuncture
Ancillary Residential Beds for children
Ancillary Self-Help Groups
Ancillary Smoking Cessation
Pharmacotherapies Antabuse
Pharmacotherapies Naltrexone
Pharmacotherapies Vivitrol
Pharmacotherapies Campral
Pharmacotherapies Nicotine Replacement
Pharmacotherapies Non-Nicotine Cessation
Pharmacotherapies Psychiatric Disorders
Pharmacotherapies Methadone
Pharmacotherapies Buprenorphine without naloxone
Pharmacotherapies Buprenorphine with naloxone (Suboxone)
Operate an Opioid Treatment Program
All clients in OTP
OTP for maintenance/detoxification/both
% of clients receiving individual counseling
% of clients receiving group counseling
% of clients receiving family counseling
% of clients receiving marital/couples counseling
Use frequency of substance abuse counseling
Use frequency of 12-step facilitation
Use frequency of brief intervention
Use frequency of cognitive behavioral therapy
Use frequency of contingency management
Use frequency of motivational interviewing
Use frequency of trauma-related counseling
Use frequency of anger management
Use frequency of matrix model
Use frequency of community reinforcement plus vouchers
Use frequency of rational emotive behavioral therapy
Use frequency of relapse prevention
Use frequency of other treatment approach
Standard Continuing education for staff
Standard Periodic drug tests
Standard Case review with supervisor
Standard Case review with quality review committee
Standard Outcome follow-up after discharge
Standard Periodic utilization review
Standard Client satisfication surveys
Program for DUI/DWI/other offenders
All SA Tx clients DUI/DWI
Tx in sign language-y/n
Tx in language other than English-y/n
Tx lang provid by staff counselor/interpreter/both
Tx in Hopi
Tx in Lakota
Tx in Navajo
Tx in Yupik
Tx in Other American Indian/Alaska Native
Tx in Arabic
Tx in Chinese
Tx in Creole
Tx in French
Tx in German
Tx in Hmong
Tx in Italian
Tx in Korean
Tx in Polish
Tx in Portuguese
Tx in Russian
Tx in Spanish
Tx in Tagalog
Tx in Vietnamese
Tx in other language
Specific Program/gr'p for adolescents
Specific Program/gr'p for co-occurring
Specific Program/gr'p for crimn'l justice clients
Specific Program/gr'p for persons with HIV/AIDS
Specific Program/gr'p for lesbian/gay/bisexual/trans (LGBT)
Specific Program/gr'p for seniors
Specific Program/gr'p for adult women
Specific Program/gr'p for preg't/postpart'm women
Specific Program/gr'p for adult men
Specific Program/gr'p for other groups
Hosp Inpat'nt SA care offered currently
Hosp Inpat'nt Detoxification care offered
Hosp Inpat'nt Treatment care offered
Non-hosp Res SA care offered currently
Non-hosp Res Detoxification care offered
Non-hosp Res Short Term Tx offered
Non-hosp Res Long Term Tx offered
Any Outpat'nt SA care offered currently
Outpat'nt Detox offered
Outpat'nt meth maint offered
Day Tx/partial hosp offered
Intensive outpat'nt Tx offered
Regular outpat'nt Tx offered
Uses sliding fee scale
Offers no charge or free Tx
Receive any Fed, State, C'nty, or Local Funds
Free Tx to all clients
Accepts cash or self-payment
Accepts Medicare payments
Accepts Medicaid payments
Accepts state financed health ins
Accepts Federal military insurance
Accepts private health insurance
Accepts ATR Vouchers
Accepts IHS/638 contract care funds
Accepts other payments
Client counts for only this facility, this plus others, none
# of Facilities in Client Count Data
Any patients rec'd Hosp Inpat'nt SA services, 3/31/11
Hosp. Inpatient clients, Detox
Hosp. Inpatient clients, Tx
Total Number of Hospital Inpatients
Hosp Inp Clients Under 18 years old
Total Methadone Inpatients
Total Buprenorphine Inpatients
Total Beds Designated-Hospital Inpatient
Any clients rec'd Res Non-Hosp SA services, 3/31/11
Residential Clients, Detox
Residential Clients, Short-term Tx
Residential Clients, Long-term Tx
Total Number of Residential Clients
Residential Clients Under 18 years old
Total Methadone Residential
Total Buprenorphine Residential
Total Beds Designated-Residential Clients
Any clients rec'd Outpat'nt SA services, 3/31/11
Outpat'nt Clients, Detox
Outpat'nt Clients, Meth Maint
Outpat'nt Clients, Day Tx/Partial Hosp
Outpat'nt Clients, Intensive
Outpat'nt Clients, Regular Outpat'nt Care
Total Number of Outpat'nt Clients
Outpat'nt clients under 18 years old
Total Methadone Outpat'nts
Total Buprenorphine Outpat'nts
% of Clients Treated for both Alc/Drug Abuse
% of Clients Treated for only Alc Abuse
% of Clients Treated for only Drug Abuse
% of clients with mental health and SA diagnosis
Total # of admissions for Sub Abuse Tx
Setting, Halfway House
Fac smoking policy
Licns'd/certif'd by State SA Agency
Licns'd/certif'd by Mental Health Dept.
Licns'd/certif'd by State Health Dept.
Licns'd/certif'd by Hospital Authority
Accredt'd by The Joint Commission
Accredt'd by CARF
Accredt'd by NCQA
Accredt'd by COA
Licns'd/certif'd by another State Agency
Has Web site - y/n
Unrolled client count
Added:Report Level
Added:Total Outpatient Meth+Bup clients (on 3/31/11)
Added:Total Hospital Inpatient Meth+Bup clients (on 3/31/11)
Added:Total Residential Meth+Bup clients (on 3/31/11)
Added:Total Clients (on 3/31/11)
Added:Total Methadone Clients (on 3/31/11)
Added:Total Buprenorphine Clients (on 3/31/11)