Reducing Paperwork

Paperwork requirements vary from state to state and from agency to agency, even within the same state, depending on whether the provider is serving clients funded by Medicaid, the county, or other special contracts, and if the provider is CARF and JCAHO accredited. As a result, streamlining paperwork must be implemented within the provider agency, with support from the state or system level.

Making Changes to Paperwork

  • To support providers, identify a system-level person who is familiar with state and other requirements and willing to work with provider sites to streamline paperwork. This person must be knowledgeable enough to provide information about requirements and answer questions, including when the information is required. He or she also needs to have the authority to approve changes that may result in improvements at the provider level and be able to negotiate with other regulatory authorities about possible changes. This person may also update providers when regulations and requirements change.
  • Select a few provider agencies in each state to pilot test improvements that will reduce paperwork.
  • After pilot tests have identified improvements, spread improvement ideas by providing a sample packet of minimal forms that meet state requirements and include well-designed best practice forms to other providers within the state. Work with the state to update the regulations so that all provider agencies can take advantage of these improvements.


  • During the STAR-SI project, Iowa assembled a change team to apply the NIATx approach and improve the process for ruling on these requests for recovery support services, and to decrease the time it took to accommodate requests. Read the full story Add to portal for more information.
  • The Delaware Division of Substance Abuse and Mental Health (DSAMH) reduced the time required for paperwork Add to portal by 2 hours per client by reviewing every form completed at six different agencies and eliminating forms that were not required. [link: Delaware ppt, presented at 2007 Summit] They reviewed every form to determine if the form was required and recommended standardizing certain forms to decrease redundancy and increase efficiency.
  • The state of Iowa analyzed intake and assessment paperwork Add to portal at 5 provider sites. They found that these agencies were routinely collecting at least 5 pages, and at one agency, as much as 12 pages, of paperwork that was not required for licensure.
  • The state of Oklahoma suspended all paperwork related to financial eligibility requirements, eliminating the delay in getting treatment by as much as 30 days. They also designed a new weekly progress note format, to replace the daily format for all providers in the state. Time required for counselors to complete progress notes decreased from about 24 hours per week to 10 hours per week.
  • The state of Oklahoma began using video teleconferencing for provider certification training Add to portal to acquaint providers with annual revisions to the Standards and Criteria for program
    certification as articulated in the Oklahoma Administrative Code (OAC). In the past, these training sessions were conducted on-site. Read the full story Add to portal for more information.
  • The state of South Carolina streamlined required intake forms and eventually eliminated 85 percent of the required intake forms, reducing the time required for intake by half. Read the full story Add to portal for more information.