Skip to content
Main Menu
Home
Our Impact
Membership
Benefits of Membership
Our Members
Membership Application + Renewal
Members’ Code of Ethics
Annual Conference
2024 Conference Overview
Conference Registration
Sponsor Registration
Silent Auction Donor Sheet
Current Initiatives
Contact Us
Menu
FY JULY 2023 – JUNE 2024
Annual Membership Application
This form is for all new applicants as well as existing members renewing their annual membership dues.
"
*
" indicates required fields
Organization
*
Address
Address
City
ZIP / Postal Code
Phone
Fax
EXECUTIVE DIR. or CEO:
Email
*
Voting Representative if other than ED/CEO:
DATE(S) LAST APPROVED BY:
DOH:
CARF:
JACHO:
COA:
Have you ever lost certification from any of the above bodies?
Have you ever lost certification?
Yes
No
Lost Certification Date
NUMBER OF PATIENTS SERVED IN LAST 12-MONTHS:
Patients Served - Adults
Patients Served - Youth
SO WE CAN BEST REPRESENT YOU, CHECK WHICH BHA SERVICES YOU OFFER (Check all that apply):
Outpatient – Adult
Outpatient – Adolescent
Outpatient – COD
OST/MAT
Residential – Adult
Residential – Adolescent
Residential – PPW
Mental Health Licensed
Detox – Acute/Medical
Detox – Sub-Acute/Social
Drug Court
DUES: Membership fees are based on the gross revenue of the SUD program.
Annual dues run from July 1 through June 30 and are prorated from the month membership is commenced. Dues may be paid July 1 for the year, or payments may be made semi-annually or quarterly. For new members, we offer 50% off the first year of membership dues (minimum of $1,000 due). Dues Schedule:
Gross Revenue
Over $10,000,000
$7,500,000 to $9,999,999
$5,000,000 to 7,499,999
$3,000,000 to $4,999,999
$1,500,000 to $2,999,999
$500,000 to $1,499,999
Up to $499,999
Gross Revenue Over $10,000,000
Annual Dues
$20,000.00
Semi-Annual Payment
$10,000.00
Quarterly Payment
$5,000.00
Gross Revenue $7,500,000 to $9,999,999
Annual Dues
$15,000.00
Semi-Annual Payment
$7,500.00
Quarterly Payment
$3,700.00
Gross Revenue $5,000,000 to 7,499,999
Annual Dues
$10,000.00
Semi-Annual Payment
$5,000.00
Quarterly Payment
$2,500.00
Gross Revenue $3,000,000 to $4,999,999
Annual Dues
$8,000.00
Semi-Annual Payment
$4,000.00
Quarterly Payment
$2,000.00
Gross Revenue $1,500,000 to $2,999,999
Annual Dues
$6,000.00
Semi-Annual Payment
$3,000.00
Quarterly Payment
$1,500.00
Gross Revenue $500,000 to $1,499,999
Annual Dues
$4,000.00
Semi-Annual Payment
$2,000.00
Quarterly Payment
$1,000.00
Gross Revenue Up to $499,999
Annual Dues
$2,000.00
Semi-Annual Payment
$1,000.00
Quarterly Payment
$500.00
MY ORGANIZATION’S 2022-2023 DUES ARE
* Payment schedule:
- Annually (pay in full now, or prorated when less than 1-year)
- Semi-annually (pay ½ July 1st, ½ January 1st)
- Quarterly (pay July 1st, October 1st, January 1st and April 1st)
AAP COMMITTEE PARTICIPATION – Each member is encouraged to serve on at least one committee reflecting your interests. Please check your preference(s):
Public Reimbursement (Medicaid rates, MCO contracts, HCA & Provider One, State budget issues)
Insurance and Private Reimbursement (general insurance WACs and payment issues)
Licensing and Accreditation (BHA, RTF and Counseling rules and regulations)
Residential Program Issues (inpatient, recovery house, long-term care, involuntary treatment, rates and issues)
Outpatient & Drug Court Issues (DUI, deferred prosecution, rates and issues)
Conference and Training (planning annual provider conference, staff development)
Code of Ethics
*
As a member of the Association of Alcoholism and Addictions Programs in Washington State, I support the Code of Ethics of the Association as stated above and will endeavor to follow these ethical practices in providing substance use disorder treatment services. Treatment shall reflect adherence to the following accepted philosophy: Alcoholism and other drug addiction is a primary, diagnosable, treatable disease for which abstinence is the foundation for recovery. Alcoholism and other drug addiction is not a mental disorder, nor is it a matter of morals, intellect or willpower. A person with alcoholism or other drug addiction can never return to the use of alcohol or other mood-altering chemicals without adverse effects. A return to drinking or drug use during recovery is viewed as a sign of relapse and not an indication of failure of the individual or program. Every effort should be made to include the family and significant others in treatment. Treatment should encourage involvement with 12-step or other abstinence-based self-help groups during and after completion of professional treatment. Treatment will be offered only in discrete setting under the supervision of knowledgeable chemical dependency professionals. Members must not utilize any form of false or misleading advertising, must not exploit patients and/or families, and must not engage in competitive practices that are predatory or destructive to a collaborative marketplace There shall be no personal or financial exploitation of patients. There shall be no financial exploitation of third-party payers. Each organization shall conscientiously assess its own role and limitations in consideration of the recovery of the patient and family, and it shall refer to other services and professionals according to the best interests of the patient and family. Treatment organizations will not advertise their services in a manner that implies or expresses that recovery is simple or effortless and will not make negative reference to other treatment modalities or programs. Respect for the integrity and interests of other member organizations shall be preserved, and suspected violation of this Code of Ethics by another member shall be handled in the manner set forth in the bylaws.
I Agree
Name
*
First
Last
Total
Credit Card
*
Cardholder Name
Card Details