CARF creates accreditation standards for sobering centers

Person-centered, interdisciplinary, and field-driven standards

CARF International has released new interdisciplinary, field-driven accreditation standards for sobering centers. These standards for sobering centers demonstrate a person-centered approach to providing a safe place for individuals with acute intoxication from alcohol and other drugs to stabilize, often diverting them from emergency healthcare and justice systems.

Following more than a year of discussion with the National Sobering Collaborative (NSC), CARF’s Behavioral Health services staff convened an International Standards Advisory Committee (ISAC) to develop new accreditation standards for sobering centers in August 2025. CARF worked with the NSC to get representatives from a national cross-section of sobering center programs and included persons with lived experience, providers, researchers, and others.

Sobering centers as an alternative

“Sobering centers are the front line for persons in a substance use crisis. It is a more appropriate alternative to emergency departments and/or jail,” said Michael Johnson, Senior Managing Director of Behavioral Health, CARF International. “The connection to resources that sobering centers can offer persons served upon discharge span a range of treatment programs, social services, or other community resources.”

The Substance Abuse and Mental Health Services Administration (SAMSHA) includes sobering centers in the continuum of crisis services. Aligning with this continuum, CARF has standards in the Behavioral Health Standards Manual for crisis programs including crisis contact, crisis intervention, and crisis stabilization. The new standards for sobering centers will be incorporated into the standards for crisis programs in the 2026 standards manual.

“It was important for CARF to recognize that sobering centers play a vital role in the crisis continuum, and offering a program of accreditation in this space can help to improve overall quality,” said Johnson. “Accreditation for sobering centers will create greater recognition with regulators and payers that in turn can improve access to care for persons served.”

Standards created

Key concepts addressed in the standards include:

• Low-barrier accessibility for persons served, emergency medical services, hospitals, law enforcement, and other stakeholders.
• Streamlined intake process with minimal requirements to allow rapid access to a safe space.
• A multidisciplinary team of medical and other professionals who provide continuous monitoring of the person’s condition.
• Identification of short and longer-term needs to connect persons served by referrals to treatment and social services.
• Physical facilities that provide a calm and safe environment.
• Engagement with community partners and stakeholders to optimize resources for persons served, enhance safety, and reduce stigma.
• Annual competency-based training for direct services personnel on topics unique to services and the population served.
• Data collection and analysis of redirect rates, emergency transfers, and persons leaving the program against advice.

Published in the 2026 Behavioral Health Standards Manual

The standards, published in the 2026 Behavioral Health Standards Manual, will be applicable to accreditation surveys beginning July 1, 2026. CARF’s standards are an established, international mechanism to adopt best practices to improve outcomes. Accreditation demonstrates to persons served, regulators, and payers that the organization offers a comprehensive array of services and supports designed to enhance the lives of persons served.

CARF’s process for creating new standards includes convening an ISAC to develop the standards, then a review of the proposed standards and gaining expert insight from the International Advisory Council before conducting a public field review. Review of the sobering centers standards involved 117 stakeholders.