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For working principals in CaliforniaExecutive rehab that does not require inpatient.
A virtual intensive outpatient program designed for the working professional who cannot disappear for a month. PHP-intensity hours when clinically indicated, delivered case-by-case under California DHCS BHIN 24-001, while you keep your job, your partners, and your calendar. Built and run by California-licensed clinicians, physician-led for medication management, with confidentiality protections that exceed HIPAA.
For most working adults, residential treatment is the wrong default.
The 30-day inpatient model came out of Hazelden's Minnesota Model in the 1950s and was cemented by 1970s insurance billing practice. It is sometimes the right answer. For a partner at a law firm, a founder, a surgeon, an investment principal, or any professional whose absence would be visible and consequential, it is often the wrong one.
The actual clinical question
Level of care is decided by the ASAM Criteria 4th edition (2023), not by venue. Most working adults with sustained employment, a stable living situation, no acute medical complications, and adequate support fall at ASAM 2.1 or 2.5. Both are outpatient levels. Neither requires you to leave home.
What changes when you stay employed
Outcomes research is clear that disruption of work, identity, and routine is one of the larger relapse risks in the first 90 days after treatment. Programs designed to fit a working life remove that disruption rather than manufacture it. Staying in your role is usually a clinical asset, not a clinical compromise.
Where inpatient is still right
If withdrawal carries medical risk that cannot be managed in an ambulatory setting, if the home environment is actively unsafe, or if there is acute psychiatric instability, residential or inpatient is the right answer. A clinical screening tells you which case you are in. The screening is free.
An intensive outpatient program that fits a working calendar.
Same clinical model as a traditional IOP. Different delivery.
9 to 19 hours per week, scheduled around your day
Morning, afternoon, and evening cohorts. The evening cohort is built specifically for executives whose work day ends past five Pacific. Individual therapy and physician medication management are scheduled around your calendar, not against it.
PHP-intensity hours when clinically indicated
When the ASAM placement supports it and your payer authorizes it, Shift delivers Partial Hospitalization (Level 2.5) intensity hours, roughly twenty per week, under California DHCS BHIN 24-001 hour expansion. The setting stays outpatient. The intensity matches the clinical need.
Physician-led medication management
Buprenorphine, naltrexone, and Vivitrol protocols are written and authorized by our Medical Director, a California-licensed physician (CA license A152831). Medication decisions are not delegated to a counselor.
Two layers of legal protection, not one.
For most medical care, HIPAA is the privacy floor. For substance use treatment records, federal law adds a second, stricter layer.
HIPAA
The baseline federal privacy framework for protected health information. Restricts what a provider can disclose without your consent. Standard across all of healthcare.
42 CFR Part 2
A federal regulation that applies specifically to substance use treatment records. A Part 2 program cannot disclose even that you are a patient, without your specific written authorization. Stricter than HIPAA. Older than HIPAA. The original confidentiality protection in addiction medicine.
What this means in practice
Your partners at the firm, your board, your co-investors, your bar association, your medical board, your spouse, your parents, do not find out unless you sign a paper saying so. Insurance is verified through procedures that comply with both HIPAA and Part 2.
What we are not.
Brief, because clarity is more useful than marketing.
We are not a 30-day residential program
Shift is licensed as a virtual outpatient program (DHCS Cert 191663AP). We do not provide residential, inpatient, or medically managed withdrawal services. When ASAM places you above 2.5, we refer.
We are not in-network with commercial carriers
Shift is out-of-network with all commercial insurance carriers as of May 2026. We verify out-of-network benefits before admission and tell you the expected cost. We do not promise coverage where none exists.
We are not the right fit for every working professional
If a clinical screening shows that residential is the appropriate level of care, we say so and refer you to a partner facility. The screening is honest, not promotional.
What working principals ask before scheduling.
Can I keep working while in treatment?
Yes. The standard IOP cohort is 9 to 19 hours per week, scheduled around a working calendar (morning, afternoon, or evening). If the clinical picture supports PHP-intensity hours under BHIN 24-001 (roughly twenty per week), the schedule still works for most executive calendars with planning.
Will my partners or my board find out?
Not unless you sign a written authorization saying so. Substance use treatment records are protected under 42 CFR Part 2, a federal regulation that is stricter than HIPAA. A Part 2 program cannot disclose that you are a patient without your specific consent.
Do I have to stop traveling for work?
Travel during active treatment is a clinical conversation, not a hard rule. Many concierge patients structure travel around their intensive blocks. We have evening sessions and asynchronous individual therapy options for travel weeks. Discuss your calendar with the Medical Director on the intake call.
What is the difference between this and an executive coach?
An executive coach is not a clinician. Coaching is not a substitute for treatment of a substance use disorder. Shift is a licensed clinical program with physician medication management and ASAM-grounded levels of care. If the clinical picture is sub-clinical, coaching may be appropriate, and we will tell you that.
How long does treatment last?
Intensive outpatient varies by clinical course, typically 8 to 12 weeks at the intensive level, with a step-down to standard outpatient or aftercare. PHP-intensity blocks are usually shorter, 3 to 6 weeks, with a planned step-down. The Medical Director discusses the projected length on the intake call.
What does the program cost without insurance?
We tell you the out-of-pocket estimate before admission, after a free benefits verification call. We do not quote a price before we know your specific plan, because the actual answer depends on your out-of-network deductible, your coinsurance, and whether the plan recognizes single-case agreements. The benefit check takes one business day.
A 20-minute call with Dr. Raphael, our Medical Director.
The call is clinical, not promotional. He tells you whether virtual outpatient is the right level of care, and what the next step looks like if it is not. No commitment. No paperwork.