One area for potential confusion centers on the issue of treatment in lieu of supervision or treatment as supervision. In such cases, courts may be inclined to defer sentence and require enrollment in a community-based or in-house treatment program in another state. Successful completion of the treatment program is commonly a condition of the supervision program. Such treatment programs may include drug treatment, mental health treatment, or sex offender treatment, to name a few. The difficulties with these programs arise when a supervised individual in one state is required to enroll in a treatment program only available in another state and whether such situations constitute circumstances that would trigger the ICAOS.

Supervised individuals placed in an out-of-state treatment program may still trigger the requirements of the Compact, even if they are not subject to supervision by corrections officials. If the treatment program is a condition of release and includes requirements for progress reports to be submitted to the court, along with the possibility of probation revocation for non-compliance, it is sufficient to invoke the Compact and its rules.

Enrollment in out-of-state treatment programs is generally considered a "discretionary" transfer unless the supervised individual meets the residency or family ties criteria with means of support specified in Rule 3.101. Therefore, courts should exercise caution when sentencing individuals, especially high-risk ones, to out-of-state treatment programs, even if the treatment is intended to be short-term (less than 30 days). Such sentencing practices could create a difficult situation if the individual is required to participate in the program but cannot transfer or continue treatment (if the short-term treatment extends to 45 days or more) due to the receiving state's refusal to accept the case.