Fed report: More Medicaid equals fewer addiction troubles in Florida

Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach’s Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)

Elevator scene from the National RX Drug Abuse and Heroin Summit in Atlanta:

Reporter to woman: Are you here for the conference?

Woman: Yes, I’m from Detroit.

Reporter: We’re from South Florida.

Woman: Oh, South Florida. That’s where you go when you’ve got money for treatment.

Or not.

On Monday, Health and Human Services released a report on just how many Floridians with addiction or mental health issues can’t get adequate help – in some cases, any help – because the state won’t expand Medicaid, a key feature of Obamacare.

(Comes a day before President Obama is slated to speak at the Summit. Coincidence? You decide.)

Anyway: Florida has fought tooth and nail against any such expansion, even though the rolls of Floridians on the health plan for the poor continues to rise.

About three in every ten people living below 138 percent of the poverty level need treatment for drug abuse or mental illness or both, HHS estimates.

From those numbers, the feds put together these numbers in the report:

  • 390,000: Number of uninsured Floridians age with either mental illness or an addiction problem who would qualify for treatment under Medicaid expansion. (For bragging right purposes, that’s second only to Texas among states without Medicaid expansion.)
  • Nine: Percentage of uninsured Floridians getting help for the above, 2010-14.
  • $7 million-$190 million. Budget savings range reported by different states which expanded Medicaid.
  • 17, 18, 33: Percentage drop in arrests among three groups of people frequently in trouble with the law after Washington state began providing them with Medicaid-financed substance abuse treatment.

We already tackled one tricky addiction math question this morning, one raised by this festive magazine cover.

Harpers' controversial piece on legalizing drugs- all drugs.
Harpers’ controversial piece on legalizing drugs- all drugs.

Stay tuned as Post reporters Christine Stapleton and Pat Beall cover the Summit live from Atlanta.  Stapleton and Beall are members of a team of reporters that have been investigating scams in Palm Beach County’s $1 billion drug treatment industry

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks.

 

Four million vs. 24 million: How many addicts are there in the U.S.?

Credit writer Dan Baum points for timing. But math? Maybe not.

Baum authored a recent Harpers magazine article suggesting that legalizing drugs might be the answer to the current fix we are in.

Harpers' controversial piece on legalizing drugs- all drugs.
Harpers’ controversial piece on legalizing drugs- all drugs.

His Sunday  interview on NPR about the legalization idea out there just hours before an estimated 1800 gather in Atlanta for the National Rx Drug Abuse & Heroin Summit. Among the attendees: President Obama, as well as the head of the DEA, the Surgeon General, the head of the National Institute on Drug Abuse, and various and sundry congresspeople.

Monday morning, a Daily Beast columnist weighed in on ending the war on drugs, citing Baum’s article and pointing out that Obama’s talk will take place in a city ravaged by drugs.

Michael Botticelli, director of the White House Office on Drug Control Policy, is among high-level fed officials at Summit.
Michael Botticelli, director of the White House Office on Drug Control Policy, is among high-level fed officials at Summit.

But while the timing is good, a crucial piece of math used in Baum’s interview is probably not only off base but out of the ballpark entirely.

He suggested about 4 million Americans have a drug dependency problem, citing Peter Reuter of the University of Maryland, who Baum said puts the number of people addicted to hard drugs at fewer than 4 million.

What is being defined as a “hard” drug isn’t entirely clear.

But the feds, based on years of national surveys and emergency room data, estimate more than 24 million people are in need of treatment for addiction.

Even if you’re skeptical of figures provided by the federal government’s drug-fighting agencies, consider this: There are an estimated 600,000 or so heroin addicts in the U.S.  Given its lethal dangers, heroin has all the headlines right now, but it is far from the most common drug of abuse.

Think oxycodone, benzodiazepines, Percocet; throw in methamphetamine, and cocaine. For starters.

If even those five drugs generated the same level of addiction as heroin, once you add in the heroin figures you start bumping up against four million number.

Palm Beach Post Reporters Christine Stapleton and Pat Beall  are covering the four-day Summit live from Atlanta.  The two are members of a Post team of reporters investigating scams in Palm Beach County’s $1 billion drug treatment industry.

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks.

Obama to speak at heroin summit: follow Post’s live coverage

Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
(Thomas Cordy / The Palm Beach Post)

President Obama will join high-ranking members of his Administration at the National RX Drug and Heroin Summit in Atlanta this week to discuss ongoing efforts to address the country’s worsening opioid addiction epidemic.

Among other speakers: Michael Botticelli, Director of the Office of National Drug Control Policy; Surgeon General Dr. Vivek H. Murthy; Dr. Tom Frieden, Director of the Centers for Disease Control and Prevention; Dr. Nora Volkow, Director of the National Institute of Drug Abuse; Chuck Rosenger, Acting Administrator of the Drug Enforcement Administration; and Secretary of Agriculture Tom Vilsak.

Palm Beach Post Reporters Christine Stapleton and Pat Beall will cover the event live from Atlanta.  Stapleton and Beall are members of a team of reporters that have been investigating scams in Palm Beach County’s $1 billion drug treatment industry

The 8-month long investigation by the Palm Beach Post uncovered patient brokering, insurance fraud and kickbacks. An FBI, multi-agency task force has been investigating the industry for two years. However, no charges have been filed.

The president’s appearance at the Summit on Tuesday follows his visit last year to West Virginia, where he announced a number of new public and private sector actions to address the epidemic, including a Presidential Memorandum on prescriber training and opioid use disorder treatment.

“We are honored that President Obama will participate in the important discussion of combating prescription drug abuse and the heroin crisis,” said Nancy Hale, President/CEO for Operation UNITE, the Summit’s organizer. “His presence will help focus the nation’s attention on the drug epidemic that is devastating families and communities across the country.”

 

 

More vigilante justice: Clean addicts protest outside sober house where three overdosed last week

Young recovering addicts – frustrated with the pace of the investigation of shady business practices in the sober home industry – continued their efforts to crack down on what they say are corrupt sober homes by protesting outside a Lake Worth apartment complex where three addicts overdosed last week.FullSizeRender (8)

“It just takes everyone to get together and not rely on original process,” said R. J. Vied, organizer of the protest outside the apartment where his friend died the Friday night. “We’ve been waiting for authorities to shut them down.”

An 8-month-long investigation by The Palm Beach Post found questionable business practices in the county’s $1 billion drug treatment industry including patient brokering, insurance fraud and kickbacks.

Vied advertised the protest on his Facebook page Saturday morning asking for supporters to join him at the complex on South Federal Highway in Lake Worth. About two dozen young supporters showed up and milled around the complex, which includes a two-story apartment building, small motel and pool. Vied said one young woman moved and and the group helped two others find treatment elsewhere.

A resident of the complex declined to comment, saying his friend had overdosed the night before. While standing on the sidewalk in front of the sober home, one protester spotted a small white bag of white power on the sidewalk. FullSizeRender (7)

The owner of the complex did not return a call for comment. The Post is withholding the address pending comment from the owner.

Saturday’s protest is the second effort in a week by young recovering addicts to take on shady business practices in the sober home industry in Palm Beach County. Earlier in the week, an anonymous recovering addict created a Facebook page named Bill Wilson – the founder of Alcoholics Anonymous – to expose what he described as corrupt operators.

Facebook shut down the page after he outed two sober home operators. However, within hours the anonymous addict created another Facebook page with the same purpose. On Friday he exposed two more individuals. The Post is not publishing the name of the new Facebook page for legal reasons.Bill wilson Redacted

Protesters said they are frustrated that law enforcement and state health officials have not shut down any sober homes or arrested owners and operators despite their complaints. In 2014 an FBI task force began investigating the industry and raided two sober homes. However, no charges have been filed.

“Everybody keeps saying there are going to be indictments but nobody has gotten arrested yet,” said Maureen Kielian, the Florida director of Steered Straight. The longer they wait, the more deaths we’re having.”

Vied, who has been clean and sober for 2 years, said he hoped the protest would show the community that addicts can get clean and are concerned about their perception in the community. He vowed to protest outside a sober home every two weeks.

 

 

Vigilante addicts: Tired of corruption, young addicts point fingers on Facebook

Several hours after Facebook shut down a page created by young, anonymous recovering addicts who vowed to expose what they said were corrupt operators of sober homes in Palm Beach County, the group created another Facebook page on Thursday with the same goal.
Bill wilson Redacted

“WE ARE A LEAGUE OF EXTRAORDINARY MEN AND WOMEN WHOSE PRIMARY PURPOSE IS TO EXPOSE THE FRAUDS OF THE SCUMBAGS WHO ARE PROFITING OFF OF OUR FELLOWS INSURANCE POLICIES,” a member of the group wrote when the page went live on Tuesday.

An eight-month investigation by The Palm Beach Post has revealed questionable practices in the county’s $1 billion drug treatment industry, including insurance fraud, patient brokering and kickbacks. An FBI task force began investigating the industry in 2014. However, no charges have been filed.

The group named its first page Bill Wilson – after the founder of Alcoholics Anonymous – and vowed to expose an operator daily. Dozens of commenters responded – mostly in support of the effort. On Wednesday, the group named a second operator.

By Thursday morning Facebook had taken the page down, saying the content was “abusive.” But by noon the group created another page with a similar name and exposed two more operators.

“I WAS READY TO CALL IT QUITS BUT THE SHOW GOES ON…I FEEL LIKE I LET MY FELLOW ADDICTS DOWN. SO TODAY I WILL BE EXPOSING 2 PEOPLE. SWALLOW YOUR PRIDE AND PUT AWAY YOUR EGO BECAUSE NO ONE IS SAFE, YOU WILL BE EXPOSED!
‪#‎EXPOSED”‬

 

Amid soaring heroin use, Gov. Rick Scott greenlights Florida’s first needle exchange program

Hypodermic needles   found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
Hypodermic needles found in the trash at a cottage apartment by Jean Thomas, 83, in West Palm Beach’s Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)

It’s taken a while- a few years, actually- but today Gov. Rick Scott signed off on a pilot program in Miami-Dade County, run by the University of Miami, which establishes a needle exchange for addicts.

Once politically unthinkable, the state’s soaring rates of IV drug use- and deaths- have slowly made the idea of providing clean needles to addicts acceptable.

Credit the track record of needle exchanges in reducing rates of HIV/AIDS and Hepatitis C. That helps explain why the Florida Medical Association threw its considerable weight behind the pilot program, and why a Republican-led Congress has lifted the ban on using federal money for such exchanges.

Florida’s program is, however, just a pilot. And the University of Miami won’t be able to use state or local tax dollars to get it up and running and keep it going.

But in a written statement, Bill Piper, Senior Director of National Affairs for the Drug Policy Alliance, expressed optimism: “Hopefully this pilot syringe program is just the beginning of major changes in Florida,” he wrote.

Some neighborhoods locally might welcome that: In Prospect Park, 83-year-old Jean Thomas discovered a cache of needles in her trash last year.

 

UPDATED: 15 questions addicts should ask to find a safe halfway house

These 15 questions will help you avoid being the victim of insurance fraud and patient brokering in a halfway house.

Picking a sober home: What to ask

More than two dozen sober home operators have been arrested since October 2016 and charged with accepting and paying kickbacks to enroll insured addicts living in sober homes to specific treatment centers. Asking these 15 questions will help you determine if a sober home is doing business legally and offers the best accommodations for recovery. 

1. Are you certified by the Florida Association of Recovery Residences? FARR certifies sober homes that meet 38 standards for recovery, housing, administration, training, finance and good-neighbor practices. Certified homes can be found at farronline.org.

2. Is the residence coed? Experts agree that newly recovered addicts, especially women, are vulnerable. Dating and relationships in early sobriety can take the focus off recovery.

3.What will happen if I relapse? FARR recommends that sober homes devise individual relapse protocols that include contacts and alternative housing arrangements.

4. Have there been any overdoses or deaths? Is staff trained in CPR?

5. How often do you drug test? Are tests random? What kind of tests? How much do they cost?

Here’s how the fraud works

6. Do you bill insurance? Sober homes are not licensed to offer medical care and cannot bill insurance for services, including rent.

7. How much is rent? How is it paid? What is included in rent? What is the refund policy? Are there rules about pocket change and money transfers? Experts warn insured residents to be leery of free rent, gift cards, cellphones, gym memberships and other inducements if linked to attendance at an intensive outpatient program (IOP) or the provision of urine samples.

8. Do you have an ownership interest or receive referral fees from an intensive outpatient program (IOP) or lab? Such kickbacks, often disguised as “case management fees” are illegal under Florida’s patient brokering law. 

9. Have there been any complaints filed against the sober home or its employees, including code violations?

10. How much training, education and clean time do you require of employees, including house managers?

11. Are properties and vehicles that transport clients insured? Are clients allowed to drive vehicles?

12. Are there 12-step meetings on property? Do you provide transportation to meetings? The grocery store? Is there public transportation within walking distance?

13. What are your policies regarding guests and furloughs?

14. What is your cellphone policy?

15. What is the maximum occupancy? How many to a room? How many bathrooms?

Read more of the Post’s coverage of corruption in the drug treatment industry.