Drug treatment center doctor who worked for Kenny Chatman will stay out of jail

A doctor who worked for corrupt treatment center operator Kenny Chatman will not be going back to jail – at least for now.

Federal prosecutors wanted Dr. Joaquin Mendez, who is out on $100,000 bond, back behind bars after they argued he violated the terms of his release by treating patients and prescribing opioids.

Kenneth Chatman walks into Reflections, his treatment center in Margate, in 2015.

But Mendez’s lawyer, Richard Lubin, argued the terms were vague, and both sides agreed last week simply to amend the terms of his release.

Mendez, a former medical director for Chatman’s corrupt Reflections Treatment Center, is the only one of eight defendants not to have taken a plea deal for their involvement with the facility.

The seven others, including Chatman and his wife, Laura, were sentenced to a combined 58 years in prison.

Mendez has been charged with money laundering and conspiracy to commit health care fraud for ordering unnecessary urine drug tests for addicts, according to prosecutors.

One of the terms of his release, added in handwriting to the paperwork, was that he “not use his Medicare number to provide any services.”

Prosecutors said he violated those terms after he treated at least 188 Medicare patients wrote more than 100 prescriptions for controlled substances that included oxycodone, Oxycontin, clonazepam and fentanyl.

Lubin, his lawyer, argued the terms were weirdly vague.

“Not only is this Court and Dr. Mendez left guessing at what it means to ‘treat patients using his Medicare number,’ it is entirely unclear what the Government means by ‘Medicare number,'” Lubin wrote.

HEROIN: Killer of a generation

Apparently the ‘Medicare number’ prosecutors referenced was Mendez’s Provider Transaction Access Number, which Lubin said had “absolutely nothing to do with” Medicare claims.

On Thursday, both sides agreed to changing the terms of release.

Mendez is one of two doctors in charge of overseeing patient care at Chatman’s facilities to be arrested. Last Week, Dr. Donald Willems was sentenced to 10 years in prison – the maximum sentence – after pleading guilty to conspiracy to commit health care fraud.

Chatman was sentenced to 27 years in prison last month after admitting to turning his female patients into prostitutes and pimping them out online.

Adviser for notorious treatment center sentenced to nearly 5 years in prison

A former clinical director at the notorious drug rehab center run by Kenneth “Kenny” Chatman was sentenced to four years and nine months in federal prison today.

Barry Gregory was responsible for overseeing patients’ treatment plans at Chatman’s Reflections Treatment Center. But he largely turned a blind eye to problems there; he admitted in February to signing orders for patients to take urine and saliva tests that weren’t necessary, and he ordered DNA and allergy tests regardless of whether patients complained of allergies.

Dr. Barry Gregory, former clinical director for Reflections Treatment Center

He also said that as many as 90 percent of Reflections’ patients were actively using drugs.

Gregory pleaded guilty to conspiracy to commit health care fraud and knowingly falsifying a matter involving health care programs.

He joins six other people, including Chatman’s wife, who have pleaded guilty to various federal crimes related to Chatman’s drug treatment centers.

Chatman, first exposed in a 2015 Palm Beach Post story, created Reflections in a central Broward County strip mall in 2013. In Palm Beach County, he ran a series of sober homes that were notorious drug dens. He admitted last month to turning some of his female patients into prostitutes, pimping them out on websites like Craigslist and Backpage.

Chatman built Reflections into a multi-million dollar treatment center, and Gregory, a licensed mental health counselor, was instrumental in making that happen.

Chatman hired him in July 2015 to a position where Gregory would oversee addicts’ treatment and counseling. But Chatman was the one who dictated which patients were admitted and how they were treated, Gregory admitted.

When he was hired, Reflections was still on probation with the Department of Children and Family Services. Gregory was the one who filled out the forms to get Reflections fully licensed. To do so, he helped hide the business under Chatman’s wife’s name; because Chatman was a felon, he couldn’t legally own or operate a treatment center.

When Chatman wanted to open up a second treatment center, Journey to Recovery, in Lake Worth, Gregory again helped him fill out the forms, knowing that Chatman, and not Laura, was the real owner of the business.

Federal prosecutors said Gregory has shown remorse for his actions.

“While the defendant has not yet completed his cooperation, he has fully accepted responsibility, recognized his wrongdoing and shown true remorse, and assisted significantly in the investigation,” federal prosecutors wrote in a recent filing.

Chatman and his wife are scheduled to be sentenced May 17. He faces up to life behind bars. His wife, Laura, faces up to 10 years in prison.

 

Addicts to get needles from vending machines in Las Vegas

In an unprecedented approach to curb the spread of diseases and infections caused by sharing needles, health officials in Las Vegas are using vending machines to dispense clean syringes to addicts.

But unlike vending machines that dispense candy and snacks, no money is needed. Addicts participating in the pilot project scan a card and enter a unique ID number in order to vend one of the colorfully gift-wrapped boxes. Each box contains syringes, alcohol wipes, safe-sex supplies and a sharps disposal box.

Source: Las Vegas Review-Journal

People using the new needle exchange vending machines must register through Trac-B Exchange, a storefront harm reduction program aimed to prevent infectious disease. The machines will be available at three locations by the end of May.

Besides providing intravenous drug users with access to sterile needles and disposal of used ones, the program serves as a gateway to services and care that addicts may not access otherwise.

Justin Kunzelman, CEO and co-founder of Rebel Recovery Florida in West Palm Beach, said vending machine needle exchanges are the “most objective and honest,” harm reduction programs because they are unmanned.

Lawmakers worry that by endorsing needle-exchange programs it will appear that they are helping addicts use drugs, Kunzelman said. To avoid that, they impose conditions on needle exchanges that discourage addicts, such as requiring them to provide personal information, get tested for other diseases and receive counseling.

Vending machines don’t ask questions, he added.

“It’s a machine,” Kunzelman said. “It’s not asking you how many times you have been arrested, what’s your sexual orientation – all of the things that come along inherently when the legislature passes acts.”

Nevada is the first U.S. state to launch a vending machine program for clean syringes, but the vending machine model has been in use for several years in Puerto Rico, Europe, and Australia.

In Indiana, after roughly 200 people contracted HIV from sharing needles, Vice President Mike Pence – then the governor – lifted a ban on needle exchanges in 2015 in affected counties.

Still, many communities and states prohibit needle exchange programs even though they are endorsed by the Centers for Disease Control and Prevention.

In Florida, where Dade and Broward counties led the nation in new HIV cases in 2014, the Legislature allowed last year the University of Miami to establish a pilot needle-exchange program.

But lawmakers refused to pay for it. And everywhere else in the state, including Palm Beach County, supplying addicts with clean syringes is a third-degree felony.

With more addicts dying of overdoses than ever before, some policy makers are warming to the idea of needle exchanges and other harm reduction programs that encourage recovery.

When the Palm Beach County Heroin Task Force began meeting in June 2016, Kunzelman’s efforts to discuss needle exchanges ended when he stopped talking. Today, it is among topics discussed.

At its April 4 special meeting on the opioid epidemic, Palm Beach County Mayor Paulette Burdick suggested the county explore a needle exchange program and how the county might pay for it.

Kunzelman and several other harm-reduction advocates met with Palm Beach County Health Department Director Dr. Alina Alonso last week and intend to bring up a needle exchange during the Governor’s 90-minute workshop on the opioid crisis on May 1.

“They’re still getting used to the idea that current policies aren’t working,” Kunzelman said. “I think it will take awhile.”

 

 

 

 

 

 

 

 

How many addicts is too many to treat?

Physicians who prescribe buprenorphine to treat opioid addiction will no longer be limited to 100 patients. Under a rule change announced during a White House press conference on Tuesday, the new rule increases from 100 to 275 the number of patients that qualified physicians can treat.

Hypodermic needles mixed with cigarette butts and empty prescription bottles filled garbage bags recovered from a cottage apartment rented by Jean Thomas, 83, in West Palm Beach's Prospect Park neighborhood. (Thomas Cordy / The Palm Beach Post)
(Thomas Cordy / The Palm Beach Post)

The announcement came as lawmakers today consider the President’s request for $1.1 billion to address the nation’s opioid epidemic, fueled largely by cheap heroin laced with the powerful painkiller fentanyl. Opioid overdoses kill 129 people every day in the U.S.

Buprenorphine, also known by the brand names Suboxone and Subutex, is among a handful of drugs that block the high produced by heroin and other opioids, such as Percocet and Oxycodone, and prevent the addict from suffering the painful side-effects of withdrawal.

These drugs – if misused – can produce a high. To prevent “diversion” – using the drugs to get high rather than to wean an addict off opioids – qualified physicians were only allowed to treat 100 patients with the drugs.

Critics claim that medication-assisted treatment with drugs such as buprenorphine still leave addicts dependent on a drug. They question whether a physician can adequately care for 275 addicts at once and fear buprenorphine clinics may become the new pill mills.

Still, providers, policymakers and experts have pointed to the current 100 patient limit as a barrier to treatment. Administration officials estimate the increased limit coupled with the President’s $1.1 billion budget request will enable 70,000 addicts to access treatment next year.

Under the President’s budget proposal, Florida would be eligible for up to $47 million dollars over 2
years to expand access to treatment. However, the final amount the state could receive depends on congressional approval of the budget and the strength of the State’s application and plan to combat the epidemic.

Florida lawmakers have expressed little interest in addressing the state’s heroin epidemic even though the state – especially south Florida – is considered the recovery capital of the U.S. A Palm Beach Post investigation of the county’s drug-treatment industry revealed evidence of patient-brokering, insurance fraud and kickbacks.

This year lawmakers reluctantly approved a bill that would allow researchers at a Miami hospital to operate a needle exchange program and shot down efforts to control unethical marketing practices in the billion-dollar drug treatment industry.

The homepage of the State’s Dept. of Health is devoted to controlling the spread of the Zika virus. Its “Programs and Services” menu makes no mention of addiction services.

Still unresolved is how uninsured addicts who wish to get clean will find in-patient beds during the initial detox procedure – which takes an estimated 7-10 days. Administration officials said Tuesday that grants will enable communities to develop programs to provide such care.

In Palm Beach County, the Drug Abuse Foundation in Delray Beach is the primary provider of in-patient detox beds for addicts who have no insurance and cannot afford to pay for detox. There is often a waiting list for those beds.

 

Will Florida’s prescription monitoring database broaden to share anonymous information?

Deaths linked to prescription oxycodone in Florida plummeted after drug monitoring database was adopted.
Deaths linked to prescription oxycodone in Florida plummeted after drug monitoring database was adopted.

Tallahassee could probably feel the love emanating all the way from the second floor of the Westin Peachtree in downtown Atlanta Tuesday morning: The object of affection at the 2016 Summit on RX Drug Abuse and Heroin is Florida’s Prescription Drug monitoring database, or EForcse.

Fought for since 2001, approved in 2009 and finally operational in October 2011, the database curbs doctor shopping for opioids by tracking prescriptions for the drugs.

It’s been wildly successful at curbing oxycodone-related overdose deaths in Florida, as its latest report shows. In fact, it’s considered a model for other states of just how effective such a database can be.

At a Summit seminar Tuesday morning, there was a discussion by program manager Rebecca Poston of possibly broadening its scope, by linking it to other databases, such as the database of drug-related deaths compiled annually by Florida medical examiners, or the state database on Hepatitis C infections.

The idea is to provide a sweeping look at Florida public health issues, particularly as it involves patterns of drug use.

Nothing on that scale is happening yet. Whether it occurs depends in part on the University of Florida securing a grant which would fund such a program. (EForcse gets no state money for its operations.)

But it raises a question of whether Florida’s lawmakers would resurrect the same privacy concerns they raised back in 2009 and later when arguing against establishing the prescription monitoring database at all.

Poston points out that, as envisioned, there would be no way an individual could be identified. You could not, for instance, be able to individually link Adam Smith to his oxycontin prescriptions, then his treatment for Hepatitis C, his medical treatment for addiction or his death from an overdose. The data would have no names attached.

Post reporters Christine Stapleton and Pat Beall are covering the Summit live from Atlanta. Look for continuing updates on The Insider blog.

 

In unexpected moment, Agriculture Secretary Tom Vilsack reveals a life torn by addiction

Secretary of Agriculture Tom Vilsack
Secretary of Agriculture Tom Vilsack

Taking the wraps off a pair of new federal efforts to address addiction in rural America, Tom Vilsack did the expected thing, the sorta-surprising thing and the totally knock them right out of their socks thing.

Left sockless was a group of more than 1,000 people attending the  2016 Summit on RX Drug Abuse and Heroin in Atlanta.  Vilsack, head of the U.S. Dept. of Agriculture, was among the opening speakers at the Summit Monday. Tuesday afternoon, his boss – that would be the President- will show up for what is described as a Town Hall meeting.

But Monday night, it was Vilsack’s turn.

After announcing that his agency would be giving out $1.4 million in grant money to assist in researching opiate addiction in rural America, and that he would take part in a series of town halls in states hard-hit by the drug crisis, Vilsack explained the origins of his concern.

“I started life in an orphanage in Pennsylvania” before being adopted, he said. It was a loving home, but there was a problem tearing it apart: “My mom had a prescription drug addiction and she was violent. She was mean. She tried to commit suicide a couple of times.

“It was  a tough situation. My parents split up for a period of time. I nearly flunked out of high school.”

He said he judged her harshly, something he now regrets.

“I thought all she had to do was stop taking medications. I did not realize that at that point in time, we were dealing with a disease.”

But, Vilsack said, “on December 25, 1963, she realized she hit bottom.”

His mother got sober, said Vilsack. “She could not have done that without a 30-day treatment program. She could not have done it without a supportive community.”

With an estimated 78 Americans a day dying from prescription opioids, Vilsack said, entire communities now need to  step up: Pastors and community leaders as well as doctors and government.

“Person by person, we can do this,” he said. “We must do this.”