The following Op-Ed feature is by award-winning investigative journalist Burl Barer. Mr. Barer has been pro-active in the support of effective prevention and treatment of alcoholism and addiction since 1973 when he served on the Seattle Mayor’s Task Force on Drug Abuse Treatment and Prevention. Often outspoken and admittedly opinionated, the views expressed are his own and intended to foster further conversation and increased dedication to honesty and integrity in the Recovery Industry.
Thousands of dedicated professionals from diverse disciplines devote their lives and careers to the treatment and prevention of addiction, and they do so with sincerity and the highest standards of professional ethics. The recent highly publicized scandals involving unethical and/or illegal practices are neither common nor acceptable to most addiction service providers. These scandals impact the entire recovery community by undermining confidence in, and respect for addiction treatment providers and mental health professionals.
One recent revelation of wrongdoing involves “Patient Brokering” or “Body Brokering.” A widespread method of Patient Brokering uses online websites with toll-free numbers that ring call centers offering to help the suffering person get into appropriate treatment. There are two similar, yet distinct techniques used by online Patient Brokers as explained by addiction expert and ethics advocate, Paul Hokemeyer, JD PhD.
“First, an independent person or organization creates a generic treatment ‘help’ web site that directs people to a generic toll-free treatment helpline. These phones are typically manned by young people, often only several months in recovery with no clinical experience. The caller, usually the person seeking help or a family member, is asked generic questions and then told they are being ‘assessed’ or ‘evaluated’ by the ‘specialist’. Eventually, a referral suggestion is made to a specific treatment center.”
In truth, what is really happening, explains Dr. Hockmeyer, is that the person seeking treatment – a sales lead – is sold to the highest bidder. “Numerous treatment centers are paying for these leads. Never mind that the caller has not actually been evaluated or assessed for their necessary clinical needs and never mind that the treatment center purchasing the leads are admitting patients that often are clinically inappropriate for their center. It is simply a tactic to put heads in beds. “
The second situation involves a similarly generic website and toll-free helpline, but this time the website and phone number are not owned by an independent party selling a “lead,” but rather owned by specific treatment centers in collusion filtering patients to their own doors.
This brings us to the National Addiction Foundation, self- described as dedicated to helping people with issues of mental health and/or the medical condition of addiction connect with appropriate and affordable treatment options. The NAF has more red flags than the NFL
“We did have a name change,” confirmed Wendy Hart, Secretary of the National Addiction Foundation. “We were first called the National Assessment Foundation, but the new name more accurately reflects our primary concern and the scope of our services. I am happy to say that we have received our official status as a registered not-for-profit corporation in the State of California.”
As of January 22nd, 2018, the Office of the State Attorney General database of registered non-profits had no entry for the National Addiction Foundation. It is possible, of course, that the online database has simply not been updated. The Foundation’s website has a button to push to make donations. Two donations to the foundation were made as part of my research, but no receipt noting the tax-deductible nature of the donation was provided.
The National Assessment Foundation is registered in California as a small business under the designation of a “club” with three to five members. The President of the National Assessment Foundation/ National Addiction Foundation is Aaron Hart Brower, who, according to public records, is also is the primary contact person at Recovery Bridges, LLC, and Laguna Detox in Costa Mesa.
This raises potential issues of perceived conflict of interest and brings us back again to our concern over “accurate assessment” being an evaluation of your insurance, not your medical condition.
The Foundation maintains high visibility via social media such as Facebook and Twitter. The Foundation’s official website has not been updated since Spring 2017 when it was already claiming non-profit status. The website provides two phone number for free consultation. The number linked to receiving “Accurate Assessment” took me directly to the main switchboard of the Southern California Treatment Center.
The Foundation’s website kindly assured me that everyone at the National Addiction Foundation is in recovery from issues of mental illness and/or addiction. The rehab industry is the only business that touts having mental illness and/or addictive disease as positive reassuring qualifications.
The website doesn’t say: “Mentally ill drug addicts are standing by to take your call,” but the “about us” section has no information about the people behind this “Foundation” other than that they have all faced the conditions of mental illness and/or addiction.
Do we also want eye doctors with vision problems, oncologists with cancer, or a cardiologist with heart disease?
The upbeat and dedicated young woman answering the toll-free number for “Accurate Assessment” in November 2017 was exactly as Hokemeyer described: she recently completed drug treatment, had no clinical training whatsoever and was honestly eager to share recovery.
Q: “When doing the free accurate assessment,” I asked, “do you use the ASAM Criteria?”
A: “What’s that?”
Q: The standard of “Accurate Assessment” protocols is The ASAM Criteria –guidelines that give clinicians and care managers a way to standardize treatment planning and determine where patients are placed in treatment, as well as how to provide continuing, integrated care and ongoing service planning and management. With the ASAM computer-guided interview, the interview may be conducted by any properly trained team member. Are you one of those properly trained team members?
A: “No, we just ask the client what their problem is and what kind of insurance coverage they have.”
Wendy Hart, Secretary of the National Addiction Foundation, was friendly and cooperative in clarifying issues and answering questions when we recently spoke.
“We do use the ASAM Criteria,” explained Hart, “in a modified form. Many of the questions are the same, As the people answering the phone are not clinically trained, we didn’t want to burden them with too much, but yes, it is very important to know exactly the situation and condition is of the person calling. We take great care to make sure we suggest appropriate treatment options.”
Q: Why does the National Addiction Foundation’s phone number for accurate assessment ring the general switchboard for the Southern California Treatment Center?
A: Everyone at the National Addiction Foundation has a vested interest in the recovery industry in one way or another. We are all recovery professional working together in the best interests of those who call us. But we do not automatically send people to the treatment centers where we work. Oh, no. We are far more personalized and thorough than that. We give the client a list of at least three treatment centers that meet their needs,
Q: Do treatment centers pay you a referral fee or bid on your clients?
A: Absolutely not. We do receive donations from treatment centers but there is no quid pro quo. Treatment centers donate to us because they like what we are doing.
Q: Do the treatment centers you recommend have doctors on staff to treat the medical aspects of addiction?
A: Well, all rehabs should have a medical doctor who knows about addiction on call in case you have to take someone to the hospital. Simply having a nurse, especially one who has no training in dealing with addiction is not sufficient.
Conclusion: At this time, I am regretfully withholding endorsement of the National Addiction Foundation because of two significant issues described by Hockmyer in The Underbelly of Addiction Treatment: A look at the Unethical and Illegal Practices of “Saving Lives” published in March 2017 by the Maryland Addiction Recovery Center.
- The misleading use of the term, “accurate assessment” – it implies medical/psychological assessment when it is an evaluation of your insurance coverage.
- The direct connection between the Foundation and specific treatment centers in which members of the Board of Directors may have a financial interest and/or employment.
Both issues will hopefully be corrected or significantly modified in the near future.
If you or a family member has concerns regarding issues of mental health or questions regarding drug dependence and/or addiction contact a board-certified medical professional with a specialization in addiction.
Burl Barer is an Edgar Award winner and two time Anthony Award nominee with extensive experience consulting rehab facilities and programs on matters of ethics and client-driven, internally referenced recovery. Barer also serves on the Advisory Board of Writers In Treatment.