Pubdate: Mon, 16 Jan 2006 Source: Greensboro News & Record (NC) Copyright: 2006 Greensboro News & Record, Inc. Contact: http://www.news-record.com/ Details: http://www.mapinc.org/media/173 Author: Margaret Moffett Banks Bookmark: http://www.mapinc.org/rehab.htm (Treatment) ADS DIRECTOR DEFENDS AGENCY Critical Report Was Right, ADS Says, But Problems Are Out Of Its Hands Remember those unused beds at Alcohol and Drug Services -- the ones that remain empty despite the thousands of untreated addicts in Guilford County? Chuck Fortune, the agency's director, has something to say about that: Don't blame ADS. Government regulations control who gets admitted to the facility and for how long, he says. And if ADS steps outside those guidelines, the nonprofit won't get paid for the treatment it provides. "We're not trying to keep people out," Fortune said. "We're just trying to get reimbursed for the ones we serve." Fortune and his staff of 120 are still reeling from harsh comments leveled at them earlier this month. A consultant's report said the agency -- which serves low-income addicts who can't afford private treatment -- has too many empty beds and has strayed from its original mission of providing a 12-step treatment program. The report was commissioned by the Guilford County Substance Abuse Coalition, a collection of citizens and members of 43 organizations associated with alcohol and drug treatment. It followed a News & Record series in November 2004 dealing with the county's 20-year battle with crack cocaine. Several community leaders who have been concerned about ADS, including Guilford County Public Defender Wally Harrelson, who helped found the agency, said the public criticism was long overdue. Some county commissioners also are concerned about the findings, since the county last year awarded ADS $1.7 million in contracts. On Thursday, commissioners will hear a more detailed report on the county's drug and alcohol rehabilitation services from the substance abuse coalition. It's unclear whether the coalition will recommend reform at ADS. Coalition members have declined to discuss the report, which could include some of the consultant's recommendations. Fortune doesn't dispute the consultant's facts: About half of ADS's inpatient 55 beds are occupied. And addicts typically stay less than a week. But there are reasons, he says -- all beyond ADS's control: * The Guilford Center, the county's mental health agency, decides who gets into ADS's treatment programs and how long they stay. * State government, which reimburses ADS for its services, no longer favors 12-step recovery programs, said Jackie Butler, ADS's director of client services. Recent reforms in mental health put more emphasis on letting the client chose his or her recovery model, she said. The state also believes the 12-step program's emphasis on spirituality might turn off some potential clients, Butler said. ADS hosts 12-step meetings seven days a week through Alcoholics Anonymous and Narcotics Anonymous, she said. "We're not at all opposed to 12 steps," she said. * The state prioritizes addicts based on its "target population," Fortune said. Women with children, for instance, are more likely to receive an open slot at ADS than single men who never have relapsed. * The state rarely pays for monthlong inpatient treatment, Fortune said. It prefers to send addicts to one-to three-day detox programs, which means it can treat more addicts with a limited pool of cash. "There was a time when you could walk up (to a treatment facility) and say, 'I need help,' and get 28 days," he said. "But decisions are now based on money. "We can't just go back to the old days because everybody wants to." According to the national Drug and Alcohol Services Information System, the median length of stay for detox programs is four days. But many of ADS's harshest critics say addicts, particularly crack addicts, need more time in treatment. Several community leaders, including Commissioner Melvin "Skip" Alston, want the county to build a long-term treatment center for crack addicts. Fortune said the Guilford Center usually approves one-day stays for cocaine addicts. Alcoholics are given a higher priority, he said, since there's more of a risk of a client having serious medical problems during alcohol detox than with cocaine. ADS has performed substance-abuse services for the county's mental health agency for more than a decade, chipping away at a drug problem that costs the county tens of millions of dollars annually. Fortune said his staff works hard to treat clients and follow state guidelines -- a must, he says, if his agency is to be reimbursed for its services. All of its outpatient facilities are full, he said. Staff members also try to find longer-term treatment for crack cocaine addicts after they finish the detox program, he said. ADS raises money from private sources, including area United Way agencies and ABC boards. That extra money sometimes affords clients longer stays or provides open slots to addicts the state considers to be a lower priority. And sometimes, he said, the agency simply doesn't get reimbursed for its services. "We just eat it," said Fortune. "And we do a lot of that kind of thing." - --- MAP posted-by: Beth Wehrman