Source: Standard-Times (MA)
Contact:  http://www.s-t.com/
Copyright: 1999 The Standard-Times
Pubdate: 1 Jan 1999
Author: Polly Saltonstall, Standard-Times staff writer

WAREHAM SUPPLIER SOLD TO FOR-PROFIT FIRM

The nonprofit Center for Health and Human Services has sold its Wareham
methadone clinic to a for-profit company and is negotiating to sell its
Fall River clinic to the same firm, company officials confirmed yesterday.

The sale of the Wareham clinic to Boston-based Habit Management means at
least two out of five SouthCoast area methadone clinics now are run by
private for-profit companies. The for-profit Community Substance Abuse
Centers opened a clinic in New Bedford's North End last September.

Brian Foss, Center for Health and Human Services vice president, said
for-profit companies can provide excellent care.

But the shift in providers from nonprofit to for-profit concerns some drug
abuse specialists.

"The nonprofit will do things that are non-reimbursable for their clients,"
said Carl J. Alves, executive director of the New Bedford Prevention
Partnership and Positive Action Against Chemical Addiction. "A for-profit
has to answer to stockholders, so they may be less likely to go that extra
mile to provide services."

Habit Management closed Nov. 20 on the purchase of the Wareham clinic,
located on Cranberry Highway, said Habit president Tom Magaraci. The
13-year-old company also runs clinics in Lowell, Lawrence, Yarmouth,
Brockton, Taunton, Quincy, Weymouth and Boston.

"Wareham was a natural fit for us," said Mr. Magaraci.

He and Mr. Foss confirmed Habitat also is discussing the possibility of
buying the center's Fall River methadone clinic. Mr. Foss said he expects
to know in the next month whether that deal will go through.

Neither Mr. Magaraci nor Center for Health and Human Services officials
would discuss the sale price of the Wareham clinic.

The center's methadone operation has been under investigation for almost a
year by a handful of state and federal agencies. Those probes influenced
the sale only in their impact on the nonprofit's overall financial status,
Mr. Foss said.

Neither the Fall River nor the Wareham clinic is losing money, he said.

"We made the administrative decision that it was in the best interest of
the company to sell," he said. "There was a good offer, so we decided to
accept it."

The company does not plan to get out of the methadone business, he said,
and will continue to run its New Bedford clinic. He added that the clinic,
which does not have a waiting list for its services, was re-licensed by the
state a few weeks ago.

About 100 people get methadone at the new Community Substance Abuse Clinic.
The Center for Health and Human Services serves another 550 clients at its
Gifford Street clinic in New Bedford. The center's Fall River clinic has
about 350 patients. Habit serves about 160 clients at the Wareham clinic,
company officials said. St. Anne's Hospital also runs a nonprofit methadone
clinic in Fall River.

Methadone is a narcotic that blunts heroin addicts' craving for the street
drug and eases the painful symptoms of heroin withdrawal. It has similar
physiological effects on the brain as heroin, but without the "high" that
addicts crave.

Addicts drink daily doses of the liquid narcotic.

But methadone can be a more painful habit to kick than heroin, said Dr.
Stephen Cabral, an anthropologist who works in drug treatment and teaches
courses on drugs and society at UMass Dartmouth and Bristol Community
College. Dr. Cabral also writes columns about New Bedford and Fairhaven for
The Standard-Times.

In addition to criticizing the concept of for-profit methadone clinics, he
questioned why New Bedford has two methadone clinics but no in-patient
detoxification programs.

The idea of for-profit health care used to concern Mr. Foss. But when the
center sold its Wareham office, company officials carefully researched the
buyer, he said.

"The potential always exists to cut expenses to drive profits up," he said.
"But just because a company is for profit, that does not mean their level
of care is bad."

Habit has hired most of the center's previous staff and has been providing
good service in Wareham, he said.

Methadone clinics must be licensed by the state Department of Public Health
and the federal Food and Drug Administration and Drug Enforcement Agency. A
Department of Public Health spokesman said the state agency makes sure all
clinics, whether for-profit or not, offer a high quality of care.

The treatment for most clients at area methadone clinics is paid for by
either state contract or Medicaid, Mr. Foss said. About 20 percent of the
centers' clients are covered by private funding sources.

The rates, which the state sets, run from $70 a week for methadone alone,
to $20 to $50 for counseling, depending on whether it is provided in a
group or individual setting, Mr. Foss said.

Ed Kania-Bloniarz, chief executive officer of Community Substance Abuse
Centers, said the public should not focus on the tax status of health care
providers.

"The issue should be the quality of care that's provided," he said.
"Clearly there are nonprofit programs that are poorly run and poorly
administered that don't attend to quality of care and don't do a good job,
and there are nonprofits that do. The same thing can be said about
for-profits."

Habit Management and his company are the only for-profit drug treatment
providers in the state, he said. But for profits are common in other
states, including California.

"The three of us who own this practice work in the practice every day," he
said, noting his two partners, who are physicians. "We have dedicated our
career to addiction medicine. We really love this work and really respect
and admire the patients we treat." 
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