Renowned US Drug-Rehab Program Spun Out of Control
BY :KRISTINA COOKE AND ROBIN RESPAUT
SEPTEMBER 03, 2015
New York. Martin Szczupak had already been in and out of rehab when, for a misdemeanor possession charge, a judge sent the 21-year-old heroin addict to a century-old estate in the wooded hills of upstate New York for another chance to clean up.
Belle Terre, the former home of a 19th-century copper baron, housed the 168-bed Phoenix House Delaware County Center, a private, nonprofit residential drug treatment facility. When Szczupak arrived in June 2012, all was not well behind Belle Terre's stately walls.
In the two years prior to Szczupak's arrival, New York's Office of Alcoholism and Substance Abuse Services (OASAS) had twice closed Belle Terre to new admissions after inspectors discovered illegal drug use, insufficient treatment and bad record-keeping, among many other regulatory violations. In each case, Belle Terre resumed admissions after Phoenix House submitted a "corrective action plan" to regulators.
Even so, residents and a counselor at Belle Terre when Szczupak was there said little had changed. Residents trafficked in drugs, cigarettes and other contraband. Nor were residents receiving the 40 hours a week of therapeutic services OASAS required.
"This place is basically a super minimum security prison camp," Szczupak wrote in an Aug. 29, 2012, letter to a friend. "We do nothing all day." Still, Szczupak was hopeful. "I'm gonna be out before I even know it," he wrote.
By December 2012, he had given up on the treatment program. He felt he would be stuck going from "dead end job and rehab and jail until I eventually drop dead," he wrote in a letter to his fiancée. "You deserve better than that." He didn't want to use drugs anymore, he wrote, "but realistically the odds are against me."
Szczupak never sent the letter. Three weeks later, he walked out of Belle Terre without permission. One day after that, police visited Szczupak's mother, Inez, at her Brooklyn home to tell her that her son had been found dead from a drug overdose.
Sending addicts to treatment rather than jail or prison for nonviolent offenses has become increasingly popular across the US political spectrum. In the 2016 presidential campaign, candidates from Democrat Hillary Clinton to Republican Chris Christie have hailed drug treatment as a smart way to tackle the problems of prison overcrowding and excessive sentencing.
Facilities like Belle Terre are part of that solution. Underwritten by taxpayers, they work with the courts and probation departments to rehabilitate offenders. In 2012, the US criminal justice system sent 580,000 people to drug treatment.
There's little doubt that quality care in a controlled setting can help. Multiple studies have shown that people who complete drug treatment court, a special court for drug addicted offenders, are less likely to reoffend in the first year or two after their release.
At Belle Terre, criminal-justice referrals account for the majority of residents. The facility is run by Phoenix Houses of New York, whose parent foundation is one of the nation's largest drug treatment nonprofits, operating in 10 states and the District of Columbia. In the year ended June 20, 2014, the Phoenix House Foundation and its affiliates reported operating revenue of $141 million.
Phoenix Houses of New York is 95 percent publicly funded and enjoys star-studded endorsements. Beyonce donated a cosmetology center at a Brooklyn facility. Financier Pete Peterson chaired a summer fundraiser in 2013 in the posh Hamptons on New York's Long Island.
But as the case of Martin Szczupak suggests, the system as practiced doesn't always deliver on the promise in principle. A review of Szczupak's journal and letters and of state regulators' reports, as well as interviews with dozens of current and former Phoenix House employees and residents, reveal a respected institution that in recent years has consistently failed to provide the quality of care necessary to help addicts kick the habit.
"Persistent regulatory violations"
The closures that preceded Szczupak's arrival weren't the last. And nor is Belle Terre an anomaly. In November last year, OASAS suspended admissions to Belle Terre and four other Phoenix Houses of New York facilities. In a letter to Phoenix House's then-chief executive in November 2014, OASAS said Phoenix House had "persistent regulatory violations and resident/patient care concerns dating back several years."
An OASAS site report on the five facilities went into graphic detail. The regulator's findings at some or all of the facilities included use of marijuana, cocaine, heroin and other illegal drugs; sexual activity among residents; reports of violence and sexual assault; insufficient, inadequately trained or abusive staff; dirty premises; and lax security, with residents coming and going as they wished.
In each case, OASAS allowed admissions to resume "based upon sustained systemic improvements," the agency said in a written response to questions from Reuters.
On Aug. 19, Phoenix House said it would be closing Belle Terre and its 185th Street facility in New York City. In an open letter to staff, Phoenix Houses of New York's president and regional director, Peter Scaminaci, cited a changing environment, "particularly as a result of health care and criminal justice reform," as a reason for the closures. "These facilities do not lend themselves to our vision for a transformed Phoenix House," he wrote.
In a statement to Reuters, Scaminaci said his organization was "engaged in a strategic effort to re-allocate our resources to locations where we can achieve the greatest impact." Phoenix House, he said, is "collaborating closely with OASAS on designing better treatment programs, improving our standard of care and offering increased options for those suffering from substance abuse."
"Rampant drug use"
Belle Terre's recent run-ins with regulators date back to at least May 2010. That's when Albany City Court Judge Thomas Keefe, who had sent three addicts there, became concerned by stories of "rampant" drug use and high staff turnover at the facility.
Keefe, long a proponent of drug treatment as a way to stop addicts from cycling in and out of jail, called the facility's director, Jerome Pryor. He was surprised by what he described as Pryor's cavalier attitude and "virtual non-action to address the problem," Keefe told state regulators in a subsequent 2010 complaint to OASAS. Believing his "addicts were in danger," the judge had them reassigned to other facilities.
Later that year, Jessica Deagan, now 26, started a court-ordered 9-month stay at Belle Terre to treat her heroin addiction. "It was like the street inside of a building," she said. "There was a great amount of access to drugs. I used heroin, angel dust, Xanax, whatever was in there for the week."
Former residents said dealers would throw drugs over the stone wall around the property or hide them along nearby hiking trails for residents to retrieve.
On Aug. 11, 2010, three months after the judge's initial complaint, a team of OASAS inspectors descended on Belle Terre unannounced. As the inspectors introduced themselves to a staff member, who was leading a house meeting, residents began shouting, "Shut this place down," and "Get us out of here," according to the regulator's report, a copy of which Reuters obtained New York's Freedom of Information Law.
"There was no staff"
OASAS recommended halting new admissions, citing widely available illegal drugs, unsupervised outings, sexual activity among residents, diversion of medications, unavailability of staff members, and lack of group counseling.
Belle Terre Director Pryor, according to the OASAS report, attributed most of the problems to the recent loss of five staff members. Four new employees, he told the regulators, lacked experience in treating chemical dependency.
Pryor declined to comment.
A month after admissions were stopped, OASAS conducted a follow-up visit and determined that the facility had stabilized. Admissions resumed.
Two weeks after that, Jordan Nedlik, a resident on kitchen duty, was stabbed in the back by another resident unhappy with the size of his meatball supper. "There was no staff," Nedlik said. Nedlik returned to Belle Terre after a brief hospital stay. He was sent back to Belle Terre in 2012, after failing a urine test, and later spent time in prison for his initial grand larceny charge. He said that as of August 2015, he has been clean for 14 months.
In September 2011, inadequate staffing prompted counselor Mary Moynahan to quit. In her resignation letter, a copy of which she sent to OASAS, she complained that nonviolent, often very young offenders were mixed with residents who were "not addicts, but rather, hardened criminals avoiding jail time." She added: "The bottom line is the understaffing."
Some former counselors told Reuters they lacked the training required to provide the individualized, holistic drug and alcohol addiction treatment Phoenix House promised on its website. Group sessions were haphazard, often pieced together from information gathered through Google searches the night before, they said.
Treatment records were suspect. "There were times when I would say, 'I didn't write this. That's not my handwriting,' " said Glenn Williamson, a former counselor and military veteran.
Another counselor, who asked not to be identified for fear of losing her license, recalled chasing a young man high on the synthetic opioid fentanyl around the grounds to keep him out of sight during an OASAS inspection.
In November 2011, OASAS again halted admissions. The agency cited insufficient clinical and mental health services, strip searches conducted without consent, and failure to file incident reports. Residents drove program vans and stayed up all night as "night watchman," which kept them from participating in group therapy.
OASAS also found that Belle Terre's new director, Henry Bennett, obstructed their request for records in an attempt to modify them before handing them over. Phoenix House fired Bennett. Bennett, who went on to work for various treatment providers before retiring in Georgia, said he had not been aware that the records were being altered.
Bennett said Phoenix House "took their eye off the prize" by emphasizing business considerations over "things they need such as clinical functions and a good medical records system."
Tool of abuse
About 75 percent of Belle Terre residents at the time were on psychotropic medications, state records show, but the only psychiatric care for residents was a four-hour drive away in New York City. A van took seven residents there twice a week.
Myke Champlin, a 2011 resident with borderline personality disorder, said he stayed clean for his first four months at Belle Terre, but by the time he graduated, "I was smoking more K2 [synthetic marijuana] and everything than you could imagine."
Courts rely on treatment providers for updates on offenders' performance. If offenders don't comply with a treatment provider's rules, the court can use sanctions such as short jail stints or can extend their time in treatment. In some cases, offenders end up spending more time incarcerated than if they had eschewed drug treatment.
At Belle Terre, the threat of reporting infractions could become a tool of abuse. As is common practice in many rehab programs, residents were assigned jobs in a hierarchy, from the lowest cleaning crew to managing other residents' schedules. This system, which counselors and residents called "the Structure," was meant to help residents break bad habits and prepare for working life.
Former residents said the system became a means of settling personal scores. Higher-ranking residents could punish others for minor infractions, such as talking in the medication line. Infractions could result in cancellation of family visits, or could be reported to the courts.
Partners in addiction
This was the milieu Martin Szczupak entered in the summer of 2012.
Szczupak grew up in the New York City boroughs of Brooklyn and Staten Island. In middle school, he met Priscilla Pardo, with whom he shared a love of punk rock. "Punk rock is angry and abrasive, and for several years, so was I," Szczupak wrote in his journal.
Szczupak was addicted to heroin by age 15, Pardo said. She was hooked at 18. Still, they managed to start college. He studied biology. She studied mortuary science. They missed a lot of classes, mostly to get high, Pardo said.
They didn't know it, but they were part of a resurgence of heroin abuse in the US In 2013, 517,000 Americans abused or were dependent on heroin, more than twice as many as in 2007, according to the National Survey on Drug Use and Health. Staten Island had the highest rate of heroin-related deaths among all New York City boroughs in 2012. Local officials have called it an "epidemic."
Pardo nearly died from an overdose in 2011. That "scared the crap out of Martin," Pardo said. He persuaded his girlfriend to admit to their parents that they had a problem.
Szczupak finished a stint in rehab in March 2011. On his way home, according to the account he gave to his mother and Pardo, the rehab facility van he was riding in made a stop. Szczupak, woozy and disoriented from prescribed medications, stepped out of the van. When he returned, he told Pardo and his mother, he mistook another vehicle for the rehab facility van.
According to the police report on the incident, Szczupak was pulling on the vehicle's door handle and shouting, "open the door." Inside the Ford Explorer sat a woman and her 3-year-old son. She called the police. Szczupak was charged with attempted grand larceny and resisting arrest. Records show Szczupak told the police that he "wanted to take the car home."
"Down the drain"
Szczupak later told police he had no recollection of the incident. He pleaded guilty and agreed to go to treatment. A year later, he relapsed. He was arrested for possession on Staten Island, a probation violation. In court, the judge agreed to give him another chance at treatment.
When Szczupak arrived at Belle Terre in June 2012, the facility was still short-staffed. Residents at the time described the lack of counseling and widespread use of illegal drugs that OASAS staff had cited over the prior two years.
Brian Moody, 33, a former Bank of America contractor who had been remanded to Belle Terre after violating probation on a drug-sales charge, said the place was in chaos. "There were people who were high," he said. "It was a circus show."
Moody said he befriended Szczupak, whom he described as smart and determined. "He wanted to change," but felt he was getting no help, said Moody, now working as a debt-collection agent.
Szczupak at first rose within the Structure. He was assigned to computer work, where he spent days listening to music, according to a letter to a friend.
"I hoped this one would work, mentally he wanted it to work, he was pretty optimistic," said his mother, Inez. "And then all of a sudden everything went down the drain, and every phone call that I got was, 'I can't stand this place, this is bullshit, they don't treat me fair.' But I never understood what happened."
In December 2012, Szczupak was demoted within the Structure for disrespecting a staff member, his treatment records show. The details are unclear.
Szczupak told friends that the time already spent in treatment was worthless and that he would end up going to jail anyway.
According to treatment records, Szczupak was given the option of starting over again in drug court, but he refused, saying he had heard "nightmare stories" from others.
"He seemed like a shell"
"This whole episode here has pushed back my completion of this shit," he wrote in an undated entry that ends his journal. "This whole drug court thing has got me frustrated."
When Pardo spoke with Szczupak on Thursday, Jan. 3, 2013, six months after his arrival at Belle Terre, he seemed "really mad at the world, very dark, not making any jokes," she said. "He seemed like a shell."
The next day, Moody said, Szczupak told him he would rather be in jail, with a clear end-date. He packed his belongings and walked out without approval.
That Saturday, police were called to a Brooklyn house where they found Szczupak, dead from a heroin overdose.
In November 2014, regulators again suspended admissions at Belle Terre, as well as four other Phoenix House facilities. State regulators noted high staff turnover and need for improved clinical practices at Belle Terre. They also warned the facility to let clients speak to their attorneys without staff present.
OASAS let Belle Terre reopen in January 2015. Three of the other centers were reopened with limited admissions in late 2014 and early 2015. The Shrub Oak teen residential treatment facility was closed permanently in June 2015.
In March, OASAS inspected Belle Terre again, prompted by unspecified complaints against director Alan Hargrove, OASAS reported. Phoenix House then fired Hargrove, based on OASAS's feedback.
Hargrove declined to comment.
Phoenix House announced on Aug. 19 it would be closing Belle Terre and the 185th Street facility.
Pardo, now 24, lives with her parents on Staten Island and works the night shift at a convention center. She has been sober for three years after receiving treatment at Mount Sinai Beth Israel Medical Center in New York City.