Former employees describe years of problems at clinicProblems at the Lake Superior Treatment Center date back to at least 2003, about two years after the clinic opened, according to eight former clinic staff members who spoke to the News Tribune.
Problems at the Lake Superior Treatment Center date back to at least 2003, about two years after the clinic opened, according to eight former clinic staff members who spoke to the News Tribune.
In 2003, when Kathy Jarve said she started as a counselor at the treatment center, the clinic had about 90 patients. Even then, she and the other counselor had too many clients to adequately provide other services to them, Jarve said.
“It was about bringing them in and getting them dosed,” said Jarve, who worked at the clinic until 2006 and is now the outpatient treatment director for Minnesota Teen Challenge in Duluth.
For methadone maintenance therapy to be effective, according to the American Society of Addiction Medicine, the drug should be given with “psychology and vocational services, medical care and counseling.”
“With methadone, if all you’re doing is giving people medication and very little else, and there’s no real expectations on improving of functional activities and improving in your other life spheres, you’re going to have many more problems,” said Dr. Marvin Seppala, the chief medical officer at Hazelden, a well-known alcohol and drug addiction treatment center northeast of Forest Lake, Minn.
But vocational services were rarely offered at the Lake Superior Treatment Center while they were there, former staff members told the News Tribune. And while the staff members said counseling was offered, it was at most about 20 minutes a week.
The reason for the limited amount of counseling, said LeAnn Ryan, who worked at the Treatment Center from 2003 to 2011, was that counselors were not only expected to provide the therapy but do all the paperwork and patient intake, verify insurance, answer phones and do the drug tests. And as the number of clients increased, so did the demands on the counselors, said Jarve and Ryan.
“It was like you couldn’t keep up with the demand coming into the clinic,” Jarve said.
Long lines; ‘hurry treatment’
“It was all people did was run,” said Ryan, who also is now a counselor with Teen Challenge. “You could have someone in your office crying and have someone knocking on your door.”
They blamed part of the problem on federal law, which allows up to 50 clients per counselor. That number must be reduced so counselors can spend more time with patients, Jarve and Ryan said. Records show the treatment center was cited for having a client-to-
counselor ratio of higher than 50-1 in 2009 and 2012.
“You have to build a rapport with clients. You have to establish trust, and a good working relationship, and that takes time to do,” Jarve said. “This place was hurry treatment. We had lines that would circle around the waiting room.”
With limited counseling provided, the clinic became “a dose and go” — slang for a clinic that provides methadone and little else, said Greta Winter, who worked there from August 2008 to May 2009 and then again from January 2010 to September 2011.
Group therapy sessions mandated by the state “did not happen,” said Winter, who is now a chemical dependency counselor in Detroit Lakes, Minn.
Indeed, among the violations cited by the Minnesota Department of Human Services was a lack of group therapy.
Reports of drug sales
Another concern the former staff members said they had: knowing the clinic’s clients were selling methadone on the streets but able to do little about it.
Winter said she would often see clients appearing to be selling doses near the clinic and would find needles nearby, a sign of methadone abuse, since clients drink liquid take-home doses.
If it was discovered that clients were selling methadone, they would be kicked out of the program or their take-home doses would be stopped, the former staff members said. But measures to prevent drug sales were taken too infrequently, they said. For example:
The DHS also cited the clinic for failing to adequately perform bottle checks and adequately conduct urine tests.
Dr. Tom Payte, a corporate medical director for Colonial Management Group, which owns the Lake Superior Treatment Center along with more than 50 other clinics across the country, said he had never heard about the violations at the Duluth clinic before being contacted by the News Tribune.
“I’m sorry to hear that all is not well with that department,” Payte said. “But I’ve never seen a situation that was beyond repair, but sometimes you need to make some changes. … You certainly can expect to bring the clinic in line with state and federal standards. There’s no excuse for some of those types of infractions.”
The Lake Superior Treatment Center has been accredited by the Commission on Accreditation of Rehabilitation Facilities since 2006 and was reaccredited for a three-year term in 2012, according to CARF spokesman Al Whitehurst.
To achieve CARF accreditation, facilities must “commit to quality improvement, focus on the unique needs of each person the provider serves, and monitor the results of services,” according to the CARF website.
Whitehurst declined to comment on the state findings at the Lake Superior Treatment Center.
Area narcotics investigators told the News Tribune that they’ve long had problems with drug-dealing among people who also are patients at the Lake Superior Treatment Center.
“You talk to people who have gone there,” said Cloquet Police Detective Darrin Berg, “(and they say) you have a line of people standing there, talking about dope deals and trades.”
He added: “When you’re dealing with individuals who are using, selling, even arrested for other crimes, I would have to say a large number of those people are involved with the methadone clinic.”
6 percent completion rate
Former Lake Superior Treatment Center counselors said they told center management they were concerned that few patients were weaned off methadone.
Jarve said in the four years she was there, she could only remember about six clients who completed the treatment. Ryan said she could count only seven in the eight years she worked at the clinic; Winter counted five.
From 2007 to 2010, DHS data indicates that about
6 percent of the Lake Superior Treatment Center’s patients were weaned off methadone. However, that’s one percentage point higher than the state average during that time.
Proponents of methadone treatment say lifetime treatment with the drug should still be considered effective as long as patients are able to live normal lives and don’t abuse the medication.
Jarve and Ryan said for several years they never brought their concerns to the attention of the DHS.
In March 2002 and August 2004, the DHS released reports on the clinic, finding only minor violations. The DHS did not have inspection reports for the clinic from 2004 to 2009, though inspections are supposed to be performed annually.
Eventually, Jarve, Winter and Ryan said they spoke with DHS investigators and provided records to them at various times from 2009 to 2012, hoping to bring change to the clinic.