Former employees describe years of problems at clinic

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: