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May 31, 2018

Inside a rehab empire

Co-produced with PRX Logo

The collision of the opioid epidemic with criminal justice reform has created a boom for the rehab industry. Those with wealth and insurance often are able to pay thousands of dollars for private long-term programs. But the less fortunate have become easy prey for rehabs with a tantalizing promise: freedom from addiction for free.

Reveal reporters Amy Julia Harris and Shoshana Walter have been uncovering the ways that some of these rehabs exploit their desperate clients. In this episode, they describe to host Al Letson the shocking things they found at one rehab in the mountains of North Carolina.

Dig Deeper

  • Read: She said she’d free them from addiction. She turned them into her personal servants
  • Read: Response to N.C. rehab investigation: ‘This is a horrific scheme that preys on people at their lowest’
  • Listen: All work. No pay. Life at a rehab work camp.

Credits

Support for Reveal is provided by the Reva and David Logan Foundation, the Ford Foundation, the John D. and Catherine T. MacArthur Foundation, The John S. And James L. Knight Foundation, the Heising-Simons Foundation and the Ethics and Excellence in Journalism Foundation.

Reveal is a co-production of The Center for Investigative Reporting and PRX.

Transcript

Reveal transcripts are produced by a third-party transcription service and may contain errors. Please be aware that the official record for Reveal's radio stories is the audio.
Al Letson: From the Center for Investigative Reporting and PRX, this is Reveal. I'm Al Letson. Ian Hays is sitting in the middle of a bustling café talking to Reveal reporters, Amy Julia Harris and Shoshana Walter.
Ian Hays: Oh, and feel free to have as much of this as you want. You gotta try it.
Shoshana Walter: Grilled cheese? [crosstalk 00:00:19]
Ian Hays: No. No I don't.
Al Letson: Over fries and grilled cheese sandwiches, they talk about what happened at a drug rehab outside of Asheville, North Carolina. Ian was a client there when he was struggling with drug and alcohol addiction. Afterwards, he actually went to work there full-time.
Ian Hays: Go ahead.
A J Harris: Let me ask you about [inaudible 00:00:38].
Ian Hays: Any questions you have, I got you. Like I said I know where all the bodies are buried for Christ's sakes.
Al Letson: And he has some secrets to tell about the program called Recovery Connections Community. Ian is 44 years old but walks and talks with a swagger of a much younger man. He prides himself on always telling it like it is. No matter the consequences. He's battled with chronic addiction most of his life.
Ian Hays: Am I clean and sober? Most of the time, but not always. So I'm gonna keep it real.
Al Letson: Recovery Connections is free and opens it's doors to people like Ian who need help.
Ian Hays: People are at the end of their rope. They're desperate. They need to get somewhere. They can't go back to the house because the wife kicked them out, their mom or whatever. They got nowhere to go. This program is for people that really don't have any options, and that's the catch.
Al Letson: While Recovery Connections is free, there's some ground rules for everyone in the program. They get housing and food and in exchange, they have to work full-time jobs at local businesses.
Ian Hays: You're gonna work, work, work, work, work and-
Al Letson: And Recovery Connections keeps all their pay.
Ian Hays: That's how the program works. That's how it's funded. It's by the residents working, and the money that's made on the jobs goes back into the program.
Al Letson: But over time, Ian began to doubt where the money was going. The program's founder, Jennifer Warren, was always talking about money.
Ian Hays: "Y'all need to make some money, no, no, no, no, money, money, money, money." And I'm just like ... And that's kind of where I was like "You know what?" That's where I was starting to get pissed off.

 

Al Letson: Ian says Jennifer demanded that people work around the clock, 16 hours or more every day. The more they worked, the more money they brought in. But Ian says instead of going to the program, he saw money going somewhere else, into Jennifer's pockets. Ian grew so disillusioned that he quit his job there. Amy Julia and Shoshana Walter are here with me in the studio to talk about what they found. Hello, ladies.

 

Shoshana Walter: Hi, Al.

 

A J Harris: Hey, Al.

 

Al Letson: So Shoshana, how did you two get onto this story?

 

Shoshana Walter: Well we wrote about one rehab program in Oklahoma last year that was essentially sending people to work at chicken plants. A lot of these people who were going to this rehab and working had never been convicted of crimes. They were in court diversion programs for drug and alcohol issues. So they were sent to this rehab to get treatment, but they basically were forced to work for free in chicken processing plants, making food for Walmart, Popeye's, KFC. Many of them were hurt and many of them were basically working under threat of prison.

 

Al Letson: So this program in North Carolina, Recovery Connections Community, also calls itself a drug rehab facility and they also send their clients to work, but instead of chicken plants, they're sent to work as caregivers at assisted living homes to take care of the elderly and disabled. So tell me how this operations works.

 

Shoshana Walter: Well it's a two-year long program. They basically spend the majority of their time working in these contract jobs at care homes. They don't get paid. All the money goes to the rehab program. And they work more than 16 hours per day as caregivers for elderly, disabled, and mentally ill patients. They're changing their diapers, they're bathing them, they're sometimes dispensing medications, helping to feed them, and they don't really get much training, if any training at all, in most of these jobs.

 

Al Letson: Amy Julia, how does this help them in their drug rehabilitation?

 

A J Harris: What they're told initially when they get into the program is that this structure and work is gonna be good for them. It's gonna keep their mind off drugs. Idle hands are bad. Work is supposed to help them. But when they're working in these facilities, the facilities are often awash in drugs and like Shoshana mentioned, some of these recovering drug addicts are actually tasked with dispensing narcotics and opiates and things went wrong all the time.

 

So people told us that on the job, drug thefts were common. People would steal prescription pain killers and snort them. Often if they were tasked with dispensing drugs which they also weren't allowed to do -- you're supposed to have a special state certification to do that -- they would take drugs meant for the patients and take them for themselves. And we actually talked to Ian who you heard from earlier who got the inside scoop on some of this, and he's describing how these drug thefts were routine.

 

Ian Hays: So the residents were going in the Sharps containers and taking the real empty residual plastic containers of morphine and squeezing them all into one cup to accumulate enough to get high.

 

A J Harris: So what he's talking about right there is the Sharps containers are the medical waste, sort of the garbage cans for a lot of this. People would go in there and just steal the residual morphine. Another thing that was pretty common was that people would steal fentanyl pain patches which are the patches meant for people in chronic pain and they slowly release pain killers, that they would just take those off of the residents for themselves. Ian's describing that as well.

 

Ian Hays: They were taking drugs off the residents that had patches on them, take their patches off them and then suck the Fentanyl out or do something to get it. Yeah, couple of women did that.

 

A J Harris: Did they get kicked out?

 

Ian Hays: No, you don't get kicked out for relapsing.

 

A J Harris: We actually found that for most people who go through this program, it doesn't really help them at all. I mean most people don't make it to the two-year mark.

 

Al Letson: So Shoshana, why would people who are struggling with addiction work with vulnerable people in assisted living facilities that are full of drugs? That just doesn't make a lot of sense?

 

Shoshana Walter: Basically the adult care homes contract with Recovery Connections as if they were kind of like a staffing agency, and it's cheap. They don't have to pay worker's compensation. They don't have to pay insurance. They don't have to pay overtime. Some of the facilities are only paying minimum wage for the Recovery Connections workers which is about $7.25 an hour. It's cheap source of labor for them.

 

Al Letson: What kind of facilities would take these people?

 

Shoshana Walter: Well we wanted to know that too so we actually went to one of these facilities. This is back in December. It's called Candler Living Center. We went there around nine o'clock at night. It was super dark. There were trees all over the place. It was kind of secluded in this wooded rural area, and in the parking lot, we actually found a Recovery Connections worker and we followed him inside through this kind of flimsy wooden door, totally unsecured.

 

Speaker 5: Hey.

 

Shoshana Walter: Hi.

 

Speaker 5: [inaudible 00:07:23].

 

Shoshana Walter: We walked down this dimly lit hallway into this kind of cafeteria area. There were people everywhere. It was totally chaotic. There was this loud radio going, people milling around, pacing back and forth. To the right of us, there was this open office room where all the meds were being held, prescription pain killers and all sorts of medications.

 

Al Letson: So opioids would be in there?

 

Shoshana Walter: Opioids would be in there, absolutely. People were just running in and out. There were residents running in and out of there, staff members, no one really asking who we were, what we were doing there.

 

Al Letson: Amy Julia, did you guys get a chance to talk to any of the companies that own these homes?

 

A J Harris: Yeah, we talked to a lot of them. One of them, the company that owns Candler Living, had said that they contract with the Recovery Center because they're cheap, they're a reliable source of labor, and they said that they thought they were doing a good thing, that they were giving these people struggling with addiction a chance to gain job experience. What they said though was that they've never had any problems with these rehab workers whatsoever which is kind of surprising because when we talked to a lot of the rehab workers and former employees at these facilities, they said that this whole arrangement was a bad idea. There were drug thefts. A thing that we did not touch upon was there were a lot of allegations of sexual assault as well. There was some really serious cases, seven cases that we had identified where these rehab workers were accused of sexually assaulting patients at the care homes.

 

Al Letson: Tell me more about that. What did you learn about the assaults and what happened?

 

A J Harris: Well we heard about these assaults from employees at these care homes, and many of them were so concerned because none of the incidents, they said, had ever been reported to authorities which is required under law. Some of the allegations were very serious. There was one rehab worker who was accused of sexually assaulting a disabled patient in the shower. It was never reported, never investigated. The home did actually institute a policy preventing rehab workers from bathing female patients, but as far as we know, that rehab worker is still working in the care homes.

 

Al Letson: That's horrifying. Let's get back to the rehab itself. How do people with addictions end up in a place like this?

 

A J Harris: We actually found a lot of participants at Recovery Connections were court-ordered there as part of their probation. A judge will say "Okay. I'm not going to send you to prison, but I require you to get treatment or go to rehab for your drug problem." There are a lot of rehabs like this all over the country that advertise themselves as free and specifically cater to people who don't have any money and don't have any insurance and therefore don't really have anyplace to turn. Also a lot of social workers at state-funded psych facilities, rehab centers, detox facilities send people to Recovery Connections as well.

 

We talked to one guy named Ryan Bailey who was ordered by a judge to complete treatment out of Cleveland, Ohio. He had a charge of domestic violence for pushing his stepfather during an argument related to his heroin addiction. He had some driving-related charges from his heroin addiction. He ended up at Recovery Connections and realized it was not at all the treatment that he needed to overcome that.

 

Ryan Bailey: There was no real structured recovery. The only recovery that we got was work your tail off, wake up, go to work, do everything they tell you to, or they'll put you on the move, put you on punishment, take what little bit of privileges or freedoms that you have from you, keep you working 18, 20 hours a day like every day of the week.

 

Al Letson: So people are working these crazy long days, soliciting donations. Amy Julia, walk me through what a day is like in one of these rehab centers.

 

A J Harris: It's incredibly structured. People have told us that they wake up at 6:00 AM and they're going to work at the assisted living facilities. They're working double shifts, usually 16 hours a day. That's common. After that when they're back at the rehab facility as Ryan was describing, if they're put on the move, that means that they always have to be working. That can be cleaning up around the house. People told us that they had very strict rules and sort of these odd punishments where they would have to cut the front lawn with a pair of scissors or scrub the baseboards of the home with a baby toothbrush. They would have to do this for hours and hours on end. This was ostensibly to help keep their mind off of their addictions, but we talked to a lot of people that said it was about control, it was about sort of breaking them down.

 

Al Letson: That sounds really cult-like to me.

 

A J Harris: Yeah. What a lot of people have said was that the most cult-like part of this was actually these therapy groups that they had that would happen once a week, and the way that it would work is that someone would be sitting in the middle. They'd be sitting in the hot seat, and everyone else in the rehab program would be around them and would scream at them about their flaws. It would get incredibly abusive. They weren't allowed to say anything. People said that they would frequently break down crying. People would tell them, use things from their past, say "You were a bad mother. You're a spoiled brat." There was a lot of profanity. It would often be incredibly traumatic.

 

Ryan Bailey: Yeah, they break you down and then don't even bother to build you up. It's pretty much just tearing you down and tearing your self-esteem down in order to get what they want out of you.

 

A J Harris: People had said that that was about all of the therapy they got, and what the rehab said was "Oh, this was supposed to be an exercise that would sort of bring their flaws front and center and help them confront this and overcome it." But what people said was it was incredibly abusive. It would break them down. Again, this was all about control.

 

Al Letson: I've been in therapy, and that doesn't sound anything like therapy to me. What happened to Ryan?

 

Shoshana Walter: Well he ended up fleeing the program. He became homeless for a while. He relapsed. He found out that, as a result of all this, he violated his probation. He actually currently has a warrant from Cleveland for his arrest. As a result, he's been kind of on the run ever since. I mean he has a hard time getting a job. He kind of has to lay low. He can't get a driver's license. It's really affected his life for the worse.

 

Ryan Bailey: I can't even go back to Ohio or they'll arrest me. I mean I wouldn't go back and do that again if I had to. I would almost just rather take my chances on the street.

 

Al Letson: It hasn't worked out for Ryan, but as we'll hear, the program worked out pretty well for the woman who's behind this whole scheme. She turned the rehab into her own personal empire complete with a collection of exotic animals.

 

Ian Hays: Three horses plus 11 llamas plus seven dogs plus eight donkeys plus sheep, goats, arctic fox.

 

Al Letson: That's coming up on Reveal from the Center for Investigative Reporting and PRX.

 

From the Center for Investigative Reporting and PRX, this is Reveal. I'm Al Letson. I'm talking with Reveal reporters, Amy Julia Harris and Shoshana Walter about their story looking at Recovery Connections Community outside of Asheville, North Carolina. Now, it bills itself as a drug rehab program, but the therapy consists of sending clients to work 16-hour days as caregivers at assisted living facilities and the workers never saw the money they made. A woman named Jennifer Warren set up the program and seemed to profit off it. So Amy Julia, tell me more about this woman. What's she all about?

 

A J Harris: She's a really interesting character. She herself has struggled with addiction. She was getting her PhD in clinical psychology. That's when you got hooked on crack cocaine. She dropped out. She went to this rehab program in North Carolina that had this similar model. It was a work-based rehab. It was free, but she had to turn over all of her pay to the rehab. Basically she was in this rehab program, met some other people, and she decided to start a rehab of her own and it was called Recovery Ventures.

 

She stared this rehab program, but soon it sort of began to go off the rails for her. She got into some ethical problems. She was forcing people in her program to babysit her kids and color-coordinate her closet and take care of her animals and was really blurring the line between helping the recovering drug addicts and helping herself. Because she was in part of this non-profit rehab program, she would have then solicit donations and some of them ended up going to her rather to program participants.

 

Then sort of the final straw for all of this was when she started sleeping with one of her rehab participants who she was counseling. That's obviously a huge ethical breach. Some of her colleagues were trying to intervene and said "You're jeopardizing your license. This is career suicide. What are you doing?" She held firm and said "I love him. What am I supposed to do?" She continued all of this. That was kind of the final straw. She ended up getting fired. She lost her therapy license. She got into a lot of trouble. Then she ended up just starting a new program called Recovery Connections that was basically an identical version of her previous program, but this time she didn't have to answer to anyone. She was in charge.

 

Al Letson: So Shoshana, she starts this new place, but does she continue the same behavior?

 

Shoshana Walter: Yes, the same exact thing although this time she's running an unlicensed program. There's no one really to hold her accountable. There's another thing that we haven't told you about yet which is her "animal therapy program."

 

Ian Hays: Jennifer has a ... Well she's got a thing for collecting animals. She likes exotic animals.

 

Shoshana Walter: She actually has an extensive exotic animal collection. They're basically like her pets, and she uses the program to buy the animals and make participants take care of them.

 

Al Letson: So what type of animals are we talking about? Like how many are we talking?

 

A J Harris: There were hundreds. She keeps them at her house in Black Mountain, North Carolina. People have told us that her entire bedroom was full of cages of exotic birds like toucans and parakeets and other tropical birds. Then we asked Ian this question: How many animals are there? Here he is going through all of them.

 

Ian Hays: Gosh, I don't even know where to begin. I would say mammals, probably 50. There's probably-

 

A J Harris: 50 different types of mammals?

 

Ian Hays: No, well 50. Three horses plus 11 llamas plus seven dogs plus eight donkeys plus sheep, goats, arctic fox.

 

A J Harris: An arctic fox?

 

Ian Hays: Yeah, two of them. Kinkajou.

 

A J Harris: I don't even know what a kinkajou-

 

Ian Hays: It's some cute but violent-looking monkey.

 

Al Letson: I hate monkeys. No, no, no, no, no. Okay. 11 llamas? 11 llamas? No.

 

A J Harris: What we also heard that was really sad is that some participants had to bury the llamas. Some of the llamas died so part of their duties after they're working at the assisted living facility is they come home and they have to bury a dead llama. It was very traumatic.

 

Al Letson: So what happened with Ian?

 

A J Harris: Yeah, Ian had a rough time. He ended up going to the rehab center in 2014. He stayed for 16 months. He saw ... He sort of saw things breaking down. He questioned the way the money was being spent. He would get into arguments with Jennifer over the way she was spending program funds on herself. He ultimately ended up leaving on not good terms, and because he struggles with addiction his entire life, he ended up relapsing. He was in a really dark place, and after a couple of months, he ended up going back to the program as a participant, no longer as an administrator. He was going through the program working 16-hour days at the assisted living facilities. He did that for a couple of months, and he finally realized nothing was going to change. This program was not going to work for him, and it wasn't working for some other people as well. He ended up leaving.

 

Al Letson: So how is she able to get away with this? I mean how can she just keep doing the same thing over and over?

 

Shoshana Walter: It is amazing. There have been at least four state agencies that have investigated her, that have received so many, dozens upon dozens of complaints about her, and she's managed to basically get out of trouble each and every single time. I think the worst of it was when she first started Recovery Connections and someone submitted a complaint that she was running an unlicensed program to the Department of Health and Human Services which regulates rehabs.

 

They sent an investigator out there. The investigator met with Jennifer Warren. Jennifer kind of sweet talked her. She told her about the program and that she wasn't providing treatment, and the investigator was basically like "Well okay. Here is the state code that says you're exempt from licensure." Ever since that point whenever anyone has complained about the program, about abuse, about neglect at the care homes, about all the misuse of donations, she just has pointed to the state code saying she's exempt. The state agency has just turned the other cheek every single time.

 

Al Letson: So what does Warren say about all this? I mean how does she defend herself?

 

A J Harris: I think overall she has sort of said that she's providing a valuable service, that there's not enough affordable treatment programs anywhere in the country, that it's better for people struggling with addiction to get some sort of rehab help than go into prison, and she's sort of made this point to probation officers and courts all over the state.

 

Al Letson: So is there an alternative?

 

Shoshana Walter: People generally feel like doing work and doing a good job at the work gives them a sense of self-esteem, but there are programs that do that without working them excessive number of hours, depriving them of sleep, and programs that also at the same time provide them with actual treatment for their addictions where they might take classes, where they might actually have therapy or counseling. I think there's that part of it, and also if a program is licensed then there's some oversight and there's someone who can say "This is abusive and this must stop."

 

Al Letson: So now this is a part of a wider trend, right? I mean we're in the middle of an addiction crisis and people are struggling to pay for rehab.

 

A J Harris: Right. So I think what we have found is that programs like this are marketing themselves to courts all over the country, sort of riding this wave of criminal justice reform, and hopping onto the bandwagon of trying to keep people with addiction out of prison which is a really laudable goal but are sort of marketing themselves as providing this valuable service that is attractive to courts and probation officers who want to help people. But what they don't know is what these programs are really like.

 

Even though they market themselves as free, it comes with a big catch. A lot of people just end up being worked to the ground and not getting any help at all and are often worse off than they were before. I think it's just a lesson to a lot of courts and to people who find these type of programs that often they look very attractive, but there's sort of this dark side of them that I think not a lot of people know about.

 

Al Letson: Amy Julia Harris and Shoshana Walter, thank you for coming in.

 

Shoshana Walter: Thanks, Al.

 

A J Harris: Thanks, Al.

 

Al Letson: Now just as we were putting the finishing touches on this podcast, we got some breaking news. Those regulators who'd done nothing for years, they finally sprung into action after Amy Julia and Shoshana started asking them questions. Suddenly there are numerous criminal and regulatory investigations into Recovery Connections, specifically into the issues we raised here. There are so many in fact that the Attorney General of North Carolina says he's taking a lead in coordinating all of them. North Carolina Governor Roy Cooper ordered a crackdown too. He called the rehab a horrific scheme that prays on people at their lowest. The state has ordered the rehab to stop sending workers to the assisted living facilities. That would cut off a major source of its funding, and people on probation are no longer allowed to go to the rehab either.

 

We'll have more stories on this soon, and we can email them to you. Just sign up for our newsletter by texting the word "Newsletter" to 63735. That's one word, newsletter, to 63735. You can text "Stop" or "Help" at any time, and standard texting rates apply.

 

Today's podcast was recorded and produced by Amy Julia Harris and Shoshana Walter. It was edited by Andy Donohue. Our sound design team is the dynamic duo, [J Breezy 00:25:54], Mr. Jim Briggs and Fernando "My Man Yo" Arruda. They had help this week from Catherine Raymando. Our acting CEO is Christa Scharfenberg. Amy Pyle is our editor in chief. Our executive producer is Kevin Sullivan. Our theme music is my [Camorado, Lightning 00:26:08]. Support for Reveal is provided by the Reva and David Logan Foundation, the John D and Catherine T MacArthur Foundation, the Jonathan Logan Family Foundation, the Ford Foundation, the Heising-Simons Foundation, and the Ethics and Excellence in Journalism Foundation. Reveal is a co-production of the Center for Investigative Reporting and PRX. I'm Al Letson. Remember, there is always more to the story.