State officials have ordered a private Wilmington drug abuse clinic to stop administering methadone to narcotics addicts. The order has drawn sharp criticism from the clinic's owner who contends it is aimed at forcing his patients into government-funded programs.
The patients are also upset about the order, saying they don't mind paying for private treatment because they like the quality of care at the Wilmington Boulevard clinic, which also offers counseling and takes hard-to-care-for patients, including pregnant women.
The state issued the order because the Wilmington clinic, run by the Community Health Projects Medical Group, was operating without a license.
Community Health Projects, which took over the clinic from the Suicide Prevention Center in November, had been trying to obtain its own license, but Los Angeles County health officials refused to support the application, saying there was no need for the clinic because methadone treatment slots in this area are only 80% occupied.
More Information Sought
The state may issue licenses over the county's objections but rarely does. Scott Lewis, assistant director of the state Department of Alcohol and Drug Abuse programs, said he knows of no instance when this has been done.
Nevertheless, Lewis said he has asked the county to provide additional information to support its position and is still considering the license application from the clinic, which had served 102 patients. State officials are required to make a decision by June 25, he said.
Irma Strantz, director of the county drug program office, said there is no chance the county will reverse itself. She said a recent county study showed "there is a proliferation of private clinics fighting with each other for clients, and the quality of care is going down. We would rather see clinics operating close to their maximum licensed capacity."
Strantz said the Suicide Prevention Center was licensed to treat 70 patients in its methadone program and 40 patients in its detoxification program. She said that even if the Community Health Projects clinic was operating at near that capacity, others are not and county officials are concerned that these under-utilized clinics are also understaffed.
But Dr. Forest Tennant, who owns the Wilmington clinic and 23 other drug abuse clinics in California, asserted that county officials are trying to steer his patients to their own programs because they--not the private clinics--are not operating up to capacity.
"I think that the serious issue here is, does a patient with a socially unacceptable disease like addiction have the ability to pick a private doctor and pay their own way and not be forced into a government program?" said Tennant, who is also an associate professor of public health at UCLA.
Methadone maintenance treatment costs $195 a month at the Community Health Projects clinic, which Tennant says is more expensive than most other clinics. At clinics that have contracts with the county, some patients are eligible for methadone treatment at government expense. The patients in the Wilmington clinic's methadone program have been referred to another private clinic in Wilmington and to a publicly funded clinic in Torrance, which have room for additional clients.
Tennant said some of the patients are seeking treatment at other clinics, some are remaining at the Wilmington clinic for alternative treatments that do not require methadone and others are "back to the street," using drugs again.
One tearful client who had worked out a semi-monthly payment schedule with Community Health Projects said she went elsewhere for methadone treatment and "they want me to pay $10 a day and they cut me off completely, cold turkey. I don't have the money. . . . I don't know what I'm going to do."
Community Health Projects Medical Group took over for the Suicide Prevention Center, which had operated in Wilmington for three years, because it was legally required to do so. State law requires that drug abuse clinics have a legal guarantor--another clinic that is legally authorized to take over the treatment of patients for 90 days. Community Health Projects was the guarantor for the Suicide Prevention Center.
Strantz, the county drug program director, said that when the Suicide Prevention Center closed, she notified its board chairman that she would not support continuing a clinic at that site.
Tennant apparently was unaware of her statement, and said he was also unaware that his clinic was required to file an application for its own license. His clinic has been operating without authorization since mid-February, three months after it took over for the Suicide Prevention Center.
State officials said they notified Community Health Projects in December that it was required to file an application for a new license. Tennant and other representatives of the clinic said they never received that notice, but did respond to a subsequent notification sent Jan. 29.
By May 4, when the county had refused to support the application, the state issued a cease and desist order that was effective last Monday. Tennant went to Los Angeles County Superior Court in an attempt to block the order, but a judge refused to do so.