Inspectors find more non-compliance issues at methadone clinic
Roberto M. Esquivel|Herald-Standard
The Department of Drug and Alcohol Programs filed a report on the failings of Addiction Specialist Inc.
Roberto M. Esquivel|Herald-Standard
Addiction Specialist Inc. in North Union Township was found to be failing to meet standards required by law.
Roberto M. Esquivel|Herald-Standard
A new indictment filed today in federal court levied additional charges against four people affiliated with Addiction Specialists Inc., a North Union Township methadone clinic.
The state Department of Drug and Alcohol Programs (DDAP) issued findings from a January inspection of a North Union Township methadone clinic, showing the facility continues to fail to meet standards required by law.
Addiction Specialists Inc. (ASI) was raided by federal, state and local agents in October. Director Rosalind Sugarmann and physician Dr. Dominic DiLeo have since been federally indicted for allegedly illegally distributing Suboxone and Xanax.
The raid prompted the DDAP to conduct its own search to determine whether the clinic should have a license.
Department investigators interviewed staff and reviewed available documentation on Jan. 14 and 15, and discovered two patients had died, and unusual incident reports were never filed.
By law, the clinic was required to file a report with the DDAP within 48 hours after any unusual incidents, which would include complaints of abuse, death or serious injury, significant disruptions of services due to a natural disaster, incidents with potential for negative community reaction, or drug related hospitalization of a patient.
A patient identified only by the number 19 was admitted to treatment on Jan. 27, 2015, and was discharged on Dec. 10.
“The discharge list indicated the reason for discharge was CTB (ceased to breathe),” the report stated.
Patient 32 was admitted to treatment on July 9, 2014, the report states, and was discharged on Sept. 21. According to the report, the patient died in a vehicle accident, but no incident report was ever filed.
The report also stated that by law, the clinic is required to provide counseling to each patient on a regular and scheduled basis, but has failed to do so. According to records, one client who had been admitted 16 years ago only received one documented counseling session.
Out of 31 client records reviewed in January, the DDAP found 22 files that failed to include documentation of services provided or progress notes.
The facility failed to provide an average of two-and-a-half hours of psychotherapy per month during the patient’s first two years as required by law as well, the DDAP noted.
The report shows that the clinic failed to ensure that the counselors and counselor assistants met minimum standards set out by law in terms of education and experience. Six counselors had no documentation at all of their educational background, according to the findings.
While the law requires one full-time clinical supervisor for every eight full-time counselors, the report indicated there were five counselors and seven counselor assistants under the direction of the sole clinical supervisor.
Further, there were no hours documented for the clinical supervisor attributed to staff supervision. Rather, the documentation shows the clinical supervisor worked on a caseload of 157 clients.
Investigators discovered there is no medical director to assume responsibility for administering medical services at ASI.
The report shows that an unnamed physician did provide 10 hours of narcotic treatment service per week, and that an unnamed physician assistant provided 40 hours of service per week.
“Regulations allow for only two-thirds of physician service time to be provided by a physician extender. Where the physician provided 10 hours of service per week, the physician extender was permitted 20 hours per week,” the report stated.
“During interviews, staff reported a census of 580 patients, 58 physician hours per week were required.”
The DDAP found the clinic failed to maintain confidentiality of records, pointing out that patient data was being kept in a non-secured facility.
In one instance, information from a client’s urine screening was faxed to an insurance company for prescription authorization, which is in violation of the law.
The facility also failed to follow urine testing protocol in other ways, the report states. Clients were not screened on intake as required, nor was there any documentation showing that random monthly urine tests were being administered.
Investigators found identical drug screen results in two separate client files as well, down to the requisition number that should have been unique to each sample submitted.
Additionally, the report stated, an unnamed physician reportedly cut dosage of Suboxone, despite the fact that it’s not formulated to be cut into smaller doses.
“Copies of the Suboxone prescriptions were reviewed and 20 prescriptions were found to require the patient to halve or quarter the single dose Suboxone films,” according to the report.
There are no approved plans of correction on file regarding any of the items of noncompliance listed in the report.
DDAP press secretary Jason Snyder said in January, a week prior to the inspection, that generated the most current report, that ASI was granted a provisional license in late December. That license will be valid for four months and can be renewed up to three times.
Snyder has not responded to several requests for comment regarding the current inspection report or the status of ASI’s license.