Pubdate: Fri, 18 Apr 2003 Source: Newsday (NY) Copyright: 2003 Newsday Inc. Contact: http://www.newsday.com/ Details: http://www.mapinc.org/media/308 Author: Michael Rothfeld NASSAU TO SHUT 2 REHAB CENTERS Closures to Save At Least $2 Million When he first tried to kick his alcohol and drug habit, Kevin Johnson checked into an upscale treatment program in Connecticut where he received breakfast in bed but was kicked out after 30 days. He returned to delivering the mail in Farmingdale, and soon suffered a relapse. Three years later, after losing his job and his health insurance, the Bethpage native entered the Plainview Rehabilitation Center, a treatment facility run by Nassau County for nearly three decades. The atmosphere was less cushy, but after two months Johnson broke his decades-long addiction. "Nobody made your bed, you didn't have omelets to order, but the treatment was top-of-the-line," said Johnson, 41, who now lives in Uniondale and volunteers at the treatment center, telling others about his eight years sober. By the end of June, however, Nassau officials plan to close the center, and one other, under a cost-cutting plan that would eliminate the only residential addiction treatment programs in the county today. Instead of sending addicts to Plainview Rehabilitation Center or Topic House, another county-run center, case managers would direct them to nonprofit or state programs in Suffolk County, Queens and beyond, where providers say space is already in short supply. No other county in the state directly provides residential addiction treatment, by all accounts an expensive social program. But as Nassau prepares amid a fiscal crisis to drop 144 treatment slots that served more than 400 people last year, some wonder whether adequate alternatives will remain. "I wouldn't turn away someone that needs services, but beds are very tight everywhere," said Kathy Riddle, president of the nonprofit Outreach Project. Although Nassau has contacted Riddle about taking its clients at programs she runs in Brentwood and Queens, she can offer only five beds. "This could all backfire and they could end up with more people in their criminal and juvenile justice systems," she said. Nassau terminated out-patient treatment at Nassau University Medical Center last fall and steered clients to nonprofit agencies across the county. Given the multimillion-dollar deficits Nassau faces, County Executive Thomas Suozzi has decided to follow other counties' leads and farm residential treatment out to community-based organizations, a move his aides estimate will shave at least $2 million a year from the county's $2.2 billion budget. New York State, which gave Nassau $1.8 million in federal grants to run the centers last year, also stands to save money through the closures. Mitchell Sahn, Suozzi's deputy for health and human services, is engineering the transition to a new system in which redeployed county employees would guide clients into specialized services and track their progress. "It's an improvement in treatment because you're able to pinpoint people with specific needs," he said. Within three years, he added, the county plans to solicit bids from nonprofit agencies to reopen a residential program in the county. Topic House was founded in 1967 and Plainview Rehabilitation Center in 1975, when government was more often seen as an agent for curing social ills. The benefits they still offer at two rundown buildings in a wooded complex in Plainview - often to the homeless, those coming straight from jail or others whose insurance will not pay - are more generous than those normally offered in nonprofit and private settings. The treatment is sometimes twice as long. The wait to get in is shorter. Even those without Medicaid insurance can enter immediately, while the county seeks reimbursement. "I'd say the larger percentage of people who come into Plainview are people who have already been through other treatments and could not maintain their abstinence," said Paul White, 64, of East Meadow, a retired night manager who founded Friends of Plainview Rehabilitation Center, a support group that has donated supplies to offset cuts by the county. Nassau intends to place 40 union employees who work at the centers in other jobs, Sahn said, saving money by reducing costs for overhead and cutting employees hired on contract. The county would also save on Medicaid payments because nonprofit treatment programs are shorter. At Plainview Rehabilitation Center, for instance, the average stay is 55 days. Similar nonprofit programs last 28 days. At Topic House, a "therapeutic community" for severe addicts, stays can exceed a year. Kevin Johnson said that without a treatment program in the county, where family members can visit and receive treatment themselves, addicts may go without help. He also said the longer term treatment he received at Plainview was more effective. "You could hide your personality for three or four weeks at a 30-day [program] but your true self is going to come out in a 90-day rehab," Johnson said. Nonprofit treatment providers and advocates for the county programs also say that addicts may face waiting lists for programs far from their homes in the future, and that those without insurance may simply be turned away. Sahn said the county would not close the centers until the county resolves those questions, though some may have to travel to New York City. He said Nassau would try to enroll uninsured addicts in Medicaid within 30 days, a process that now takes months. "Poor and indigent people will receive treatment, regardless of their ability to pay," Sahn said. "That's the county's commitment." - --- MAP posted-by: Alex