METHADONE MELTDOWN

There's not much seedier than the sight of the sun rising on a methadone
clinic's early-morning trade. Everything about the scene screams shame,
from the darkened predawn opening hours to the shaded, lifeless windows to
the absence of identifying signage on the dingy, partly vacant brick
building that anchors Houston Maintenance Clinic to an aggressively
unrevitalized stretch of Main Street. Solitary clients trickle through the
plate-glass entrance door and then re-emerge, a few minutes later, with
suspicious glances up and down the street before ducking into waiting cars
or shuffling off down the sidewalk.

Methadone patients generally don't like to advertise their status, because
methadone's inevitable implication is heroin. People on methadone are
usually trying, with or without success, to stay off heroin, to maintain
jobs and families and lives, and to eventually get clean. And while there
are good arguments to be made for heroin addiction's status as a disease,
the daylight world perceives it as a lifestyle choice. A poor one. As far
as Main Street's passing traffic is concerned, a methadone patient is just
a junkie, and nobody much wants to be seen strolling into the junkie shop
in broad daylight.

The double whammy of addiction and shame, experienced as need and fear,
tends to make methadone patients doubly powerless. They are easily
manipulated by the fear of having treatment withheld, and they are rarely
in any position to complain.

Methadone, being itself addictive, is a tightly regulated medication
subject to state and federal oversight, with scattered local providers such
as Houston Maintenance Clinic contracted to serve as faucets through which

the medicine flows, with little fanfare, to those who need it. But on a
gray, anonymous morning in February, with clients and clinic employees
arriving before daylight to conduct their quiet business, three agents of
the Texas Commission on Alcohol and Drug Abuse (the state agency that
distributes and regulates funding for the nonprofit clinics serving the
poorest methadone clients), along with a representative of the Texas
Department of Health (which licenses methadone providers), converged on
Houston Maintenance Clinic to turn off the faucet.

For many former HMC patients and employees -- most now moved on to other
clinics and other jobs, and thus no longer bound to silence by fear -- the
only real question raised by TCADA's termination of HMC's contract is this

Why did it take so long?

In 1997, the inaugural year of TCADA's contract with HMC, the clinic
received $386,540 in federal block grant money through the agency. HCM then
received $509,900 in 1998 and $496,400 in 1999. TCADA's 2000 allotment to
HMC, before the contract was terminated, was set at $546,040. All told,
close to one and a half million dollars of state funds have been routed to
Houston Maintenance Clinic, and the reason those funds have dried up,
according to TCADA spokeswoman Stephanie Goodman, is that TCADA doesn't
have any idea how any of that money was spent.

"The problem in this particular case is we don't have the information in
hand to tell you what they were doing financially. We can't tell if it was
a good use of state dollars or not, because they never provided the
financial statements we need to make that determination," Goodman says.

According to TCADA regulations, clinics receiving more than $300,000 per
year are required to provide independent financial audits annually. HMC has
"occasionally submitted some financial statements, but they are not
complete. They don't meet generally accepted auditing standards," Goodman
says. "They just had a number of problems, and we can't tell basically if
they are doing what they should be doing with the money." One of HMC's
audits, says Goodman, was "so poor that we've filed a complaint against the
auditor with the board."

Goodman stresses that TCADA has received no allegations of "mis-spending"
at HMC, and that the termination of the clinic's contract was based
entirely on the clinic's failure to provide required accountings of proper
spending. But for TCADA to be unaware of such allegations, the agency must
have spent the past three years stumbling under a heavy dose of opiates itself.

"I tried to tell TCADA what was going on," says Tabitha Okeke, who served
as the clinic's bookkeeper from September 1997 until January 1998. "A lot
of people have called TCADA, but they never did anything about it."

Okeke's stories of HMC operations, combined with dovetailing accounts by a
dozen former and present HMC employees interviewed by the Press, constitute
a dirty laundry list of irregularities and possible illegalities that
should have waved red flags in regulatory faces long before that February
morning when TCADA agents arrived at HMC to direct patients to alternate
treatment centers.

Responsibility for the dirty laundry, these sources say, lands squarely on
the desks of HMC's husband-and-wife team of CEO Dr. Amos Ozumba and program
director Cecilia Ozumba.

Amos Ozumba was reportedly out of the country during Press interviews, and
unavailable for comment. Cecilia Ozumba, in a brief interview, attributed
allegations to unnamed "instigators" with designs to close her clinic.

"We're contracted to render services to clients. We exceeded the amount of
service we were expected to give, and even when we exceeded the number, the
due process was not rendered. They know what they did. If they think trying
to put all the lies together is going to help them, so be it."

Amos and Cecilia Ozumba incorporated Houston Maintenance Clinic as a
501(c)(3) nonprofit corporation operating at 4900 Fannin Street in July
1996, with Cecilia Ozumba as the corporation's registered agent and an
initial board of three directors, including both husband and wife. By
August 1998 a doctor originally on the clinic board had been replaced by
HMC's current financial manager. The Press was unable to document the
membership of the clinic's current board of directors.

>From the start, Houston Maintenance Clinic comprised two distinct
entities housed in the same quartersthe nonprofit methadone clinic funded
with TCADA dollars, and a private, for-profit methadone clinic funded by
paying client/patients. To qualify for the TCADA program -- which might
require a small co-pay from patients, or might be free, depending on the
level of need -- patients are required to meet financial eligibility
standards. Patients who don't meet standards for enrollment have the option
of enrolling in the private clinic and covering the cost of treatment
themselves.

The arrangement is not an uncommon one, but it does require strict
accounting and separation of income streams and expenses between the two
entities. That accounting and separation, current and former employees
agree, did not exist at HMC.

Gail Lee, a former administrative secretary at HMC, answers her phone,
listens to a reporter's introduction and laughs. "Oh, I know what this is
about."

Hired on the TCADA payroll, Lee says she spent a good portion of her three
months at HMC answering phones for both the private clinic and the Partial
Hospitalization Program, which accepts Medicare and Medicaid patients for
various therapies, operated by the Ozumbas in the Fannin building's
downstairs office.

Additionally, she says, the Ozumbas directed her to conduct personal
business for the couple on state time. Lee provides copies, which she says
she took with her when she left HMC, of letters she typed on the Ozumbas'
personal stationery. One is addressed to the consulate general of Nigeria,
requesting passport renewals. Another thanks state Representative Garnet
Coleman for a "Declaration" delivered upon the occasion of son Donald
Ozumba's college graduation. A letter to the Home Depot customer
satisfaction department requests the replacement of kitchen cabinets
installed in the Ozumba home.

Lee hands over another three-pager she says she typed up for the Ozumbas on
state time. Titled "Anyibuofu Group Agreement," the document lays out
conditions under which money is to be collected for what appears to be a
lottery pool. Six names are listed on the apparent draft, including that of
Amos Ozumba, the only HMC employee on the list.

Lee says she left HMC over a disagreement about how her work time was being
spent.

"I would have to count the receipts for the week, and this is both TCADA
and private clients. So I was in there in the middle of counting money, and
the phone's ringing, and CeCe [Cecilia Ozumba] comes in, and she's like,
'You're not answering the phone.' And I told her, 'No, I'm counting money.'

And she said something about TCADA, if they call up and nobody answers the
phone, then I'm going to be in trouble. And I said, 'Really, well, would I
be in trouble if they found out that while they pay me, I'm doing work for

the clinic downstairs?' And she said, 'Oh, no, that's okay, they wouldn't
mind about that at all.' "

Two days later, Lee says, she was fired.

Lee says she had called TCADA to complain, left a message on the state
agency's voice mail and never got a call back.

Former HMC nurse Joyce Thomlinson, speaking of her three months at the
clinic, is succinct and extravagant at the same time.

"That is the worst job I ever had in my life. I had to do weeks and weeks
of prayer to get over that experience. I was on my knees day and night
begging the Lord to forgive me for the thoughts I had about those evil people."

Thomlinson has been in nursing 25 years, and took the HMC job "because it's
easy," she says. "You don't have to deal with doctors and IVs and sick
people. You just sit behind a computer and dose."

It did not, however, turn out to be easy. She, a TCADA-payrolled employee
like Gail Lee, also was asked to perform work at the PHP clinic downstairs.

"Just things that you could do for him for free."

Thomlinson is one of a large majority of HMC employees who report a chronic
problem with payroll checks bouncing, and salaries sometimes covered with
personal checks from Amos Ozumba, some of which have bounced as well. "How
can you get government funds and then give bad paychecks?"

Like others, she says she observed Ozumba harassing patients for money and
intimidating both clients and staff.

Like others, she says she was asked to manipulate documents.

"I didn't start there until September 7, and they wanted me to go back in
July and sign my name to work I didn't do. Hell, no! My license is on the
line! I'm a registered nurse!"

Thomlinson worked the day in late 1999 that the DEA arrived unannounced.

"We were just sitting there dosing, and all of a sudden they said, 'The DEA
is in the building.' We weren't expecting them, but from the gossip, people
were complaining about the clinic.

"[HMC] failed the inspection big-time, and then [Amos Ozumba] tried to
blame it on [nurse] Audrey [Shippey] and I that things weren't right.
They're looking through the books, the balances were wrong, the medicine
was wrong, all of it was wrong. Dr. Ozumba tried to say it was us."

Nurse Audrey Shippey backs Thomlinson's story and then some.

"They are abusive to everyone. The employees, the clients, they are very
rude to them. For example, there is this client that comes in every morning
to be dosed, and since TCADA closed the place down, he's requesting to go
back to the VA hospital where he came from, because now he has to pay $45
or $40 a week, and he doesn't have this money. And every time he comes and
he requests to go back there, they get mad. I've heard Dr. Ozumba saying to
the patient, 'Look at what I've done for you. When you came in here you
looked so bad, you looked like nothing, and look at you now, you want to
turn your back on me.' That's manipulation. These people are on drugs, and
they're easily manipulated."

Nurses are not always as easily manipulated, and when the Ozumbas told
Shippey to deliver a dose of methadone to a prison-bound client, Shippey
had to refuse.

"They know that the client is no longer in their jurisdiction. I had to
call the board of nurses."

The Board of Vocational Nurse Examiners confirms that it did receive an
advice call from a nurse at HMC regarding prison delivery of methadone. The
board advised the nurse that she could lose her license for following the
Ozumbas' instructions.

Shippey also confirms a story related by several individuals about the
late-February TCADA shutdown.

"Drugs were missing that day. There were two nurses there, myself and
someone else, and I and the other nurse did the final count on the
medication. She told me her balance was wrong, and I knew the balance was
wrong, because I knew what I had out, and then when I go to find it, it was
really missing. The medication was stolen from where we had it. We had
three keys. I have one key, [Cecilia Ozumba] has one key, and her husband
has another key. And I was with the people from TCADA. When I went back,
the medication was missing. TCADA was made aware. I told TCADA everything
that I knew. The lady from TCADA told me and the other nurse that we had
inherited a problem, the books have not been kept properly for years. It's
nothing new."

Emma Haywood, the "someone else" working with Shippey that day, says that a
bottle of orange 40 milligram methadone wafers totaling 5,080 milligrams
disappeared.

Shippey, who still worked at HMC at the time of her interview, said she was
looking for a different job. Asked why she remained, she says, "Because of
my clients. These clients are attached to me, and I look forward to taking
care of these clients. That's the only reason I'm there, and I've told them
that. And I've told my clients also that I'm looking for work, and they beg
me every day not to go. I'm the only stable person they have there, if I
have to say so myself."

Former nurse Lucille Villareal worked at HMC for two years, from 1996 to
1998, and, she says, almost had a nervous breakdown over the abuses.

"CeCe and Dr. Ozumba would tell me to ask the [methadone] patients if they
had Medicare or Medicaid, and if they did to furnish their number. And that
that would pay for their medication. And they would have counseling. They
would have therapy. Well, they never did. They were charging their account
800 and some-odd dollars a month, and they never did get any kind of
counseling or therapy. They would just come in every day to dose, get their
medication and leave. They never did get counseling or therapy, but CeCe
was still charging, billing Medicare/Medicaid, for something they weren't
receiving. In fact, she used to get mad when they'd come in and talk to me
about a problem."

Carl Sprague, a blind former HMC client whose name has been changed to
protect his identity, was one such patient. Sprague says he agreed to sign
papers that had not been read to him, and when he and his companion were
called into the clinic for what was described as a routine physical
examination, he went. Sprague says he stayed at the clinic an entire Friday
and part of the morning on a Monday before deciding that the Narcotics
Anonymous-style lectures he was hearing were something he had already heard
plenty of times before, and he chose to leave. He did not return. Several
weeks later Sprague's lawyer and trustee noticed a Medicare summary
indicating a $3,950 HMC billing to Sprague's Medicare account for
therapeutic and psychiatric services over a seven-day period.

With help from Steve Tapscott, owner of the Texas Treatment Center
methadone clinic, to which many HMC patients were transferred after TCADA's
HMC shutdown, Sprague alerted Medicare to the apparent fraud. As of
February 22, 2000, Medicare provider TrailBlazer Health Enterprises of
Dallas had investigated and informed Sprague that "Medical records were
secured from the provider and reviewed by our medical staff. It was
determined that the services were not properly documented. We have,
therefore, taken the necessary steps to recover the overpayment made to
this provider."

Nothing above surprises Patrick Nolan, an HMC counselor who worked at the
clinic less than five months before TCADA shut it down. Nolan has since
gone to work for Tapscott's Texas Treatment Center.

Nolan never could understand the system by which HMC billed its methadone
clients. TCADA provided reimbursement of up to $56 per week for HMC's
treatment of methadone patients, some of whom qualified for free treatment
or co-payments on a sliding scale, generally $1 to $3 per treatment.

"The clinic was still charging $21 a week extra. We determine eligibility
as counselors, to see whether these clients can afford nothing, 50 cents a
week, $5 a week. No matter what we determined, the computer would always
say $21 a week, and it would keep racking up that bill for them, and
racking it up and racking it up."

Nolan says clients were never forced to pay the bill before being treated,
a practice known with an ugly lack of euphemism as "administrative detox,"
but that the bills caused a lot of arguments and confusion at the clinic.
"Every morning, every day, every week, it was, 'Why do I owe so much when
you told me I only owed a dollar a day?'

"I don't know if they somehow could get reimbursed for that. I really don't
know that angle of keeping that in the computer. I'd say, 'It's not right,'
and they'd say, 'You don't understand how we bill.' You could tell it was
money-oriented because that's all we ever talked about. It was always,
'Where's the money, let's talk about the money, we need more money.' And I
can tell you for a fact I happened to get a glance of the payroll one time,
for the Ozumbas, and it was shocking. They're literally [taking home]
around $300,000 a year for both of them."

A current employee claiming knowledge of the payroll, who doesn't want his
name used, confirms, after a long pause, the $300,000 figure as "close enough."

Regulatory agencies were not unaware of Houston Maintenance Clinic's
idiosyncrasies. The Texas Department of Health, in response to a Freedom of
Information Act request filed by the Press, provided copies of its own
inspection reports for 1997, 1998 and 1999. TDH found that in HMC's first
year of operation, a random review of 23 patient files found 21 that were
incomplete or inaccurate. In 1998, 18 files were reviewed at random, and 15
were deficient. In 1999, 16 out of 19 patient files contained various
irregularities.

TCADA also long had reason to be suspicious. The agency had, by its own
account, weathered the entire course of HMC's contract without an
acceptable accounting of the clinic's finances. A November 1998 TCADA audit
reads like an encyclopedia of mismanagement. "Significant programmatic and
financial weaknesses previously identified by the Commission in September
1997 remain uncorrected," the auditors wrote. "The clinic does not have
policies and procedures for the following areasRecording and reporting of
program income." The commission found, contrary to Patrick Nolan's belief
that no administrative detox was practiced at HMC, that 10 percent of
examined client records "indicated that inability to pay would result in
'no dose' or administrative detoxification." Of the examined client
records, 52 percent "contained no financial assessment, an incomplete
assessment, or an assessment showing inability to pay," wrote the auditors.

"However, progress notes discuss repeatedly 'client fees' and 'need to make
payment' as an ongoing issue."

"A review of client records at Houston Maintenance Clinic indicates that
treatment services are not adequately planned and delivered."

"Based on a review of general ledger accounts, it is evident that the
Clinic charges the commission for costs that are unallowable, such as bank
charges, donations made, employee meals, property taxes, and penalties &
fines."

TCADA identified "questioned costs" totaling $23,299.

HMC management provided replies and corrections to the commission's
findings, but a post-audit letter from TCADA to HMC board chairman Dr.
Youmay U. Ogboso stated that while "Management's responses do indicate
corrective action planned, they did not adequately address all of the
recommendations in the report." One year later, in November 1999, the
commission wrote to Amos Ozumba, rejecting HMC's request for "more time" to
submit "an acceptable single audit covering the fiscal year 1997 and fiscal
year 1998 periods." Later the same month TCADA wrote Ozumba that HMC's
failure to submit the audits had resulted in suspension of the TCADA
contract. Ten days later TCADA wrote Ozumba again, "abating" the suspension
because Ozumba had "indicated that cash flow problems may impact [HMC's]
ability to continue contractual obligations to TCADA clients."

Finally, on February 16 of this year, TCADA terminated HMC's contract.
Final audits, and possibly a final payout of state money to cover recent
documented and acceptable expenses, are still to come. TCADA's Goodman also
confirms that the commission is investigating "a complaint" against the
clinic, but she is not authorized to say more than that.

This is hardly the first time that TCADA has been caught short by apparent
mismanagement of state funds on the agency's watch.

In 1995 a state investigation of the commission showed that TCADA had
failed to take action against an Austin rehabilitation clinic, even though
it had been aware of financial irregularities for three years. TCADA, the
investigation concluded, "failed to probe allegations of misuse of funds."

That same year, after the preliminary investigation revealed TCADA's "gross
fiscal mismanagement," Governor George Bush placed the agency into
conservatorship, widely reported as the first time such action had been
taken against a Texas agency in modern history. TCADA was still in
conservatorship in 1997 when it awarded the contract to HMC. Also in 1997,
a follow-up state audit indicated that while improvements had been made in
the two years since the conservatorship board took over, "a number of
issues related to rate setting, performance measures, management
information systems, and complaint resolution were left for the new
commission and management to address." Current director Jay Kimbrough took
TCADA's reins in February of this year, as the agency emerged from
conservatorship, and announced a scaling back of 200 contracts statewide
because of an estimated $28 million budget shortfall.

The newly-moved-into rental house is sufficiently close to Houston
Maintenance Clinic to walk, in a pinch (after TCADA shut down the
subsidized clinic, HMC relocated from its original Fannin Street location
to a nearby Main Street location). And the $750 monthly rent is considered
a good deal by the current and former patients who share it, mostly
youngish people who are trying to get back on their feet after years of
heroin use, with the methadone treatment, with new jobs.

Debra and Greg -- their names have been changed -- have gathered two more
former HMC clients to describe for a reporter their experiences at the
clinic, which have little to do with the alphabet soup of regulatory
agencies like TCADA and TDH and DEA. These are the people who trickle in
and out of the clinic's plate-glass door in the early-morning hours, three
or four or five times a week, to get dosed on their way to work, so that
they can go to work, so that they won't, hopefully, fall back into the
pattern of spending their days hustling for heroin.

Greg, without a conveniently close alternative, has continued treatment at
HMC's private clinic, at a cost of $40 a week, but says that CeCe Ozumba
told him he could get a discount if he'd get his wife on the program as well.

All say that they have watched Amos Ozumba make change, for both private
and TCADA clients, out of his own pocket, and stash incoming cash in a shoebox.

All have taken advantage of lax medication controls to take their methadone
wafers out of the clinic, unsupervised. The wafers have a street value that
Greg estimates as $40 to $50 for 100 milligrams, and some clients, they
say, sell their methadone to get money to buy heroin. Others will sell a
day's dose to make the money to pay the Ozumbas for a week's treatment.

Greg says he has seen doses sold, client to client, inside the clinic and
on the street in front, which he describes as "an open-air drug market."

Debra says, "It's very hard to detox at that clinic." The single
prescribing doctor on staff, she says, is only on site two Wednesdays a
month, and thus any change in dosage can take up to two weeks to authorize.

At other clinics, she says, such requests are processed in a matter of
days. "I went in asking for a three-month detox," she claims. "But I
started on 40 [milligrams] and left three months later on 80."

Debra entered the program, she says, as an indigent client qualified for
dollar-a-day payments, which she paid in advance, and within three weeks
found herself staring at a bill for $80. One day, when several clients got
upset over the billing, they confronted Amos Ozumba. Ozumba, Debra says,
got angry and yelled, "You're all upped to $3 a day." CeCe Ozumba, she
says, once told her that if she could afford a heroin habit, then she
should be able to pay for her methadone.

Three different patients report being dosed on "20 or more" occasions by
CeCe Ozumba, who is not a registered nurse, and thus is not authorized to
dispense medicine, a charge documented by TDH investigators.

At the Fannin Street location, former clients say, there were three "dosing
windows," where clients received medication. Two were designated for TCADA
program clients, one for private clients. "In the three months I was
there," Debra says and Greg supports, "I never saw anyone dosed at the
private window."

"They cater to the long-haulers," Debra says. "That's where the money is."

Male clients, Greg adds, aren't even supervised during required urinalysis
tests, making it more than easy to test clean with fake samples and qualify
for take-home doses. "It's just straight-up legal dope-running."

Cecilia Ozumba, contacted by phone, wanted to know which clients had given
a reporter her name before saying, "I don't have the authority to talk to
anyone, anytime, without authorization, from the board of directors, or
corporate attorney, or somebody."

She went on to say that TCADA's stated reason for the termination of HMC's
contract was "more bureaucratic than what they're stating. It's just that
they found a loophole, but there's no such thing. That's not the truth.
That's not the truth at all." She won't elaborate on what she means by
"loophole."

Presented with a partial list of client, employee and regulatory
allegations, Ozumba offers a blanket denial.

"I think all these are made-up stories. I'm not available to speak to you
at this point, and what I want you to know is that all of that is made-up
stories. You got this off what the instigators are making up for the
clients to say. People have been after closing this program, and there's
been instigating on the clients to claim everything."

Asked if she knows who the instigators might be, Ozumba says, "Yes, I know
who. A competitor has been wanting to close this program."

Asked if that competitor is Steve Tapscott, who operates Texas Treatment
Center and inherited the state contract after TCADA shut off HMC's money,
she says, "It could be him, yes. He's been claiming that he wants to close
this program and he will do it by all means. He's been trying to sabotage
it by all means."

Tapscott thinks that's absurd.

"I helped them start. I gave them everything to get started. All my forms,
policy and procedure manuals. So I can't see how I've done anything but
been up-front. And I have no idea why TCADA took her funds. I just know
that TCADA did. We were on the board of the Texas Methadone Treatment
Association up until November of last year together, so I don't know where
that's coming from. All I've ever done is report what I believed, at the
request of a patient, was Medicare fraud."

Before terminating the phone call, Cecilia Ozumba promised to provide
contacts for several former and current HMC clients who, she implied, would
counter the allegations with a balanced version of events. She then asked
that a written questionnaire be faxed to her so that she might respond in
particular to specific questions. The promised contacts were not provided,
and the questionnaire was not returned, but perhaps Ozumba felt that her
reply was not, in the long run, necessary.

"God will know what is right," she had said. "The right information, the
Lord knows. Whatever they tell has happened, let God judge them."