ADDICTS' CARE AND A CRISIS ALL ITS OWN

IT was a sprawling empire. On any given day, Crossings Recovery
Systems, with 9 substance-abuse clinics and 15 group homes scattered
from West Hempstead to Moriches, provided some combination of
treatment, counseling, room and board to as many as 1,500 recovering
alcoholics and addicts on Long Island.

But somewhere along the way, things went terribly wrong.

Former patients began complaining last year about what they said were
slumlike conditions and a climate of abuse in the company's group
homes, also known as sober homes. Around the same time, signs began
to appear that the company was having financial problems, running up
debts, skimping on expenses and falling behind on payments.

The former patients took their complaints to the State Office of
Alcoholism and Substance Abuse Services, known as Oasas, which
licenses and regulates inpatient and outpatient treatment centers.

But the agency's investigation tripped over a fault line running
through Crossings and through the overall business of treating
addiction. Many of the complaints concerned the company's sober
homes, and such homes, whose primary services are room and board
rather than treatment, are not regulated under state law.

No authoritative count is kept, but most estimates say there are at
least 200 sober houses on Long Island. Some are run by for-profit
companies like Crossings, others by nonprofit groups like Catholic
Charities or independent operations. Their quality varies widely, say
state officials, advocates for addicts and other treatment providers.

The state and federal governments continue to pay for residents'
housing and care at all of them, good or bad, through Medicaid and
Social Security disability benefits, other programs meant to help
recovering addicts in treatment, and food stamps.

Crossings had sober homes in the communities where it also operated
separate outpatient clinics: Central Islip, Deer Park, Port Jefferson
Station, Patchogue, Huntington Station, Ronkonkoma, Coram, Moriches
and West Hempstead. And by the accounts of the former patients,
conditions in the homes were deteriorating: maintenance was
neglected, furniture was inadequate, food and heat were scarce, and
residents were badly treated.

Oasas decided to move ahead with its investigation of these and other
complaints despite its lack of jurisdiction over sober homes. In
December, the agency cited the company for 174 violations, including
allegations of inadequate medical care and supervision, inappropriate
treatment, and failure to pay employee salaries and rent and utility
bills. Oasas then levied the largest fine in its history, $6.9
million, against Crossings.

On Feb. 14, Oasas suspended the operating licenses of all nine of
Crossings' clinics and ordered the company to stop treating its
patients, numbering between 1,200 and 1,500, some of them mentally
ill and others convicted sex offenders.

The 174 violations included some at four of Crossings' sober homes.
Oasas asserted that it had jurisdiction over those homes because the
relationship between the company and the residents went beyond that
of landlord and tenant: Crossings routinely admitted patients to a
home and a clinic program at the same time and made remaining in one
contingent on remaining in the other.

Frank Buonanotte, the owner of Crossings, challenged Oasas's actions
in State Supreme Court in Riverhead, and a hearing in the case began
on Feb. 21.

Scott J. Fine, a lawyer for Crossings, defended the company's clinics
and homes as "safe and healthy places for recovery" and called the
Oasas actions illegal. Mr. Fine said that many of the problems Oasas
had said were part of a pattern of repetitive violations actually
dated from before Crossings acquired some properties in March 2005.

By the time of the hearing, the company's finances were in crisis.
Crossings employees testified that the company had not met its latest
payroll, that it was nearly $500,000 in debt and that Medicaid, which
accounted for about half its revenue, was withholding payments.

The company abruptly shut down its Huntington Station clinic in
January without the required state oversight, according to testimony
by Henry F. Zwack, Oasas's general counsel. He said that the Moriches
clinic was about to be evicted and that several others were threatened.

Outside the courtroom, Mr. Fine confirmed that Crossings's financial
situation was dire. "But it's been caused solely by Oasas's actions," he said.

Several witnesses at the hearings also testified about shortcomings
in the way Crossings operated its clinics and homes.

Charles Monson, the head of the Oasas enforcement bureau, said that
state investigators had found 20 to 40 residents living in each
house, with many of them in treatment for an unusually long time.
Although people typically stay in outpatient treatment for about
three months, he said, some Crossings clients were there for a year or more.

"We didn't see them moving toward the recovery aspects: going out
looking for a job, connecting to an outside community," he said.

The company's own compliance officer, Louis Sabatino, testified that
he found violations in every patient chart that he examined.

After two days of testimony, the hearing was halted on Feb. 23 while
Mr. Fine consulted with Denis J. McElligott, the assistant state
attorney general representing Oasas, in a hallway outside the
courtroom to forge a settlement.

After a couple of hours of negotiations, Mr. Buonanotte agreed
essentially to hand Crossings over to the state. The company went
into voluntary receivership, and Mr. Zwack, the Oasas general
counsel, scratched together $250,000 in emergency state money and a
platoon of Oasas officials to help pick up the pieces, reopening the
doors of the seven remaining clinics the next morning.

"It's a triage that we have to do now," Mr. Zwack said. "The goal is
not preservation of the program, but preservation of treatment for
the patient."

Mr. Fine said his client had agreed to the settlement reluctantly.
"It's not about benefiting Crossings or Mr. Buonanotte," Mr. Fine
said. "This is for the sole benefit of the clients. Period."

About three dozen Crossings employees who went to the court hearing
each day expressed relief to hear that Oasas would pay their
salaries. "There's going to be some uncertainty, but I think we can
work through it together," Mr. Zwack told the employees after Justice
Peter H. Mayer approved the deal.

Starting last Monday, Oasas officials and the remaining Crossings
staff began dismantling the company one patient at a time, evaluating
patients' files and referring them to other treatment programs.

The Crossings sober house in Brentwood, where as many as 22
recovering addicts once lived, was down to just a handful by Feb. 25.
Most of them had been transferred to Seafield Center, which has an
80-bed in-patient facility in Westhampton Beach and a number of
outpatient clinics from Brooklyn to Riverhead.

When told about the state takeover, Wilfred Randall, a former
Crossings patient, whooped like a cowboy. "You go, Oasas!" he shouted
into the telephone.

Mr. Randall, 43, said he started drinking at 12 and began using crack
cocaine in his early 20's. He lived in the Crossings Brentwood sober
home for eight months last year.

Craig Jackson, 46, another former Crossings patient, said he drank
for 30 years and used heroin for 20, and lived in the Brentwood house
for three months.

In interviews, the two men offered similar bleak descriptions of life
in the home. Residents slept three or four to a room on wooden box
springs, they said, and were fed spartan meals like hot dogs or a
single bowl of canned soup for dinner; sometimes there was no food,
and residents had to visit a local soup kitchen instead.

The roof leaked, ceilings cracked and electrical wiring was exposed,
they said; phone and other utilities were often turned off for nonpayment.

Both men said that the house captain, a recovering addict with
seniority, and the manager, a Crossings employee, were verbally
abusive to them. And the men said that in violation of Medicaid
regulations, they were required to work 10 hours a day on weekends,
washing cars for as little as $4 an hour, to raise money for house supplies.

"They said, 'Do what you're told or get out,' " Mr. Jackson said.

Mr. Fine, the lawyer for Crossings, vehemently denied the men's
allegations about conditions in the sober homes, calling the homes
safe, healthy and properly run.

"The residents aren't forced to go to soup kitchens," Mr. Fine said.
"They are properly fed. There are no wooden beds. They are not forced
to work at a car wash."

He confirmed, however, that Crossings house captains and managers
were given no special training in operating a sober home or
monitoring residents. "We're not required to train them, because the
state does not regulate sober homes," he said.

Mr. Randall and Mr. Jackson both eventually turned to the nearby
Brentwood United Presbyterian Church for help. Through its pastor,
the Rev. Kennedy McGowan, they also got in touch with Long Island
Congregations, Associations and Neighborhoods, known as Lican, a
coalition of churches, social service groups and labor unions that
advocate for social change.

Lican is now working with other treatment providers, including
Catholic Charities, Madonna Heights and Eastern Long Island Hospital,
to push for state laws that it says would require humane treatment of
sober-home residents.

Lican and Mr. McGowan also encouraged Mr. Randall, Mr. Jackson and
other former Crossings patients to speak out about conditions at the
company's homes.

Mr. McGowan said many members of his congregation were recovering
addicts. "This atmosphere of intimidation is not helpful to people
already beaten down by the addiction, and trying to get their lives
back in order, people in a situation of extreme powerlessness," he said.

Crossings is the second Long Island treatment provider in a year to
face stiff sanctions from Oasas. Last year, the agency fined Lake
Grove Treatment Centers, a clinic operator, $1.5 million and
eventually shut it down.

Local addiction-recovery experts say that in recent years, Long
Island had become oversaturated with programs to treat alcoholism and
drug addiction, and especially sober homes, which were attractive to
for-profit operators like Crossings and Lake Grove because they were
unregulated. Oasas found that at one point, Crossings' profit margin
was 20 percent.

When competition for addicts' Medicaid benefits became stiff, though,
some operators cut corners to save money, according to Mary
Silberstein, the president of the Quality Consortium of Suffolk
County, which has 23 treatment providers as members.

"This has everything to do with greed and putting profits ahead of
people," said Ms. Silberstein, who is also the director of addiction
recovery services at the Pederson-Krag Center, a nonprofit group.

According to Oasas, as of Feb. 22, there were 153 licensed chemical
dependence programs in Nassau and Suffolk, serving 16,897 patients -
figures that do not include sober homes.

The settlement of the Crossings case meant that the court never
decided whether Oasas was on solid legal ground in claiming
jurisdiction over homes linked to licensed clinics. "Our position is
that where chemically dependent treatment services occur, Oasas does
regulate," said Mr. Zwack, the agency's general counsel. In other
cases, he said, local health departments, fire marshals or social
services agencies should be the ones to intervene when there are problems.

Mr. Randall moved out of the Crossings house in Brentwood in October.
He now rents a room in Deer Park and follows a 12-step recovery
program; he says he has been clean and sober for 13 months.

Mr. Jackson now lives in another sober home in Bay Shore, has a
part-time job driving a taxi and also follows a 12-step program; he
said he had been clean for six months. "I met a nice girl," he said.
"My life is getting back on track."

He added: "Getting thrown out of Crossings was the best thing that
ever happened to me. I was going nowhere there."