ADS DIRECTOR DEFENDS AGENCY

Critical Report Was Right, ADS Says, But Problems Are Out Of Its Hands

Remember those unused beds at Alcohol and Drug Services -- the ones
that remain empty despite the thousands of untreated addicts in
Guilford County?

Chuck Fortune, the agency's director, has something to say about that:

Don't blame ADS.

Government regulations control who gets admitted to the facility and
for how long, he says. And if ADS steps outside those guidelines, the
nonprofit won't get paid for the treatment it provides.

"We're not trying to keep people out," Fortune said. "We're just
trying to get reimbursed for the ones we serve."

Fortune and his staff of 120 are still reeling from harsh comments
leveled at them earlier this month. A consultant's report said the
agency -- which serves low-income addicts who can't afford private
treatment -- has too many empty beds and has strayed from its
original mission of providing a 12-step treatment program.

The report was commissioned by the Guilford County Substance Abuse
Coalition, a collection of citizens and members of 43 organizations
associated with alcohol and drug treatment. It followed a News &
Record series in November 2004 dealing with the county's 20-year
battle with crack cocaine.

Several community leaders who have been concerned about ADS,
including Guilford County Public Defender Wally Harrelson, who helped
found the agency, said the public criticism was long overdue.

Some county commissioners also are concerned about the findings,
since the county last year awarded ADS $1.7 million in contracts.

On Thursday, commissioners will hear a more detailed report on the
county's drug and alcohol rehabilitation services from the substance
abuse coalition. It's unclear whether the coalition will recommend
reform at ADS. Coalition members have declined to discuss the report,
which could include some of the consultant's recommendations.

Fortune doesn't dispute the consultant's facts: About half of ADS's
inpatient 55 beds are occupied. And addicts typically stay less than a week.

But there are reasons, he says -- all beyond ADS's control:

* The Guilford Center, the county's mental health agency, decides who
gets into ADS's treatment programs and how long they stay.

* State government, which reimburses ADS for its services, no longer
favors 12-step recovery programs, said Jackie Butler, ADS's director
of client services.

Recent reforms in mental health put more emphasis on letting the
client chose his or her recovery model, she said. The state also
believes the 12-step program's emphasis on spirituality might turn
off some potential clients, Butler said.

ADS hosts 12-step meetings seven days a week through Alcoholics
Anonymous and Narcotics Anonymous, she said.

"We're not at all opposed to 12 steps," she said.

* The state prioritizes addicts based on its "target population,"
Fortune said. Women with children, for instance, are more likely to
receive an open slot at ADS than single men who never have relapsed.

* The state rarely pays for monthlong inpatient treatment, Fortune
said. It prefers to send addicts to one-to three-day detox programs,
which means it can treat more addicts with a limited pool of cash.

"There was a time when you could walk up (to a treatment facility)
and say, 'I need help,' and get 28 days," he said. "But decisions are
now based on money.

"We can't just go back to the old days because everybody wants to."

According to the national Drug and Alcohol Services Information
System, the median length of stay for detox programs is four days.
But many of ADS's harshest critics say addicts, particularly crack
addicts, need more time in treatment.

Several community leaders, including Commissioner Melvin "Skip"
Alston, want the county to build a long-term treatment center for
crack addicts.

Fortune said the Guilford Center usually approves one-day stays for
cocaine addicts. Alcoholics are given a higher priority, he said,
since there's more of a risk of a client having serious medical
problems during alcohol detox than with cocaine.

ADS has performed substance-abuse services for the county's mental
health agency for more than a decade, chipping away at a drug problem
that costs the county tens of millions of dollars annually.

Fortune said his staff works hard to treat clients and follow state
guidelines -- a must, he says, if his agency is to be reimbursed for
its services. All of its outpatient facilities are full, he said.

Staff members also try to find longer-term treatment for crack
cocaine addicts after they finish the detox program, he said.

ADS raises money from private sources, including area United Way
agencies and ABC boards. That extra money sometimes affords clients
longer stays or provides open slots to addicts the state considers to
be a lower priority.

And sometimes, he said, the agency simply doesn't get reimbursed for
its services.

"We just eat it," said Fortune. "And we do a lot of that kind of thing."