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."