Five days after losing her daughter to a drug overdose in a South Florida sober home, Jennifer Flory found herself standing before a task force set up to investigate sober homes.
“My daughter passed away on Thursday night and I’m coming here to get her stuff – and her – and to find out why she died,” the grieving mother from Illinois told the assembled group in West Palm Beach.
Months later, she said her public appearance so soon after her daughter’s passing was aimed at helping other parents and other addicts avoid the pitfalls that took her daughter’s life.
“Alison knows that I love her and care about her and miss her terribly. But that can wait,” she said in an interview with the Monitor. “Right now there is an urgent need for people to be helped and saved.”
With more than 140 people dying every day in the US from drug overdoses, addiction treatment has become a growth industry across the country. South Florida, in particular, is a national destination for those seeking treatment.
It isn’t just Florida’s warm and sunny weather. Those suffering under addiction are targeted by aggressive marketing tactics featuring national advertising and patient recruiters.
In the process, Florida has also become a prime location for unscrupulous drug treatment centers that seek to recruit young addicts covered by their parents’ insurance policies. Many of the “patients” are allowed to continue to use drugs while the treatment center overcharges their parents’ insurance policy for unnecessary drug tests and other unneeded services.
Federal, state, and local authorities are cracking down, but the insurance scams continue.
Flory says chief among her mistakes was assuming that everyone in the drug treatment industry was honest and actually cared about the well-being of her daughter.
“I think people need to know, there are scam artists out there,” she says. “Don’t just send your kid to Florida and expect a miracle.”
Two years ago, that’s what Flory did with Alison.
“I didn’t know the industry wasn’t [closely] regulated. I didn’t know that addiction treatment wasn’t under the supervision of a doctor at all times,” Flory says. “I was picturing white lab coats and stuff like that. I didn’t know. I didn’t know any of it.”
Instead of being helped along a road to recovery to a new life, Flory’s daughter was recruited away from an effective drug treatment program and lured into a sham program.
As reported in the first part of this two-part series, the program, Reflections Treatment Center in Margate, Fla., was set up largely as a mechanism to overcharge health insurance policies for unnecessary tests and treatments at inflated prices. As the operators of the treatment center grew richer, Flory’s daughter experienced relapse after relapse while living in a fake “sober home” where illicit drug use was permitted.
It was in one such sober home where, on Oct. 14, Alison and one of her housemates, Nicole De La Pena, smoked crack cocaine laced with the synthetic opiate carfentanil. Alison passed out and never woke up. Nicole spent a week in the hospital and is suffering from memory loss.
Although Reflections was later raided by the FBI and shut down, many other treatment centers and sober homes in South Florida are continuing to operate under a similar business model based on insurance fraud.
Criminal investigations are ongoing. And a special task force is exploring how to reform the sober home industry to weed out bad actors.
In the meantime, parents are continuing to struggle to identify legitimate and effective treatment centers and recovery residences. Flory and other mothers of addicts are part of an informal support network that offers help and advice to those seeking to identify quality treatment centers and avoid the fraudsters.
Key questions parents should ask
Flory and Johanna De La Pena, Nicole’s mother, both offer the same essential piece of advice to parents or loved ones of an addict seeking treatment: Talk to other moms of addicts.
Both of them say that parents and others researching rehab programs are at a significant disadvantage when trying to differentiate legitimate treatment centers and recovery residences from the bad actors in the industry.
The issue of selecting a treatment center and recovery residence arises at a time of crisis not only in the life of the addict, but also in the lives of those affected family members who are attempting to help the addict. In other words, the addict isn’t the only one whose life is in turmoil.
These vulnerable family members are confronted by a well-organized, well-funded, and in some cases highly deceptive marketing effort designed to attract and recruit new patients. Sometimes they offer free airfare to Florida, a tactic that experts say should raise red flags to family members.
“I would have never sent her [to Florida] if I knew then what I know now,” Ms. De La Pena said in an interview. “I would have picked a different state. I would have researched the facilities more. I would have gotten references.”
She says when her daughter agreed to enter treatment in Florida, she was so desperate to do something to help her daughter that she did not fully investigate the drug treatment industry.
“At the time my daughter was sent off to Florida I was still kind of in denial about her addiction,” De La Pena says. “In my hometown, we don’t really talk about this.”
Experts stress that not all drug treatment centers in Florida are engaged in health-care fraud. There are many long-established, reputable, and effective treatment facilities in the state. One key piece of advice offered by many experts and many parents of addicts: Find a reputable treatment center and stay there. Resist patient recruiters, they say.
The difficulty is being able to ignore fancy advertisements and slick website presentations to identify a truly reputable treatment center. Equally important is the ability to identify legitimate recovery residences and bypass fake sober homes, flop houses, and drug dens.
Addiction recovery specialists suggest parents and other loved ones ask a few key questions:
- Is the recovery residence certified by the Florida Association of Recovery Residences? If not, look elsewhere.
- Does the sober home offer residents free rent and money for food? Experts say residents should pay their own way. Offers of free rent or other benefits can be evidence of illegal patient brokering.
- Is the recovery residence coed? Experts say sober homes should be segregated by gender and not facilitate dating-type relationships between patients, which in the early stages of drug treatment can take the focus off recovery and make relapse more likely.
- Is the staff of the sober home trained in CPR? Do they have a supply of naloxone in the house for use as an emergency antidote in the event of an overdose?
- Are random drug tests performed? How much do they cost? Such tests should cost $5 to $10.
- Are referral fees paid to the sober home from a drug treatment center if residents enroll at that center? If so, it suggests the presence of an illegal kickback scheme, specialists say.
Parents need fortitude, strategy
For some parents, dealing with a child who is an addict requires not only fortitude but strategy and cunning.
After spending a week at her daughter’s bedside at a South Florida hospital following Nicole’s overdose in October, De La Pena decided it would be best to take her daughter home to Texas.
She arranged for security officers to accompany them from the hospital to the airport until they safely boarded their flight. As they entered the line for TSA screening, Nicole saw an opening.
“She just started running and I couldn’t get to her,” De La Pena says. Nicole apparently wanted to be with her boyfriend, who was also in a drug treatment program.
It took two months of pleading on the telephone before Nicole agreed to return to her mother’s house in Texas. Soon, Nicole began plotting her return to Florida.
De La Pena refused to pay for a flight to Florida. But that didn’t stop Nicole’s boyfriend from pulling strings to arrange a “free” Texas-Florida flight.
“These kids already know that they can get free flights back to Florida, so when she was here she was already planning it,” De La Pena says.
The mother says she was able to intercept and stop attempts by two different treatment centers to send a free ticket to Nicole. It is a common recruitment tactic to offer to pay for airfare to Florida if the would-be patient has health insurance and is willing to enroll in their treatment program.
Maureen Kielian is the Florida director of the anti-drug group Steered Straight and a member of the Sober Homes Task Force. She says there is a relatively easy way to determine if a treatment center is engaging in an illegal activity such as patient brokering – offering something to a prospective patient in exchange for their agreement to enroll in a particular treatment program.
“If they are being offered anything free, they are being brokered,” she says. “The way to think about it is if my son had leukemia, would this be happening?” she says. “Would they be flying you in for treatment? Would they be offering you free anything? No.”
After dealing with her daughter’s overdose, De La Pena knew about patient brokering and was twice able to intercept and block free plane tickets meant for Nicole.
“Then one of them did purchase her a ticket,” she says. “It was late at night when I saw it and I personally contacted the person and told them they better cancel. They were really ugly and rude. So I told them I am canceling my insurance because I know that is the only reason they wanted her out there. They said, no, we’ve already verified the coverage.” De La Pena upped the pressure. She told them what they were doing was illegal. They disagreed.
After the telephone call ended, De La Pena sent them a text message with the business card of an official with an anti-fraud task force in South Florida. She repeated her statement that what they were doing was illegal. “Within minutes he texted me back, saying that he had canceled the flight,” she says.
“The next morning, my daughter did not know that I had canceled the flight,” she says. “I was asleep at six in the morning when she got a ride to the airport.”
De La Pena sent a text message to her daughter who, by then, was stranded at the airport. The message: Give your mom a call when you are ready for a ride home. Nicole called her grandmother for a ride.
The time away from Florida has been good for her daughter, De La Pena says. Nicole has a job and has been drug-free for three months. The mother says it is easier to fight off patient recruiters when they think there is no insurance policy to fleece.
A fast way to stop the fraud
Flory says she believes any chance her daughter Alison had for recovery was lost amid the ongoing fraud in South Florida. “I think she was doomed by the people who were supposed to help her,” she says.
Flory has hired a lawyer to investigate a possible lawsuit against one or more of the drug treatment centers Alison attended.
The lawyer, Susan Ramsey of West Palm Beach, says the increased law enforcement scrutiny of the treatment industry in recent months is causing some people to close their doors and move on.
“There are those who are going to pull up their shingle and go find some other scam. I think that is happening,” she says. “But the struggle is going to continue for some years.”
One development that Ms. Ramsey says might trigger a rapid cleansing of the treatment industry would be if insurance companies launched their own investigation into past practices and demanded their money back from shady treatment centers and laboratories that overbilled.
“That is what they need to do,” she says. “That would stop this pretty darned fast.”
At one point De La Pena got the same idea. She called her insurance company and asked them to block a South Florida treatment center from billing more charges to her health insurance plan. “They declined to do that,” she says.
She called a fraud investigator with the insurance company. He never called back.
'I know the warning signs'
Flory says she will always feel an emptiness from the loss of Alison, her oldest child. But in a cruel twist, her struggle dealing with an addicted child is not over yet.
Four months after Alison’s fatal overdose, her 20-year-old son came to her with a heart-breaking admission.
“I’m doing heroin and I need help or else I’m going to die,” she says he told her. That’s not all. “He wanted to go to Florida. That wasn’t my idea, but he said that’s where he wanted to be.”
He enrolled in a South Florida drug treatment facility.
“So at first it looks like I’m doing the same thing all over again, expecting a different result,” Flory says. “But now that I know how it works… I have people watching out for him. If I knew then what I know now, I would have seen what Alison was falling into.”
This time will be different, she says. “I know what to expect. If he is going to get into trouble, I know what the warning signs are and I am going to have him watched like a hawk by all the people I have met. I have a big network of people now who live (in South Florida) because I’ve made it my business to know them.”
If there is any one rule she will enforce with her son that she did not enforce with Alison it is that he will enroll in a legitimate, high-quality program and remain in it.
“You don’t move,” Flory says. “You don’t make any decisions about that. He knows that he is not allowed to make those decisions.”
This is Part 2 of 2. You can read Part 1, "Alison's story: How $750,000 in drug treatment destroyed her life," by clicking here.