Few were able to properly oversee treatment at Serenity PlaceBy MARK HAYWARD
New Hampshire Union Leader
February 11. 2018 3:41PM
MANCHESTER - A lack of properly certified drug-addiction treatment counselors is emerging as a key factor in the financial collapse of Serenity Place, though the organization's leadership and state officials who did business with them are refusing to talk about details.
According to sources, Serenity Place employed only two full-time clinicians with proper licenses to perform intake diagnoses and oversee counseling services for the drug users who went through Safe Station. Even so, Serenity Place's abrupt closure late last year upended the treatment system in the Greater Manchester community.
"The work was being done, but I don't think it was done up to par with clinical standards," said one source, who worked at Serenity Place and asked not to be identified. Sources who spoke to the New Hampshire Sunday News said they wanted anonymity for employment reasons.
Efforts to reach Stephanie Bergeron, a former communications director who took over the reins of Serenity Place as the opioid crisis struck the city, were unsuccessful. Former board Chairman John FitzGerald III did not return repeated calls to discuss the organization.
In late December, state officials stepped in to appoint a financial receiver when the collapse of Serenity Place appeared imminent. The Executive Council also spent $180,000 to cover payroll, money that one councilor predicted New Hampshire would never get back. The decades-old addiction treatment program had become the behind-the-scenes therapy provider for drug users who showed up at Safe Station, the city's highly touted program to address opioid addiction in the state.
Of the 3,100 people who entered Safe Station from its inception, two-thirds ended up at Serenity Place, said Chris Hickey, the Manchester Fire Department's emergency medical services officer.
But as different organizations take over responsibilities of Serenity Place, its problems are coming into the open.
According to documents provided by the Attorney General's office, the organization that stepped in to operate Serenity Place - Families in Transition - quickly terminated two outpatient programs, citing "use of noncredentialed staff to perform services."
Families in Transition also opted not to bill the state for outpatient services on behalf of Serenity Place. It was a question of ethical billing, said Stephanie Sevard, chief operating officer for Families in Transition. "There wasn't credentialed staff to provide it," she said.
Serenity Place also lacked properly licensed workers to operate a third program, which provided treatment for impaired drivers, according to state records.
What remains uncertain is whether Serenity Place attempted to bill state programs such as Medicaid and the Bureau of Alcohol and Drug Services for the programs.
State health officials have refused to be interviewed for this article, citing an investigation by Attorney General Gordon MacDonald. They also denied a request by the Sunday News for communications between Serenity Place and the Department of Health and Human Services over billing.
The billing documents have been "compiled for law enforcement purposes," according to Frank Nachman, the DHHS' in-house lawyer.
State regulations lay down the parameters for people to be licensed as a drug and alcohol abuse counselor. They allow unlicensed people to provide treatment services, but only if they meet educational requirements and only if they are under the clinical supervision of a properly credentialed supervisor.
Hickey said the Fire Department became concerned this past fall, after Serenity Place made a pitch for local dollars. Fire Chief Dan Goonan called the office of Gov. Chris Sununu and the Department of Health and Human Services. What he found out caused Goonan's eyebrows to raise.
"My assumption was they were chugging along normally. Everyone was billing what they were supposed to bill," Goonan said. "Obviously, they dug themselves a hole they couldn't get out of."
He added that he and Fire Department brass weren't well-versed in state regulations about treatment licensing and credentialing.
Goonan said he didn't know whether Serenity Place had billed for services and been turned down, or whether the organization didn't bill at all.
But he said he received lots of letters praising Serenity Place for the job it did.
"Nobody has ever complained about Serenity Place. Whether they were clinicians or not, they had to be some of the most compassionate people I ever met," he said.
Statewide, 514 people are currently licensed to provide treatment services as drug and alcohol counselors or recovery social workers, according to the board that oversees their licensing.
The need for licensed providers is strong, with clinics, hospitals, jails and prisons all looking to hire, said Doreen Wittenberg, the Board of Alcohol and Other Drug Use Professionals administrator.
Serenity Place struggled when it came to bringing professionals on board, the source said. One properly certified professional turned Serenity Place down flat despite a $60,000 offer.
"The resumes we were getting were from people working at Dunkin' Donuts," the source said.
The impact of using unlicensed people to provide treatment to Safe Station clients is unclear.
Hickey said that about one-third of the visits to Safe Station represented people who had gone through Safe Station before, something he attributed to the nature of addiction.
But he also said there has only been just one repeat since the new model emerged. Mayor Joyce Craig has favored a decentralized approach to Safe Station, giving the Farnum Center responsibility for clinical treatment and Granite Pathways the task of arranging for health insurance, community support, housing and other services.
Hickey said Serenity Place had addressed community support issues before, but not at the clinical level that is taking place now. And that word is getting out on the street, he said.
"We are seeing people who are more serious about seeking help and recovery services," Hickey said.