The city is looking into concerns raised about Rainforest Recovery Clinic during public comments at the Assembly meeting on Monday night.
Susan Christianson and Howard Scaman, who came to the meeting separately, cited related concerns about the clinic in their public testimony. Foremost among them is that they don't believe the clinic works.
A September operational assessment update of the clinic by Diamond Healthcare Corporation states, "Over the years since Diamond's last operational review (of Rainforest in 2005), turnover among RRC Program Directors has been high, financial losses have continued, staff morale has fallen and the operations have struggled."
Some of the concerns listed in the assessment are that clinical outcomes at the clinic are deteriorating, the admissions process is "somewhat chaotic," insurance verification delays result in loss of admissions, and outpatient services have declined by as much as two-thirds in one year due at least in part to the hospital's policy of billing patients before they receive services.
"In my opinion, people are dying because these people don't know what they're doing," said Scaman at the meeting.
Scaman, a recovering alcoholic, said he has run addiction recovery programs in the past and Christianson said she has been heavily involved with addiction issues in the Juneau community.
Bartlett Regional Hospital recently entered into a two-year, $239,000 per year contract with the National Council on Alcohol and Drug Dependency for management services at Rainforest. Hospital board member Loren Jones said the assessment was "the reason we decided to go with the management contract."
Bartlett Director of Community Relations Jim Strader said the contract is "a step aimed to heighten our efforts at making this service run more effectively."
Scaman and Christianson, however, also raised concerns about the contract, which was bid on a limited solicitation. The hospital received two proposals, one from Diamond Healthcare and the other from the council, Jones said.
Scaman said he requested to be involved in the bid process and the request was "totally ignored."
City Manager Rod Swope said Wednesday that the contract does fall under a legal exemption for public bids under city code.
"What they did was legal," Swope said. "Whether given the size of the contract it would have been appropriate to put it out for review is another question... . That's one of the things I'm going to have to look into."
Both Scaman and Christianson also said treatment at the center is much too expensive and ranks in the top five most expensive in the country. In documents she provided to the Assembly, Christianson cited one inpatient's $23,000 bill for a 28-day treatment. She also provided other treatment centers' cost for comparison, saying Sundown Ranch in Texas costs $12,600 for a 28-day stay, and Promises Treatment Center in Malibu, which she said the most expensive, costs $53,500 for a 31-day program.
"It is not accurate to use a single bill to portray charges for services at Rainforest Recovery Center," Strader said in a statement. "There are many variables depending on services required."
Rainforest Recovery's 152 inpatients in the 2009 fiscal year stayed an average of 19.4 days, he said. The average cost for that average stay was $10,031.
Strader said patients pay on a sliding scale based on ability, and "in many cases, they pay nothing at all."
Overall, he said Bartlett is compensated for 25 percent of the cost.
While the $23,000 is from a specific bill, Christianson said she saw other bills for around the same amount.
"They're getting distracted by 'Oh, you said it's this amount or that amount.' My point is that they haven't been able to fulfill the obligation... of having a cost-effective program that works," Christianson said.
"We consider the substance abuse problem in Juneau critical... We continue to work with all stakeholders in this community to seek positive solutions," Strader said In the statement. "We also recognize that Rainforest Recovery Center has had its challenges... none of which have gone unnoticed or unaddressed by hospital management. We are working diligently to resolve every issue as quickly as possible."
Swope said Wednesday that he is meeting with Bartlett representatives and with those who raised concerns. Swope also said he's concerned about finding an objective perspective.
He said he intends to get back to the Assembly with an assessment in two to three weeks; Assembly member David Stone, the city's liaison to the hospital, will also be assisting.
"It is kind of an unusual situation because they (the Assembly) don't have any legal authority that I can think of over the hospital's operations," Swope said. "With the exception of some funding, mostly Bartlett is self-funded."
Rainforest Recovery Clinic annually receives about $222,000 of tobacco tax revenue, $705,000 in alcohol tax revenue, and $200,000 from the city's general fund.
While Bartlett is a municipally run facility with a board appointed by the Assembly, the city government has traditionally relied upon it to operate on its own, Swope said.
Swope said if they did determine there were problems, they would probably discuss those issues with the board members and could possibly order an audit of the facility.
Contact reporter Mary Catharine Martin at 523-2276 or firstname.lastname@example.org.