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Mom's Program in danger

A mothers addiction recovery program at OnTrack Inc. is in danger of being closed after state officials found significant health and safety risks, including failure to send two children with serious illnesses to the emergency room.

“We have sent a clear signal to them, if these things aren’t fixed, we have no other choice but to revoke their license,” Oregon Health Authority spokeswoman Michelle McLellan said.

The threat to the Mom's Program is the latest in a series of crises at Southern Oregon's largest addiction treatment provider that include "deplorable conditions" found at OnTrack housing, legal actions alleging abuse toward employees and clients, and departure of its 39-year executive director.

The Mom's Program is a state-licensed, 45-bed facility at 3397 Delta Waters Road in Medford also known as the HOME program. Multiple violations there are detailed in a 12-page "Notice of Intent to Revoke Alcohol and Drug Residential Treatment License" the OHA sent Feb. 24 by certified letter to OnTrack board president Jim Maize.

State investigators observed two children who were feverish and lethargic during a visit Jan. 25, according to the letter, written by Chris Norman, contracts and compliance director for the OHA.

Parents of the children told state investigators they were waiting for an appointment to go to the emergency room.

"Facility staff was unclear about the current policy about whether or not they would need approval to coordinate emergency transportation," Norman writes.

Other residents told investigators about two separate incidents in January at the facility in which emergency care was delayed for children.

Failing to coordinate emergency medical transportation is a violation of two Oregon Administrative Rules regarding endangering health, safety and welfare, Norman writes.

OnTrack has 21 days to request a hearing to respond to the letter. OnTrack officials have been meeting with the OHA over the last several months to resolve the myriad issues with its residential treatment programs. 

Norman lists unsanitary conditions at the Mom's Program, failure to address mold issues, improper medical protocols and a failure to complete documentation of the treatment clients receive.

"At OHA's review on Jan. 18, 2017, multiple medication administration records were missing a section to document or track observed side effects, which is a violation of OAR," Norman writes.

OHA and Oregon Department of Human Services have found similar problems at OnTrack's Teen and Dad’s programs. The Oregon Department of Justice also is looking into regulatory actions against OnTrack.

At a Feb. 3 site visit, the Office of Oregon Adult Abuse Prevention and Investigations issued a report about the poor physical condition of the Mom's Program facility, including leaks and cracks in the ceiling and walls.

"The facility has a hole in the roof through which rain and moisture was leaking into a bedroom," Norman writes. "On Jan. 27, 2017, OAAPI investigators observed that the ceiling was sagging and wall was cracked where moisture and rain had entered."

Norman sent OnTrack a separate letter Feb. 24 placing conditions on the license for the Mom's Program. OnTrack can no longer admit any new clients to the facility and is required to comply with all state health and safety rules.

"Please be advised that the Authority (OHA) will be monitoring your facility and may initiate additional notices of conditions or may suspend your license, if necessary to protect the health, safety and welfare of individuals in your facility," Norman writes.

OnTrack scrambles to address problems

With so many issues plaguing OnTrack, local rumors that it may shut down have reached state officials.

"I can’t confirm or deny that OnTrack is going to shut down," McLellan said. "One thing saving OnTrack is that they have turned a lot of lives around. But that is an amazing amount of weight that they are under."

McLellan said OHA takes a program-by-program approach with organizations such as OnTrack in considering whether to revoke a license.

Asked to address the rumors, Maize said, "That would be the last thing the board would want to see. There is a lot of dedication by the volunteer board members."

Maize said OnTrack is spending $250,000 on remodeling its crisis housing units on 11th and 12th streets, where multiple safety issues were found by state investigators. More upgrades to other housing have been started or are in the works, he said.

"I think we're handling it really well," he said. "Financially, we're all right."

At the Mom's Program, OnTrack has replaced old furniture and bedding. Maize said at least half of the roof will be replaced when the weather improves.

Maize said OnTrack is building up its staffing to better handle the services provided, and he thinks the community will soon see a marked improvement.

"We provide a tremendous service that is recognized by the local community, the state of Oregon and our partners," Maize said.

Dad's Program complaint initiated investigation

OnTrack offers almost two dozen programs for drug and alcohol treatment, but in the last year it has been buffeted by lawsuits, threats of lawsuits and extensive problems with existing facilities, which state officials denounced as "deplorable housing."

Longtime Executive Director Rita Sullivan was let go in February after three months' administrative leave, and an interim director, Dr. Kerri Hecox, left after less than a month.

The OHA started looking closer at OnTrack's operations last year after receiving a complaint from a resident in the Dad's Program, a 10-bed facility in Medford serving fathers in recovery with children up to age 5.

"This prompted an investigation on June 17, 2016," McLellan said in an email response. "It was evident that there were numerous problems that required a more in-depth review, which occurred on June 22, 2016."

The OHA found a "substantial failure to comply" with state laws at the Dad's Program, including mold, insufficient food for children and complaints of abusive behavior toward clients by staff. In one case, a father holding his 18-month-old tripped over torn carpeting and fell down the stairs. By November, OnTrack had improved and had addressed most of the issues, OHA said. 

But the Dad's Program is currently undergoing review by OHA after another site visit, this time in mid-January. McLellan said her agency is still working through drafting its findings on the Dad's Program based on the site visit.

A former client of the Dad's Program has alleged physical abuse by the program director in a lawsuit filed Feb. 1.

On June 23, 2016, OHA officials conducted a site visit at the Mom's Program, and found a number of health and safety issues.

More complaints started coming in, prompting an expanded investigation into other OnTrack programs, McLellan said.

On Aug. 8, 2016, OHA notified OnTrack about compliance concerns, including service plans and notes for clients that were incomplete or appeared to be copies of other service notes.

By Sept. 14, 2016, OHA officials had found more clinical documentation issues. Similar problems were found Oct. 24, 2016, and then again Jan. 18.

Investigators found substandard living conditions at the Teen Program, a 10-bed facility at Fifth and Holly streets. While DHS approved the teens' relocation to 1501 W. Main St., the facility there is not licensed by OHA. The two agencies have sometimes overlapping responsibilities in overseeing OnTrack.

"We're waiting for them to submit an application," McLellan said.

As OnTrack works to correct issues found in the state's investigations, DHS is routinely monitoring OnTrack for safety and compliance, spokesperson Andrea Cantu-Schomus said.

She confirmed an ongoing investigation into the Teen Program and hinted at other potential actions against OnTrack.

"DHS continues to work with DOJ (Oregon Department of Justice) to explore regulatory actions, but nothing to disclose at this point," Cantu-Schomus said in an email response.

— Reach reporter Damian Mann at 541-776-4476 or dmann@mailtribune.com. Follow him on www.twitter.com/reporterdm.

Ryan Hagerman, left, and Scott Wattles of HamCon Builders move cabinets Friday into an apartment at an OnTrack housing facility on 11th Street in Medford. [Mail Tribune / Denise Baratta]