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DUII program in disarray

Oregon health officials have found that Southern Oregon's largest addiction treatment provider failed to maintain records over the past three years confirming that clients completed a DUII treatment course — and a former coordinator of the DUII program claims that's just the tip of the iceberg.

Jeff Houston, who resigned from OnTrack in December 2016 after helping run the DUII program for six months, alleges that administrators often said they didn't need to provide better treatment because they would get more money when the clients returned after receiving another DUII conviction.

“This greedy and scandalous attitude places clients and our community at terrible risk with tragic consequences,” said Houston, who handled about 200 clients at any one time.

The Oregon Health Authority, which previously raised alarms about “deplorable housing” at OnTrack's residential treatment programs, has taken the organization to task again for the disarray in handling outpatient treatment that includes not only the DUII program but also addiction recovery for women and adolescents.

“All service records reviewed did not document that the services provided … to adolescents (were) being delivered,” according to the OHA.

In March 3 and April 11 reviews of OnTrack’s programs, the OHA found scant evidence that clients had received a required Certificate of Completion for their DUII program. The OHA “found only one Certificate of Completion sent to the Department of Motor Vehicles to verify completion of treatment. Management was unable to convey what had occurred or where the numbered certificates were.”

In the OHA review of March 3, authorities found that records at OnTrack also didn’t include required service plans for DUII clients. The Mail Tribune received documents from the reviews through a public records request.

Houston, who said the problems at OnTrack were widespread and troublesome during his time there, said the DUII program generally failed to check on the backgrounds of clients to determine their risk of drinking and driving again. OnTrack employed inexperienced, undertrained and uneducated counselors, Houston said, and these counselors often failed to find out how many times clients had received previous DUIIs to help provide better treatment.

“It has done more damage than good,” said Houston, who noted that OnTrack had lots of paperwork problems when he worked there.

Michelle McLelland, spokeswoman for OHA, said her agency has no way to determine how many certificates of completion should have been sent to the DMV. But the time period covered by the review, which is part of the state program certification process, is three years.

McLelland said it is a highly unusual situation to have one service provider that has been found to have so many deficiencies in various areas of operations.

“Nothing quite like this has happened before with one provider,” she said.

As a result, the state will continue to conduct unannounced and announced site visits to make sure OnTrack works on the issues.

“We do see them making progress,” McLelland. “We do see them making an effort.”

In an April 25 letter to the OHA, OnTrack responded that it will institute more training and provide better documentation but generally didn't refute the bulk of OHA's findings.

Jim Maize, OnTrack board president, said the claims being made by Houston are unsubstantiated, though he acknowledged he's not familiar with all the inner workings of OnTrack during the time Houston worked at the organization.

"We've made a distinct effort since that period of time, last November and December, to make dramatic changes to OnTrack," Maize said.

He said many of the concerns raised by state health officials are being dealt with, and OnTrack has undergone a major effort to train employees in filling out the necessary paperwork. Maize said he thinks OnTrack has complied with many of the issues raised by state health officials.

"We're making significant progress," Maize said.

As to the DUII program, OnTrack said it would conduct training on certificates of completion and develop better service plans.

DMV spokesman David House said his agency couldn't search for a list of certificates of completion by provider, only by an individual's record.

He said the certificate is required along with court documents and possibly other treatments to reinstate a driver's license after a DUII conviction.

"But, we need to get the certificate from the provider," he said.

OnTrack's lapses in providing documentation under Oregon Administrative Rules were not confined to the DUII program.

Human resources records also were found lacking, and OnTrack didn’t know the hire dates of many employees, according to OHA.

“Due to the disarray and incomplete personnel records, there did not appear to be any documentation of staff training, within six months of hire, or effective principles of evidenced-based practices for individuals with crimonegic risk factors,” the OHA said.

Other problems include OnTrack staff being asked by administrators to sign documents and back-date the signature.

According to the OHA, OnTrack didn't adequately coordinate its services with the criminal justice system.

OnTrack was operating two outpatient treatment programs in Ashland and in the Illinois Valley without notifying the OHA about their addresses.

“We did not think to add them to the application because they are embedded in other agencies/programs,” Tonia Moro, interim deputy director of OnTrack, wrote in her April 25 letter. OnTrack has since submitted the appropriate documentation listing the addresses to the state.

However, the OHA discovered that at many locations where OnTrack provided services, there were missing fire inspections and no current emergency policies and procedures posted.

The OHA insisted OnTrack make sure all its buildings complied with state and local regulations for plumbing, safety, zoning and other conditions. Some locations didn't have restrooms that were compliant with Americans with Disabilities Act requirements.

In Oregon, a first-time DUII offender who was not involved in an injury- or death-causing incident receives a one-year diversion program and must participate in 12 to 20 hours of alcohol and drug education.

According to Houston, OnTrack performed a urinary analysis at only the beginning and end of treatment during his time there.

He said OnTrack refused to conduct other tests even if clients were suspected of drinking or taking drugs.

"In spite of this unfortunate policy, I tested clients I knew to be using substances," Houston said. "I did so to see if they needed to have their level of care increased to get them the treatment they needed to be well."

Houston said he was often chastised for the expense of the additional urinalyses and for placing DUII clients in intensive outpatient groups.

Some clients had gone through OnTrack's DUII program seven or eight times, but still received only the minimal education course rather than a full treatment program, Houston said.

Houston said OnTrack’s program needs to pay more attention to the first DUII arrest because it indicates that someone may have a history of drinking and driving. It’s also the time to properly treat clients so they don’t receive another DUII, he said.

According to Mothers Against Drunk Driving, the average driver arrested for DUII has driven 80 times previously under the influence.

One-third of all drivers arrested or convicted of drunken driving are repeat offenders, according to MADD. 

Sandy Nelson, who retired from the Jackson County Sheriff’s Office and also retired from MADD, said the punishment for a DUII conviction is severe.

Insurance rates go up, a hefty fine is levied and many receive up to 36 hours of treatment, she said.

“Many people lose their job,” Nelson said. “Any driving professional will lose their jobs, and teachers will lose their careers.”

Nelson said she is not familiar with OnTrack’s screening program and how it determines the level of treatment for a particular client.

She said OnTrack has been a little less expensive than other DUII treatment programs in the area.

Nelson has seen people with multiple convictions of drunken driving.

One in Josephine County had received 22 convictions. “That’s unusual,” she said. “He didn’t care at that point.”

While Nelson's seen her share of repeat offenders, she's also seen the opposite.

“Many who saw those flashing lights, know they will never do it again,” she said.

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

State health authorities have found multiple violations of administrative rules at OnTrack's outpatient programs. Mail Tribune / Jamie Lusch