BOYNTON BEACH, FL- Sunday, December 14, 2003
Reprint from the South Florida Sun Sentinel
By: Ted Jackson, Special Correspondent
Next month The Watershed Treatment Programs will break ground in Boynton Beach on a 120-bed addiction treatment facility. The center, which will employ 350 and is slated to eventually grow to more than 300 beds, is the beginning of a major expansion push by privately held Watershed. It also reflects the growing role of Palm Beach County as a major national center for the treatment of substance abuse. Palm Beach County is now on par with other well-known places, including the Minneapolis area, where the world famous Hazelden Foundation is based, and Palm Springs, Calif., home to the Betty Ford Clinic, according to Ron Hunsicker, president of the National Association of Addiction Treatment Providers. “It is a premier destination for addiction treatment,” he said. “Just as sunny Florida attracts tourists, private treatment providers have been able to exploit the desirable location as a means of attracting patients.”
The area’s reputation seems to be growing internationally as well. Fed up with his addiction to cocaine, 23-year-old Rory Harrison traveled from the United Kingdom to the Advanced Recovery Center in Delray Beach to seek recovery. “I was told this was a great place to go for someone in early recovery and that there were more support facilities here for recovering addicts than anywhere else,” said Harrison, whose family spent about $55,000 for his six-month treatment here.
But as Palm Beach County’s fame as a top addiction recovery center has grown, so too has opposition to the industry from county residents, bureaucrats and politicians, many of whom are uneasy about large numbers of alcoholics and addicts arriving in their communities. And treatment providers have had to navigate some rocky shoals to survive the sharp swings in fortune the industry has undergone during the past two decades. The rise of managed care has curtailed once-generous insurance policies for treating substance abuse, and several large treatment providers have fallen by the wayside.
Nevertheless, some providers, such as Delray Beach-based Watershed Treatment, are flourishing. Watershed also has a center in Texas under expansion and is scouting locations in the Chicago area and the Northeast, said Senior Vice President Chris Crosby. “We plan on eventually having about 9 or 10 facilities nationwide located in every major region of the country,” he said. Crosby helped found the company more than 20 years ago after he arrived in South Florida, himself a newly recovering alcoholic with a dream of helping other alcoholics while making a few bucks along the way.
Others had similar dreams. “There were a number of us, people in recovery, who were entrepreneurial,” Crosby said. “We wanted to build a business that helped people.” Now Palm Beach County has about 1,400 addiction treatment beds, about 550 of which are in private facilities, according to the Florida Department of Children and Family Services. And as treatment centers have expanded their presence, a burgeoning support industry has developed to service the growing recovery community, including halfway houses, sober living facilities and counseling services. “The growth in these types of post-treatment facilities and services has been especially dramatic,” said David McVinney, executive director of the Palm Beach Institute, the country’s oldest private treatment facility, founded in 1970.
Halfway house entrepreneur Steve Manko, whose BocaHouse and Awakenings facilities in Boca Raton have more than 500 beds, says there are more than 50 halfway houses and sober living facilities in Palm Beach County, many clustered in Boca Raton and Delray Beach. “The continued growth of our business is closely liked to the growth of treatment centers here,” Manko said. “It’s where we got a lot of our referrals.”
The addiction treatment industry has had a golden period in the 1980s, when dozens of treatment facilities sprang up in Palm Beach County to meet surging demand. Nationally, companies like Charter Behavioral Health Systems of Alpharetta, Ga., and Milwaukee based Compcare made big expansion plays, either through buying up smaller players of through the purchase of real estate for new centers, according to Hunsicker.
But with the advent of managed health care in the early 1990s, insurance providers and health maintenance organizations (HMOs) began to put pressure on prices and restrict access to care. The economics of medicine changed drastically. Insurance companies and HMOs have tried to rein in costs mainly by limiting access to addiction treatment. The typical stay at The Watershed is now just 21 days, compares with 90-day treatments that were sometimes offered prior to the 1990s. “Most of the local players didn’t survive the transition to managed care,” Crosby said.
Local facilities that didn’t make it in the new managed care environment include Boca Raton-based National Recovery Institute and Anon Anew, according to Crosby. And Charter is now out of business and Compcare no longer offers addiction treatment services.
Into the breach have stepped smaller private facilities and nonprofit foundations that have been better able to nimbly manage costs, as well as develop new treatment alternatives. “You have the re-emergence of a relatively fragmented industry across the country that again may be ripe for some consolidation,” Hunsicker said.
While the changing economics of medicine have roiled the treatment center industry, for halfway houses and sober living facilities a key obstacle has been opposition from residents and local politicians. Efforts to stifle the growth of sober living homes and halfway houses, mainly through a zoning ordinance in Boca Raton, have hit roadblocks. Not only do halfway house entrepreneurs continue to see demand for their services, but the Justice Department has questioned the legality of Boca Raton’s ordinance based on the American with Disabilities Act and the Fair Housing Act, both of which prohibit housing discrimination against the disabled.
Seeing that Boca Raton’s zoning ordinance was running into trouble, Delray Beach chose instead to work with the larger halfway house operators to establish higher operating standards, according to Delray Beach Commissioner Pat Archer, who also head the city’s Drug Task Force. “Some are excellent facilities, well run with standard practices and ethics,” she said. “But some are operated under the wire by unqualified entrepreneurs after a fast buck in a rising real estate market.” Halfway House operators say they should be allowed to expand because there is demand for their services. Manko, whose Boca House is one of the largest halfway house operations in the county, said his company just bought its 28th property in Boca Raton.
But while Manko says his 15-year-old business is quite profitable, not everyone is doing so well. Eight months ago, Gary Guzzo started Bridge Back to Life, a 30-bed sober house in downtown Delray Beach. He admits he’s struggling: “I’ve lost about $30,000 so far and it’s been a lot more work than I thought,” he said. Manko says the key to making money in the halfway house business is making sure residents have a safe environment to live in, so they can stay clean and sober. “If you’re doing your job by helping them stay clean, then there is less turnover in the beds, which provides for more stability of income,” he said.
Guzzo says local politicians should begin to understand the importance to the area economy of people in recovery. At the One Cup at a Time Café, in the Pineapple Grove retail district in downtown Delray Beach, Richard Joslin estimates that recovering people make up more than 70 percent of his clientele. That’s mainly because his café is geared toward the recovering community by selling supportive literature, T-shirts and bumper stickers. “One of the best things about catering to recovering people is that the business is not seasonal,” said Joslin. “It’s one of the reasons my business has been profitable from the start.”
The Watershed is consistently listed among the top alcohol drug addiction treatment providers nationally. The Watershed Addiction Treatment Programs, Inc. treats over 3000 patients from across the United States annually and is ranked as one of the largest private providers of addiction treatment in the United States. The Watershed is based in Delray Beach, Florida with facilities in Boynton Beach, Boca Raton and Lake Worth, Florida.