At These Rehabs, Patients Work To Pay For Care

Jun 3, 2019

When you work, you expect to get paid, right? But not for participants who work while getting sober at a type of substance abuse rehabilitation facility in North Carolina. These facilities are known as therapeutic communities. Shortly after patients arrive at these long term residential treatment facilities they start working at outside companies, and the money they earn goes directly to the rehab. The jobs involve long hours at unexpected places. In one case, moving the substance they are trying to avoid.

Nick Carlton went to FIRST at Blue Ridge five years ago at 18-years-old. He was arrested for selling drugs. Carlton went to FIRST Blue Ridge as part of a deal to get his charges dismissed. He was soon given a key assignment as part of his therapy: stacking boxes at the ABC liquor warehouse in Asheville.

“Seemed pretty dumb,” Carlton said. “Even though, yeah I was drinking, I never really enjoyed drinking so it wasn’t as difficult for me.”

But it was difficult for Justin. He went to FIRST at Blue Ridge around the same time. Justin, who agreed to talk if WFAE didn’t use his last name. He said he needed to stop drinking. Nonetheless, he was assigned to the ABC warehouse.

“One time, couple of cases broke and it was on the truck,” he said. “I had to take a breather, just getting back on and smelling all that liquor. Now, liquor wasn’t necessarily my thing, but still was just overwhelming.”

Pay for both Justin and Carlton went straight to FIRST Blue Ridge to pay for their treatment. Patients are also assigned jobs in kitchens, laundry facilities, even collecting trash for the nearby city of Montreat. They often change jobs. Both Carlton and Justin say they are sober today, but have mixed feelings about their time at FIRST at Blue Ridge. They got help, but they feel FIRST at Blue Ridge benefited from their labor.

WFAE spoke to 13 former patients who went to FIRST Blue Ridge in Ridgecrest and a nearby facility called Recovery Ventures. All told similar stories of not getting paid for working. However, patients at Recovery Ventures complained of 16 hour work days and questionable treatment. WFAE learned about these two facilities from the program Reveal at the Center for Investigative Reporting as part of a network of local journalists investigating work-based rehab programs across the country. There are five licensed therapeutic communities in North Carolina that serve up to 596 people. 

Joseph Martinez is the CEO of FIRST at Blue Ridge.

“It’s not a work-based program,” he said. “It’s an individual-based program that’s case management driven.”

Then why assign someone to work in a liquor warehouse if they’re seeking treatment for alcoholism?

“I always thought it was a little odd that they want our people but they said it's ok. We believe it's ok. The people that we send there, we’ve really never had any issues. And the folks that we send there... It's real simple, I’m moving a box of widgets. I don’t care what’s in it.”  

One of the big appeals for patients at FIRST at Blue Ridge is they don’t get a bill. Many patients don’t have insurance. How else are they going to get help? The idea of work also appeals to court systems that send people to therapeutic communities as part of pre-trial release or alternative sentencing programs.

But these work arrangements are new to attorney Michael Hancock. He was a senior official at the Department of Labor’s Wage and Hour Division, which investigates worker complaints. He’s now a private employment attorney in Washington D.C.

“In 20 years at Wage and Hour, I did not encounter residential treatment facilities that were essentially acting as temporary staffing agency,” he said. “Placing residents as a matter of routine with third party employers and retaining all their wages.”

According to reporting by Reveal from the Center for Investigative Reporting rehabs in Oklahoma, Texas and Louisiana have also put patients to work without pay.  

North Carolina regulations about these types of rehabs prohibits patients from getting income for their work, unless facilities get a waiver. But Hancock said that isn’t likely in line with federal labor laws. A 1985 Supreme Court case established working without pay even for a non-profit with a religious or rehabilitative purpose violates federal labor laws. 

Federal and state labor department spokespeople declined interviews. A federal labor department spokesperson said people can file a lawsuit if they believe their rights are violated.

The ABC board pays FIRST at Blue Ridge $9 an hour for each patient who works at the warehouse. Martinez, the CEO said most of its contracts are with private employers, so they are not publicly available. Martinez wouldn’t detail all of the companies he works with citing confidentiality.

He said it costs more than a million dollars a year to operate FIRST at Blue Ridge and pay the staff. The program reported a little more than $2 million in revenue on its 2016 tax form. The most recent year available. Martinez toys with the idea of running things differently.

“If we received funding we would look at the whole work thing differently,” he said.

But he added there’s a non-monetary value to the work. Some participants get to keep their pay. FIRST at Blue Ridge has contracts with the Department of Public Safety and Veterans Affairs. They fill about a third of FIRST at Blue Ridge’s 150 beds. Those agencies pay for services, so Martinez explains those patients keep their pay.

FIRST at Blue Ridge offers 12 step programs, and classes in anger management, coping skills and relationships. And Martinez says there are counselors for one-on-one treatment. But work often gets in the way, said Conor Fowler. He enrolled in FIRST at Blue Ridge in July 2018.

“If you weren’t going to be back in time because you were working, they didn’t really care. You know, it was always like, it’s your responsibility to make it to these classes.”

Fowler said he worked at the Biltmore. A Biltmore spokesperson wouldn’t confirm the relationship, but said it worked with various programs to help people re-enter the workforce.

Patients at Recovery Ventures tell similar stories. Its facility is in Swannanoa, a few miles away from FIRST at Blue Ridge in Ridgecrest. Tommy Parker says he was desperate for help when he went there in 2015. Parker says he was looking forward to working with a counselor.

“But there was no time for that because we were working all the time,” said Parker.

He said he worked in the kitchen at Ridgecrest, a Christian conference center, sometimes 16 hours a day.

“I washed so many pots and pans that I would dream about washing pots and pans,” said Parker. “I would wake up, like my arm would jerk, and I’d realize I was dreaming about washing dishes.”

Ridgecrest confirms it has a relationship with Recovery Ventures. A spokesperson says it pays the rehab an hourly rate for each patient who works, but declined to say how much. The most recent tax filings from 2017, show Recovery Ventures brought in $2.7 million and expenses were $2.3 million.

I wanted to ask staff at Recovery Ventures about this practice. But they canceled one in person interview and multiple follow up interview requests weren’t returned.

Parker ended up leaving the two-year program after three months. Parker says he continued using drugs, but eventually ended up at a different kind of rehab in Tennessee that helped him get sober.  

“I didn’t get sober with someone yelling at me while sitting in a chair in the middle of a room,” he said. “I think their mission was to break you down to subhuman level and then like try to build you back up in some way with structure.”

It’s not so easy for everyone to leave. Some are there as part of their probation or pre-trial conditions. That happened to Shawn Yarborough. He went to Recovery Ventures in 2017 but was kicked out after a few months for breaking program rules. He eventually ended up back in the Chatham County Jail where he spoke to WFAE from. He said he had trouble with the concept of ‘fight night’.

“I think the whole thing is like bull****,” he said. “Like a whole lot of weird stuff like if someone was there they wouldn’t be doing.”

Tomorrow, we’ll hear more about “fight night,” as well as a lawsuit alleging labor violations in which a former patient of Recovery Ventures talked about therapy practices. Also, how much does the state know about the work and therapy at these facilities?