Moreau began calling other counselors, who eventually decided to meet and talk about the issue. "We said, 'This does not bode well,'" Moreau says. "What we became very keen to — and this is going to sound very crass — we understood very clearly that RMOMS was calling a price war on the provider community."
Less than a week later, 43 Front Range treatment providers met at Moreau's office in Cherry Creek. Competitors under normal circumstances, they realized they'd have to band together.
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And their concerns involved more than just pricing. People convicted of DUI often aren't allowed to drive or drink alcohol, and the providers worried that offenders who violated those rules wouldn't feel safe admitting it to RMOMS treatment providers. Maybe they'd gone to a summer barbecue with the intention of staying sober but hadn't been able to resist. Or maybe their ride to work fell through and they'd gotten behind the wheel. These are the types of things therapists need to know so that they can help clients identify triggers and challenges in order to overcome them, the providers say. But they're also the types of things that could get a client in trouble with his case manager.
"Clients say, 'I'm not going to talk about my personal life or open up when I might get put in jail,'" says Tammy Lovejoy-Teixeira, a counselor and owner of Horizon Counseling and Education Center in Lakewood.
The group christened itself the Treatment Providers Alliance of Colorado and made two important decisions: to hire an attorney to assist it in communicating with the Division of Behavioral Health, and to begin collecting what members called "critical incident reports," which they hoped would illustrate the burgeoning conflict of interest.
"We began to hear from our clients coming into our groups saying, 'I had the oddest meeting with my case manager, and I felt really anxious and afraid,'" Moreau says. "They would talk about being there and the case manager telling them what a no-good agency [my agency] was and how they really should come to RMOMS."
Beeck denies that RMOMS case managers ever said such things. In fact, he says, his company's treatment clients sign an agreement acknowledging that they weren't forced or coerced to enroll. "We give them the knowledge they need to have," he says, "which is, you can go anywhere, anytime you want."
But the group's reports, which it sent to the Division of Behavioral Health, say otherwise. One from June 2009 relays a client's experience with an RMOMS case manager after he signed up for counseling at a treatment provider in Aurora. That treatment provider reported that the client said his RMOMS case manager "was very upset that he had enrolled with us and told him that we were not the agency she wanted him to attend. She told him that he needed to transfer. He refused to do so and stated that he had the right to select which agency he would attend. She accused him of being disrespectful to her. She then proceeded, according to client report, to tell him that if he stayed in our agency, he would get nothing out of treatment."
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In June 2009, the Division of Behavioral Health hosted a regional meeting with substance-abuse treatment and probation providers. What was supposed to be a routine gathering turned into a referendum on RMOMS. At that point, the company had had its provisional treatment license for seven months while, in accordance with state rules, the division evaluated whether RMOMS should be granted a full one. Lea Blumer, now the director of treatment services at Beeck's 1st Alliance Treatment Services, says the meeting devolved into a "bashing session," and Beeck says his staff was "verbally abused."
Moreau remembers that most of the pointed questions were directed at the Division of Behavioral Health. How, the providers asked, could you grant RMOMS a treatment license when it presents such a clear conflict?
A Denver Post story about the meeting says that then-DBH director Janet Wood "expressed her own misgivings about the agency's decision, saying the temporary license had been approved by a staff member without enough discussion about its implications." Reporter David Olinger quoted Wood as saying, "I don't want to vilify one of my staff, who is very deeply troubled by putting the agency in this situation. We recognize there's a problem, and we're working on it."
On June 30, 2009, the division denied RMOMS a full license. A letter written by DBH staffer Marc Condojani, who is now director of community treatment and recovery programs, says RMOMS was guilty of several violations. Among them: It did not produce documentation showing that its staff was credentialed or had passed background checks, it did not select an approved curriculum for its treatment program, and it failed to document that it was screening clients for HIV and infectious disease, as required by state rules. Nor, Condojani noted, was RMOMS properly creating individual treatment plans for clients or keeping acceptable treatment notes.
However, the biggest problem, Condojani wrote, was that RMOMS was "exercising undue influence" over clients, which is against Division of Behavioral Health rules. "By obtaining a license to provide treatment services in addition to probation supervision, RMOMS maintains a dual relationship with clients...thus creating an inherent conflict," he wrote. He cited "numerous complaints" to the division "related to recruiting clients for treatment away from other programs, intimidation of clients, delays in clients receiving services, and abuse and mismanagement of clients."
