Addiction clinic Crossroads has past problems with state

Crossroads of Delaware, the adolescent addiction clinic, had problems with Delaware state officials before a recent controversy over a counselor’s arrest for raping an underage patient.

State regulators were critical of the company’s performance years before its owner, the former Delaware lawmaker Michael Barbieri, was hired without a competitive process this summer to lead the state’s Division of Substance Abuse and Mental Health, a $144,000-a-year job on the front lines of Delaware’s addiction crisis.

In July 2011, a Delaware monitoring report noted a long string of problems at Crossroads, including improper documentation of a rape allegation, a failure to individualize treatment plans for adolescents facing substance abuse issues, and problems with sending sensitive client information over unsecured emails.

A panel reviewing Crossroads’ proposal for Delaware contract work in 2012 said the company had a “long history of struggling with quality and administrative issues and meeting the goals of corrective action and program improvement plans.”

Crossroads consistently ranked lower than other clinics seeking state business.

Despite that record, Barbieri, an influential lawmaker who chaired the Health Committee of the Delaware House of Representatives while working as a state contractor, increased Crossroads’ state business 57 percent from 2011 to 2015 – from about $680,000 to $1.07 million this year.

Another Delaware substance abuse contractor, Aquila of Delaware, which ranked higher than Crossroads in the 2012 procurement review, saw its payments fall over that time period.

Barbieri and state officials agree that increase was partly driven by Crossroads’ expansion into Kent County. “Those areas were underserved,” said Steve Yeatman, chief policy adviser at the Delaware Department of Services for Children, Youth and Their Families (DSCYF).

Barbieri now works for the Delaware Department of Health and Social Services, which operates separately from the DSCYF, which contracts with Crossroads.

The former lawmaker disputes he has a poor record with the state. He pointed to a March 2015 review that shows Crossroads improved its level of compliance as a state contractor. Barbieri also said Crossroads built its business with credibility in the communities it serves – not merely through state referrals of patients.

“Our market drove our revenue, not the state,” Barbieri said. “I don’t think they have given me anything, to tell the truth. I think we have had to argue, fight and push to get what we get. That’s not wrong. If we agree all the time, I think something’s not right. I hope our providers in the adult system fight with me.”

But his history as a state contractor and legislator has some questioning whether Barbieri was able to use his influence as a political insider to advance his business and personal interest.

“There is a clear appearance of impropriety here,” said John Flaherty, president of the Delaware Coalition for Open Government. “Having a legislator owning a company that’s generating all kinds of appropriations doesn’t look good.”

Flaherty also questioned Barbieri’s hiring into his new state job. “You shouldn't use your legislative position to slide into a job in the public sector,” he said.

Some of Barbieri’s former colleagues in the Delaware House of Representatives also are questioning the lawmaker’s record. Rep. John Kowalko, a Newark Democrat, called Barbieri’s contracts and his company’s relationship with state officials a “serious cause for concern.”

“I do have concerns about any process where a legislator has a state-funded operation that they either own or have a significant interest in,” Kowalko said. “I have a concern on behalf of my taxpayers, and about the appearance of a serious conflict of interest.”

Last Tuesday, six Republicans who served under Barbieri on the House Health Committee sent a letter to Gov. Jack Markell, saying they did not know he had a health-related contracting business with the state, and the Republicans questioned that arrangement.

The six Republicans said they learned of Barbieri’s state contracting business from reading The News Journal.

Barbieri has reported his ownership of Crossroads on annual financial filings with the Delaware ethics office, the Public Integrity Commission. But the lawmakers expressed concerns he wasn’t transparent enough during legislative discussions.

“Until today, none of us was aware of this state contract or his ownership of Crossroads. This raises serious concerns about proper disclosures during the deliberations of our committee on legislation that did or could have directly affected the nature of his contract with the state,” said the letter, which was signed Tuesday by Republican Reps. Joe Miro, Mike Ramone, Ruth Briggs King, Timothy Dukes, Kevin Hensley and Lyndon Yearick.

Documentation not reviewed before hire

Crossroads came under significant scrutiny this month after one of its counselors was arrested, accused of raping a 16-year-old patient. Counselor Rebecca Adams, 30, is the daughter of Alberta Crowley, Barbieri’s longtime business partner and president of Crossroads, who said Saturday she had completed her purchase of the firm. Adams faces 12 counts of fourth-degree rape.

Crossroads’ contract is under internal review at the Delaware Department of Services for Children Youth and Their Families. Adams, meanwhile, remains on home confinement awaiting a court hearing. She is accused of having an illegal sexual relationship with the patient from June through August of this year.

Adams’ case is separate from the rape allegation mentioned in the July 2011 monitoring report, prepared by DSCYF. That report says a client of Crossroads made the allegation against another peer in the program, but Crossroads provided “no documentation of proper follow up, support, or intervention provided to the client.”

“No incident report was completed,” according to the audit.

The incident stems from a documentation issue, Crowley said. But the allegation was reported to police – and the client had access to counseling services, she said.

“We did some retraining after this and had our clinical supervisor continue to work with therapists regarding documentation,” Crowley said.

Rita Landgraf, the secretary of the Department of Health and Social Services, who hired Barbieri this summer, acknowledges that she interviewed no one else for the substance abuse job, and accepted no applications. Nor did she consult with the Department of Services for Children Youth and Their Families, where Barbieri was a contractor, before his hiring.

Landgraf also did not review documentation of his time as a state contractor, which would have shown that his company ranked last among contractors seeking adolescent substance abuse treatment business in 2012.

“I did not review documents. I don’t review documents,” said Landgraf, who made the appointment under her executive authority. “In any industry you are going to sometimes have competency issues.”

In an interview with The News Journal, Landgraf passionately defended her hiring of the former lawmaker, saying he was not given preference for political reasons.

“I have 16 months left to combat an addiction epidemic. That’s what I’m working on,” Landgraf said. “All hands on deck. If people want to help me with that, help me. If people want to be critical of that, shame on you. I hired a highly qualified individual.”

Susan Cycyk, director of the Division of Prevention and Behavioral Health, the section of DSCYF that oversees Crossroads’ contract, said she would not characterize the department’s relationship with Crossroads as good or bad. Cycyk said, “It’s true [Crossroads] was ranked lower than” other bidders on state work.

“But they weren’t disqualified,” Cycyk said. And the clinic's ability for providing “intensive outpatient” services led to increased billings to the state.

In an interview with The News Journal, Barbieri rejected claims that he used political influence to either increase his business as a state contractor or obtain his division director job.

Barbieri and Crowley admit to longstanding disagreements with DSCYF over treatment for adolescent patients facing substance abuse problems, especially clients in Wilmington.

Crowley contends that the state’s suspension of referrals is not directly related to the arrest of her daughter, but retaliation for her well-known criticism of the department.

“I believe this is motivated by ‘opportunity’ given my longstanding, vocal complaint about their refusal to provide appropriate services to the quite disenfranchised population we deal with,” Crowley said. “My concerns have been well documented along with the obvious history of retaliatory behavior by DSCYF.”

Crowley provided dozens of emails between herself and officials at DSCYF that document a poor relationship between Crossroads and officials at their contracting state agency dating to 2011. In an email this January, Crowley accused top department officials of attempting to steer business away from Crossroads during discussions with a patient’s family.

“Going to the client’s home and reiterating the misinformation to the family does not make it any more true; in fact it shows the intent is to move a client away from Crossroads regardless of the fact that mother and child are requesting Crossroads,” Crowley wrote.

In May 2014, Crowley expressed frustration that DSCYF was denying payment for substance abuse clients who need treatment.

“So, is the new approach going to be to just deny deeper end services to everyone? Because, I could be saved a good bit of time and hassle by not even referring them,” Crowley wrote in a message to Yeatman.

Crowley took her concerns to Gov. Jack Markell and lawmakers, saying that DSCYF was unjustly denying services for adolescents with a serious need for substance abuse services. In an email also signed by Dr. Mandell Much, director of clinical services for Aquila of Delaware, Crowley said that the Division of Prevention and Behavior Health Services “has become the sole barrier to treatment access for Delaware youth.”

Officials at DSCYF refuted Crowley’s claims, saying its suspension of referrals comes amid a criminal investigation and has nothing to do with prior disagreements over Crowley’s criticism of the department.

“It's our responsibility to hold our providers accountable to assure that our children achieve quality services,” said Cycyk, director of the Division of Prevention and Behavioral Health Services. “That's our job.”

“Our job all the time, regardless of whether there's a criminal investigation, is hold our providers accountable and work along with them to assure quality services for our children,” Cycyk said. “We have a serious event that has occurred at this particular provider's location and we want to do a full contract compliance review.”

‘Client focused and client centered’

Barbieri, 66, has a wealth of experience in the substance abuse field, two decades experience as a state contractor and staunch defenders in his professional community. He has worked in counseling since 1972, when he worked inside the Philadelphia court system.

In 1977, he was hired as executive director of a youth counseling center in Reading, Pennsylvania, and later served as program manager of addiction services for the Valley Force Medical Center in Norristown, Pennsylvania.

Before founding Crossroads in 1991, Barbieri worked in Washington, D.C., as vice president of operations for Recovery Centers of America. He has run Crossroads as the company’s president, chief executive officer and sole owner since June 1991.

Crossroads is one of several treatment centers contracting with the Department of Services for Children Youth and their Families to provide partial day and full-day treatment and counseling services for adolescents facing substance abuse problems, some of them addicted to heroin.

“Mike has devoted his entire life to this kind of work,” said David Humes, a director of Attack Addiction who lost his son, Greg, to a heroin overdose in 2012. “People like him are the guys who are really the impressive ones, to make a career out of doing things to help other people.”

Carla Markell, the wife of the governor, consulted with Barbieri among others during a review of Delaware’s substance abuse treatment services last year. She called Barbieri “highly qualified” for the Delaware substance abuse position, “in terms of his knowledge and wherewithal.”

Lynn Fahey, chief executive of Brandywine Counseling and Community Services, a competitor of Crossroads, said she is optimistic about Barbieri leading Delaware’s substance abuse division. “The things that I’ve always heard about Mike is really that he was always very concerned about compliance and the quality of care. He was always very client-focused and client-centered,” Fahey said. “I’m more in a wait-and-see pattern.”

Landgraf said Barbieri’s knowledge of the political system also will help him make positive changes with just months left in Markell’s tenure as governor, which ends in January 2017.

Likewise, Barbieri said his hiring was not political, and should not be viewed as a former lawmaker capitalizing on his influence in the political system. The former lawmaker said he doesn’t need the money, and took the substance abuse division director job to help steer policy around Delaware’s addiction crisis.

“I’m too old to be dealing with this crap,” Barbieri said. “Bottom line. I should be retiring. I’m doing this because I believe in it. Whether you believe it or not, it doesn’t really present a tremendous financial gain on my part. I’m doing it because it’s an exciting opportunity.”

Barbieri believes “personality” differences may have led to Crossroads’ poor record in the 2012 bidding process.

“Personalities sometimes do influence narrative,” Barbieri said. “We identified some of these things and took more aggressive action to respond to that. You saw what happened in the most recent report. It was much better.”

Contact Jonathan Starkey at (302) 983-6756, on Twitter @jwstarkey or at jstarkey@delawareonline.com.