Lives were at stake. Action was needed. Fast.
“(T)here is a critical need to protect victims who are currently being harmed by unscrupulous operators of illegitimate addiction treatment facilities and body brokers looking to profit from victims’ addiction,” Orange County CEO Frank Kim told county supervisors in October of 2018.
Predators prowled sober living homes and AA meetings, hunting for recovering users who’d agree to get unnecessary surgeries in exchange for money, Kim told the supervisors. “Many of these patients/victims were from out of state and developed serious side effects from the surgery upon returning home,” he wrote.
The proposed solution: A revolutionary “sober living registry,” requiring private addiction treatment providers in Orange County to come clean by publicly disclosing their money-making affiliates — sober living homes, blood- and urine-testing labs, pharmacies and the like. It was touted as a first-of-its kind bid to bring transparency to an industry rife with fraud and abuse.
If the state wouldn’t crack down, local leaders said, Orange County would. County supervisors — save one — embraced the idea. Hopes were high.
But today, more than three years later, the envisioned registry does not exist.
Information is power
The idea was that the registry would offer consumer-focused information, not medical advice.
“This is really designed just as a start, to have the addiction treatment places provide information on affiliated businesses, so if any conflicts of interest exist, that’s out there,” said Tracy Hughes, then the deputy district attorney who did much of the legwork on the new law, back in 2018.
“That’s the model skilled nursing facilities use. They have to declare businesses where they own a 5-percent-or-more stake. We’re trying to protect people by shedding a little more light.”
The registry also would make it easier for law enforcement and the District Attorney to pursue bad actors. Businesses that failed to register honestly and completely would face a misdemeanor carrying fines of up to $1,000 and jail time of up to six months.
“There is a critical need to protect victims,” Kim told the supervisors in 2018.
Yes, the state collected data on licensed facilities, but just the bare minimum — name, address, phone number and the like. But county officials thought it wasn’t enough. “When you take a look at what this ordinance does, it goes well beyond the state registry,” Supervisor Lisa Bartlett said at the time.
“It’s something that gives our law enforcement the ability to act, and for our DA to act, and get bad players out of this field. The existing state registry doesn’t go nearly far enough. It doesn’t connect those dots for us.”
Orange County’s groundbreaking sober living registry would empower officials to connect those dots.
“We need to act now,” Bartlett told her colleagues in 2018. “People’s lives are at risk.”
MIA
The problems deemed critical when Bartlett said that haven’t gone away.
In December of 2021, when officials from the Dept. of Justice announced criminal charges against 10 local rehab operators, they noted that Orange County has overtaken south Florida as the nation’s epicenter for rehab crime.
Many drug and alcohol rehabs in Orange County are still run by people with little or no medical background. Many patients and their insurance plans are still brokered to the highest bidder. Many investors still own invisible, interconnected webs of rehab centers, sober homes, pharmacies and testing centers that churn patients and insurance dollars with little regard for medical care.
Many rehab patients still die unnecessarily.
Three years after saying a registry was essential to addressing those problems, county officials now say they’re fulfilling the letter of the law by linking to state licensing data — the very data whose inadequacy spurred Orange County’s effort to begin with.
“Is that sufficient? Is that enough?” asked Pauline Colvin, spokeswoman for Bartlett. “Not in the supervisor’s opinion. She would like to have more done with the registry.”
Only one other supervisor on the board in late 2018 is still in office — Andrew Do. Michelle Steel is now a Congresswoman. Neither weighed in on the registry, and Supervisors Doug Chafee and Don Wagner did not return requests for comment.
However, Supervisor Katrina Foley — who recently was elected to the board, and who led Costa Mesa’s successful charge to regulate sober living homes while mayor of that city — said Orange County can do better.
“Improved coordination and transparency would help law enforcement and the Insurance Commissioner enforce the law against unscrupulous operators,” Foley said by email. “These objectives could be advanced through a revised county registry, a model city ordinance, or another policy initiative. All options are on the table.”
Kim, the county’s executive officer then and now, said that his office takes direction from the Board of Supervisors.
“At the present time we are reevaluating how to improve the integrity of the database so it is useful for its intended audience,” said spokeswoman Molly Nichelson by email.
The Southern California News Group asked about the status of the sober living registry for months. Officials did not respond.
After a public records request was filed in the summer seeking to understand the registry’s development, documents began dribbling out — but they were largely already-available public agenda reports, newsletters and SCNG’s own stories. Nothing shedding light on how the registry was to be built, or why officials decided to link to the state site after it was specifically determined to be inadequate, has yet surfaced.
County attorney Massoud Shamel said that the OC Health Care Agency produced the relevant documents it could find, but that privileged communication between attorney and client would not be released.
The District Attorney’s office — where the registry idea was born — said it had no responsive documents, officials said.
Politics may have a hand in how the registry unfolded. Or didn’t.
Battle
Back in 2018, Todd Spitzer and Tony Rackauckas were locked in an exceptionally bitter race for District Attorney.
Long-time D.A. Rackauckas proposed the registry to the Orange County Board of Supervisors just weeks before the November election. Spitzer was one of those supervisors.
“Talk about a hoax close to an election,” Spitzer said at the time. “There was only one reason to put that on the agenda and we all know what it is.”
Rackauckas denied any political motivation, saying his office has been working on the issue for more than a year. The actions came in the wake of the SCNG’s ongoing probe of fraud, sexual assault and death in the private addiction treatment industry.
The registry passed, over Spitzer’s objections. Rackauckas lost the D.A. race to Spitzer. It’s unclear how the registry proceeded after that.
Responsibility for it was unusual. The OC Health Care Agency would collect information, and the D.A.’s office would use that information to root out potential wrongdoing. Spitzer’s office said it had no records responsive to SCNG’s request about the registry, despite the fact that the D.A.’s office is where it began; and declined to provide comment or further detail for this story.
Rackauckas did not return requests for comment either.
A recent state law requires licensed or certified treatment centers to disclose some business relationships to state officials, but that information is not currently available to the public.
How can unseen affiliates and financial ties be deadly? Rose and Allen Nelson of Santa Monica know all too well.
Their son Brandon was 26 when he went to what was supposed to be a top-of-the-line Sovereign Health facility for a mental health crisis in 2018. But shortly after suffering a debilitating psychotic break, Brandon wound up in an unlicensed “sober living home mental health facility” run by Sovereign.
He didn’t get timely medications because his prescription went to a pharmacy owned by the CEO, rather than one that might fill it more swiftly.
Left to his own devices, Brandon Nelson used his sweatpants and the fire sprinkler on the ceiling to hang himself.
