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Do No Pharma

Former SRJC intern says local rehab didn't follow rules when it came to dispensing pills

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REHAB REFORM Mountain Vista Farm, a Glen Ellen rehab facility, says residents don't get medication without a prescription.
  • REHAB REFORM Mountain Vista Farm, a Glen Ellen rehab facility, says residents don't get medication without a prescription.

In late February, former Santa Rosa Junior College student Jane Moad lodged a series of complaints with the state and SRJC against the Mountain Vista Farm alcohol and drug rehabilitation center in Glen Ellen.

The complaints from Moad allege that the residential treatment center utilized college interns, herself included, to dispense medication to residents, something she says they were not legally authorized to do. She also alleges that medications were dispensed to residents who didn't have a prescription for them. Those medications, Moad says, included Valium.

Moad, 55, was an intern and then a per-diem counselor at the facility last year when she was instructed, she says, to dispense medications to residents. Moad says she dispensed the medications under protest until she was terminated on Feb. 2.

"My issue isn't that they have medication or that they dispense it," she says. "My issue is that there's no training. Within a month of working there, they had me giving out Valium."

Moad is no longer associated with the school or the rehab center, one of the nation's oldest. She's a recovering alcoholic and an attorney who says she went back to school after she "decided to use my time and energy to help people who have similar problems to me."

Moad's complaint, filed with the California Department of Health Care Services (DHCS) by Sonoma attorney Robert A. Edwards, alleged that there was a medical cart at Mountain Vista Farm that contained prescription drugs, and that residents without prescriptions for these drugs were able to access them.

"[P]rescription drugs such as diazepam and Suboxone are kept in a middle drawer of the cart, the property of no particular client but with past clients' names attached to prescription bottles," Moad alleged in her complaint. "[T]he facility felt it could dispense these 'leftover' medications to any and all clients as needed, even without a prescription."

Spokeswoman for DHCS Carol Sloan couldn't confirm or deny whether they had received Moad's complaint. Moad provided the Bohemian with a letter from the state dated March 5 that says they did.

Moad also filed her complaint with SRJC, which conducted an investigation of its own. The college clarified its protocols for interns following Moad's complaint, which she also sent to the Novato-based Accrediting Commission for Community and Junior Colleges (ACCJC).

That organization provides accreditation to schools like SRJC and is regulated by the U.S. Department of Education.

"Our role here is to nudge a resolution to this complaint," says ACCJC vice president Jack Ford.

Junior college spokeswoman Ellen Maremont Silver says resolution has occurred. The college offers internships throughout the area, she says, and even though the school's priority is to protect its interns, "it is not possible for us to do an extensive legal screening of every company and know every situation."

"Mountain Vista has since revised their polices," says Maremont Silver. "We've confirmed that they no longer request that any interns handle patient medications. We're comfortable with that. We also looked to see if we could do anything differently here. We reviewed how we were handling internships. We have very clear practices and procedures to protect students, faculty and staff."

The college has two interns serving at Mountain Vista this semester, she says. According to the new protocols, they "will not be permitted to dispense, administer or handle in any way patient prescription medication."

The college also pledged to include the relevant state laws that govern rehab centers into its curriculum, and relevant faculty at SRJC are now subjected to training on the state laws too.

Sloan, the DHCS spokeswoman, says that non-medical rehabilitation facilities such as Mountain Vista are subject to state licensing requirements, and that clients are permitted to see doctors and take prescribed medications. She drew a distinction between Mountain Vista and places like the Betty Ford Clinic, which is a licensed medical facility.

In an email, Sloan detailed the licensing requirements for places like Mountain Vista: "Medications at DHCS-licensed facilities are self-administered, must have the proper prescription label and must be prescribed to the person taking it. Facilities may store all resident medications, and facility staff members may assist with a resident's self-administration of medication."

Mountain Vista Farm's founder, Lee Hamilton, defended the practices at the facility, which has historically emphasized the 12-step, Alcoholics Anonymous approach to addiction. The center gets generally high marks for offering a comparatively affordable 30-day treatment in the neighborhood of $10,000, according to online resources that rate rehab clinics.

"This is a non-medical facility, and this state takes a lot of care to tell us what we can't do," says Hamilton. Mountain Vista is "set up for non-licensed people to do the oversight of the self-administration."

Hamilton says interns are not allowed to dispense medication, and that Moad was wearing two hats while engaged at the clinic—intern and then paid staffer. "It's not our problem if she was confused over the role she played," he says.

Hamilton stressed that medications are not being given to residents who don't have a prescription for them. "That is not happening at Mountain Vista Farm at this time" he says.

"If that was happening, the staff certainly had a big correction," adds Hamilton. "We're really clear with our staff that medications may not be borrowed."

The California Senate Office of Oversight and Outcomes in 2012 published a report called "Rogue Rehab" that was critical of DHCS for its regulation of residential rehab programs. The study was prompted in part by a series of 2008 deaths at a Riverside County facility, and linked at least one of them to a resident there who died after taking an unprescribed antidepressant. The report said this was not an isolated incident, and examined the "widespread flouting of the state's ban on medical care at residential drug and alcohol programs."

Sloan says that the "DHCS has taken several actions to address recommendations in the 'Rogue Rehab' report. DHCS implemented a new death investigation policy and procedure and also implemented a quality review process to ensure that red flags are detected during the application review process and during routine licensing. Currently, residential facilities licensed by DHCS are statutorily non-medical and medications are not allowed to be dispensed by staff."

Debriefer can be found online at Bohemian.com this week.

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