Letter to Ameythyst about the sorry job
they did for my son. I've heard plenty of scare stories about how these
jerks say they treat people but when the insurance money runs out.they
let them go!! We need a better system!!! What we have now is not working
well enough. BTW..I never received a response from them..nothing!! What
-This place is closing February 2000. see
Dan Harrison, Administrator
August 2, 1997
PO Box 35082
Charlotte, NC 28235-5082
Dear Mr Harrison:
On July 1, I came to Amethyst with my 19 year-old son Thomas
for a “free” assessment of his substance abuse difficulties. Pauline Lockrow
was the interviewer and after a 1 hour or so private meeting with Tommy,
she was very emphatic that he needed to be admitted as he was suffering
from a life-threatening narcotics habit that required a medical detoxification
program and intensive care to learn how to overcome this disease.
She sighted a seizure he had at 16 and urged that he be treated NOW.
However, there was the major concern of finding an affordable
facility able to admit him. He does have insurance thru his employer but
it is limited to $5,000 for illnesses of this kind. After your staff’s
initial contact with the insurance carrier(ACS in Winston-Salem) it was
determined that he was eligible for treatment at Amethyst which Tommy agreed
About 15 minutes into processing Tommy for admittance,
a supervisor who’s name I don’t remember, informed me that there was a
mistake and that a second call to his insurance carrier revealed that it
would not cover him because Amethyst is not a Medicare certified
facility. I offered to pay the fee out of my pocket and petition the insurance
company later to reverse its decision, however she encouraged me to take
Tommy elsewhere but offered no alternatives. She explained that a detox
program is ineffective without intensive follow-up care and that some places
do not accept patients for after-care if they didn’t do the detox at the
same facility. She did however offer to negotiate a reduced up-front fee
from $3,000 to $1,800 that was required to admit him for detox. By this
time, Tommy and I were going thru a emotional roller coaster:
Being upset with all this and very concerned about my son, I gave the lady
my credit card and asked her to admit him. I had been convinced by your
firm that my son needed treatment NOW and that we were at a qualified place
to get it done. I also felt confident that being the President of the company
where Tommy works that I could influence ACS to change their classification
so that Amethyst would qualify.
First, learning how urgent it was to get him admitted
Then learning that he could be admitted to Amethyst even though only
$5,000 in insurance was available
Then that there was a mistake and that he can’t be admitted due to insurance
However with a reduced up-front fee- he could be admitted.
Several times over the next few days I contacted Nancy
Langy(sp?) who I believe was the case worker there. I asked her about Tommy’s
progress and the availability of effective aftercare. She was quite helpful
and commented that she would refer him to Tri-County in Salisbury for treatment
on Monday the 7th. I told her that Tri-county was on the verge of dissolution
and I was concerned about their effectiveness in providing intensive care.
I also told her that Tommy’s insurance company reversed itself and that
paying for intensive aftercare was a possibility. She was surprised but
told me to contact Kathy Womble about reapplying for insurance which I
did. In any event, my conversation with Nancy lead me to believe that due
to the severity of withdrawal associated with the type of drugs Tommy was
using, he would not be released until Monday July 6th and at that
time we would talk about effective alternate after-care.
Unfortunately your company released him a day earlier
on Sunday with a referral given to him to Tri-County. He only made it to
Tri-county for the initial meeting and never attended the 3 hour daily
meetings that was considered sufficient to arrest his addiction. By Tuesday
and for every day following for the next three weeks, he was back using
stronger and more frequent amounts of narcotics while stealing and pawning
more stuff to support his habit than he was before he visited Amethyst.
On July 22, 1997, Tommy was admitted to Mercy Hospital for a
second medical detoxification. They had been highly recommended by two
different after-care facilities-McLeod and Hope Valley. I also learned
that Amethyst had previously referred some of their de-tox patients to
both of these facilities. This made me wonder why in god’s name you
all didn’t do that in the first place. I had informed your people about
Tri-county’s difficulties and that he now had insurance-two key pieces
of information that should have made a big difference in who your company
referred my son to. Why wasn’t I informed about these affordable alternatives
of McLeod and Hope Valley? With Hope Valley in particular, Tommy
could have gone straight from Amethyst into their program and only exceed
his insurance limits by $1,500 which I could have made up for him. Now
his insurance is used up because his first detox with your firm cost so
much and actually did more harm than good. I realize that it was July 4th
weekend and the initial confusion about insurance was a problem, but there
still is a question of ethics here and whether there was ever an intention
to find the right level of care for my son or just to take advantage of
his insurance policy.
Tommy is now in Hope Valley after spending 6 days
at Mercy Horizons center. We are praying that he will be receptive to and
receive adequate care that will help him resist substance abuse for the
rest of his life.
As for your firm, you folks have a lot of room for improvement.
At a very minimum, your firm must reassess your admittance policy. The
powerful emotions that are aroused when your “free assessment” indicates
urgent action is needed must be tied to the availability of care that stands
a reasonable chance of successfully treating the patient. Why entice someone
in the front door with “free assessments,” urge immediate action for treatment
and then if insurance is not available, tell them to leave or give them
the option to pay a reduced up-front fee for limited treatment? Anyone
experienced with the type of substance abuse Tommy was in knows it won’t
work. Why not say “We need to check your insurance to see if we can afford
to treat your son to our standards if indeed our interviewer recommends
urgent action. We don’t want to end up recommending a program that will
only treat him half-way as a narcotic addiction requires far more than
just a few days of detoxification. In the mean time, here is a list
of alternate facilities that are available.” Then as in Tommy’s case,
it comes back that no, your insurance doesn’t recognize Amethyst because
it’s not a Medicare certified facility, we could go to another facility
and not be out $3,455.
The other major improvement that your firm needs to address
is your discharge procedure. It seems to me that there ought to be an exit
interview with the staff person assigned to the patient and the family
member that admitted him. How can you spend 2 hours in an initial interview
where urgent care is recommended and not spend at least ½
hour for an exit interview? I was given a 5 page family profile
to fill out and expected to at least be contacted by one of your staff
but wasn’t. In addition, wrongful assumptions outlined above could have
been clarified which almost assuredly would have lead to a decision to
admit Tommy to a 28 day program.
Finally, we still owe $1,655.60 on your bill after having paid
$1,800 up-front. I am going to urge the insurance company not to pay the
balance as I believe your company failed to adequately treat my son and
harmed him by reducing the amount of insurance available for intensive
aftercare. I might also contact a lawyer to see about recouping the up-front
fee. I don’t want to be completely negative here so one bright side about
his visit to Amethyst is that he had a one week break from substance abuse
and he spoke highly of your medical staff.
In conclusion, I hope you will take these comments seriously
as I can assure you that these faults I’ve outlined are very real. It may
be too late to help my son, but it’s not too late for others who are substance
abusers who get lost in the shuffle at Amethyst over a holiday weekend
or any other time for that matter. I trust you will review your procedures
as they are truly inadequate. If you have any comments or wish to contact
me, I can be reached at 1-704-279-5526 during the day or at 1-704-633-3543
in the evenings.
PO Box 958
Granite Quarry, NC
CC: ACS consulting
Senator Betsey Cochrane
NC Dept of Justice-Consumer Protection
NC Public Health Association
Carolinas HealthCare will close Amethyst
By KAREN GARLOCH
After more than seven years of operating in the red, Amethyst, a 24-bed
substance abuse treatment center in southeast Charlotte, will close at
the end of February.
The Willows, a four-year-old sister facility next door, also will close.
has 52 beds for adolescents with substance abuse problems and
The owner, Carolinas HealthCare System, plans to sell the buildings on
Sharon Road West and transfer patients to other sites, including
CMC-Randolph, the former Center for Mental Health, on Billingsley
The two facilities have more than 125 counselors, nurses, aides and
clerical workers. Some will move to other jobs in the hospital system,
spokesman Scott White said.
The closing, which will save the hospital system $3million a year, is
prompted by changes in the way substance abuse treatment is
financed, White said.
"When that facility was built, the 28-day inpatient treatment model was
the norm," he said. "You rarely find that today. The payers are not
willing to reimburse for 28-day treatment when they see intensive
outpatient treatment as being very effective."
Most patients at the two centers are outpatients, White said.
The number of inpatients has been declining steadily; those remaining
are in detoxification, which takes about a week. Detox patients will be
referred to centers at Mercy Hospital, Union Regional Medical Center
and Kings Mountain Hospital, all owned or managed by Carolinas
The hospital system took over several million dollars in debt when it
merged with Amethyst in January 1993.
In the mid-1980s, the private board of Amethyst (then known as the
Charlotte Treatment Center) undertook a $12million building program
on the assumption that insurance companies would continue to
reimburse for inpatient care. That changed in the late 1980s as
employers and insurance companies tried to curb the rising cost of
And that's when the Amethyst board went looking for a partner.
Steve Newman, a Mecklenburg County Health Department official and
former director of the county's substance abuse services, said the
closing is not good for Mecklenburg County.
"We're not a community that has so many substance abuse beds that
we can afford to give them up," he said.
But he acknowledged that "it's very difficult to get residential treatment
approved for third-party payment."