Providers call for investigation of referral process they consider unfair

By Charles Hallman
Staff Writer


Hennepin County residents seeking chemical health assistance are offered “culturally competent and specific” programs to meet their needs, according to County officials. But providers of culturally specific services claim that is not what’s happening.

The Minnesota Department of Human Services defines a culturally specific program as one that (a) “address[es] the unique needs of individuals who share a common language, racial, ethnic, or social background; (b) is governed with significant input from individuals of that specific background; and (c) that employs individuals to provide individual or group therapy, at least 50 percent of whom are of that specific background.”

Rex Holzemer Photo courtesy of Hennepin  County Public Affairs
Rex Holzemer
Photo courtesy of Hennepin
County Public Affairs

However, an owner-operator of a local Black culturally specific chemical dependency treatment program claims that culturally specific organizations, including his own, are not getting their “fair share” of County referrals.

“The majority of our clients are African Americans,” says John Woods of New Perspectives Behavioral Health System (NPBHS). He also points out that his organization received less than 100 of over 4,000 total cases reviewed and assigned in 2012 and 2013. He explains that the Hennepin County Chemical Health Review Team, a group of five counselors and a supervisor, makes the determination

A Hennepin County top administrator points out that the review team includes no person of color.

Assistant Human Services Administrator Rex Holzemer told the MSR that if an individual wants a culturally specific program, their requests are met. “Culturally specific is a question that any good assessor is going to ask the person when they do the assessment,” he explains. “Most assessors in most situations are going to find that whatever treatment program they are working for probably is going to be sufficient to fit the needs of the individual. We accept those recommendations as they have been made by…the assessor.”

John Woods  Photo by Brandon Jones
John Woods
Photo by Brandon Jones

NPBHS assesses the individual in need of service, who may also indicate that they want “culturally specific” treatment for their problem: “We do the paperwork, then we send it down to the review team,” explains Woods. “The review team doesn’t see the client [but] makes the decision on where that client goes.”

However, Woods says only eight cases in 2012 and nine last year “were direct referrals from Hennepin County.” Other Black culturally specific programs are seeing similar declines in County-approved referrals during this time.

“These numbers seem extremely disproportionate,” Woods wrote in a March 12 letter addressed to County officials. He says that one White organization in 2012 received 245 of 618 County-approved cases in which Blacks requested a culturally specific program.

The state’s definition of culturally specific is “[too] general” and might be too vague, surmises NPBHS counselor Tasslean Parker.

“No one particular program should have a monopoly…and Blacks are getting shut out, one by one,” says Woods. He told the MSR last week that a meeting is being set up between him and Hennepin County officials to discuss his concerns. One County-referred case to NPBHS can be worth an estimated $6,000, says Woods. “We deal with African Americans, but [even] when they refer White clients, the numbers still are disapportionate.

“Millions of dollars are being derailed” by Hennepin County not directing more cases to Black-owned chemical treatment programs like his, says Woods. “Everybody is getting rich, and I am just asking that we and other [Black organizations] get our fair share.

“This isn’t about a personal thing but a business thing,” he reiterates. “All we are asking is our fair share, because the system has got to change in some way or justify why the system ought not to change.”

“We are struggling to get people in the door, and we are seeing some of these larger organizations that are predominately White-run organizations are busting at the seams with people of color receiving services from them,” concurs African American Family Services head Thomas Adams in supporting Woods’ contention. “It doesn’t matter who’s on the [review] team,” he says. “We know systems can be biased.” He adds that he would like to see an annual report from the County to show how cases are distributed and their success rates.

Holzemer, however, points out that “data related to treatment outcomes is maintained and published annually by the State Department of Human Services.” The most recent data the MSR was able to obtain was from the calendar year 2012.

Blacks should always get their first preference when they seek help, says Parker.  “There are African American treatment [programs] specifically. It’s available to them, but they are not being told [by the County],” she believes. “They must be made aware of that. Then, if they choose not to, that’s a different story.

“That’s one of the things we want from the County. The [review] team is supposed to be deciding where people are supposed to go according to their needs. We want to know why [other programs] get preference over us,” says Parker.

“We are transparent with the community and providers regarding where referrals are made and respond to any inquiry with as much information as we track at the County level related to referrals, denials and changes,” says Holzemer.

“I want to see this matter investigated,” concludes Woods. “I believe that this is a real devastating impact on the Black programs. We are not able to compete — not that we are not qualified, but we are not given our fair share.

“I am willing to go to any lengths to make sure that this situation be addressed.”


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3 Comments on “Providers call for investigation of referral process they consider unfair”

  1. After reading this article it disturbs me to find that if true this kind of practice still exist in the year 2014. I applaud Mr. Woods for his courageous stance and opening up the eyes of people that were unaware. I sincerely hope that there is no retaliation but reconciliation and fairness with the powers that be.

  2. Brother John, I’m so proud of you for stepping up to the plate and exposing the unfair practices that exist in Hennepin County as well as other counties. I pray this is beganning to the end of steering and monopolizing county funding.

  3. The amount of information within this article is only enough, really, to propose that unfair referral practices exist, and by no means is it anything definitive. There is distance between possible and probable, especially in the world of chemical dependency treatment. After five years researching the state system, and having gone through it myself, it is very important to look at the myriad factors that go into a client’s treatment plan. Through decade-old political actions we are now in a world of out-patient treatment plans (not the traditional in-patient) where clients need easier daily access to their facilities. If a client needs to travel 12 miles round-trip everyday, instead of maybe 4 or five, the likelihood of their success is inhibited. Facility location is one thing, its success rate is another. These are both considered in the placement process, along with a multitude of other factors, including client wishes (especially important). I’m not going to say institutional racism doesn’t exist, but it’s going to take more than what this article exhibits as proof that it does. The state DHS website has all the information you might want to download for years 2007-2012. It’s a LOT of data, and it paints a more detailed picture. For instance, there were more than 50,000 treatment admissions in 2012. If the Consolidated Chemical Dependency Treatment Fund accounts for half of these (the other half being private funds/insurance), and half of all admissions happen in Hennepin County, that means there were at least three times as many overall admissions than just the 4000 stated in this article as coming from the county review board. In fact, the average person would assume from this article that the only treatment that happens comes from the county review board. That’s certainly not the case. In fact, I myself, as a white male, graduated treatment at a black-owned and focused facility in south Minneapolis – and it was a great experience.

    So, lets’ look at the effectiveness of the facilities mentioned in this article. Could it be that a lower completion rate (and other measures of client improvement) than that of other facilities be more a deciding factor in client placement than skin color? Could it be that the facilities are further from where the client lives than others? Could it be that a client chose not to go to these specific facilities (they do have that option)? Before a more definitive declaration of racism in placement practices can be made, there is so much more that needs to be eliminated. If it can be proven that clients are A) not told about culturally-specific programs (many facilities offer these programs, regardless of the color of the owner), B) denied the opportunity despite their wishes, C) placed inconveniently (as in distance traveled) despite a more accessible facility, D) placed where their chemical dependency (and perhaps mental illness) is not most effectively treated, and/or E) the county is not reimbursing a given facility for the services already rendered (which would be highly illegal), then there is a much stronger foundation for claiming institutional racism. All else being equal, it wouldn’t be this hard, but we all know darn well that most things are not equal. I wish you the most sincere luck in researching these factors. There is a lot of work to be done in making sure that all of our brothers and sisters suffering from addiction can find resolution. Since 2007, the state has been failing, and we are now back to levels a decade old. Time to turn it around.

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