Former staff allege addiction treatment provider Care Crossings is breaking law, putting clients at risk

Former employees and clients of addiction treatment provider Care Crossings allege the business is breaking state law and committing ethical violations that put vulnerable Minnesotans in danger.

The accusations by former clinical and administrative staff include claims that the Oak Park Heights-based business admits as many people as possible without properly assessing their needs, has too few staff to provide adequate care, and doesn’t follow rules to help people safely move on from treatment.

“There needs to be some accountability in this field because there is so much going on. These bad actors need to be exposed,” said Jennifer Scouton, a former supervisor at Care Crossings. “These practices are so unethical, they are dishonest, they are so fraudulent, and they are bad for our clients.”

Officials at the Minnesota Department of Human Services said they have received complaints about Care Crossings and have launched an investigation into the program, but would not reveal additional details.

Former employees told the Minnesota Star Tribune that they asked state authorities to investigate Care Crossings, and said the vast majority of its clients’ treatment is paid for by the state-run Medicaid program. DHS data shows Care Crossings received more than $1.2 million in Medicaid reimbursements last year and more than $740,000 so far this year.

Allegations against Care Crossings come as Minnesota officials are bolstering regulatory measures for some substance use disorder treatment providers, and after investigators cracked down on other providers over billing and kickback concerns.

Care Crossings owner Cathy Harvieux said she is not committing fraud and the state is welcome to investigate. While she does things “out of the box,” she said her decades of experience have shaped a program that benefits the roughly 100 clients served.

However, former client Richard Bate said he and others felt the program’s operations were “all about the money.”

“You’re just a dollar sign,” he said. “You’re just a number.”

Minnesota requires alcohol and drug counselors to conduct a comprehensive assessment of a person’s substance use disorder and create an individual treatment plan for new clients shortly after they start services.

After that, experts say the client should meet regularly one-on-one with their counselor and attend group therapy sessions with no more than 15 other clients, allowing them to build trusting relationships with their counselor and connect with others who have similar experiences.

That’s not what happens at Care Crossings, said former staff who left or were fired from the organization over the past year.

From treatment plans to group therapy session notes to discharge documents, paperwork that should be personalized and done by licensed drug and alcohol counselors was instead generated by staff without proper qualifications so counselors could just sign off on them, said former Care Crossings counselor Samantha Bucholz-Anderson.

“We were there to facilitate groups so that they could bill, bill, bill, bill, bill,” she said of counselors.

State licensors found Care Crossings violated 15 treatment rules and statutes, including requirements on assessments, treatment plans and discharge summaries, during a review two years ago.

Care Crossings had a revolving door of staff who couldn’t properly handle the number of clients the company takes on, according to former employees. Counselors, some of whom had caseloads of dozens of people while also running group therapy sessions, said they were overburdened and weren’t always able to meet regularly with clients one-on-one as they should.

Bate, who lives in St. Cloud, started treatment at Care Crossings in January and said he had four counselors during his six months with the program.

“You are supposed to trust these people, be able to tell them anything, and then all of a sudden, boom, oh you got a new counselor,” he said.

He attended virtual group therapy and said some nights there were about 40 clients with one counselor in the session. He described those meetings as “chaos, people all trying to talk at once.”

“Nothing would get done besides check-ins,” he said, where people went around and said how things were going. “Where’s the treatment in there if everyone’s just telling you how they are doing?”

The federal Substance Abuse and Mental Health Services Administration says group therapy typically involves six to 12 clients who meet with one or two therapists and is supposed to help people with recovery strategies, interpersonal skills and developing support networks.

Many former Care Crossings staff who ran group sessions said there were often more than 30 clients participating, violating state law — and generating a lot of money for the business.

In an interview at the Care Crossings office near Stillwater, where inspirational quotes decorate white cinderblock walls, Harvieux said concerns are “coming from people who are inexperienced and have an educational knowledge base but not a practical knowledge base.”

Harvieux said she has been in the industry for four decades and started Care Crossings five years ago. The outpatient treatment and counseling service program has about 15 staff members, she said. Their treatment-to-work model helps clients gain independence and is different from many other programs, she said, noting it is more flexible, including allowing clients to decide how often they want to meet one-on-one with a counselor.

“People don’t understand you can deliver treatment in a way that is beneficial for clients, with a favorable outcome, and you can have 40 clients on your caseload and still deliver awesome treatment by the processes and systems that I’ve set up at Care Crossings because I have the years of knowledge and experience to do that,” Harvieux said.

She and lead counselor Kelly Ables disputed allegations that group therapy sessions have 30 or more clients per counselor. They said counselors are supposed to individualize treatment plans after there’s been an assessment and meeting with a client, and Harvieux said she doesn’t know why people weren’t doing that.

People have been attacking her business on Facebook and in client emails, she said, and she believes some are trying to take her clients.

Care Crossings has used similar practices to those that came under fire at other organizations, former staff said, including billing for four hours of treatment while providing three. Harvieux said that was only done briefly last year and stopped after Nuway Alliance got in trouble for the practice.

Like Nuway and many other Minnesota treatment providers, Care Crossings also has been helping pay to for housing for people who attend treatment at their business. Federal investigators have called that practice an illegal kickback and the state recently added an anti-kickback law.

Harvieux said the organization will stop paying for sober housing to comply with the new state law, which takes effect Aug. 1. She, like some others in the field, are worried the change will increase homelessness. She said they’re adding a part-time position to help people find work so they can afford housing.

Though Care Crossings touts its experienced staff, interns just starting in the field said they ran group therapy sessions and handled counseling for people in delicate situations without adequate supervision and support.

The Hazelden Betty Ford Graduate School, which trains addiction counselors, said it stopped placing interns at the provider in December but declined to comment.

“All the interns were basically running the show,” said Lisa Berger-Kahn, who was one of the Hazelden interns.

At one point, she said, she was running group sessions and managing 29 clients.

Marti Paulson, who runs Project Turnabout Addiction Recovery Centers and is president of the Minnesota Alliance of Rural Addiction Treatment Programs, said organizations should wait to give interns patients until they have been on the job for months and their caseloads should remain very small.

Many of the practices former staff at Care Crossings described raised major red flags for Paulson, who said she had never heard of the organization.

“This is not only fraud, it is absolutely a disgrace to health care. ... We are put in charge of these people, in charge of their lives, and we are disregarding that,” she asserted. “It’s going to hurt the field.”

When clients are discharged from a treatment program, state law says a counselor is supposed to write a summary within five days that includes details on client progress, reasons for terminating services and recommendations for continued care with referrals to other providers if needed.

Berger-Kahn and several other former staff at Care Crossings said that wasn’t the case for many clients.

Before people leave treatment, Paulson said, they should be set up with a sober living home, a peer recovery specialist, initial appointments — if needed — for mental health services and medication refills, and potentially connections to local recovery groups and a temporary sponsor.

She said it’s critical to ensure “you’re not scared to death walking out those doors with nowhere to turn — that’s relapse. And not only relapse, that’s overdose death."