Methadone Meltdown

Dr. Amos and Cecilia Ozumba ran Houston Maintenance Clinic for four years. Have they finally run it into the ground?

There's not much seedier than the sight of the sun rising on a methadone clinic's early-morning trade. Everything about the scene screams shame, from the darkened predawn opening hours to the shaded, lifeless windows to the absence of identifying signage on the dingy, partly vacant brick building that anchors Houston Maintenance Clinic to an aggressively unrevitalized stretch of Main Street. Solitary clients trickle through the plate-glass entrance door and then re-emerge, a few minutes later, with suspicious glances up and down the street before ducking into waiting cars or shuffling off down the sidewalk.

Methadone patients generally don't like to advertise their status, because methadone's inevitable implication is heroin. People on methadone are usually trying, with or without success, to stay off heroin, to maintain jobs and families and lives, and to eventually get clean. And while there are good arguments to be made for heroin addiction's status as a disease, the daylight world perceives it as a lifestyle choice. A poor one. As far as Main Street's passing traffic is concerned, a methadone patient is just a junkie, and nobody much wants to be seen strolling into the junkie shop in broad daylight.

The double whammy of addiction and shame, experienced as need and fear, tends to make methadone patients doubly powerless. They are easily manipulated by the fear of having treatment withheld, and they are rarely in any position to complain.

Methadone, being itself addictive, is a tightly regulated medication subject to state and federal oversight, with scattered local providers such as Houston Maintenance Clinic contracted to serve as faucets through which the medicine flows, with little fanfare, to those who need it. But on a gray, anonymous morning in February, with clients and clinic employees arriving before daylight to conduct their quiet business, three agents of the Texas Commission on Alcohol and Drug Abuse (the state agency that distributes and regulates funding for the nonprofit clinics serving the poorest methadone clients), along with a representative of the Texas Department of Health (which licenses methadone providers), converged on Houston Maintenance Clinic to turn off the faucet.

For many former HMC patients and employees -- most now moved on to other clinics and other jobs, and thus no longer bound to silence by fear -- the only real question raised by TCADA's termination of HMC's contract is this: Why did it take so long?

In 1997, the inaugural year of TCADA's contract with HMC, the clinic received $386,540 in federal block grant money through the agency. HCM then received $509,900 in 1998 and $496,400 in 1999. TCADA's 2000 allotment to HMC, before the contract was terminated, was set at $546,040. All told, close to one and a half million dollars of state funds have been routed to Houston Maintenance Clinic, and the reason those funds have dried up, according to TCADA spokeswoman Stephanie Goodman, is that TCADA doesn't have any idea how any of that money was spent.

"The problem in this particular case is we don't have the information in hand to tell you what they were doing financially. We can't tell if it was a good use of state dollars or not, because they never provided the financial statements we need to make that determination," Goodman says.

According to TCADA regulations, clinics receiving more than $300,000 per year are required to provide independent financial audits annually. HMC has "occasionally submitted some financial statements, but they are not complete. They don't meet generally accepted auditing standards," Goodman says. "They just had a number of problems, and we can't tell basically if they are doing what they should be doing with the money." One of HMC's audits, says Goodman, was "so poor that we've filed a complaint against the auditor with the board."

Goodman stresses that TCADA has received no allegations of "mis-spending" at HMC, and that the termination of the clinic's contract was based entirely on the clinic's failure to provide required accountings of proper spending. But for TCADA to be unaware of such allegations, the agency must have spent the past three years stumbling under a heavy dose of opiates itself.

"I tried to tell TCADA what was going on," says Tabitha Okeke, who served as the clinic's bookkeeper from September 1997 until January 1998. "A lot of people have called TCADA, but they never did anything about it."

Okeke's stories of HMC operations, combined with dovetailing accounts by a dozen former and present HMC employees interviewed by the Press, constitute a dirty laundry list of irregularities and possible illegalities that should have waved red flags in regulatory faces long before that February morning when TCADA agents arrived at HMC to direct patients to alternate treatment centers.

Responsibility for the dirty laundry, these sources say, lands squarely on the desks of HMC's husband-and-wife team of CEO Dr. Amos Ozumba and program director Cecilia Ozumba.

Amos Ozumba was reportedly out of the country during Press interviews, and unavailable for comment. Cecilia Ozumba, in a brief interview, attributed allegations to unnamed "instigators" with designs to close her clinic.

"We're contracted to render services to clients. We exceeded the amount of service we were expected to give, and even when we exceeded the number, the due process was not rendered. They know what they did. If they think trying to put all the lies together is going to help them, so be it."

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