Methadone Meltdown

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

This is hardly the first time that TCADA has been caught short by apparent mismanagement of state funds on the agency's watch.

In 1995 a state investigation of the commission showed that TCADA had failed to take action against an Austin rehabilitation clinic, even though it had been aware of financial irregularities for three years. TCADA, the investigation concluded, "failed to probe allegations of misuse of funds."

That same year, after the preliminary investigation revealed TCADA's "gross fiscal mismanagement," Governor George Bush placed the agency into conservatorship, widely reported as the first time such action had been taken against a Texas agency in modern history. TCADA was still in conservatorship in 1997 when it awarded the contract to HMC. Also in 1997, a follow-up state audit indicated that while improvements had been made in the two years since the conservatorship board took over, "a number of issues related to rate setting, performance measures, management information systems, and complaint resolution were left Š for the new commission and management to address."

Current director Jay Kimbrough took TCADA's reins in February of this year, as the agency emerged from conservatorship, and announced a scaling back of 200 contracts statewide because of an estimated $28 million budget shortfall.


The newly-moved-into rental house is sufficiently close to Houston Maintenance Clinic to walk, in a pinch (after TCADA shut down the subsidized clinic, HMC relocated from its original Fannin Street location to a nearby Main Street location). And the $750 monthly rent is considered a good deal by the current and former patients who share it, mostly youngish people who are trying to get back on their feet after years of heroin use, with the methadone treatment, with new jobs.

Debra and Greg -- their names have been changed -- have gathered two more former HMC clients to describe for a reporter their experiences at the clinic, which have little to do with the alphabet soup of regulatory agencies like TCADA and TDH and DEA. These are the people who trickle in and out of the clinic's plate-glass door in the early-morning hours, three or four or five times a week, to get dosed on their way to work, so that they can go to work, so that they won't, hopefully, fall back into the pattern of spending their days hustling for heroin.

Greg, without a conveniently close alternative, has continued treatment at HMC's private clinic, at a cost of $40 a week, but says that CeCe Ozumba told him he could get a discount if he'd get his wife on the program as well.

All say that they have watched Amos Ozumba make change, for both private and TCADA clients, out of his own pocket, and stash incoming cash in a shoebox.

All have taken advantage of lax medication controls to take their methadone wafers out of the clinic, unsupervised. The wafers have a street value that Greg estimates as $40 to $50 for 100 milligrams, and some clients, they say, sell their methadone to get money to buy heroin. Others will sell a day's dose to make the money to pay the Ozumbas for a week's treatment.

Greg says he has seen doses sold, client to client, inside the clinic and on the street in front, which he describes as "an open-air drug market."

Debra says, "It's very hard to detox at that clinic." The single prescribing doctor on staff, she says, is only on site two Wednesdays a month, and thus any change in dosage can take up to two weeks to authorize. At other clinics, she says, such requests are processed in a matter of days.

"I went in asking for a three-month detox," she claims. "But I started on 40 [milligrams] and left three months later on 80."

Debra entered the program, she says, as an indigent client qualified for dollar-a-day payments, which she paid in advance, and within three weeks found herself staring at a bill for $80. One day, when several clients got upset over the billing, they confronted Amos Ozumba. Ozumba, Debra says, got angry and yelled, "You're all upped to $3 a day." CeCe Ozumba, she says, once told her that if she could afford a heroin habit, then she should be able to pay for her methadone.

Three different patients report being dosed on "20 or more" occasions by CeCe Ozumba, who is not a registered nurse, and thus is not authorized to dispense medicine, a charge documented by TDH investigators.

At the Fannin Street location, former clients say, there were three "dosing windows," where clients received medication. Two were designated for TCADA program clients, one for private clients. "In the three months I was there," Debra says and Greg supports, "I never saw anyone dosed at the private window."

"They cater to the long-haulers," Debra says. "That's where the money is."

Male clients, Greg adds, aren't even supervised during required urinalysis tests, making it more than easy to test clean with fake samples and qualify for take-home doses. "It's just straight-up legal dope-running."

Cecilia Ozumba, contacted by phone, wanted to know which clients had given a reporter her name before saying, "I don't have the authority to talk to anyone, anytime, without authorization, from the board of directors, or corporate attorney, or somebody."

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