In an unexpected twist of good intentions having bad outcomes, a moratorium intended to keep less effective larger-scale drug treatment centers from opening in Wyoming has turned into an unexpected hurdle for a small-scale treatment center in Powell’s backyard. 

Northwest Treatment Center’s original application was withdrawn from the Wyoming Business Council at the end of August because of a state moratorium on residential treatment center beds.

The center’s original $3 million grant application with the Business Ready Community Grant program was for a new 20-bed facility. Under the moratorium, the center could operate with 16 patients and be fine — but their plan called for room for potential future growth.

The center currently is licensed for 16 beds, but its board maintains a self-imposed internal cap of 10 beds, since the center’s approach to youth rehabilitation is quality over quantity at its current facility on Julie Lane.

The moratorium sort of came out of nowhere for the center’s leaders, since they deal primarily with the Department of Health and not the Department of Family Services, said Powell Economic Partnership Executive Director Christine Bekes. A new application will be submitted soon.

The moratorium originated with a 2012 budget footnote to the Wyoming Department of Family Services budget. At the time, legislators implemented a moratorium on new beds as they undertook a study of costs. In 2014, the footnote was amended to establish a statewide cap on treatment center beds.

The moratorium changed in 2014 to be a combination of group home beds and residential treatment beds. If a facility closes, those licenses stay in the mix — which is why Northwest Treatment Center is aiming to build for 20 beds and not just 16.

“I think the moratorium was put on and requested by residential treatment centers to keep the Walmart of residential treatment centers from coming in,” Bekes told the Powell City Council on Sept. 8. “They don’t want a 100-bed facility opening.”

The center already is licensed to treat 16 patients at a time, but it can’t do that in the facilities they currently use, Bekes said.

“They want to expand, and they need assistance to make it happen,” Bekes said.

The strange thing about the moratorium blocking the center’s expansion is that the legislative study within its footnote actually backs up the center’s application and supports what Northwest Treatment Center is trying to do, Bekes said.

“You would think more beds available would be better,” Powell City Councilman Josh Shorb said.

Group homes are a different level of care; they are like a home, and the patients go to school during the day. Northwest Treatment Center does residential treatment for juvenile males with addiction issues, which is more involved and complex with on-site schooling and an all-encompassing drug rehabilitation program.

The center’s leaders planned on expanding for a long time and had saved up $600,000 by setting aside a building fund under the direction of their board of directors, said the center’s director, Ty Barrus. When they found out about the grant, they applied using those funds as their match, with the city of Powell sponsoring their application through the Business Ready Communities Grant and Loan Program from the Wyoming Business Council.

“We were saving money for a bigger facility to buy and build, then this came about and we thought it was an opportunity to benefit us and the community,” Barrus said. “We were probably another year or so out from getting the facility we would like, but now we are months away from it.”

The center needs to be able to show and identify the treatment-needs gap, and that Wyoming has youth in need of treatment, said the center’s clinical director, Greg Bennett. They also need to find out how many patients are being sent to Montana for issues aside from drug addiction, when the case is really that the patient has more than one disorder.

“We want to treat Wyoming kids,” Barrus said.

The center also needs to educate people about their program so that they can be known as an option, he said.

There is no timeline for the revised application process, but another site visit from the Wyoming Business Council is anticipated for the center and the council to learn more about the moratorium, Bekes said. If all goes well, a special meeting will then take place with the business council and the State Loan and Investment Board.

“The sooner we get the grant application approved and funded, the sooner we can move forward,” Bekes said.  

There are no changes to the floor plan and design of the new facility, since it means the difference between two bedrooms. There is the possibility that the moratorium will be lifted or changed by the time Northwest Treatment Center is ready to take full use of its license and facilities.

“The cost difference in terms of not building for 20 beds and building for 16 is minimal,” Bekes said.

The highest number of patients the center has ever had at a single time was 11, and the typical amount is about six or seven patients, Bennett said.

“Going up to capacity would create more jobs,” Bennett said.

“The work we do with 16 (patients) might as well be 120, because it is so individualized and takes more work — we are willing to do it, but need low numbers to be successful,” Barrus said. “I think having a facility that has school rooms, therapy rooms and security and everything for safety measures — it is vital to move in that direction.”

“And with a home-like atmosphere,” Bennett added.

“The kids leave saying we cared about them,” Barrus said. “We know them and their families and the intimacies of their lives.”

Despite having operated in Powell for six years, many locals do not know the center exists or what they do. The following is an introduction to the neighbors local may not have met yet:

Q: Why does Powell support the center?

A: The city of Powell supports the center’s endeavors primarily due to the help it can provide local families who have a child with addiction problems, said Mayor Don Hillman. Providing rehabilitation treatment in Powell means families do not have to travel far to get the help they need.

“That is one of the big reasons I see,” Hillman said. “It is nice to have the center here for local people, and when they have family in that situation, you don’t have to travel hundreds of miles.

“It is nice for the city to support anything that is going to provide that service locally. Why wouldn’t we want that facility here?”

Q: Who owns the center and who governs it?

A: Northwest Treatment Center is a 501c3 nonprofit organization with a board of directors. The board is comprised of Powell residents, president Joe Bridges, Trace Paul, Sarah Mainwaring, Jason Wardell and Shelly Schultz. Barrus and Bennett are also present for board activities, but are not voting members.

Directly below the board are Barrus, Bennett and the center’s CFO Chad Lindsay.

Barrus grew up in Meeteetse and his wife is from Powell. He’s a licensed clinical social worker and has been working with local treatment centers since 2000.

Bennett moved to Powell from Louisiana when he was just 2 years old and was involved in several Powell athletics while growing up. He said he might still hold the track record for pole vault, but wasn’t sure. He left from 2001-07 and moved back with his wife, a fellow Powell native. Now he coaches several youth teams, and is the northwest regional vice president of the Association for Addiction Professionals.

“I love working with kids, it keeps me young,” Bennett said.

Lindsay was born in Powell and lived in Lovell his entire life, except for while attending University of Wyoming. He went on to earn his master’s from the University of Phoenix. He previously worked in drug and alcohol prevention in Big Horn County and has been with the center for five years.

From there, the center has a team of case managers, treatment planners, certified addiction practitioners and more to help perform an all-encompassing rehabilitation program. Overcoming drug addiction means an entire lifestyle change and giving the kids the tools needed to succeed — everything from life skills like cooking and changing oil to coping with problems in a healthy way instead of with drugs.

“Our philosophy is, if you can’t make your bed and cook breakfast, how will you do anything else correctly,” Bennett said. “Drug use comes with numbing of emotions because of childhood trauma, and those things are used to cope with it. We teach about their emotions and how to cope with them and how they co-mingle.”

Outside their walls, the center works along with the criminal justice center, judges, probation officers and child protection services, Bennett said.

“Drug addiction isn’t just an addiction for one — it is a family illness and affects everyone,” Bennett said.

Q: Why are these services needed?

A: According to the Association for Addiction Professionals, drug addiction costs $385 billion every year because it impacts everything from school and work attendance, criminal behavior, vandalism, theft and legal fees, Bennett said.

“There is a huge need for the public to get educated on drug addiction; it is a stigmatized and misdiagnosed problem,” Barrus said.

According to the Substance Abuse and Mental Health Services Administration, there were 23.2 million Americans over 12 years old who needed treatment for illicit drug or alcohol problems in 2007. Of those Americans, only 2.4 million, 10.4 percent, received treatment at a specialized facility.

“The need for beds is huge,” Bennett said. “If everyone was identified and screened, there would be a bigger need for beds.” 

If those same numbers are applied to Powell, 10 percent of the population, or 500 people, would be in need of treatment, and the center only has a license for 16 beds.

“The kids who need services in Park County, before us, went to Casper, Rock Springs, or Cheyenne, and they came back and nothing changed,” Bennett said.

Northwest Treatment Center is trying to create a facility to comfortably house 16 patients at a time, since smaller is better and there always will be a need for adolescent treatment, Barrus said.

As far as what needs to be treated, that part changes over time.

“Another interesting statistic from July is among high school seniors — driving under the influence of marijuana has surpassed alcohol,” Bennett said.

Many of the center’s patients became addicts when they started using drugs or alcohol to deal with the traumatic realities they faced in life. For instance, one patient’s mother died, then he was sent to his grandmother and she died as well, so he was left with no family at all.

“They come to us with trauma, and their drug and alcohol use is something they do to cope with trauma,” Barrus said. “They want to change. We are trying to change those thought processes and get them motivated to deal with the world sober.”

Placement into treatment facilities has a 60-90-day wait time for adults, and for adolescents the issue of quality of care arises, Bennett said.

“Big centers aren’t effective,” Bennett said, noting that kids who act out violently get more attention than well behaved kids even though both need help overcoming their addictions. “Our modality is to provide individualized care according to their needs.”

Q: What kind of treatment does the center do?

A: Treating addiction means more than just addressing the substance itself; it’s everything surrounding it, and that means taking a “biopsychosocial modality” approach. Patients participate in individual sessions and processing groups to address how they are feeling mentally, emotionally, physically, spiritually and socially. They also participate in topic groups, morning meditation, recreational activities and equine-assisted therapy, family work and groups to address emotions.

“It is ever-evolving,” Bennett said.

All of this is done within as close to a home-like setting as possible with bedrooms, bathrooms, desks and preferences on food for each patient.

“Each kid has their own history, so the treatment is focused on them,” Barrus said. “Treatment is built and structured around the individual and what they need.”

Q: Who are the patients and where do they come from?

A:  Some of the center’s patients are court ordered through drug court treatment, some through regular adolescent courts and some are sent there at their parents’ request. All of them come from Wyoming and are between the ages of 12 and 17 years old.

“Our main goal is to help local kids,” Barrus said. “Big Horn Basin is a priority for us.”

About 60 percent of the patients are from the Basin and the other 40 percent are from other parts of Wyoming, Bekes said.

Treating kids close to home means family work is easier to do.

The center has a special therapist designated for family work at a distance, whether it is by phone or Skype, Barrus said.

“It is an essential component to success,” Barrus said. “Some of their home lives are part of the problem ... Sometimes we find that mom and dad supply the drugs or are hosting the parties.”

Clients from outside the community benefit from losing their connections to drug dealers or other negative influences, Lindsay said.

In addition to drug addiction, some of the patients are also dealing with learning disabilities, Barrus said.

Q: Do the patients continue with their schooling in-house, and if so, who is their teacher?

A: Because of their struggles with addiction, the center’s patients can be as much as a couple of grades behind on their schoolwork, so the center brings a teacher onsite to help catch the kids up as much as possible.

“A huge risk factor is falling behind in school ... so credit recovery is our main goal,” Barrus said.

The students remain enrolled in their original school district while at the center.

“Since they are addicts, we don’t want them having access to students outside because, potentially, they could obtain some type of substance,” Lindsay said.

Some have been able to make up an entire year’s worth of school work while treating their addictions at the center, Bennett said.

Former Powell High School employee Christy Muecke teaches at the treatment center with lessons during the day and evening time. But, the current facility lacks a dedicated classroom setting that’s conducive to the learning experience, so most lessons are done at the dining room table. Part of their proposed facility includes a classroom to address that issue.

“They come in a year or more behind for a reason, school isn’t a priority,” Barrus said. “The kids we get are smart, it is just a matter of motivation. Drug culture just deflates motivation in school.”

Once treatment kicks in and the drugs leave their system, the fog starts to lift and they are able to retain what they’ve learned and pass academic tests, Barrus said.

“It is exciting to watch them get excited about school,” Barrus said.

Unfortunately, some of the patients are almost 18 years old and only have a sophomore-equivalent amount of school work done, so graduating on time is impossible. Some of the patients earn their GED and others go on to earn their diploma after their treatment at the center. Others move on to employment through the Wyoming Job Corps.

Q: What happens once the patients turn 18 years old?

A: Just because a patient turns 18 years old does not mean that he or she is turned loose to battle their addiction recovery on top of the challenges that come with adulthood. The center establishes a transitional discharge plan for employment, home life and medical problems, Bennett said.  

Patients normally have a roommate, but they get their own room once they turn 18, Barrus said.

Q: Do the patients get involved in the community?

A: Going out into the community allows the center’s patients to use the tools they’re learning in treatment. The patients can often be found at the gym, the aquatic center or exploring the parks.

“Community integration is not only one of our top priorities; it is also an opportunity for them to practice the things they learn in treatment,” Bennett said. “They can’t practice in a controlled environment.”

Another reason for the recreational outings is because some of the patients don’t know of any alternatives to drug and alcohol use, Barrus said.

“Some haven’t gone on hikes or fishing,” Barrus said. “We do these things to show there are options out there to do when bored, and to teach a hobby is a huge thing.”

The center tries to take patients out each week and to Yellowstone as well.

“There are kids who were from Wyoming who never went to Yellowstone,” Barrus said. “We take them to waterfalls, and they didn’t even know there are waterfalls here — they are like ‘Oh my gosh, there is more to life than sitting at home and smoking pot.’”

All of the outings are staffed and supervised with about three staff members for seven kids.

Q: Are there enough beds in Wyoming for juveniles with addiction problems?

A: It’s not a simple yes or no answer when it comes to determining whether there are enough beds in Wyoming’s treatment facilities to care for all of the patients. Part of this is due to changes in how society handles drug addiction.

“There is definitely a need,” Barrus said. “We had kids in our beds since we started — if that means the need is being met, I don’t know.”

Northwest Treatment Center is categorized along with residential treatment centers, and that brings into question how many of those centers serve addictions, Bekes said. And how many have qualified personell to treat addictions, added Bennett.

“NWTC is unique, because the primary issue is addiction — they usually have co-occurring disorders,” Barrus said.

The Wyoming Boys School doesn’t do treatment, and the 12-step model used at Narcotics Addicts Anonymous groups doesn’t help if the kids learn best with hands-on approaches, Bennett said.

“There is not another NWTC,” Bennett said.

Instead of sending drug addicts to jail, as was the practice in the past, more courts are sending addicts to treatment facilities. The Department of Health defines drug addiction as a brain disorder that is treatable and manageable, similar to other diseases such as diabetes, Bennett said.

“About 10 years ago, 93 percent of the people incarcerated were due to drug charges, and they didn’t have any treatment,” Bennett said. “Now that number has dropped, and they are getting options for treatment.”

More people need treatment now and one of the stipulations of the Affordable Care Act is for insurance to cover treatment, he said. But, loopholes are often found, and the state and federal governments usually end up footing the bill.

“It is recognized as a brain disorder and not a moral weakness issue,” Bennett said. “It is not as stigmatized as it was before.”

Q: How is the center funded?

A: The U.S. government has a substance abuse block grant with funding set aside for each state, based on population size, and the state matches those funds, Bennett said. He estimated that 90 percent of Wyoming’s treatment facilities get 90 percent of their funding from state and federal dollars.

Insurance companies have loopholes to avoid paying for drug addiction treatment, Bennett said. When that happens, Medicaid steps in to foot the bill. Medicaid also pays when treatment is court ordered, Bennett said.

The majority of substance users are low income, so most go to Blue Cross Blue Shield or a subsidiary of Medicaid, he said.

“One reason for opening a center was because kids were getting thrown into Montana and Provo Canyon, Utah,” Bennett said. “We want to keep those state funds here.”

Q: Who decides when treatment is needed and when it is done?

A: A decision to send a juvenile to a treatment facility can be made by parents, or it can be court ordered. It also can be suggested by mental health practitioners who find that an illness such as depression is tied in with a substance abuse issue.

Once placed at the center, the staff develops a treatment plan with the adolescent and his parents. Long-term goals are made and meetings are held regularly to discuss their progress.

Discharge from the center is based on the progress they make, and every drug and child is different.

The average stay at the center is six months. Once previously high-risk criteria has transitioned into medium or low risk, then steps are made to get the patients back into the community.

“We sign off when they have the best shot of succeeding,” Barrus said.

Q: What kind of jobs would the expansion create?

A: The revised plan lowered the number of new jobs created by expanding from ten to nine, which still is an economic boon for the community, since most of those jobs are specialized and require workers with degrees, certification and special training.

“Training and education specific to addiction disorders is a paramount thing,” Bennett said.

Finding highly trained and experienced staff who are dedicated to helping young people overcome their addictions and also “buy into Wyoming” is another goal, Barrus said.

Substance abuse treatment is a career field with a lot of emotional value that tends to attract relatives of former addicts, Bennett said. Of course, there are degrees and certificates that need earned on top of the desire to help others.

So far, the center has helped multiple employees further their education so they can provide better services to their patients. Three of their employees went from no higher education to one nearly completing a master’s degree, another is nearly done with a bachelor’s degree and one finished a bachelor’s degree, Bennett said.

“I love people that love Wyoming, so when they go through their first winter they don’t leave,” Barrus said. “I like people that buy into Wyoming, because these are Wyoming kids.”

Retaining or bringing back Wyoming residents by creating jobs within the state also helps the grant application, Bekes said.

“These are professional jobs to attract people here,” Bekes said.

Some of the staff moved to Powell from outside the state, one from South Dakota and another from New Mexico, Bennett said.

“People know the treatment we do and are excited about it,” Bennett said.