Four top officials in the District's drug treatment program were moved out of their jobs yesterday as the city's health chief pledged to restructure the oft-criticized agency and farm out more work to private providers.
D.C. Health Director Ivan C.A. Walks said the Addiction Prevention and Recovery Administration (APRA) has failed to improve despite additional funding that was supposed to extend help to many more of the city's 65,000 drug abusers this year.
The agency, with a $32.3 million annual budget, has for years carried a stubborn waiting list of more than 1,000 drug addicts and has developed a reputation as unfriendly and insensitive to the clients who need its help at the most critical moments of their lives.
"There are several problems that we just couldn't reconcile," Walks said. "We have waiting lists for treatment, and yet we have treatment slots that are empty."
The agency funds 241 substance abuse treatment beds, about 100 of which are directly operated by the city.
Walks, who has been health director since September and oversees the agency, said that he will study how to restructure the agency but that, in his view, it is an inherent conflict for an agency to provide services while also overseeing the effectiveness of the program.
Various city officials also expressed dismay over answers given by APRA officials at a hearing last month when D.C. Council members asked what initiatives they have begun with nearly $3 million in new funding. No new programs have been launched yet, said council member David A. Catania (R-At Large).
"The system itself is broken," Catania said yesterday. "Regardless of who heads the agency, they need to deconstruct the entire agency and build it from the ground up."
Walks said senior Health Department officials will fill in at the agency until replacements are hired.
Among the four, agency administrator Deidra Y. Roach, a medical doctor, resigned yesterday from her $105,000 post after about a year on the job. She gave as the reason her unwillingness to comply with rules requiring her to move to the District from Maryland.
Marcia Richardson, executive director of Safe Haven Outreach Ministry, a nonprofit drug treatment provider, said she is ambivalent about Roach's departure. Since taking over the agency a year ago, Roach had encountered intransigence from city employees under her.
"While there are significant historical problems and systemic problems at APRA, the real problem in many instances is an entrenchment of some old staff persons who are impediments to her [Roach's] desires," Richardson said. "In many ways, she was a victim of her own staff. Because Dr. Roach doesn't have an assertive personality, I don't think she was feared" by her employees.
In other moves, management services officer Keith Vance, the No. 2 official, retired from his $88,000 job, and Linda Holifield, a $67,000-a-year health systems specialist and third in command, was transferred to a Health Department post outside APRA.
David Hailes, a 30-year city employee, retired from his job supervising the 50-bed detoxification unit, which takes addicts in the first days of withdrawal from drugs or alcohol. Walks said he had concerns about the safety of clients in that unit.
"It's a time when people are very vulnerable," Walks said. "It's not the time when we, as trustees, can have them in situations when their safety isn't the No. 1 priority. I was clearly concerned that everything wasn't being handled appropriately when it came to protecting client safety."
Catania has been a relentless critic of APRA and has been calling for high-level ousters since September. More than $1 billion of the city's annual budget is consumed by police, courts and countless other agencies in coping with the many consequences of drug addiction, he said.
Catania remains a leader of council efforts to expand drug treatment services through the private sector, but he praised Walks for what has happened thus far.
"I'm pleased that Dr. Walks has shown this kind of initiative," Catania said. "I have incredible confidence in him. . . . It's a remarkable improvement."
Council member Jim Graham (D-Ward 1) urged Walks to seize the moment and revamp the agency.
"For a very long time, our substance abuse services have not been functioning the way we want them to," Graham said. "I'm not saying they've been a failure. I know a number of people who have gotten sober and clean as a result of APRA services. But I'm saying it can be much much better than it is."