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A Conversation About Criminal Justice and Addiction With Dr. Wiley of the National Institute on Drug Abuse

Can you tell me about your work with The National Institute on Drug Abuse [NIDA]?

I’ve been at NIDA almost 10 years, and I’ve worked on justice issues pretty much the whole time. A few years ago, Congress made a big appropriation to the National Institutes of Health[1]—which included NIDA—to address the pain and opioid public health crises. That became what’s called the Helping to End Addiction Long-TermSM Initiative[2], or NIH HEAL Initiative.SM

The NIH HEAL initiative gave us the opportunity to launch one of the biggest justice programs we’ve ever introduced, the Justice Community Opioid Innovation Network [JCOIN]. Across the whole initiative we have a shared vision, which is to ensure that every person with a substance use disorder who is involved in the justice system has access to effective treatment.

We’re about two years old, so we’re just starting to take our training wheels off. We’re hoping that over time, JCOIN will become a go-to resource for both researchers and practitioners. Our hope is that once we achieve that vision, we can make it faster to turn science into solutions that people out in the community can actually put into practice.

That’s great. That was one of my questions, how it translates to practice.

Yeah, traditionally what happened is our researchers did these great studies and published their papers; the idea was that people would see the research and find it so compelling they’d have to act on it. But that’s not really how it works, and it meant the science was really slow to get to practice.

In JCOIN, we’ve built a lot of opportunities to hear from our stakeholders—the sheriffs, judges, probation officers, and treatment providers—so we know what they’re looking for and what questions they have. We have a training program, where we recruit both people who are working in these community settings and researchers who are earlier in their careers; they learn together about how to do research in these settings and the different ethical and pragmatic challenges that come up.

We’re doing a lot of things in JCOIN that aren’t strictly a classic research project; we’re trying to break down some of the silos and build communication across the different stakeholders.

What does the treatment landscape look like now with medications for opioid use disorder [MOUD] in prisons and jails?

Historically there hasn’t been a solid source of information about how many jails are providing medications. One of the very first things we did in JCOIN was launch a survey to try to figure out the answer to that question. It took place over the last couple of years and our researchers are just wrapping up, so we hope to have a solid, rigorous answer soon.

But at least historically, it was a small minority of jails offering medication. That has been changing rapidly, but our sense is that as it’s changed, maybe only one medication is offered in a jail; maybe the medication is only offered to a specific population, like women who are pregnant; maybe it’s only offered if you’re already on a medication when you come into the jail.

We’re trying to figure out who’s providing medications, what they’re providing, where the gaps are, and how we can provide support to reduce those gaps.

Yeah, I saw that JCOIN was doing research about jails that are already providing MOUD.

Yeah, for a long time at NIDA—even before JCOIN—we’ve supported research looking at what happens when you provide medication in jails.

One of our researchers partnered with the state of Rhode Island, which was among the first places that offered all three forms of medication [buprenorphine, methadone, and naltrexone] to people in jail or prison. They found that when all three were offered to people while they were incarcerated, they were much less likely to die of a drug overdose when they returned to the community.[3]

The first couple weeks that someone returns to the community, there is a really high risk for mortality. Offering those three medications really helped reduce that risk—so much so that it reduced risk not just for those folks; you can see the impact on mortality rates at the community level in Rhode Island. That’s really compelling, and lots of states started modeling after that.

You kind of answered two of my questions: “How can MOUD help people with addiction in the justice system?” and “What are some ways to reduce rates of relapse and overdose after reentry?” Can you go into more detail about that?

Sure, yeah. If people are already on medication and they go to jail, the standard of care has been just to detox someone. Often that’s really uncomfortable for people. There are medications that can make detox less uncomfortable, but those typically aren’t offered in jails.

If someone has a really negative experience of detoxing when they go to jail without any supports, it can make them less likely to engage in treatment when they return to the community.[4] It’s important what happens while people are incarcerated, but it’s just as important what happens when they return to their communities. There has to be that linkage.

So many people who become incarcerated have Medicaid, and it can either get turned off or paused while someone is incarcerated. If you return to the community and don’t have insurance, you can’t get access to treatment; you can’t pay for it because you don’t have a job.

All those things mean that even if someone was getting treatment while they were in jail, they can’t continue when they return to the community. The evidence is becoming really compelling that you have to have both pieces in place.

And what are some solutions to that—how are people linked to treatment and care?

In JCOIN, we have six studies that are testing models of how to link people to treatment when they return to the community. Some use peers who have lived experience. We have one that uses what’s called the Transition Clinic model, which brings people into primary care clinics and provides them all of their care, including medications.[5] Doing things like making sure people’s insurance is ready to go as they return to the community, so they don’t have to spend a month or more trying to figure out how to get insurance.

I think it’s important not to be looking for a one-size-fits-all. We hope that when these studies are completed, we’ll be able to offer a lot of different options, so that people can find what works best in their particular community with their particular constellation of service providers.

What drew you to this work?

In some ways I fell into it, and in others it was always the path I would end up on. When I started my career, I was really interested in what happens to children who come into contact with the legal system, particularly kids who are victims of maltreatment or abuse. I did a lot of work on that when I was in graduate school. Then I came to NIH and NIDA and ended up morphing into juvenile justice.

I started looking at what happened to kids, and then what happened to kids as they grew up. I see it all as connected, because what happens to kids depends on what happens to their parents. If we don’t support parents in becoming the best versions of themselves, we create these cycles that are very difficult to escape. I’m also a child of a parent that was incarcerated for a large part of my childhood, so these things come together in the work I do.

Are there any logistical barriers to providing effective treatment in jails and prisons?

I strongly believe it’s important for people to have access to medications, but it’s also really hard for jails and prisons to pull this off. Stays for people in jail can be really short; it can be really hard in a short amount of time to identify what people need and get them connected to care.

A lot of the jails we’re working with are trying to figure out how to offer methadone, and that’s extraordinarily difficult; it’s shocking how difficult it is. They have to make these really complicated decisions about what is most cost-effective.

Through JCOIN, we’ve created partnerships between people in jails who are working to set up access to all three forms of medication and economists on our research team; we’re hoping to build out a tool where if you are a jail or prison that’s considering doing this, you can figure out the best option given how many people you’re serving or what contracts you’re able to set up with providers in your community. We’re trying to give folks in jails the research and tools to make providing these medications a little easier.

It seems like every step of the way there’s partnerships in the work you’re doing.

Yeah, and that’s really exciting. Even when I was doing child welfare work, a lot of it was partnerships. I think a lot of the hard problems are about getting people to work together across their typical silos. So that’s been a key theme for me in my career—the kind of thing I find really interesting to work on and solve.

 

[1] https://www.nih.gov/news-events/news-releases/nih-launches-heal-initiative-doubles-funding-accelerate-scientific-solutions-stem-national-opioid-epidemic

[2] https://heal.nih.gov/

[3] https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2671411

[4] www.sciencedirect.com/science/article/pii/S0740547215002871

[5] https://www.sciencedirect.com/science/article/pii/S0740547221000416

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As we continue to grow Amatus Health, the need to stay competitive and differentiate ourselves in unique ways is crucial. Building creative approaches to reach more people will take our company to new heights. This is why I am pleased to announce that we are officially rebranding. Our new national name, TruHealing Addiction & Mental Health Treatment, will eventually replace Amatus Recovery Centers.

You may be asking, “Why are we doing this?” This new name will give us national uniformity and help brand ourselves as a whole, which will be done in phases. You will still see our existing facility names co-branded with TruHealing for the time being.

Healing is what we do. Everyone who comes through our doors is in a moment of profound struggle in their lives. We support them through a life-changing process of healing and recovery, and they leave our facilities changed. This new name is a representation of that process. As mentioned above, it also allows us to have a national brand, which will make us a recognizable name in the addiction and mental health field.

In summation, these changes present an excellent opportunity for our organization to develop our mission, vision, and purpose. I look forward to prosperous growth as we head in a new and positive direction.

Sincerely,

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Mark Gold
CEO
Amatus Health

Dr. Adam Cusner, PhD is an organizational psychologist by training and has brought his decade-plus experience to the healthcare field serving as the Executive Vice President of Operations for a 22-facility portfolio of skilled nursing facilities, assisted living and independent living centers across Ohio and Arizona, with an annual revenue over $250MM. While serving in this position, Dr. Cusner brought accelerated growth to these facilities, while increasing employee retention and workflow optimization. Dr. Cusner has a proven track record in the healthcare industry of providing successful leadership through his financial acumen, strategic planning, interpersonal skills, along with his ability to build strong, effective teams.

 

Dr. Cusner’s credentials include a Philosophy Doctorate in Organizational Psychology (PhD) from Cleveland State University, a Master of Arts in Psychology (MA) from Boston College with an emphasis on Psychology of Work, a Bachelor of Science in Psychology (BS) from Boston University with an emphasis in Organizational Behavior in Business and is a board-certified Nursing Home Administrator (LNHA). He has published and presented research articles in the field of organizational psychology at national healthcare conferences. Dr. Cusner is completing a book on organizational psychology in the healthcare field, which is expected to be published late early summer 2022. He is also a member of the American Psychological Association (APA), has served as the APA’s Division 17 communications chair, is a member of the Society for Industrial Organizational Psychologists (SIOP), and was selected as a professional reviewer for national conference research presentations.

 

Dr. Cusner is an advocate for his employees and is drawn to the tie between culture and quality. His extensive strategic and operational skills have delivered a high degree of success across all department levels. Dr. Cusner facilitated the establishment of an in-house financial team to provide billing and collections, accounts payable, vendor management, along with financial reporting. This provided $1.5MM annualized savings. Further, he developed department efficiencies for: Medical Staff recruitment, service-line growth, quality and safety, corporate accountability of budgetary expectations balanced with direct reporting to investor groups.

 

Dr. Cusner coordinated the financial turnaround of a 300 bed CCRC (skilled nursing, assisted living and an independent living center) in Arizona, which has been epitomized as the most financially challenging state to manage CCRC facilities. Dr. Cusner also strengthened the business growth of the Ohio facilities by 12%. He was recognized by the Governor for demonstrating a “care-conscious approach” during COVID, when Dr. Cusner carefully consolidated facility residents to accommodate staff and improve clinical care. Dr. Cusner demonstrates a results-driven culture by delivering a high-quality level of care and employee engagement.

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Yaffa Atias is the Director of Special Projects at Amatus Health. Atias is a leadership professional with a decade of experience in healthcare. She holds a BA in interdisciplinary studies from Thomas Edison State College, and a Master’s in Healthcare Management with a concentration in project management from Stevenson University. She completed her graduate capstone at Mosaic Community Services, now an affiliate of Sheppard Pratt.

 

In her role at Amatus, Atias leads and manages interdisciplinary team projects, creates solutions for any operational gaps, and continually strives for quality improvement in all processes. Atias led the organization’s COVID-19 preparedness strategy, resulting in all facilities remaining operational, and in 600 employees being retained as staff without resigning out of fear. In her role so far, she implemented licensure for three new states.

 

Atias believes Amatus Health and TruHealing stand out because every employee, from corporate to center staff, has a real passion for helping people. Atias shares this passion, “My natural compass always tugged me to behavioral health. I’ve always been fascinated by the human psyche. I have also been intimately privy to those suffering from mental illness and substance use. I later understood that my experiences weren’t unique, and quickly realized how pressing the need really is to effectively prevent and address. Moreover, how life-changing proper intervention truly is.”

 

Atias was born in Los Angeles, California and grew up in Israel and Maryland.

Melissa McCarthy is the Vice President of Business Development at Amatus Health. With a decade of experience in the behavioral healthcare and addiction treatment industry, McCarthy is passionate about recovery. She has her finger on the pulse of marketing trends, with the end goal of helping businesses grow so they can serve more people in need.

 

McCarthy has worked at large enterprise recovery centers across the country spearheading business development teams. She has a wide range of experience, including transforming a third-party digital marketing and client acquisition services company into a full-continuum behavioral healthcare provider, managing several successful rebrands, and growing annual revenue fivefold.

 

As VP of Business Development, McCarthy leads a team of over 20 business development professionals nationwide. She manages client acquisition, coordinates in-service trainings with various referents and hospitals, and presents at conferences on addiction and mental health disorder treatment.

 

“Sadly, many individuals die waiting for access to life-saving behavioral healthcare services,” says McCarthy. “I am in relentless pursuit of better—better access, better care delivery and better outcomes. I consider it a privilege to work in an environment where miracles unfold daily.”

 

McCarthy lives in Maryland with her daughter.

Hometown: Saugus, MA

 

Passions & interests: The greatest passion of mine is being able to dig into the work with men in early recovery. There is nothing better than witnessing and being a part of the change. My journey in long-term recovery has taught me to value the little things in life that I am now able to do. I love to do anything that allows me to be present with my wife, family, and friends. My wife and I enjoy traveling, trying new foods, and taking long motorcycle rides with our friends. If I am not on the road working or with my wife, I am studying or playing softball.

 

The best part of my job is being able to show up for my team and clients; they all mean the world to me. I get to brainstorm and strategize with tons of different personalities. A lot of the team does not know, but I love learning from them. If I am not learning something about our industry or workplace, I am certainly learning how to effectively collaborate with different types of individuals.

 

Together, we can change the narrative and be a part of the solution to better treat those trapped in the problem.

Allison was born in Columbus, Ohio and was raised in South Florida. She graduated from the University of Florida’s College of Journalism and Communications. After college, Allison started working at the largest talent agency in the world, William Morris Endeavor. There, she learned marketing from top leaders specializing in global PR and endorsement campaigns, in both the Latin and English markets.

 

Through strategic public relations and creative campaign concepts, Allison has secured more than 200 national broadcast and print media placements for behavioral healthcare organizations. She brings over 15 years of marketing and PR experience, with a strong background in leading communications strategy for addiction treatment and behavioral healthcare facilities. In her role as VP of Communications, she oversees branding, public relations, social media, marketing, events, and content creation.

 

In her spare time, she loves cooking, boating, yoga, and traveling. She and her husband Bryan reside in Boca Raton, Florida.

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Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.

 

Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.

 

“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.

 

Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.

 

“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Marty Markovits is the Chief Information Officer at TruHealing. He oversees the people, processes, and technologies of the whole organization to ensure the business is running smoothly.

 

Markovits grew up in Brooklyn, NY (which he calls “the greatest city on Earth”) and graduated with a degree in Clinical Psychology from Queens College.

 

Markovits is a veteran in Information Technology within the healthcare field. He ensures that IT processes are simple, cost-effective, and secure. His expertise spans the entire healthcare domain, from billing and claims, to clinical, to Human Resources. He says, “My passion is to provide fully automated and operationally meaningful Business Intelligence analytics, with absolute data integrity.”

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Hometown: Savannah, GA

 

Passions & Interests: I spend my time outside of work with my wife and children and am actively involved in various community needs and causes.

 

The best part of my job is knowing that we are creating a safe, healthy, nonjudgmental environment where people can come and better their lives. There is nothing more satisfying than helping others learn to live again and piece their lives back together as they become strong, productive members of society.

Together, we can bring families back together and promote healing and well-being.

MARK GOLD, CEO OF AMATUS HEALTH BIOGRAPHY

With over 16 years of proven executive leadership and driving company growth, Mark Gold’s momentum for success isn’t slowing down anytime soon. He serves as the CEO of Amatus Health, one of the fastest-growing, behavioral healthcare organizations in the country.

Possessing an excellent handling of clinical compliance and high performance standards, Mark established 14 CARF/JCT accredited addiction and mental health treatment centers and three ancillary healthcare businesses. Mark’s natural leadership skills as well as his creative thought process to generate new revenue strategies make him one of the most sought-after professionals in healthcare. Mark has a track record of leading organizations to outstanding ROI on overall portfolio performance. In addition, his expertise includes workforce planning, growth revenue, high client and investor satisfaction.

Aside from daily business oversight, Mark invests in his staff and helps build their professional development. His commitment to his colleagues and employees toward advancement and inclusiveness helps them achieve goals, builds connections, and provides a competitive advantage in the healthcare field.

Corporate and Charitable Leadership

Mark has been instrumental in building healthy communities and providing access and quality healthcare to underserved populations. His service in the community is a testament to his passion and selfless dedication to the cause of eradicating addictive disorders and stigma.

He launched several prevention and education programs and created the first-ever “Social Justice” scholarship fund of over $750,000.00 to help communities of color into inpatient drug treatment. Mark says, “The best part of my role is the knowledge that what we do impacts countless lives, with far-reaching effects,” he said. “It is incredibly rewarding to be part of a team that guides individuals onto a safe and accessible path to healing and recovery.”

He is a board member of Ahavas Chaim, a non-profit that offers at-risk teenagers crisis intervention and mental health support. He is also a committee member of the organizations Bonei Olam and Chai Lifeline Mid-Atlantic.

Personal and Educational Background

Mark studied Talmudic Law at Yeshiva’s Mir Yerushalayim in Israel. In Mark’s free time, he loves snowboarding, boating, and spending time with his wife and children.