A serious allegation about a $50 million quid-pro-quo offered by the county’s chairwoman has led to a lot of questions.
The allegation is that New Hanover Couty Chairwoman Julia Olson-Boseman and former Commissioner Pat Kusek met with the President and CEO of Coastal Horizons Margaret Weller-Stargell, as well as the former Chairman of Coastal Horizons Andy Jones, when Olson-Boseman offered $50 million from the sale of New Hanover Regional Medical Center in exchange for a promise to drop criticisms of The Healing Place, the county’s planned substance abuse recovery facility.
One of the biggest questions — why was Weller-Stargell coming forward with this information now, more than two years later?
As it turns out, these allegations aren’t new — and New Hanover County has confirmed they were made aware of the alleged offer in 2020, after being asked about a meeting, described by Weller-Stargell, in which the Coastal Horizons CEO said she raised the issue of the alleged quid-pro-quo, and not for the first time.
“Chris has confirmed that Margaret first mentioned this allegation to him in late September of 2020. She also did raise it again in the meeting you mention below regarding opioid settlement funds, and that took place in March and Kenny House was also present,” according to a New Hanover County Spokesperson.
Previous statements about the alleged offer from the county didn’t deny that they were aware of the allegations — but also did not outright say that this had been brought to their attention in 2020. In an email from the county on Monday, a spokesperson wrote,” And to your question about the meeting, Chris [County Manager Chris Coudriet ] is not aware of any promise that was made to Coastal Horizons.”
The county later qualified that by “not aware of any promise” they meant they did not have solid evidence it had taken place, on Weller-Stargell’s recounting of the event.
“There were never conversations that county staff was a part of or aware of around giving money directly to Coastal Horizons. While it has been alleged that some type of offer was made, no evidence has ever been shared with me to confirm that and neither commissioner referenced by Ms. Weller-Stargell has ever suggested or implied to me or any other staff member that such a promise was ever made,” Coudriet said in an email to WHQR.
Even if such an offer had been made, Coudriet said that couldn’t be made by one or two commissioners alone.
“Any decision to provide funding to another entity would have to be thoroughly vetted, discussed, and then approved by the Board of Commissioners,” he said.
Olson-Boseman’s response
Commissioner Julia Olson-Boseman has denied the allegations of the $50-million offer and in a statement to Port City Daily called it a ‘damn lie.’ She also made the accusation that the coverage of this story is due to WECT anchor Frances Weller being the sister of Weller-Stargell.
Weller-Stargell responded to that accusation and expects that she’ll continue to see attempts at retaliation for speaking out.
“I expect in the days to come, and you should look for it, that they're going to come after me. I understand that, I'm prepared for that. What I don't understand or appreciate is anyone coming after your colleague who is my twin sister. But what I will say to you is even that, I'm not going to worry about it because she is a journalist who has recently celebrated 40 years in the business. She didn't get there not being someone of integrity, not being someone who is professional,” she said.
Possible consequences if the allegations proved to be true
As for the alleged offer of $50 million and what implications it might have if true, State Treasurer Dale Folwell says getting to the bottom of what transpired is crucial.
“If it came to light that this was accurate, this would be one of the most serious violations of public trust there is,” Folwell said.
“... When people make a charge like this, they don’t just do it instantaneously,” he continued.
District Attorney Ben David also explained his next steps involving the allegation — and says it’s already been passed along to state officials.
“The news story regarding the latest revelations about Ms. Boseman was forwarded to the prosecutor at the Conference of District Attorneys who is handling this matter. Due to the close working relationship our office has with the County Commissioners an outside prosecutor was assigned. Our office won't be able to make comment at this time,” according to a statement from David’s office.
How, and why, the alleged quid-pro-quo is being made public now
Weller-Stargell said she repeatedly told people in the county about the offer over the last two years– and said she was often essentially ignored, in part because it wasn’t actionable.
“Perhaps it was dismissed, because they know, again, it was something that — you can offer her the world, but you can't deliver on it. And I think it was just largely dismissed back then,” Weller-Stargell said.
But while Weller-Stargell spoke up about the offer, it was in personal meetings, not in a public forum; it only became public recently — when she emailed her concerns to Coudriet, and which became a public document.
Weller-Stargell said all of this came to light due to recent changes announced by The Healing Place which will allow patients relying on medically assisted treatment (MAT) to receive treatment at the facility.
In her email to County Manager Chris Coudriet , Weller-Stargell questions the changes to the planned facility that will allow medication-assisted treatment since the concept for The Healing Place which was intended to be abstinence-based.
Not allowing medication-assisted treatment at The Healing Place was something that Coastal Horizons opposed when the facility and program was first discussed.
“During the time when there was a lot of discussion and dissension about and concern about medication-assisted treatment, we were advised that clients would not be able to be residents there if they were actively receiving medication-assisted treatment,” Weller-Stargell said in an interview with WECT and WHQR.
These changes caught Weller-Stargell by surprise — especially since she believes Coastal Horizons’ stance on MAT was part of the reason Trillium decided to go with another non-profit organization to run the facility.
“Coastal Horizons was described as a great organization, but given we firmly believed that Medication Assisted Treatment (MAT) for treating Opioid Use Disorder (OUD) should be part of the treatment modalities for this residential facility, it was determined to be in direct opposition to the fidelity model of the Healing Place in Louisville, Kentucky, who stated the Healing Place in New Hanover County would be a peer-run, abstinence-based model program,” she said in her email to Coudriet.
Weller-Stargell said while the abstinence-based model does work for some — she believes it’s not the right fit for New Hanover County.
“I have nothing but praise for the program in Louisville, it works well in that community, it works well, I assume, and other communities that have an abstinence-based model that they follow. We know it will not work in New Hanover County. Communities have different substance use needs to address substance use needs in New Hanover County, opioid use is a major one for us,” she said.
Medication-Assisted Treatment - The ‘Gold Standard’
Medications like Buprenorphine, methadone, and naltrexone are all used to help those with opioid addiction, and are approved by the Food and Drug Administration (FDA).
“MAT is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers that contain opiates. The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative and euphoric effects of the substance used,” according to the Substance Abuse and Mental Health Services Administration (SAMSA).
Related: Deep Dive: A closer look at medically-assisted opioid use treatment in New Hanover County
While there is debate on the effectiveness of MAT, SAMSA’s position is in favor of its use.
“MAT has proved to be clinically effective and to significantly reduce the need for inpatient detoxification services for these individuals. MAT provides a more comprehensive, individually tailored program of medication and behavioral therapy that address the needs of most patients,” according to SAMSA.
While MAT is most often associated with opioid dependency there are other medications for other substances as well. Acamprosate, disulfiram, and naltrexone are used to treat those with alcohol use disorder.
In New Hanover County, where opioid dependency is a concern, there have been recent discussions about the Healing Place’s model that prohibited those currently receiving medications as part of their treatment from utilizing the services of The Healing Place.
Weller-Stargell believes Coastal Horizons' position on MAT — a service provided to patients with the organization – was a driving factor that led Trillium to go with The Healing Place instead of Coastal Horizons.
“Coastal Horizons was ousted because of our position on MAT, yet this facility will now open and allow MAT?” Weller-Stargell wrote in her email to Coudriet .
Although the email was addressed to the county, the decision to go with The Healing Place instead of Coastal Horizons was not a county decision. The choice was made by Trillium — something the organization made clear in an email to county officials from Chief Executive Officer of Trillium Leza Wainwright in June of 2020.
“Nowhere in the Agreement between Trillium and New Hanover County is it envisioned that the County would have any authority for or obligations regarding the non-profit entity that would operate the facility. The County agreed to 'work with Trillium' to identify members of the 501(c)(3), but Trillium is responsible for 'establishing' the nonprofit and assisting it with setting up operations,” Wainwright said.
Trillium was clear that if the county tried to push back — there would be consequences — consequences that could have prevented any facility from moving forward.
“If the New Hanover County Board of Commissioners were to try to overrule the decision of operator made by Trillium, it is the view of the Trillium Health Resources Governing Board that such action could trigger the reversion clause associated with the land transfer and abrogate the Agreement between the parties,” Wainwright said in her email in 2020.
What changed?
Despite the previous stance that the facility would be an abstinence-based program, Coudriet provided clarification and answers to Weller-Stargell’s questions. He explained the decision on allowing those currently receiving MAT.
“I, along with Tufanna Bradley and Lisa Wurtzbacher from our team, had a long discussion with The Healing Place late yesterday after receiving your e-mail. They assured us their model of recovery and service has not changed, but, in response to the federal expectations, they will accept residents and participants into the program who are under care of a provider with meds to include MAT,” Coudriet said.
As for the county’s stance on the changes — Coudriet said in a statement that there’s no one-size-fits-all solution to addressing substance use disorder.
“New Hanover County is supportive of all our providers of mental health and substance use treatment in the area, including Coastal Horizons and The Healing Place. And we are supportive of Trillium, as the state-appointed Local Management Entity/Managed Care Organization for mental health, developmental disability and substance use disorders, that is charged with identifying the gaps in services, building a network of providers in the area, and ensuring the needed services are provided to the community. Trillium understands the mental health and substance use needs of our county and our region, and we are grateful to Coastal Horizons, The Healing Place, and others who are, or will be, offering those important services. We understand that there is no one way or one method of treatment that is right for everyone, so having different options and services to help our residents is imperative. We look forward to the opening of services at The Healing Place in early 2023 and the county remains committed to doing all we can to further the mental health and substance use disorder services and treatments for.”
However, he reiterated the facility would not be providing any medications to their residents.
“They are not involved in administering, prescribing, etc. medically-assisted treatments; it is not part of their treatment model or philosophy,” he said.
As for the federal expectations — the Department of Justice reached a settlement with a medical facility in Massachusetts that refused treating those who utilize MAT in 2019 — and said that by refusing services due to medications violated the Americans with Disabilities Act.
“This agreement ensures that people in recovery from an opioid use disorder do not face discriminatory barriers to health care services,” said Assistant Attorney General Eric Dreiband of the Civil Rights Division. “Unlawfully denying services to individuals with disabilities because of their medical conditions subjects these individuals to unwarranted stigma and harm, and will not be tolerated by the Department of Justice.”
More recently, the county shared a letter from Brian Mingia, executive director of The Healing Place of New Hanover County, outlined those federal guidelines.
“[W]e have recently reviewed our client acceptance guidelines related to two specific directives or requirements. On April 5, the U. S. Department of Justice, Civil Rights Division issued Guidance on Protections for People with Opioid Use Disorder under the Americans with Disabilities Act," Mingia wrote.
But it’s not just the settlement that caused concerns. The prohibition of MAT patients also jeopardized The Healing Place’s chance of receiving money paid out by opioid manufacturers.
During a recent trip to Wilmington to discuss the use of funding from North Carolina’s settlement with opioid companies, Attorney General Josh Stein noted that the money would only be authorized for projects using medication-assisted treatment, calling MAT the ‘gold standard.’
“It's not only the gold standard, it is the standard of care, the addiction doctors of this country say that MAT is the standard of care. And so if you are funding opioid programs that don't offer MAT, they're not meeting the basic standard and [are] certainly not evidence-based. And so as you go forward with these opioid dollars, just understand that is a requirement of the use,” Stein said during his May 4 visit.
Wilmington Mayor Bill Saffo agreed with Stein’s statements.
“This is a whole new process and a whole new treatment option that the Healing Place is going to be using,” Mayor of Wilmington Bill Saffo said. “So, there’s a lot of questions being asked. Is this the right direction to go? And I think it just needs to be evaluated, because I do agree with the Attorney General, that the treatment option with the medication (MAT), I think is much more powerful.”
County provides further insight
On Wednesday afternoon, Coudriet provided responses to several questions from WECT and WHQR which are provided in their entirety below
When the County Manager first heard about these allegations, was there any action taken to confirm or refute the claims?
“Margaret asked me to attend a meeting on September 23, 2020 at Coastal Horizons. During this meeting, she shared with me that she was told she would receive $50 million from the hospital proceeds. It was the first time I had heard this, and I shared with Margaret that I had no knowledge of this promise.
At that point, the financial framework for the use of hospital proceeds had already been developed and was part of the Asset Purchase Agreement (APA). That APA had already been fully drafted and shared publicly five days prior to my meeting with Margaret in preparation for a planned public hearing of the Board of Commissioners. The use of net proceeds document was developed with the support of staff and input of Commissioners for many months, and I was the main staff person charged with leading that process. So, I would have been told if a change or inclusion of Coastal Horizons needed to be made, and that did not occur at any time. And at no time was any pressure applied to me to favor or include Coastal Horizons in the crafting of the financial model of the use of net proceeds, so I had nothing to substantiate the claim being made.
As an aside, the APA and use of net proceeds was adopted by the hospital board and the Board of Commissioners just days after this meeting, and there was never a mention to me from any Commissioner to incorporate any language around Coastal Horizons in those documents at any point. The import of the APA in this context is that it defined how the mental health and substance use disorder escrow, and the revenue stabilization revenue escrow, could be used going forward.
The other meeting I had with Margaret where this was also mentioned was on March 14 of this year, this time at the county government center. This meeting was related to the opioid-settlement money and she was inquiring about how the county would be using that funding. We discussed that the county would be developing a strategy around mental health and substance use disorders that would help inform how both the opioid settlement money and the $50 million escrow would be used. She reminded me at that point that she had been promised that $50 million. I again told her I knew nothing about that and had never received any direction or indication of that, but I assured her that Coastal would be a part of the strategy development around mental health and substance use disorders, and they have been.”
Do you recall what might have been said in response to these allegations when you first heard about it?
“As I recall, I shared that I had no knowledge of that promise.”
When Mr. Coudriet said in an email that everything else in Weller-Stargell's email was a 'total surprise' what was he referring to?
“That reference was my surprise that The Healing Place’s model had changed and they would be an MAT provider, which didn’t end up being the case. But that’s what the focus of Margaret’s letter was about, so that is what I was reacting to. As you are aware, The Healing Place did follow up and confirm that they are not providing or administering MAT but will be allowing participants who are on MAT to be part of their program.”
