An apparent disagreement over how the Greater Los Angeles Veterans Affairs Office authorizes referrals to Legacy Village Wellness Center has placed the future of the private veterans treatment center at risk.

An apparent disagreement over how the Greater Los Angeles Veterans Affairs Office authorizes referrals to Legacy Village Wellness Center has placed the future of the private veterans treatment center at risk. (Legacy Village, LLC/Facebook)

(Tribune News Service) — Just two months ago, retired Master Sgt. Brian Clark, a 20-year Air Force veteran, was living under a tarp in Lompoc and referring to himself as “23.”

That number was a reference to the 22 veterans on average who commit suicide every day in the United States. Two months ago, after more than two years of homelessness, Clark though he would be the 23rd.

Clark, 50, was suicidal but said in February he decided he couldn’t put a knife in his own chest.

Instead, he went to veterans treatment court to try to resolve some legal issues he was facing related to public intoxication and trespassing charges.

There, Clark met David “Doc” Oliver, a Marine medic who served eight years in the U.S. Navy and now works for Legacy Village Wellness Center, a Nipomo recovery center for veterans suffering from mental and behavioral health care issues, including substance abuse.

From there, Oliver was arranged for Clark to be placed in Legacy Village’s care, where Clark said he was able to begin working toward recovery.

“Had it not not been for (Oliver) coming to me with that opportunity, I’d be right back out there, living under the same tarp,” Clark said. “Luckily, they pulled me in here, got me clean, got me sober and got me working towards real things in life and actually taking advantages of the opportunities that are afforded as being a vet.”

Now, however, thanks to a dispute with the Veterans Affairs Office, the services Clark received at Legacy Village may not be as readily available to other needy vets.

Veterans Affairs no longer referring people to Legacy Village

Legacy Village CEO Dennis Farmer said the recovery center operates as a private veteran treatment center, one of the only facilities of its kind in the country.

Located in the rural countryside of Nipomo, Legacy Village offers highly individualized care to its dozen clients, using a range of experiential, recreational and environmental therapeutic practices, Farmer said.

Most of Legacy Village’s clients rely on the VA’s health insurance benefits to pay for the program, Farmer said.

Success rates are higher than most other treatment programs, Farmer said. Where the national average success rate for treatment is around two in 10, Farmer said his program averages a success rate of around 67%.

Farmer said Legacy Village’s future is in jeopardy, however, following an apparent disagreement over how the Greater Los Angeles Veterans Affairs Office authorizes referrals to the program. Farmer said the VA has effectively cut off incoming clients as of April 28 and has forced Legacy Village to stop treating the veterans currently in its care, under threat of the VA pulling its contract with the organization.

Since Farmer said Legacy Village stopped receiving referrals from the VA on April 28, he’s had to lay off half of his staff while the organization tries to “keep our arms wrapped around (the veterans).”

“I’m doing what I can to keep the doors open,” Farmer said. “It’s a giant question mark at the moment. I’m hoping that we can increase the amount of referrals and authorizations that come in at least to get us to a point where we can keep the lights on and survive until this gets fixed.”

In an email statement to The Tribune, however, the VA Greater Los Angeles denied it had cut off referrals.

“Legacy Village is a member of the VA Community Care Network,” the statement read. “The VA has not cut off referrals to Legacy Village and has sent four referrals to the facility since April 28, 2023.”

Farmer said the VA’s issue stems from Legacy Village taking in clients without authorization and referral from its Domiciliary Care Program, which which normally handles all intakes, provides housing and health care, and refers clients to community care centers such as Legacy Village when their facility is at full capacity.

However, this referral process can lead to significant delays that don’t account for the immediate care many veterans need, Farmer said.

“The most critical thing in our particular sphere of the world in dealing with addiction treatment is time to care,” Farmer said. “We’re not ever going to be perfect, but we can sure be better than weeks or months before (veterans) get help.”

Legacy Village forced to cut staff, suspend care

Legacy Village is just one step in the network of care that aims to move veterans through acute treatment to stability.

When a veteran applies to use their health care benefits, they must go through a screening at the Domiciliary, Farmer said.

Under the VA MISSION Act of 2018, once a screening is complete, if the veteran has to wait more than 28 days or drive more than 40 miles to receive treatment, they can be referred to a community care center such as Legacy Village, Farmer said.

“All of those things went out the window when the Greater Los Angeles VA took the position that the MISSION Act doesn’t apply to residential substance use disorder treatment,” Farmer said. “That was an abrupt shift. We still don’t know why they did it.”

Joe Franceschi, who served in the U.S. Navy as a Marine medic corpsman, said he was discharged from the Legacy Village program after only 12 days in the program’s care.

Franceschi, 45, said part of the reason he came to Legacy Village was to get better services than those found at the Domiciliary, where he received treatment before shifting to the Nipomo care center.

He felt the addiction treatment he was receiving at the Domiciliary was inadequate, and the Domiciliary’s location near his ex-fiancee’s home and constant presence of drug dealing and consumption near the facility was hindering his ability to move forward.

During a 30-day stay at the Domiciliary in 2017, Franceschi said aside from having a roof over his head, the program was only able to offer him one meeting with a therapist, a physical examination from a doctor and daily Alcoholics Anonymous meetings.

That was a far cry from what Legacy Village was able to provide, which included equine therapy, environmental therapy, surfing, mindfulness and meditation programs, 12-step programs and staffing ratios of one therapist for every five veterans, he said.

Legacy Village also emphasizes reintegrating its veteran clients back into their community with sober group activities such as bowling or going to the movies, which Farmer said help break the link between drug and alcohol use and positive emotions.

Franceschi said that after his stay at the Domiciliary, he would later relapse into drug use and spent time living on the streets before entering Legacy Village’s care April 15.

But because Franceschi did not complete an initial intake screening with the Domiciliary, his 28-day period in which his health care coverage could be referred to Legacy Village still hasn’t started, Farmer said.

Franceschi is currently living in a temporary housing situation provided by veteran support group Band of Brothers Echo Group while Legacy Village and the VA work to address his care needs, Farmer said.

“We’ve had a contract to do business with the VA for going on six years,” Farmer said. “I have never seen a scenario where I’ve gone three weeks without a single authorization ever.”

Gap in care is dangerous for recovering clients

Only two of Legacy Village’s 12 active patients at the time of the VA’s April 28 cutoff were authorized to receive care, Farmer said. The rest were never able to obtain authorization to use their VA benefits at the facility.

Farmer said since April 28, when the VA required Legacy Village to discharge its clients, two of the 10 who were not authorized to receive care in the program have relapsed. The program also lost contact with a third client and is currently unaware of the that person’s status.

Farmer also said the VA told him that if the remaining clients could get authorization, they could opt back into Legacy Village’s care.

“I can treat anybody for free that I want to,” Farmer said. “I don’t bill for those days anyways — I don’t violate my license, I don’t violate my accreditation or any of that by providing treatment for free. Obviously, that doesn’t keep the lights on.”

On a good day, the referral-to-authorization process can take between five and seven days, Farmer said.

If a client is actively struggling with addiction or suicidal thoughts, though, that wait can be life-threatening as the risk of overdose or suicide attempts increases, Farmer said.

Farmer, who himself is a recovering alcoholic, said in his own experience, the window of sobriety and intention to change self-destructive behaviors can be very narrow.

“That moment of desperation that you have to reach out doesn’t last for days — sometimes it doesn’t last an hour,” Farmer said. “If you meet enough roadblocks in a short amount of time, you’re done, and you have no idea when it’s going to come back again.”

Veterans scramble to find housing after VA decision

In the weeks since the VA’s decision, several local support agencies have stepped in to find housing for the displaced veterans.

Farmer said Legacy Village worked with Band of Brothers and the Good Samaritan Shelter in Santa Maria to house the unauthorized veterans in temporary shelter until they can get authorization from their providers for care.

Clark is currently living in a home provided by Supportive Services for Veterans and Families in Oceano for the time being, Farmer said.

San Luis Obispo County Veterans Service Officer Morgan Boyd said Legacy Village’s program is “unlike anything (he has) ever seen,” and said a shutdown means depriving the county of its only residential veteran treatment resource.

“We are not the enemy of the VA — the VA are integral partners in our community,” Boyd told The Tribune. “I don’t come from a place of anger with the VA, although it really disheartens me to see what has been happening.”

Boyd said the county’s Veterans Services Office can only do so much for its clients, such as filing benefits, obtaining licenses, working through education benefits and arranging burial allotments.

When one link in the chain of services starts to buckle, the resulting gap in services leaves both veterans and local service providers “significantly challenged” for the foreseeable future, Boyd said.

The VA also said it “does not have the authority to require community care providers to discharge patients,” which Farmer said was not true.

Farmer said one of the four referrals was received May 10 for a client who had been discharged on April 28.

However, that referral authorized Legacy Village to treat the client for 30 days, starting April 17 and ending May 17, essentially leaving just a week of valid, authorized care time.

“If I’m gonna get an authorization until the 10th of May that was valid three weeks prior to that, what was I supposed to have done with the veteran?” Farmer asked.

The other three referrals Legacy Village has received since April 28 were all for new clients, which Farmer said still leaves most of the 10 discharged veterans — including Clark and Franceschi — without authorization to finish their residential treatment programs or proceed to outpatient care.

With a handful of referrals starting to come in, Farmer said he is “cautiously optimistic” that more clients will be authorized in coming weeks, but he said the referral and authorization process must be faster.

“This can’t get drowned out,” Farmer said. “I’m just hoping that enough noise can be made, and that enough people will call their congressperson, legislators and senators, and they won’t stop until this thing gets fixed.”

(c)2023 The Tribune (San Luis Obispo, Calif.)

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