When Sanja Babic walked into Affinity Inc. in 2015, she felt hopeless, alone and worthless.
Babic, 20, had been using methamphetamine, then became addicted to heroin. Now clean for nearly a year, the support she found through Affinity “saved my life,” she said last Monday.
The mental health organization served as a lifeline for many people in the Treasure Valley. Its sudden lapse in services following a federal raid on March 3 left a gap in treatment for some patients.
One of the largest agencies of its kind in the Valley, Affinity has operated for 17 years, according to owner Sabrina Swope. Its clientele last year included more than 800 people who were covered by Idaho’s Medicaid program. The state-run insurance program paid the company $840,330 for that care.
Through its offices in Boise and Nampa, Affinity provided “wraparound” services such as counseling and therapy, medication management, case management and other services for people with developmental disabilities, mental illness or substance-use disorders.
Swope said the agency continues to offer some of its services, like therapy, but cannot take new clients and closed its Nampa office. Affinity lost more than half its clinicians and employees in the past two weeks, she said.
The Monday after the raid, Affinity could not operate and was told to refer its Medicaid patients to other providers.
“When clinicians hear Affinity can’t serve clients, they’re going to start looking for other work,” Swope said.
“This has caused significant damage, I can’t reiterate that enough.”
Just a handful of agencies in Boise have the workforce and systems in place to provide an equal array of services. Pathways of Idaho LLC, All Seasons Mental Health and others are scrambling to get patients transferred into their care.
“Since Affinity closed its offices this past week, Pathways of Idaho accepted nearly 30 former clients and we anticipate more in the future,” Molina Healthcare spokesperson Sunny Yu told the Statesman in an email March 10.
Yu said the agency has sped up its hiring process to bring in former Affinity employees “to help decrease their unemployment gap and to mitigate any interruption in care that former Affinity clients may experience.”
Former patients and employees told the Statesman that transferring clients to new providers has been a difficult and confusing process. That’s partly because some of Affinity’s records were inaccessible after the raid.
And the agency’s contracts with its former employees include a “non-solicitation” clause that forbids them from attempting to bring patients to their next employer, said Swope.
“If [patients] want to go somewhere where their clinician is going, we are going to facilitate that. But it needs to happen with a discussion” with Affinity officials, she said.
People with substance-use disorders are at an especially high risk of relapse when they face such a disruption, said Matt Scuri, the CEO of All Seasons Mental Health. That’s because the early phases of recovery are intensive, with multiple visits a week, he said.
Scuri said health insurers “are being great” about helping to keep the transition as smooth as possible.
One former patient who lives in Meridian already struggled with relapses when he rejoined Affinity last December. He got settled in with a new counselor and felt he was making a breakthrough when two appointments last month were canceled, surprising him.
He later learned secondhand about the sudden closure. It has been six weeks since his last counseling session; he hopes to catch up when his counselor lands in a new agency.
“Affinity did not reach out to me once, they just left me high and dry,” said the man, who asked not to be named for privacy reasons.
No details about the raid and subsequent shutdown have been released by the IRS, other federal agencies or any local law enforcement.
But according to Swope and current CEO Brian Cox, it stemmed from financial problems going back more than a year.
A former chief financial officer who was preparing to retire didn’t file taxes for the third and fourth quarters of 2015, they said. (Swope declined to provide the name of the CFO, who has since retired.)
“Our CPA found it, and we got slapped with a fine and a couple of staff caught wind of it — you know, people talking and listening to conversations they shouldn’t be listening to,” Cox said in an interview Thursday. “Our accounting department kind of blew up after the CFO left. We tried to install some expectations, and nobody wanted that.”
The former CFO also failed to bill insurers, Cox said, or to pay the agency’s own bills.
Cox said Affinity’s entire accounting department quit and that “disgruntled” employees were “blowing it out of proportion and relaying information that, in fact, was truly speculation.”
Swope admits that while she was CEO in 2015, she “wasn’t paying attention” to the mounting financial problems. She handed the CEO job over to Cox and took 2016 off work for personal and mental health reasons, she said.
Former employees told the Statesman that Affinity had seemed to be on shaky ground since last year.
Their paychecks started to bounce several months ago, they said. Some also said they ran into trouble filing for unemployment because their wages hadn’t been reported, and that local law enforcement agencies are investigating.
The employees asked not to be named because of concerns that talking publicly about a former employer could damage their job prospects at other agencies.
The state’s Medicaid contractor, Optum, pulled the agency from its new-patient network as of March 1 after “investigating complaints,” said Lauren Mihajlov, Optum’s director of communications. “In order to ensure the people we serve have uninterrupted access to the care they need, Affinity continues to provide services to our members who have chosen to remain at the agency. Optum is working with [the Idaho Department of Health and Welfare], our members and providers to transition care services as appropriate, answer any questions and support them during this change.”
Cox thinks the agency will recover. But Swope isn’t so sure.
“Unfortunately it has damaged the company terribly, and who suffers from that is the client, and for that I’m sorry,” she said.
‘They were always there’
Babic was using Affinity’s services for substance-use disorder treatment, case management and counseling. Without health insurance or Medicaid, the Boise woman’s treatment has always been paid for by BPA Health, a substance-use treatment contractor for the state.
BPA Health last year paid Affinity $171,710 to provide treatment for 110 patients on behalf of Health and Welfare. (The contractor also works with other state agencies, so it’s possible Affinity did even more substance-abuse treatment work for the state.)
Babic had been using drugs since she was 14. Since she began treatment in 2015, she has relapsed, spent about a month and a half in jail and debated giving up on trying to stay clean. It was Affinity’s employees who helped her get back on track.
She didn’t have health insurance, so Affinity set her up with Terry Reilly Health Services and directed her to affordable dental treatment. Later diagnosing her with depression and anxiety, Affinity helped her find resources to treat the disorders.
“They were always there,” she said. “The thing I loved about Affinity clinicians … it was to the point where you can tell them anything going on in your life. They actually cared about you and wanted to help.”
When Babic last went to the Boise location for a group meeting on March 6, she was told the person who runs the group was out sick.
She hasn’t been to a group meeting or counseling since the company’s closure.
Like others who relied on Affinity, she is searching for a new place to go.