In 1970, ground was broken for a 100-bed residential treatment facility and Gateway Rehabilitation Center’s first patient was admitted on Jan. 2, 1972. But immediately, Gateway faced serious funding problems. “We understood that Blue Cross/Blue Shield was going to begin covering alcohol and drug treatment within a matter of months,” says Twerski. But commercial insurance coverage didn’t begin until 1975. In the intervening three and a half years, Gateway survived thanks to three funding sources: remuneration from the Pennsylvania’s Bureau of Vocational Rehabilitation, which paid 70 percent of costs for approved clients, and charitable contributions from local foundations and industry.
“The local industries could see the impact that untreated alcoholism and drug abuse was having in terms of lost time and the loss of good people,” he says. While that understanding made the job of fundraising somewhat easier, it did not solve Gateway Rehab’s early funding problems.
A mortgage to cover the payroll
“One day, the administrator called me and said, ‘I can't meet next Thursday's payroll.’ So I told her, ‘There's nothing I can do. I've used up my welcome with all the donors,’” Twerski explained. “She asked me, ‘What will we do?’ and I told her, “We tell our patients to live one day at a time. That's what we will do. If we have to shut down next Thursday, we’ll do it then. There's nothing more I can do, so we have to tum it over to a Higher Power.”
As the next Thursday came and went, Gateway remained open. Twerski recalls: “You may not believe this, but our accountant, a 70 year old retiree, a veteran in recovery, took out a mortgage on his home to cover the payroll. That was crazy because there was no prospect that he would get his money back.”
But it all worked out, again, providentially: “Gateway was built on an unrealistic dream, and that's how it functioned.” Despite repeated threats of foreclosure, Twerski credits CEO Ken Ramsey, MD, and a “dedicated board of directors” with “somehow managing to fend it off.” Today, Gateway Rehab has grown into a rehabilitation treatment system that offers not only the social and sobriety support needed by the patients of the 1960s, but also 22 locations in Pennsylvania and Ohio, serving some 1,700 patients daily.
Twerski, who became Gateway’s emeritus medical director in 2001, adds that in recent years, Gateway Rehab has begun to provide an expanding range of services to young people and their families. In early 2011, it plans to break ground on a 27,000 sq ft, 42-bed facility for teens aged 13 to 18. It will offer lengths of stay from three weeks to two months. The new facility will be located on Gateway Rehab’s 20-acre, Center Township campus, just a short stroll from the newly named Abraham J. Twersky Hall—Abe’s Place.