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Trust, but verify

June 1, 2010
by Dennis G. Grantham, Senior Editor
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In our special section about drug testing (see page 19), clinicians and organizations alike explain its essential application in substance use treatment in interconnected medical and moral terms. Medically, the clinician must know what, if any, substances are present in the system of a consumer engaged in treatment to make safe and appropriate decisions. Morally, the consumer must know that the clinician knows or can know the “truth” about his or her substance use at any time. Testing validates honesty, building support and trust between consumer and clinician, while it exposes dishonesty and teaches a lesson that can help the consumer deter it in the future.

Amid many advances and much positive news at this year's National Association of Addiction Treatment Providers (NAATP) conference, NAATP board members, led by board chair Cathy Palm, confronted in a special meeting the consequences of a trust-based relationship that, circumstances showed, lacked proper verification. In late January, Palm was informed that NAATP, notably its longtime (now former) CEO Ron Hunsicker, was under investigation by Pennsylvania's Attorney General. Subsequent investigation found that some $500,000 of the organization's funds had been misappropriated-used by Hunsicker to pay personal expenses that had been intermingled with business expenses through the use of credit cards-over a five-year period.

Given these facts, all board members of NAATP, current and past, had to face their membership and acknowledge the reality that-although their service is voluntary, although expensive third-party audits are not legally required for small non-profits, and although membership has grown steadily for over a decade-their stewardship of NAATP was insufficient. Instead of ensuring the honesty of financial reports through audits, they gave their trust without such validation, an error that none of these accomplished leaders would likely have tolerated in their own organizations.

Even then, it took willing dishonesty on the part of NAATP's former president, Ron Hunsicker, to exploit this opening. Ironically, Hunsicker's many contributions to NAATP leave it strong enough to survive, evolve, and thrive beyond the crisis caused by his own stunning behavior. Many individual NAATP members feel considerable compassion for him even while they, as an organization, are compelled to press for full restitution-which, reportedly has been promised-and weigh, along with the Pennsylvania Attorney General, options for his criminal prosecution.

All of this brings me back to a couple of thoughts. First, the obvious: that any non-profit organization must have financial controls to encourage, or compel by means of validation, honesty in the management of its funds. Audits are expensive, but validated trust-in people, processes, and organizations-is irreplaceable. Second, had NAATP's board members built the processes needed not only to encourage, but to compel and validate such honesty over the past 13 years, they would have prevented this organizational crisis. In so doing, they might also have prevented a tragic personal failure, helping to save a person once credited with saving their organization.

Dennis G. Grantham, Senior Editor Behavioral Healthcare 2010 June;30(6):6