Written by Barbara Dietrich Boose
Photos by Duane Tinkey
Rose Marie and Michael Vasquez could have retired in their mid-40s to a life of leisure after they sold their companies. With one, they had created one of the first electronic medical record systems; another, which processed real-time Medicare payments to approximately 1,700 hospitals, was purchased by UnitedHealth Group Inc.
“Then God and other things intervened,” says current colleague Matthew Phelps.
That “intervention” led the Vasquezes in 2007 to establish St. Gregory Retreat Centers, residential addiction treatment facilities in Adair and Bayard. The organization may not be well-known locally, but it has gained an international reputation for its innovative program and impressively high recovery rates among the drug and alcohol abusers who have received treatment there. In addition, in 2012, the Vasquezes opened Harbor View Medical Center in Des Moines to treat painkiller addiction. And last year, they began offering the St. Gregory treatment program to nonviolent substance abusers in the Polk County Jail.
The St. Gregory enterprise stemmed from tragedy. The couple had tried to help a friend of their oldest son overcome his years of substance abuse, but in 2005 the young man died in a car wreck. “We thought we had done all the right things and for some reason they didn’t work,” Michael Vasquez says. “We didn’t know if we were an anomaly or whether it was a weakness in the treatment delivery system that no one had addressed.”
Investigating Addiction
Moved by their faith—and “blessed with resources and time,” Michael adds—he and Rose Marie decided to investigate that question. They learned the grim statistics of addiction. Despite the ubiquity and touted benefits of Alcoholics Anonymous (AA), Narcotics Anonymous and other 12-step programs, recovery rates among individuals addicted to alcohol and drugs are low. Only about one out of 10 people who need treatment for alcohol or drug addiction receives it, compared with seven in 10 with the chronic diseases of high blood pressure, depression and diabetes, according to the National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia). Of those who receive treatment, few receive anything that approximates evidence-based care.
In fact, regarding just alcohol abuse, the scientific research organization Cochrane Collaboration, in its review of studies conducted between 1966 and 2005, concluded: “No experimental studies unequivocally demonstrated the effectiveness of AA” in treating alcoholism, even though its approach is the core of the majority of addiction treatment programs in the nation. More recently, in his 2014 book “The Sober Truth: Debunking the Science Behind 12-Step Programs and the Rehab Industry,” Lance Dodes, M.D., wrote that peer-reviewed studies peg AA’s success rate somewhere between 5 percent and 10 percent.
Equally disturbing, according to CASA Columbia, is that “no clearly delineated, consistent and regulated national standards” define who may provide addiction treatment in the United States. Of every dollar spent by state and federal governments on addiction and risky use, only 2 cents go to prevention and treatment; 96 cents pay for the consequences of the nation’s failure to prevent and treat the problem.
With no personal experience relating to addiction, and with a medical background limited to the business side, the Vasquezes decided to wade into this morass. “As we looked at the numbers nationally for recovery, we looked at each other and said, ‘I really wouldn’t want those as odds in open-heart surgery,’ ” Michael says.
Treatment Approach
The couple began with a “white piece of paper” to sketch out an addiction treatment approach based on proven, published research. From that blank slate emerged St. Gregory Retreat Centers, named after the patron saint of the desperate, the forgotten and lost causes. Based in a nondescript building near Des Moines International Airport, St. Gregory is certified by the Commission on the Accreditation of Rehabilitation Facilities and recognized by most large insurance carriers. Approximately 60 percent of its “guests,” as the staff calls them, come from out of state and many come from other countries, finding the program via referral, word of mouth or an Internet search.
Most leave sober: A survey of St. Gregory graduates conducted by the University of Iowa showed that 93 percent tested substance-free 12 months after leaving the program, and 84 percent were not abusing alcohol or drugs four years later. That compares with a national average success rate of 12 percent of individuals after leaving a substance abuse treatment program.
“I can comfortably say ours is the most sophisticated program in the country because of the medical, behavioral health, and wellness aspects we’ve integrated,” Michael says.
Its holistic approach makes St. Gregory different from other treatment programs, says its medical director, Charles Wadle, a physician and registered pharmacist. Guests commit to a two-month residential program that typically begins with five to seven days of “medical stabilization,” or detox, in Des Moines. During that time, guests are put on intravenous therapy for two hours a day to replenish nutrition, vitamins and amino acids that rebuild neurotransmitters in the brain, which reduces craving, begins to restore health and improves decision-making. They also begin cognitive behavioral therapy, which teaches them to recognize the triggers that cause their cravings for drugs or alcohol.
“When people come in, they are near death’s door. Then at the end of the week, they’re eating and active and looking forward to what’s ahead,” Wadle says. “It’s very exciting to see.”
Seven-Week Residency
Guests then spend the following seven weeks at St. Gregory’s residences in a 20-bed facility for women in Adair, Iowa, or in a 56-bed facility for men 30 miles north in Bayard. They work with counselors, participate in wellness/exercise activities and are drug-tested weekly. Each guest creates a plan to help him or her make a successful transition to home, work or education.
“Other programs use a disease model—that substance abuse is inherent to the person,” says Matthew Phelps, St. Gregory’s director of communications. “But ultimately, it’s a choice, a short-term solution to other problems. We work with guests to deal with those underlying problems as well as their addiction.”
Another aspect that distinguishes St. Gregory is that its staff members typically aren’t past addicts, as is common in 12-step programs. “Part of the participants’ recovery in those programs is helping other people: ‘It worked for me, so it’s got to work for you,’ ” Vasquez explains. “But the problem is, if I’m part of the less than 15 percent it worked for, I have only a 15 percent chance it’s going to work for you.
“The first question, then, from families is, ‘If you’ve never walked in Jimmy’s shoes, how are you going to be able to help Jimmy?’ ” he adds. “And our answer is, ‘You’re calling me today because you don’t want Jimmy walking in his shoes; you want him walking in my shoes.’ If you were talking with me about my doing open-heart surgery on you, you probably would never ask whether I’ve had open-heart surgery. You’d want to make sure I’m the best surgeon you could find. So we want to be the best medical, behavioral health and health/wellness program possible. Everyone who interfaces with our guests is a certified alcohol and drug counselor.”
That includes most of St. Gregory’s 160-some employees—Wadle, the nurses, a staff psychologist, two clinical directors, counselors, activities staff, health and wellness staff, a dietitian, a massage therapist, chaplains, a vision coach, cooks, housekeepers, maintenance staff, admissions representatives and various administrative and support staff.
Cost of Care
All those individuals, the services they provide and the facilities where they work don’t come cheap. The price tag for St. Gregory’s residential treatment program ranges from around $6,000 for individuals with insurance to nearly $30,000 for those without. That includes the two-month commitment and then a full year of “recovery life coaching,” in which graduates talk weekly with a counselor to receive guidance and review progress toward their goals.
In addition, St. Gregory’s “commitment program” allows any guest, within a year after completing the program, to go through it again if needed “at almost no cost,” Phelps says.
“Our research shows that we’re actually the least expensive among our peers who offer a similar level of service,” he adds.
The cost and duration of the program are additional reasons the program is unique. “Twenty-eight-day programs exist solely because that is a length of time commonly reimbursed by insurance companies, not because it’s an effective time frame for any specific treatment model,” states the St. Gregory website. “Unfortunately, the field of addiction treatment has been influenced more by compliance with insurance companies, pharmaceutical companies and profit than by what really works.”
That the St. Gregory model works for many is impressive in part because of its relative youth compared with other intensive addiction centers. The Betty Ford Center in Rancho Mirage, Calif., for example, was established in 1982; in Des Moines, the Powell Chemical Dependency Center opened in 1973. St. Gregory opened its first facility in a vacated nursing home in Adair in January 2007.
“I remember delivering the last chair. I sat down and said, ‘Now what do we do?’ ” Michael Vasquez recalls. “Rose Marie and I had to fund it the first three years because it was all private pay. You couldn’t use insurance because our approach wasn’t accepted.”
Community Acceptance
The Vasquezes also needed the acceptance of the community. Not all of the 780 residents of Adair, home of that sunny, smiley-faced water tower that beams down on Interstate 80, were thrilled to welcome a rehab center.
“Knowing someone wanted to purchase that empty nursing home was great, but I and many others felt a little bit of trepidation and fear about having a bunch of drug addicts in town,” says Kelby Harris, who was Adair’s mayor at the time. When the tanking economy coincidentally
led to his layoff at a local manufacturing company, he became a driver for St. Gregory, transporting its clients from Des Moines and Omaha.
“As an employee, I figured I would know exactly who they were bringing in and what they were being taught,”
he says. “But Michael and Rose Marie didn’t have to try very hard to be accepted; all they had to do was to be who they are.”
Now assistant director of the Bayard residency facility, Harris says the two communities benefit both by the fact St. Gregory is a for-profit, taxpaying entity as well as by its approach. Once a week, guests of both facilities participate in local service opportunities, from working with shelter animals to doing yard work. That’s a focus of St. Gregory’s treatment, Wadle says.
“Community service is so rewarding and very helpful to our guests, because—not necessarily because of their own fault—they’ve been very self-centered,” he says. “A lot of them have never had the experience of giving back to the community.”
Harbor View
Giving its guests hope for a better future remains the mission of St. Gregory amid its expansion with Harbor View Medical and the Polk County Jail. The Vasquezes created the former when they learned of the skyrocketing use of prescription painkillers and the often-dangerous consequences. Nearly 15,000 people in the United States die from overdoses involving these drugs, more than those who die from heroin and cocaine combined, according to the Centers for Disease Control and Prevention. The drugs are widely misused and often highly addictive.
“We think we have the best treatment program in the world, so we wanted to help that population, too,” Michael says. “We found that a lot of times getting people off their painkillers safely wasn’t enough, though, if they have orthopedic pain.”
Subsequent research led the Vasquezes and their medical colleagues to offer clients regenerative stem cell therapies to repair joints and tissues and stimulate their natural healing abilities as they withdraw from painkillers. And that led them last July to begin treating people with pure orthopedic, non-drug-addiction issues seeking to avoid knee, shoulder or other joint replacement surgeries.
“We’re the first drug treatment center in the world that has an integrated stem cell transplant center co-located,” Michael says.
St. Gregory has even more in the works. In December 2014, Kerri Rush opened Fresh Cafe, which serves vegetarian and vegan fare, as part of the 30,000-square-foot “St. Gregory Commons” on Thornton Avenue in southwest Des Moines, where Harbor View and the medical stabilization unit are located. Now preparing healthy meals for St. Gregory’s guests, the restaurant is expected to be open to the public this spring for breakfast and lunch.
While remarkable, the Vasquezes’ success is true to their purposeful, faith-driven and entrepreneurial approach. Rose Marie helps screen all individuals prior to their being hired in any roles within the enterprise. Michael, named an “American Success Story” by Entrepreneur magazine in 1994, was Ernst & Young’s Entrepreneur of the Year in 2000, and in 2012, he was a finalist for that same honor for his work with St. Gregory.
“Our goal,” Michael says, “is to build this big enough to try to have an impact and give hope to as many people as we can.”
