At hundreds of rehabs, recovery means work without pay

By Shoshana Walter | July 7, 2020

This article is part of Reveal’s American Rehab series. Listen to the American Rehab podcast.

For years, Richard Geiler struggled with alcoholism. A father of two who was always tinkering with cars, Geiler hoped one day to open his own auto repair shop, but he had never managed to stem his addiction. Finally, in middle age, he decided to try a uniquely American form of rehab.

At the Heartland Recovery Center in La Belle, Missouri, Geiler subscribed to a strict daily regimen of religion and uncompensated work. In exchange for his treatment, Geiler and fellow participants labored long hours at Heartland Dairy, a linked for-profit venture owned by Sharpe Holdings, where dangerous working conditions had led to worker deaths. Geiler’s pay went directly to the recovery center, which would set aside a portion, less than minimum wage, for him to receive if he graduated.

The cargo van that transported Geiler and other rehab participants to the dairy showcased the farm’s disregard for worker safety. The van lacked seat belts; the seats themselves faced backward and were not attached to the floor; and the back doors, one held closed by a single bungee cord, did not latch. “A cat could push open that thing,” a sheriff’s deputy would later say.

Geiler was riding in the van one day in September 2015 when the driver sped up to avoid a hay baler. Geiler shot out of his seat and through the unlatched back doors. He landed headfirst, cracking his skull. Blood flooded into his nose and throat, and his body convulsed, records show. Two days later, Geiler died at age 51. Neither Sharpe Holdings nor Heartland responded to requests for comment.

“This was the first time he got sober,” said his mother, Linda Norman. “I guess the good Lord wanted him to come home.”

Heartland is not alone. Across the country, drug and alcohol recovery programs claiming to help the poor and the desperate are instead conscripting them into forms of indentured servitude, requiring them to work without pay or for pennies on the dollar in exchange for their stay.

These programs provide shared room and board. Some offer basic rehab services, such as drug counseling, classes and recreational activities; others, only church services and Bible study. All of them, Reveal from The Center for Investigative Reporting has found, require participants to work substantial hours without pay – often with little regard for their safety.

Some work at rehab-run businesses, such as thrift stores or car washes. Others work at outside enterprises, including small businesses, temp agencies and some of the largest, most profitable corporations in the country – Exxon, Shell, Walmart and Tyson Foods. They have manufactured supplies used in the coronavirus pandemic, staffed hospitals, maintained oil refineries, made gas grills and lawnmowers, roasted coffee, detailed cars and cared for animals at a zoo. While they put in anywhere from 20 to 80 hours a week of often-backbreaking labor, the payment for their work goes to their rehab operators. A few facilities, like Heartland, offer participants a token amount of their pay in return, or a small stipend. Others offer nothing at all.

The programs claim the work is treatment, often calling it “work therapy.” Former labor officials say failing to compensate workers is illegal.

“I don’t think there’s any real ambiguity about what the law requires,” said D. Michael Hancock, former assistant administrator for the U.S. Department of Labor’s Wage and Hour Division. “There’s nothing therapeutic about not paying workers.”

Yet the Department of Labor, tasked with enforcing the country’s labor laws, has failed to rein in these labor abuses. No government agency tracks these facilities.

For the first time, Reveal has determined how widespread they have become, identifying at least 300 rehab facilities in 44 states that have required participants to work without pay. In recent years, at least 60,000 people a year attended such rehab programs, Reveal found.

The numbers of programs and participants may be far higher. The federal government leaves rehab regulation to the states, and few states require rehab programs that don’t offer medical treatment to get licensed or report information publicly. Less than 1 out of 5 programs Reveal identified were licensed.

In this oversight vacuum, the programs have multiplied, spurred by staggering addiction rates, a growing demand for alternatives to prison and a shortage of treatment facilities.

To identify these rehabs, Reveal contacted several hundred programs with survey questions, interviewed hundreds of current and former employees and rehab participants, and reviewed thousands of pages of tax records, confidential financial documents, and wage and injury reports.

“It’s really a genius idea,” said Caleb Brietzke, who in 2019 attended the HOW Foundation in Texas, where he said he trimmed trees for rehab clients for up to 70 hours a week for $20 in “walking around money.” The program did not return calls for comment. “Take people no one will miss, and nowhere to go, and use them as basically free labor.”

An American legacy of unpaid labor

For more than a century, addiction was viewed as the domain of the deviant. In the 1930s, law enforcement agencies and psychiatrists alike typically believed it was a form of psychopathy that had no cure. The only way to handle the affliction, the thinking went, was to place addicts in prisons and institutions, away from the general public.

Influential federal officials subscribed to this belief, even as they explored strategies for rehabilitation. The Lexington Narcotic Farm, a novel federal prison founded in Kentucky in 1935, accepted criminal convicts as well as voluntary admissions. Inmates were called patients, and they tended to cows, farmed crops and played musical instruments. But eventually, it appeared that this federally funded experiment had failed. One 1969 study found that 90% of patients who left relapsed, reinforcing the idea that people struggling with addiction could not be cured.

Meanwhile, in 1958, a new model of drug treatment emerged. Founded by a charismatic recovering alcoholic named Charles Dederich, Synanon was a peer-led residential community that used confrontation and punishment to break down and rebuild drug users from the ground up. The program was sustained entirely by the unpaid labor of its members. Soon, programs modeled after Synanon spread across the country. A spate of Christian recovery programs also began to incorporate unpaid work, following in the path of The Salvation Army, which had used forms of unpaid “work therapy” to serve the destitute as far back as the late 19th century.

Unpaid labor has a rich history in the United States. Supporters often justified the brutal system of slavery by claiming it benefited slaves “by remedying their inherent laziness,” writes sociologist Erin Hatton in her book “Coerced.” Prison labor, dating back to the convict leasing system of the Jim Crow South, was often deemed rehabilitative, a claim that persists today.

By 1983, the work-based model had the firm endorsement of the president of the United States. As President Ronald Reagan was slashing taxes and funding for social services, his advisers went looking for examples of private industry stepping in to fill the gap. The Cenikor Foundation, a Synanon spinoff, was funding its program by requiring participants to manufacture safety equipment for the NFL. Reagan paid the program a visit.

“I was glancing through your Cenikor booklet, and I liked the very first sentence I read. ‘In all the years that Cenikor has been in business, rehabilitating lives, we have found that nothing works as well as work itself,’ ” Reagan said to cheers from the crowd. “This center is self-sufficient, just like all of you will soon be.”

As Reagan poured money into law enforcement and cut funding for addiction treatment, Cenikor served as proof that the federal government didn’t need to be involved in treating drug addiction at all.

Beginning in the Reagan years, the nation also increased its dependence on criminalization as a response to drug addiction. His “war on drugs,” combined with state and federal mandatory minimum sentencing and Clinton-era three-strikes laws, packed jails and prisons and fueled racial disparities in sentencing. In 1980, about 41,000 people were incarcerated for drug offenses. By 2017, that number had grown to 453,000, the vast majority of them Black and Latinx. As prisons and jails became overrun with drug users, and as the opioid epidemic moved into rural White communities, court systems across the country sought cheaper, more humane alternatives. Divorced from the health care system, fueled by incarceration, long-term rehab programs requiring unpaid work filled the void.

Today, the Affordable Care Act mandates insurance coverage for addiction treatment. But even before the current recession, 27 million Americans were still uninsured, and only about 1 in 10 people struggling with addiction received any specialty treatment. Research shows that the best outcomes result from medication-based approaches, using such proven pharmaceuticals as buprenorphine, combined with individualized counseling. Although a stable, paying job can aid recovery, studies have found that work alone is not an effective treatment for addiction. Yet work-based programs have become one of the few forms of rehab available to tens of thousands desperate for help.

“The fact that people are basically being forced to work for a treatment model that is not effective, they’re not being offered what we do know is standard of care, and there’s this forced labor component of it, is just incredibly concerning to hear,” said Dr. Sarah Wakeman, medical director of Massachusetts General Hospital’s Substance Use Disorders Initiative and a professor at Harvard Medical School. “I would worry that those people are at high risk of overdose and death.”

‘Sometimes, tough love works better’

The programs span the United States, from Republican strongholds to liberal enclaves and rural towns with single stoplights. With such a shortage of treatment providers, many towns welcome them.

In interviews with Reveal, many rehab operators said work is a crucial part of instilling structure in the lives of people whose old structures were destroyed by addiction. Getting up, going to work, following a routine is a part of resocializing people to life without drugs, they said.

“A lot of these guys have never worked or lack any type of work skills,” said Guillermo Hernandez, one of the directors of Crusaders of Texas, a recovery program in Dallas that sends participants to do unpaid construction and cleanup jobs. “By the time they get out of here, they know how to do something. They have some type of trade where they can be a productive member of society.”

Other rehab directors said the work breaks participants down, giving program leaders an opportunity to instill new values and habits. Some participants said it worked for them.

Blake Uhran was 18 and struggling with heroin addiction when he entered Cross Training Ministries in Clewiston, Florida, in 2010. He was immediately sent out to work without pay mowing lawns for such business clients as U.S. Sugar, which did not respond to queries. Outside of work hours, he said, the men in the program prayed, followed Christian workbooks and kept journals. They were not allowed television or phones.

“That work, it brings something out of them. It brings them to a place where you can minister to their heart,” Uhran said. “When it’s 100 degrees outside and picking weeds, it does change a man.” Uhran said that after he completed the program, he won custody of his kids. Cross Training did not respond to requests for comment.

At least a third of the facilities Reveal identified accept participants who attend in lieu of serving jail or prison time. Judges said the programs provided an opportunity for recovery in places where there are few treatment options; others saw learning to work as an effective treatment for people with addiction.

“Sometimes, tough love works better,” the late Judge Larry Gist, who presided over a drug court in Beaumont, Texas, said in a 2018 interview. He said many defendants in his court lacked job skills and a work ethic. “They’ve never achieved anything and don’t know how to achieve it,” he said. “They are basically looking for the perfect welfare state.”

Yet many participants said the unpaid work had an unintended effect: It made them feel exploited and expendable.

“I was worn down and exhausted by the whole thing,” said Timothy Klick, who attended a Cenikor Foundation program in Fort Worth, Texas, in 2018. There, he was sent to work full time at a factory, making dinnerware for ThermoServ. (ThermoServ did not respond to requests for comment.) “I feel like a slave, honestly. I’m being forced to work and not getting anything out of it.”

In a statement to Reveal, Cenikor described its program as voluntary and said it helped participants “overcome substance use disorder and build successful work and life habits.”

“The program provides room, board, treatment, and medication if necessary, as well as an opportunity for full employment upon completion,” the statement said.

Cenikor is among several programs that tout extraordinary success rates. The rehab claims 67% of graduates remain drug-free three years after entering the program. But those numbers disguise a bleak reality: Less than 8% of Cenikor participants graduate. The few other programs that provided graduation rates to Reveal cited rates so low that it was clear most participants do not make it to the end. When participants leave early, they can face lengthy prison sentences or relapse. Many have overdosed and died.

Rehab directors said they deployed the model in order to fund their programs. But Reveal found several rehab operators have exploited the model for financial gain, using the unpaid workers to staff their own for-profit businesses. At New Beginnings in Christ in Garfield, Georgia, rehab participants worked without pay at a pecan and cotton farm owned by the rehab’s founder. While using this unpaid workforce, the farm collected thousands of dollars in federal subsidies from the U.S. Department of Agriculture. New Beginnings founder Donald Atkinson told Reveal that he no longer farms. But he continues to send participants to work at his own auto repair shop.

At least a quarter of the facilities identified by Reveal charge participants fees in addition to requiring them to work without pay. Recovery Ranch in Santa Ynez, California, charges participants a $6,000 intake fee and $4,400 per month in room and board. While there, many also work without pay at the ranch and at for-profit businesses owned by the rehab’s founder, including a construction company and a clothing store. David Martz, the intake manager, said participants agree to forfeit their wages to pay for the program, though not everyone pays the full monthly fee.

“Nobody is forced to do anything,” he said. “That is just a part of the program and an opportunity to have the guys learn a new skill.”

“His motto was: ‘Work ethic will keep you sober,’ ” Kyle Joy, a 2017 Recovery Ranch participant, said of the founder. Joy said his work assignments involved cooking food for the facility and doing construction. “While he’s raking in all of this cash, all of this money, you’re pretty much slaving away.”

A spate of injuries and violence

Although they are typically affordable, these programs carry severe costs, captured in thousands of pages of workers’ compensation files, court documents and medical records. Program participants are routinely injured on the job, these records show, whether due to unsafe conditions at their assigned worksites or to the dangerous nature of the work itself. In many cases, rehab-run businesses failed to provide adequate safety training or equipment.

The required work has resulted in such serious injuries as burns, broken bones and amputated fingers. At least three people, including Richard Geiler, have died.

At Teen Challenge of New England, one of at least 64 Teen Challenge work-based recovery programs across the country, one participant died of chemical burns in 2011 from working at the rehab’s car wash. The program, which declined to comment, had not provided safety training, according to federal OSHA.

The HOW Foundation, a residential rehab in Tulsa, Oklahoma, runs a landscaping business staffed by its participants. In 2018, one participant fell nearly 20 feet onto his head while on a residential tree pruning job. He recovered but now is plagued by seizures. The program, which did not respond to requests for comment, had not provided safety equipment, according to court documents.

Rehab participants also face risks when sent by rehabs to work for private companies.

Nicholas Culpepper, a participant at a Cenikor Foundation program in Baton Rouge, Louisiana, was sent to work without proper training for an electrical services company in 2018. While working on a ceiling light at a local high school, he electrocuted himself, falling 10 feet off a ladder and breaking his back. Cenikor declined to comment on the incident; a civil suit is pending against the employer.

“He went in there a strong, able-bodied young man, and he’s coming out of there much less than that,” said Jeanie Payne, Culpepper’s grandmother. “He’s not able to do any kind of physical labor anymore.”

No qualifications are needed to run a work-based program, and just about anyone can start one. State regulators have repeatedly issued rehab licenses to programs that mistreat workers. And courts continue to rely on programs that require unpaid work – whether they are licensed or not.

Chuck Etchison spent many years in and out of jail and prison on robbery and burglary offenses before starting his own program, the Jericho Project, in 1995. Eventually, Etchison began sending participants to work full time at some of the country’s largest firms, including Williams Sonoma, a Fortune 500 company, and AvalonBay Communities, a publicly traded property company with $2.3 billion in annual revenues. According to confidential financial records obtained by Reveal, the participants were not paid for their labor. Etchison was.

because I am physically unable to perform my duties,” Zerboni later wrote. “I had to stand bent at the waist just to keep from grinding my teeth to bear the pain.”

Former participants and staff told Reveal they saw Etchison push and grab participants. In August 2014, after Etchison allegedly strangled a participant, a police officer recommended two charges of battery, though charges were never filed. “When he walked into the room, you were scared of him,” said Mark Gravito, a former participant who left Jericho in 2016.

In response to queries from Reveal about unpaid labor and violence at Jericho, the California Department of Health Care Services said it has opened an investigation into the program. Through an attorney, Etchison declined requests for comment.

“We are not aware of any violations of law by Jericho Project,” Kurt Conway, a spokesperson for AvalonBay, wrote in an email to Reveal. He said the company’s contracts with the program “required it to comply with all laws, including specifically paying wages not less than that prescribed by law and observing other wage-related laws.”

Williams Sonoma did not respond to requests for comment.

The Jericho Project remains licensed by the State of California today.

It is not the only work-based rehab to retain its license despite allegations of mistreatment. At the Synergy Foundation in Memphis, Tennessee, rehab participants worked six days a week at US Foods, a multibillion-dollar food distributor; at local hospitals; and at the Memphis Zoo, where they moved a sedated grizzly bear and brought dead animals to an incinerator, among other challenging tasks.

Since 2011, the Tennessee Department of Mental Health and Substance Abuse Services has investigated numerous complaints at Synergy, ranging from failure to provide counseling to neglect and physical abuse by staff. One participant had been sick for weeks before being taken to the hospital, according to the investigative report. Another participant called the program “slave labor”; investigators noted the participant appeared tired, with dark circles under the eyes. Yet another said, “I would rather be dead than in here.” In 2015, the investigators concluded that participants were being abused and that “income generated by residents is more important than their treatment.” Yet Synergy’s license as a residential treatment facility remains active with the department.

A spokesperson said the department “does not enforce laws that do not fall within its jurisdiction,” including labor laws. Neither Synergy, US Foods nor the Memphis Zoo responded to requests for comment.

Jericho and Synergy’s licensures are unusual. The vast majority of work-based recovery programs identified by Reveal are not licensed, falling under state laws exempting programs that don’t provide medical care or licensed counseling. Other states explicitly exempt faith-based programs from state standards and oversight, leaving abuses in those programs virtually unchecked.

have any kind of medication whatsoever,” recalled former participant Adam Chappell. “It doesn’t matter if you have a headache – ‘Pray about it.’ If you broke your finger? ‘Pray through it, it’ll go away.’ ” The program did not respond to requests for comment.

The Lovelady Center, a residential recovery program for women in Birmingham, Alabama, was licensed as a rehab for years before its operators declared the program exempt as a faith-based organization. Now, no state licensing agency provides oversight of any kind. Yet every year, hundreds of women pass through the program. Many work at a Lovelady-run thrift store and Christian day care center.

When participant Tonia Grubaugh filed a complaint that she had been forced to work for free at the thrift store in 2019, the Alabama Department of Labor told her the state could do nothing. Instead, she was referred to the U.S. Department of Labor.

“They pay them no wages at all and label it as work therapy,” Grubaugh wrote in her complaint. “Both stores have a sweatshop type work environment as well.”

The federal Labor Department had investigated the program in 2014 and ordered Lovelady to pay program participants minimum wage and overtime. But after the order, two former participants told Reveal, the program still failed to consistently pay for work at the thrift store. Grubaugh filed a federal labor complaint in early 2019 but said no one immediately followed up. The Lovelady Center did not respond to requests for comment.

Enforcement failures

As soon as the unpaid labor model began to gain national traction, it drew the scrutiny of the Labor Department. But the federal agency has never succeeded in ending the practice.

In 1977, the Department of Labor filed a case against the Tony and Susan Alamo Foundation for violations of the Fair Labor Standards Act, a case that made it all the way to the U.S. Supreme Court. The foundation, a controversial religious ministry based in Arkansas, said it catered to former hippies who needed religious salvation to rehabilitate their lives. They put their associates, often people struggling with addiction, to work at for-profit businesses, including a jean jacket factory, a hog farm and a grocery store, all without pay.

The Labor Department ordered the ministry to pay its associates minimum wage and overtime, but the Alamos refused, asserting that the work had a religious purpose and therefore was exempt from federal law. The Labor Department filed suit, ultimately winning a judgment ordering the ministry to pay more than $3 million in unpaid wages and overtime. The Supreme Court found that Alamo participants were employees under federal law and thus could not waive their rights to compensation. The Alamos could deduct the actual cost of associates’ room and board, but all remaining wages had to be paid.

But since the Alamo case, the Labor Department has failed to use its full firepower to ensure that other work-based rehab programs are abiding by federal labor laws. Department officials have at times caved to political pressure, dropping cases even after finding violations.

In 1990, in response to a complaint from a former participant, the department launched an investigation into the nation’s largest chain of work-based rehabs, The Salvation Army, which operates about 100 programs across the country. At The Salvation Army’s rehab centers, participants were required to work full time processing donations for the organization’s thrift stores and received a stipend of $5 to $20 a week – less than 50 cents an hour. The department found that The Salvation Army had violated the Fair Labor Standards Act and ordered the nonprofit to pay its participants minimum wage.

But The Salvation Army did not comply with the department’s findings; it sued, then launched a massive publicity campaign, enlisting members of Congress from both sides of the aisle to defend the venerable charity. Rep. Marge Roukema, a New Jersey Republican, called the enforcement action “mindless bureaucracy at its worst.”

Within a month, the department backed off, suspending the investigation. Then the department went a step further, adding explicit new rules to its field operations handbook instructing investigators to get prior approval before investigating pay issues at The Salvation Army’s rehab centers.

“The Salvation Army’s position is that individuals in its rehabilitation program, called beneficiaries, are not employees,” the new handbook language reads. “Although the (Labor Department’s Wage and Hour Division) may not agree with this position, do not initiate compliance actions until receiving clearance.” The department would take what former officials described to Reveal as “a non-enforcement position.”

“Although Salvation Army has prevailed, I’m hopeful that the policy will be reversed some day,” one staffer wrote on an internal document outlining the changes.

The Department of Labor declined repeated interview requests.

In the absence of enforcement, at least one participant has filed suit against the charity. In that 1991 case, The Salvation Army again emerged victorious. In California’s Northern District, a judge ruled that a participant in San Francisco could not be considered an employee because he had signed an intake form stating that he was a program “beneficiary.” The United States Court of Appeals backed the ruling in 1996.

“No Federal court has been asked to rule on the issue since,” David Jolley, a Salvation Army spokesperson, wrote in an email to Reveal. “Thus, The Salvation Army Adult Rehabilitation Center continues its almost 140 year old work therapy model, which is designed to help beneficiaries learn or re-learn how to live productive, balanced lives.”

Reveal could not find a single enforcement action related to the charity’s rehab workers in the years since.

Other faith-based programs have followed The Salvation Army’s lead. In an undated memo to the Association of Gospel Rescue Missions, a national network of Christian charities, then-Executive Director Stephen Burger, who stepped down in June 2007, told member organizations how to avoid Labor Department scrutiny of their recovery programs. Clients should sign a statement saying “that they understand that they are not employees,” Burger wrote. Calling participants “staff” implies “employee-employer relationships,” he advised. “Use words like disciples, program members, recovery men (or women).”

Marvin Harrell, spokesperson for the Citygate Network, as the association is now known, said the memo was no longer representative of the organization, and Citygate encourages member organizations to follow the Fair Labor Standards Act.

Nearly three decades after The Salvation Army first won the case, another enforcement case stalled in the face of political pressure. In 2012, a Labor Department investigator found the HOW Foundation in Tulsa, Oklahoma, owed participants in its residential rehab program up to $1.5 million in back wages for their unpaid 60- to 70-hour workweeks, including at a Wenco Energy plant that manufactures oil field equipment. The rehab’s director had just been convicted of wire fraud for embezzling more than $1.5 million in rehab funds to fuel his gambling habit; a judge had ordered him to pay restitution. The nonprofit told the department that it had no intention of paying the rehab workers what they were owed and enlisted the help of Republican U.S. Sen. James Inhofe, who had a relationship with the program dating back to his time as Tulsa’s mayor.

“I am writing to you about a disconcerting potential action that the Department of Labor is apparently considering,” Inhofe wrote to the acting labor secretary in March 2013. Requiring the rehab to pay its participants for their hours at the plant would “essentially destroy the very essence of the Foundation’s rehabilitation program.” He made no mention of the rehab director’s criminal conviction. Instead, he praised the program and demanded the department suspend enforcement.

“I have instructed the investigator to suspend the investigation at this time,” district director Glynda Smith wrote to Inhofe, two days after the senator’s intervention. Emails obtained by Reveal show department investigators subsequently turned their attention from HOW to Wenco.

Eventually, the department dismissed its case against HOW without issuing any violations against the rehab. Once again, the Department of Labor had backed down.

In a statement to Reveal, Inhofe defended his decision to intervene. “Time and time again, we saw the Obama administration unfairly target religious organizations through the use of government agencies,” he wrote. “Perhaps the HOW Foundation would have prevailed after timely and costly legal challenges. I wasn’t willing to take that chance.”

Today, the HOW Foundation continues to require participants to work without pay.

The successful battles waged by these programs have had a chilling effect on enforcement. Since the HOW Foundation case, the Labor Department has pursued only a handful of investigations into work-based rehabs. Twice, the department did investigate unpaid rehab labor, finding the programs – the Lovelady Center in Alabama and Recovery Connections Community in North Carolina – had violated labor law. But after those cases concluded with the programs pledging to pay workers in the future, Reveal found, both programs continued to withhold pay.

Former federal wage and hour investigators told Reveal that they were discouraged from pursuing such cases because work-based rehab programs are complicated to investigate and prosecute.

Randy O’Neal, a former regional director of enforcement, said the message investigators got was: “If you want to go out and spend a lot of resources, knock yourself out, but we’re telling you right now, don’t take your investigation to us, the lawyers, and say we want you to sue them. We’re not filing that type of case.”

Will Carless, Amy Julia Harris, Sohyeon Hwang, Quinn Lewis and Heidi Swillinger contributed to this story. It was edited by Narda Zacchino, Esther Kaplan and Matt Thompson, copy edited by Nikki Frick and fact-checked by Rosemarie Ho.

Shoshana Walter can be reached at swalter@revealnews.org. Follow her on Twitter: @shoeshine.

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