by Jacqueline Marino • photos by John Landrigan
n the small porch outside her friend’s Midtown apartment, Sandra
La Cagnina sits in the shade of a large tree. The ground is still
wet from last night’s rainstorm. Raindrops glisten on the leaves.
Spring is everywhere except in La Cagnina’s heart. She hands over a laminated picture of her son, Jason Barganier, with the words from “A Box of Rain” by the Grateful Dead printed underneath:
Maybe you’re tired and broken, your tongue is twisted with words half spoken and thoughts unclear. What do you want me to do, to do for you to see you through?
La Cagnina still has a hard time talking about the last few months.
Eloquently expressive even when it seems as if she’s going to
burst into tears, she recounts entire conversations and tiny details.
At one point, she stops. Her hands are shaking so badly it’s difficult
for her to fish a pack of cigarettes out of her purse.
In her midtown apartment, Sandra La Cagnina maintains a shrine
to her dead son, including photographs and keepsakes. Below: Jason
Barganier and his mother in happier days.
It was November 1996, she says, when Jason finally came to her for help. He was 22 years old, strung out on cocaine, on the run from drug dealers, and so skinny she could feel his ribs when she put her arms around him. She wanted Jason to get into a rehabilitation program, preferably in a residential setting where he could get away from the drug culture and other negative influences in his life.
She was referred to Memphis Recovery Centers, a state-subsidized, nonprofit drug-treatment center with an intensive residential program for young men ages 17 to 31. She thought it would be his saving grace. Little did she know that in a year and a half it would become just another bill collector, like the funeral home and the hospital. Little did she know that MRC’s priorities would change from her son’s recovery to fee recovery.
Convincing Jason to go to MRC was easy, like convincing a drowning man to come up for air. But getting him to follow the tough treatment regimen was another ordeal entirely. With Jason, MRC had quite a challenge. Even now, La Cagnina doesn’t make excuses for him. As far as she knows, Jason took his first puff of a marijuana cigarette when he was 13 and had been abusing drugs on and off ever since.
After his first visit to MRC, a drug counselor told her the program could help Jason. She says he told her Jason could stay at MRC for up to 22 months as long as he was making progress.
La Cagnina agreed to pay, and Jason agreed to follow MRC’s strict diet of rules designed to help wean patients from addictive behaviors. The things he was not allowed to do would sound restrictive to anyone, especially someone like Jason, who frequently made up his rules as he went along. Patients are not allowed to have anything that could cause bodily harm or be used as a chemically abusive agent, including cigarette lighters, colored markers, cologne, and nail clippers. The reasoning behind other restrictions is not so obvious. For example, patients are not allowed to be outside on the porch after dark or to use the telephone or the mail without permission.
As Jason and his mother soon found out, MRC takes its two-and-a-half-page, single-spaced list of house rules seriously. Breaking any of them could result in the patient being discharged before the treatment is completed.
MRC requires families to be involved in the patient’s treatment, which was one of its main selling points for La Cagnina. Both Jason and his mother signed a contract in which Jason promised not to ask his mother for money, shelter, or anything else that could “enable” him to abuse drugs. La Cagnina promised not to give him anything if he did ask.
In the seven months Jason was a resident at MRC, La Cagnina saw him healing his body, his relationships, and his attitude. La Cagnina says Jason’s counselor, who has declined to be interviewed, told her he was “amazed” at Jason’s progress. Jason wrote letters to everyone he’d harmed because of his drug abuse. On Mother’s Day 1997, he wrote La Cagnina:
Mom, I am writing this letter to tell you how much I love you and how much I am grateful for all that you have done for me. I have made a lot of bad choices in my life – dropping out of school, people I hung out with, selling drugs, and so on. But you were always there for me and you never put me down for what I had done. I have lost lots of loved ones in my life also. But, again, you were there for me. No matter how much trouble or pain I was in, you were always there for me. I know I don’t show it enough, but I love you and I am the most blessed son in the world to have you for my mother. I know at treatment and your meetings they told you that the things you did for me were enabling me to kill myself, but you were the only reason I lived though all those times. I hope our relationship gets better every day. But even if it does not change, I am happy for the one that we have. I have already had a lifetime of bad events happen so hopefully I am coming upon the good ones and I hope that we can share them together as a family should. Thank you from the bottom of my heart, and I love you. Happy Mother’s Day, Jason
A few weeks later, La Cagnina received a call from Jason’s counselor telling her that Jason had been discharged for breaking a major rule. (For confidentiality reasons, MRC will not acknowledge that Jason was a patient there, so there is no official version of the story.)
La Cagnina says the counselor told her Jason and another patient, who was half-black and half-white, had a confrontation that resulted in the other patient calling Jason a “cracker.” Jason, who was white, responded by calling the other man an “Oreo.” Making a racial slur can result in expulsion from the program, according to MRC’s rules. La Cagnina says the counselor appealed Jason’s discharge, but failed to keep him from being ousted.
That weekend, Jason, who had turned 23 in October, was back out on the street without money or a place to live, too prideful and ashamed to ask his mother for help. Nine months later, he was dead.
La Cagnina has turned her bedroom, the last place where she and Jason had a mother-son talk, into a kind of shrine. On the shelves are pictures of Jason playing sports, Jason in his karate outfit, Jason frolicking on the lawn. In a memory box on the dresser, La Cagnina keeps the last $5 bill Jason had in his pocket when he died, his keys, and his college ID card. She keeps his last paycheck from UPS propped up against the box.
La Cagnina remembers that February 28th, the last time she saw her son, was a beautiful day. She already had plans to go fishing with a friend when Jason called. Since being discharged from MRC, he had gone nine months without asking his mother for help. But when he told her he needed to talk, she figured he was in trouble.
The two were sitting on her bed when he told her he still owed drug dealers money. He said they were after him again. He figured he could sell drugs to pay them back.
La Cagnina, who says she used drugs herself briefly in her youth, reacted to this plan with disapproving bluntness.
“You’re really bad at selling drugs,” she says she told him. “You suck at it. You should think of something else.”
La Cagnina remembers it was fairly easy to convince Jason this was true. He had been caught selling drugs in the past, he’d lost friends in drug-related incidents, and he was a recovering addict himself. By the time Jason got up to leave, La Cagnina thought she had succeeded in talking him out of the drug-selling scheme. They hugged. He went back to his apartment at the corner of Poplar and Auburndale. La Cagnina went fishing.
Four hours later, at about 6 p.m., Jason called his mother’s apartment.
“I’ve taken too much shit,” he told his sister, who answered the telephone. “I’m in hell.”
Then he hung up, walked up the creaky wooden steps to the landing between the second and third floors and pushed himself through the stained-glass window. He landed on the concrete sidewalk in front of the entrance. Later, at The Med, the doctor told La Cagnina her son was brain-dead. He told her to imagine how an egg would crack if it were dropped on the ground. That’s how Jason’s skull fractured.
The next day, La Cagnina ordered the doctors to take Jason off the life-support machines. The police classified his death as an “accident.” The “shit” he had ingested before he died was LSD.
The funeral, La Cagnina recalls, was packed. Jason’s friends shared their memories of him. Some of them talked about the unfairness of it all. Jason was the guy who would always come pick you up in the middle of the night from anywhere if you needed a ride, the person who would always offer to let you crash at his apartment if you needed a place to sleep, the friend who would stay up all night with you talking about God and politics. Jason may have chosen a dangerous path, but he was young, bright, and generous, and he deserved a future.
Four weeks later, La Cagnina was making arrangements to bury Jason’s ashes next to the casket of his best friend, Victor “Joey” Boldreghini III, who was shot to death here in 1993 following an argument that may have been drug-related, when she received a letter from MRC’s attorney:
Please be advised that I have been retained by Memphis Recovery Centers, Inc. to assist in the collection of the above-captioned, delinquent account balances,” it read. “My Client has authorized me to forward this letter allowing you one last opportunity [emphasis appears in letter]to make voluntary payment arrangements with my office to satisfy this indebtedness. If I do not receive a response to this correspondence in the next ten (10) days, I will have no alternative but to recommend that my client file suit and reduce its claim to Judgement. Should legal action be authorized, you will also be liable for all costs incurred in pursuing the satisfaction of this claim pursuant to the terms of the Payment Agreement you executed with Memphis Recovery in addition to a one-third attorney’s fee.
It was the ultimate cruel irony: La Cagnina’s son died a drug-related death and now MRC wanted her to pay for the treatment she expected to save him.
“I called up that attorney and told his answering machine that my son died and I hold them responsible,” she says. “If they pursued this, I’d go after them with everything I had.”
Legally, La Cagnina didn’t have a prayer. When Jason started his treatment at MRC, she signed a contract requiring her to pay 14 monthly installments of $122, even if Jason was discharged from the treatment center early for any reason. Although she says Jason’s counselor told her Jason needed long-term treatment that would last up to 22 months, the contract specified that La Cagnina would be required to pay the entire cost, $1,712, as long as Jason did not leave or get kicked out of the program within the first eight days.
La Cagnina admits she didn’t understand the contract when she signed it because of the confusing manner in which it was written.
“You’re under duress wanting them to save your child’s life and all they care about is getting paid,” she says. “Being in that state, all you know is your child’s almost dead and people are saying sign this and we’ll take him.”
Between 1995 and 1997, MRC was awarded 136 money judgments, according to a listing by The Memphis Daily News. In comparison, some other residential alcohol and drug treatment programs, including Harbor House and the Synergy Foundation, had none during the same period. Genesis House had six. In 1997 alone, the court ordered $41,503 in money judgments to MRC.
MRC executive director John Foote agrees that his organization is more legally aggressive than other treatment centers.
“If they sign a contract and they don’t pay, we will sue them,” he says. “We don’t operate this program on air. If we don’t operate this program like a business, we’re not going to continue to exist.”
MRC, however, is not a business. It’s a nonprofit alcohol- and drug-treatment center that took in nearly $2.4 million in revenues last year, according to an audit filed with the state. Public money made up a substantial portion of its revenues. MRC was awarded $804,852 from the federal and state governments, $170,444 from public donations, and $26,387 in food stamps. The Tennessee Department of Health gave MRC $220,512 for the young-adult program alone.
Patients are charged for services on a sliding scale according to their ability to pay. Foote wouldn’t divulge how much it actually costs for one patient to complete the young-adult program, which is designed to last from between three and six months. But he says the state usually picks up about 30 percent of the tab.
Foote also did not reveal how many patients in the young-adult and youth programs were expelled last year, nor the actual number who completed the program successfully. However, he says between a third and a half of people admitted to the program stay sober six to 24 months after they are discharged.
MRC is required to file quarterly reports with the Department of Health. Even in these reports, it’s not clear how many patients are discharged. For the third quarter 1996-97, for instance, 15 people were screened and oriented in the young-adult program, 14 were assessed and given a treatment plan, 14 participated in all scheduled activities, and five developed an after-care plan. Only five reached the “performance target,” which says the patients “achieve and maintain alcohol- and drug-free lifestyle, remain arrest-free, and improve living skills.” Last year, MRC assessed 65 people into the young-adult program. Nearly 62 percent of them reached the performance target.
“They [patients] know on the front end that they can be expelled or discharged immediately,” Foote says. “We are not tolerant of repeated behavior that endangers and disrupts the other patients.”
Donna Caum, director of program design for the state Bureau of Alcohol and Drug Abuse Services, says it’s not unusual for alcohol- and drug-rehabilitation patients to leave voluntarily, but she didn’t know how many are expelled. The department has received no complaints about MRC.
But that’s not because there hasn’t been any. La Cagnina isn’t the first to formally question MRC’s discharge policy. In 1993, Clarence Selman filed a lawsuit against the agency after his 15-year-old grandson, Christopher Schultz, was expelled from a treatment program. The clinical director of youth programs, Michael McLoughlin, testified that the boy became angry, punched a wall, ran to the front porch, and asked for the police to come get him. Selman says he was told Christopher was discharged for running away, when, in fact, he simply ran to the front porch of the building.
Selman, who was the director of an alcohol-and-drug counseling
and referral center in Nashville at the time, sued MRC for breach
of contract and negligent misrepresentation. In the lawsuit, Selman
says he was told that if his grandson was admitted, Christopher
would be in the program for 12 to 18 months and Selman would pay
a total of $3,690, or $175 a month for 22 months.
Like La Cagnina, however, he signed a contract requiring him to pay the full cost billed to him, regardless of whether Christopher completed the program successfully, as long as he remained at MRC for 18 days. Christopher was discharged after 28 days. When MRC tried to collect, Selman sued.
His former attorney, Eugene Laurenzi, says the contract is confusing to the patients and their families, who usually come to MRC under great emotional strain. Also, he says that his client was misled in verbal conversations with staff members and then duped into signing a contract that said something different than he was led to believe.
“Mr. Selman did not know what to do,” Laurenzi says. “He put his trust in the system. He bared his heart and soul to these people and they took advantage of him. I think it’s egregious that they would hold him to this contract. It’s atrocious. They have a responsibility to treat people and they ought to treat people and not make problems.”
When asked on the stand whether he signed the contract under emotional duress, Selman replied, “Well, I did have a grandson who was killing himself and he couldn’t stop, and that’s emotional for me.”
MRC won the lawsuit. The judge ordered Selman to pay $4,921, which included his outstanding balance plus attorney’s fees. Selman has moved and could not be reached. Laurenzi, however, claims his client paid MRC every cent.
In his office at 219 North Montgomery, John Foote, MRC’s executive director since 1977, gives terse answers to tough questions. No, his employees do not mislead patients. No, patients are not discharged because they can’t pay their bills. No, he will not comment on specific patients or lawsuits.
It’s been an eventful year for Foote and his wife, Rebecca, executive director of the Memphis Alcohol and Drug Council, an independent referral agency for alcohol and drug services that also offers addiction counseling and education programs. Three former employees of the council filed a whistleblowers’ lawsuit after being suspended without pay in February 1997. The employees say Ms. Foote retaliated against them after they contacted two board members about alleged mismanagement and illegal activities at the council.
Ms. Foote counter-sued one former employee, Candace Jefferies, the alleged author of a press release listing some specific accusations, for defamation. In the press release, some of the allegations listed were related to MRC. It was implied, for instance, that the council showed favoritism by referring more people to Mr. Foote’s agency than to other drug-treatment centers in town.
The case is still pending. Two months ago, however, the Bureau of Alcohol and Drug Abuse Services in the Tennessee Department of Health terminated its grant with the council because of an audit report that found, among other problems, that the agency had inadequate documentation of reimbursements to Ms. Foote, improper petty cash procedures, lack of internal control of receipts, and improper use of payroll accounts.
Even though federal law requires nonprofit organizations to make complete IRS 990 tax forms available for public inspection upon request, Foote says he removed information about his compensation from the tax form he gave the Flyer and declined to divulge his salary over the telephone. When this reporter asked to see a copy of the form later at MRC, it was not available for public inspection.
MRC’s board president J.B. Shay, who is also the business manager for the Memphis Alcohol and Drug Council, intervened and arranged for the entire document to be viewed. Last year, Foote earned $69,324 at MRC.
An outspoken advocate for alcohol- and drug-treatment centers, Foote says his youth and young-adult programs have struggled under managed care. TennCare Partners has been the biggest enemy, he says. Under the Partners program, two private behavioral health organizations administer public dollars for the mentally ill and chemically dependent.
“Alcohol and drug treatment programs are being financially devastated by TennCare,” Foote wrote in a viewpoint published by The Commercial Appeal last year. “Not only have benefits been severely cut back and thus payments, but also the TennCare Partners behavioral health organizations (BHOs) have not been paying their bills in a timely manner. This has contributed to program closings, massive layoff of treatment personnel, and severe scaling back of treatment beds.”
While alcohol and drug abuse remains a serious problem among young people in the community, fewer numbers of them can access treatment programs. As of April 21st, there were eight people in the young-adult program La Cagnina’s son attended. That’s about half as full as it was a few years ago. But for the two youth programs, sometimes there’s still a waiting list.
Foote says he intends for MRC to survive the managed-care shake-up, and that’s one reason it pursues money judgments so vigilantly. But, strangely enough, MRC is no longer pursuing La Cagnina. MRC forwarded a copy of the contract per her request, along with a letter from the attorney reminding her to pay the remaining balance of $955. At the bottom of the letter, however, was a “Blind P.S.” La Cagnina is sure she wasn’t supposed to see.
“As we discussed,” it read, “I will not proceed with suit on this account, but I was obligated to provide Ms. La Cagnina with documentation of the claim since she made a specific request.”
An employee from MRC later told La Cagnina on the telephone that the center would not pursue the matter in court, but declined to tell her why. When she asked for her son’s treatment records, she was denied. Foote says he cannot violate the confidentiality of patients by disclosing treatment records, even to family members.
La Cagnina says she will not pursue legal action against MRC. But she plans to lobby for an independent council to provide oversight and to help mediate problems between consumers and treatment centers. She says she does not want MRC to close and that she’s grateful for the seven drug-free months the agency gave her son. But when she attended the family sessions at MRC, she got tired of hearing about so many patients getting discharged.
“I saw so many kids thrown out of there for so many reasons,” she says. “We watched child after child get discharged. We would say, ‘Where’s so-and-so?’ and it was always something stupid, like sneaking in a candy bar or talking to someone they shouldn’t. It was never that there was violence involved or drugs. Go die. That’s basically what they’re saying when they release these kids.
“I don’t hold MRC responsible for putting the LSD in Jason’s mouth, but I would never not have given him a place to stay if it were not for them. We worked and worked and in a blink of an eye it was all gone.… People should be aware of what’s going on before they put their kid in there.”
Two weeks ago, La Cagnina finally buried Jason’s ashes in Calvary Cemetery next to an empty plot reserved for his best friend Joey. So far, the heavy spring rains have kept the two families from unearthing Joey’s casket and moving it to a place where Joey’s and Jason’s remains can be placed next to each other. The double headstone, when it is erected, will read “Best friends in this life, together now forever in Heaven.”
The young men’s mothers, La Cagnina and Debbie Penczner, remain close. But Penczner says she thinks La Cagnina’s anger with MRC has more to do with her personal grief than a legitimate complaint.
“I don’t think they’re [MRC] to blame,” Penczner says. “I know
a lot of people they’ve helped.… I’ve been where Sandy is now.
She’s wanting to blame someone.”
MRC executive director John Foote: “If they sign a contract and
they don’t pay, we will sue them. We don’t operate this program
on air. If we don’t operate this program like a business, we’re
not going to continue to exist.”
In the last five years, two men connected to Joey’s death have pleaded guilty to voluntary manslaughter and one to second-degree murder. All three are in prison. Another man indicted for Joey’s murder is still at large. Although there was no trial, two of the men have said in a Department of Correction report that they went to Joey’s house to collect money from him because he sold them fake LSD. One claimed the shooting was an accident.
To Penczner, the men who killed her son are the ones truly responsible for Jason’s death.
“He’s been trying to kill himself since Joey died,” she says. “He was always living on the edge, always wanting to do stupid, dangerous things. He was always reaching for something and always coming up empty.”
La Cagnina remembers Jason experiencing flashes of happiness after Joey’s death, but he never came to terms with it. “When Joey died, I thought Jason wouldn’t live much longer,” she says. “His heart was gone. I feel he and Joey were two parts of one soul.”
It’s been almost three months since Jason’s death, since La Cagnina’s hard-fought battle for his life ended. But she still has burial arrangements to handle, medical bills to pay, and friends to tell. To make that last task a little easier, she keeps a folder full of laminated pictures and Grateful Dead song lyrics – her own makeshift memorial to Jason – to give away to people he knew. She carries them with her always.
The song “A Box of Rain” reminds her of him. But the last lines are her message to any parent of a child with an alcohol or drug problem. She hopes they can learn something about the treatment system from Jason’s story – her box of rain:
And it’s just a box of rain, I don’t know who put it there. Believe
it if you need it, or leave it if you dare. 