California Fire Hits ‘Rehab Riviera,’ Putting Addiction Care in Jeopardy

At Creative Care’s serene hilltop campus in Malibu, California, patients typically pay more than $35,000 a month to be treated for addiction and mental health problems against the backdrop of a spectacular Pacific Ocean view.

On Friday, just a few hours after an early-morning evacuation order from the city, all anyone could see were flames.

The Woolsey Fire, one of several major fires burning across California, destroyed four of the complex’s seven buildings. Other rehabilitation centers in Malibu, including Alo House Recovery Centers, suffered significant damage. Seasons in Malibu said it had lost one of its four houses.

Since starting last week, the Woolsey Fire has killed at least three people and wiped out more than 500 structures. The Camp Fire, north of Sacramento, has killed at least 63, and thousands of people around the state have lost their homes. By Friday, smoke had pushed pollution levels in Northern California past those in some of the worst-ranked cities in China and India.

The Southern California blaze has also affected hundreds of patients battling personal demons. Many have had to leave tranquil facilities to seek refuge at sister facilities, Airbnb rentals and hotels. The operators of many rehab centers, unable to provide proper treatment after shutting down, have transferred clients to competitors.

Malibu has one of the largest concentrations of addiction treatment centers and sober living homes in the United States, with at least one per square mile, according to data from the U.S. Substance Abuse and Mental Health Services Administration. Luxury properties in the area, part of a coastal strip known as Rehab Riviera, often attract paparazzi hoping for a glimpse of wealthy clients like Ben Affleck and Britney Spears.

The centers have an uneasy relationship with the rest of Malibu, a largely affluent enclave. City officials have said many of the businesses — some of which offer meditation gardens, professional chefs, spas and other luxury amenities — are unlicensed or flout regulations. Patients have menaced neighbors. Owners have bought up vast tracts of land, edging closer to residents protective of their privacy.

Such spats, however, pale next to natural disasters. Accreditation agencies require treatment centers to have emergency plans in place but often ask for only a “bare minimum” of information, said Priya Chaudhri, chief executive of Elevation Behavioral Health, which lost two of its three properties in Malibu and nearby Agoura Hills.

“The expectation is that, as owners, we’re going to take the extra step to have a more comprehensive plan, but we don’t have to turn it in. They defer to us, to our good judgment,” she said. “A lot of things you have to just sort of wing in the moment.”

Each of the 21 patients at Creative Care in Malibu was allowed one piece of luggage before fleeing the fire. They were bundled into 12-seater vans normally used for mini-golf outings or trips to addiction support meetings and taken to Airbnbs in the San Fernando Valley. Dozens of employees responsible for keeping patients calm joined the exodus.

The trip took six hours, following a route that on any other day takes 35 minutes, said Farrah Khaleghi, a Creative Care clinical director. The Pacific Coast Highway, she said, was a “parking lot” with firefighters repeatedly stopping traffic to beat back flames along the side of the road.

“It was terrifying,” she said. “You look behind you, and there are huge flames and the smoke is thick and heavy. It’s like this monster just gobbling everything in sight.”

Six patients at a Creative Care facility in Calabasas, which survived the fire, were evacuated to an Airbnb in Pacific Palisades. Five horses used for therapy were moved from the two sites.

Creative Care’s losses in Malibu will exceed $30 million, Khaleghi said. The company, which her parents founded 29 years ago, spent more than $250,000 on the evacuation and on securing a replacement facility in Woodland Hills. After buying enough furniture and bedding to fill several homes, administrators moved patients earlier this week. Addiction therapy is most effective when it is continuous, according to experts, and detoxification programs geared toward certain drugs can last weeks. Many treatment center owners worried about the fire’s disruption.

“We treat a very sensitive, very serious group of clients,” Khaleghi said. “It’s really important to lay down roots and provide stability.”

Pax Prentiss, a founder of the Passages treatment network with his father, Chris, said the company had moved 25 clients from Malibu to Passages locations in Santa Monica and Brentwood, quickly returning them to their treatment regimen.

“Some of the other facilities don’t have that luxury,” he said. “I think almost everybody lost clients because they had to refer them out to other facilities.”

Chaudhri of Elevation said her treatment centers began to evacuate at 2:30 a.m. Friday. In the car, she rushed to research temporary lodgings for her 30 clients.

The rental market “was insane,” she said. Airbnb hosts, she added, “were doing a lot of price-gouging, and some were very candid about it.”

Hotels were not an ideal alternative — maintaining client confidentiality would be difficult, as would distributing medication and checking in on patients every 30 minutes — but Chaudhri said she had little choice. She avoided places that offered minibars and room service and settled on a midprice hotel near Los Angeles International Airport.

She later heard that several other treatment centers had set up shop in the same hotel.

“Everyone was sort of scrambling,” she said.

Offers to take in patients or donate equipment have poured in from other treatment facilities, including some in other states.

But the owners of many Malibu treatment centers said their top priority was retaining their employees. Disaster insurance typically covers workers’ pay only when employers can prove their operations were disrupted.

“It’s one thing to find a new building, but patients come and go,” Chaudhri said. “Losing your staff and having to rehire and retrain would be a huge setback. The layoffs are going to be costly to these facilities.” Garrett Braukman, executive director of Alta Centers in Hollywood Hills, said he was reviewing résumés from caregivers let go by companies struggling with the financial burden created by the Woolsey Fire. He said it was already a difficult time for the industry, which is facing increased scrutiny from the media and legislators over questionable business practices and what he called “bad players.”

“A lot of really good players that have been around for a long time were in Malibu, but many of those facilities are no longer there,” he said. “We have all rallied around them, wanting them to rebuild.”