SEQUIM — The long planned, debated, litigated and now impending Jamestown Healing Clinic is set to open in about a month.
The Jamestown S’Klallam Tribe’s medication-assisted treatment (MAT) clinic for people voluntarily seeking treatment for opioid use disorder (OUD) will begin treating patients in late April or early May, depending on when mandated inspections can be finished, said Dr. Molly Martin, executive director of the clinic.
Art and landscaping continue to be placed in and around the 16,800-square-foot, $16 million building at 526 S. Ninth St., in Sequim.
Martin, the former director of the MAT clinic inside the Jamestown Family Health Clinic on Fifth Avenue, said about 30 people have been training in recent months at the Healing Clinic.“We’re trying to plan for everything we can think of and how to best streamline intake of patients,” she said.
While it’s hard to estimate how many potential patients will come through the door, Martin said, capacity has been set at 300, which will be increased at a “manageable and planned pace.”
“With the intensive time needed to gauge each patient, it will take many months until we’re up to fully running,” she said.
Martin said patients could be with them a few years or indefinitely, depending on their needs.
Wrap-around services such as primary care, dental care and counseling will be offered in the building and referred to other community resources as needed, clinic leaders say.
“Most patients will have some other issues, and we’ll be able to take care of most of them on this site,” Martin said. “Many will not have had primary care for years.”There’s no set age requirements for treatment — those under 18 require parental consent — and services are open to tribal and non-tribal members, she said.
“I can’t tell you the number of people who said they started [opioid abuse] in junior or high school. Many feel they grew up with it and places like this give back the chance for care,” Martin said. “The goal is to show people this is a safe place with individualized treatment.”
Jamestown S’Klallam CEO and tribal chairman W. Ron Allen said the Healing Clinic is the first phase of the Healing Campus. The state Legislature recently approved $3.25 million in planning funds for a 16-bed mental health crisis facility; it had been dropped during the clinic’s original planning due to a lack of funds.
“We wanted a local option for the Olympic Peninsula that’s an all-inclusive service,” Allen said of the healing campus. “We don’t want to send people away to get healthy.”
The evaluation and treatment psychiatric hospital is envisioned as being south of the new clinic and part of other potential phases as the tribe explores other possibilities, such as affordable housing, long-term care housing, and a walk-in/urgent care clinic, said Brent Simcosky, director of tribal health services.
Allen said it’s unknown when construction could begin on the inpatient facility because of the current high costs of construction.
Martin provided a walk-through of the clinic showing the basics of a patient’s first day and ongoing treatment process. When open, the Healing Clinic’s hours will be from 6 a.m. to 2 p.m. Monday through Friday and from 6 a.m. to 10 a.m. Saturday.
Patients will arrive daily from across Clallam and Jefferson counties. Once inside, patients will sign in at one of three kiosks.
“The goal is to never have lines,” Martin said.
Kiosks will alert patients to appointments required that day, such as meeting with a counselor or a routine medical appointment.
Front desk staff also will register new patients, update insurance for patients and assist as needed, Martin said.
Many insurances don’t require prior authorization from a doctor, she said, and most will be self-referral.
Waiting lists are prohibited by the state, staff said, and it’s a first-come, first-served protocol.
The first day of intake could take at least three hours, as each person receives a full medical exam, Martin said. Staff will guide patients through the facility daily to make sure no one is roaming, she added.
A nurse case manager has been hired to help with their most medically complex patients, who may need help with specialist appointments and a champion for support.
While patients may need more time on some visits, Martin said opening at 6 a.m. allows them the opportunity to come before work and not interrupt their day.
The clinic features four group counseling rooms and 12 individual counseling rooms. All patients will have counseling services, Martin said. The tribe hired five substance use disorder professionals (SUDP) and is recruiting more who are focused on addiction-trained counseling, staff said.
They’ll be the ones leading most group counseling sessions, including relapse prevention.
“It’s important to see that you’re not alone,” Martin said.
“They’re not just here for treatment either. We help provide them a new group to help foster recovery because oftentimes they lose that friend group tied to drugs.”
Inside the clinic, public sign-in screens and callouts will remain anonymous as each person will be assigned a number. After signing in, they’ll go to the waiting area and look for their number on a screen to go to one of three dosing rooms; one is Americans with Disabilities Act (ADA) accessible.
Inside the private dosing room, patients will be asked for their names and photo identification to verify their identities before any dosing with their prescribed medication.
A nurse will provide the dosing. Methadone will come from a machine that pours the small amount of medicine in a cup. Suboxone comes as a strip, similar to breath mints, Martin said, and Vivitrol — which is given once a month — is an injection given in the medical area near the dosing area.
Those receiving methadone are given water afterward to make sure it’s consumed fully since it’s such a small amount, Martin said.
Cups are taken by the nurse and disposed of with biomedical waste.
Each dosing room and the nurse’s area feature multiple cameras to ensure patients are taking their medication.
Those medications are secured inside a $35,000 safe within a safe that requires a special key card for the first and a code for the second.
About 120 patients now receive MAT treatment at the Fifth Avenue clinic, mostly for Suboxone, tribal leaders said, and most will continue there. Martin estimates that 10 to 20 percent of those clients may seek different services at the Healing Clinic such as methadone, which she said is known to reduce cravings and block withdrawals.
“By the time they arrive at our door, they’ve already tried other places and treatments,” she said.
“Most have tried cold turkey and they need a higher level of care.”
And once patients are stabilized, programs remain available to them, Martin said. Full medical and dental areas are offered on the north side of the building.
Simcosky said tribal leaders are working to secure property by the Fifth Avenue clinic to double the size of its dental clinic. Design work tentatively starts this summer with potential construction sometime in 2023, he said.
On the west side of the Healing Clinic, separate from the rest of the facility, is the free Child Watch program for patients. While on site, patients can leave children (ages 6 weeks to 12 years old) with trained staff for up to three hours.
A Community Advisory Committee has been meeting this year and will consider approving Sequim Police Chief Sheri Crain and Simcosky’s “Jamestown Healing Clinic Monitoring and Evaluation Program” in the near future.
Simcosky said the plan meets the City of Sequim’s hearing examiner’s requirement to measure any impact on local services and put them into quarterly reports to the committee.
The tribe also paid $100,000 to the city for the first of three years of a social services navigator contractor contract. The city agreed to a contract with Peninsula Behavioral Health to hire the position and work in cooperation with the Sequim Police Department.
The tribe has hired a full security team with cameras placed throughout the campus, and Simcosky said they’ve agreed to some security measures, such as cameras and fencing at neighbors’ properties.
“If we see anything that looks suspicious, we’ll call the police,” he said. Though tribal leaders remain confident their provisions will be more than enough to keep the community safe.
“Most impacts from programs will be positive,” Martin said.