For more than 30 years, the Spokane Regional Health District has provided direct medical services to city residents struggling with addiction. The Department of Public Health is currently conducting a study to determine whether the Opioid Treatment Services Division would serve the public better if it were independent.
Health district board members approved the study last week at the request of Administrator Alicia Thompson, who started the job about six months ago.
“The opioid and fentanyl crisis has everyone wondering what else we can do. How can we have a bigger impact?” Thompson said at last week's board meeting. “Treatment services have grown to become direct service providers in their own right, requiring the ability to be agile and responsive to community needs.”
Regardless of the outcome of the study, public health agencies will continue to provide services for sexually transmitted diseases, tuberculosis, and other areas where they are legally required to do so.
Before the board unanimously approved the study, Board of Health member and Spokane City Councilman Michael Cathcart said the planned study would “exactly” affect the health district in the midst of the opioid crisis. He praised it as something that should be focused on.
“I think not conducting this feasibility study would be a disservice to existing patients, future patients, and the community as a whole, especially now that there is so much need in this area,” he said.
This vote does not guarantee that opioid treatment services will be privatized and absorbed into private nonprofit or for-profit companies. But the process of answering questions for the health district begins when it first begins direct treatment for opioid addiction.
Misty Challinor, director of treatment services, said conversations about privatizing the department go back more than a decade. The district's direct services began with his methadone clinic in 1990 and have grown since then, moving to its own building south of downtown last year.
Despite a 30-year history of opioid addiction treatment in the District, such direct medical services are not typically under the purview of public health agencies.
“We got into this business because no one else was going to do it. And that's no longer true,” said Thompson, who is working with other service providers in the community and the recent opioid epidemic. He pointed out the growing interest in “Is it time to take a step back and not provide direct services and leave it up to the community? The majority of opioid treatment programs are private organizations.”
Because of its structure as a public entity, the school district does not receive direct funding from the federal government. Federal funds must first go through states and then be distributed to public health agencies. The restrictions limit some of the federal funding treatment services could receive, Thompson said.
Still, the transition will only occur if privatization proves to directly benefit treatment services and has broad community support behind it.
“It's very important to us that our patients are taken care of and that they get the right care. That they receive the standard of care that they currently receive,” she said.
In the coming months, the health district plans to hold community meetings to better understand what the community wants. Mr Thompson will report his findings to the Board of Health, which will decide whether to seek a buyer and conduct an independent evaluation of the treatment services division.
The new health administrator has held preliminary discussions with two private parties that might be interested in such an acquisition, including a private commercial company.
When asked if part of the privatization effort was motivated by the cost to the health district of operating treatment services, Thompson said the program is not supported by the district's general fund and is not supported by fees and charges for services. He said the grant made them “self-sufficient.”
That's a question that needs to be answered even if privatization doesn't happen, she added. Ms Thompson said she recognized early in her tenure that there would always be “instability” in treatment services if this long-standing problem was not addressed.
