Tribe’s Healing Clinic to open late April, early May

The long planned, debated, litigated and now impending Jamestown Healing Clinic is set to open in about a month.

Centered around helping patients with opioid use disorder (OUD) through treatments such as daily doses of methadone or Suboxone and regular counseling, the Jamestown S’Klallam Tribe’s medication-assisted treatment (MAT) clinic tentatively begins to intake 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 approximate 16,800-square-foot building at 526 S. Ninth Ave., valued at approximately $16 million.

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, they’ve set capacity 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.

When stabilization of a patient begins, Martin said patients could be with them a few years or indefinitely, depending on their needs.

Wraparound 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, while under 18 requires parental consent, she said, and services are open to non-tribal members.

“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.”

Tour

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 6 a.m.-2 p.m. Monday-Friday, and 6 a.m.-10 a.m. Saturdays.

When the facility is ready, or nearly ready, clinic leaders said they’ll update its website at jamestownhealingclinic.org and alert community groups and agencies.

“When it’s ready, I’m confident people will know and be here waiting,” Martin said.

Jamestown S’Klallam CEO and tribal chairman W. Ron Allen said the Healing Clinic is the first phase of their Healing Campus. The state legislature recently approved $3.25 million in planning funds for a 16-bed mental health crisis facility; it was 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 will likely be south of the new clinic and be 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.

He said it’s unknown when construction could begin on the inpatient facility because of the current high costs of construction.

Sequim Gazette photo by Matthew Nash Molly Martin, executive director of Healing Clinic, demonstrates the check-in system.

Check-in

Once inside, patients will sign in on one of three kiosks.

“The goal is to never have lines,” Martin said.

Kiosks will alert patients to any appointments required that day, whether that’s meeting with a counselor, and/or a routine medical appointment.

Front desk staff will also 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.

On the first day of intake, Martin said it could take at least three hours, as each person receives a full medical exam.

Staff will guide patients through the facility daily to make sure no one is roaming, Martin said.

A Nurse Case Manager was also hired to help with their most medically complex patients, too, 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.

Counseling

The clinic features four group counseling rooms and 12 individual counseling rooms.

All patients will have counseling services, Martin said, and counselors will make an assessment to determine what’s best for each patient. 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.”

Dosing

Inside the clinic, public sign-in screens and call outs 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 patients’ identities before any dosing.

A nurse will provide the dosing with methadone coming 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 is an injection given in the medical area near the dosing area.

Vivitrol is given once a month, she said.

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 features 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 receive MAT treatment at the Fifth Avenue clinic mostly for Suboxone, tribal leaders said, and most will continue there.

Martin estimates 10-20 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.

The Jamestown S’Klallam Tribe’s Healing Clinic offers numerous “wrap-around” services, including dental care. Sequim Gazette photo by Michael Dashiell

Medical/dental wings

Full medical and dental areas are offered on the north side of the building.

These two departments share a waiting area and nurses will get patients when they’re ready for them.

The medical portion features full spectrum primary care with three exam rooms overseen by a nurse practitioner and physician, Martin said.

Each patient will go through this area, she said.

The dental area has three rooms with separate dentist chairs along with X-ray capabilities and more. Dental staff will be rotated in from the Jamestown Family Dental Clinic in Blyn.

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.

In the Healing Clinic, Martin said they’ll begin dental services a few weeks after opening because they want patients to be stabilized medically first.

Sequim Gazette photo by Michael Dashiell Molly Martin, Executive Director of the Jamestown Healing Clinic, explains services offered at the soon-to-open facility — including a daycare center.

Child Watch

On the west side of the Healing Clinic is the free Child Watch program for patients. While on site, they can leave children (ages 6 weeks to 12-years-old) with trained staff for up to three hours.

Martin said routine visits last about 30 minutes and those with wrap-around services, including medicinal dosing and counseling, could be two to three hours.

Child Watch is separated from the rest of the facility.

“We create an inclusive and supportive environment and know everyone is at different stages of recovery,” Martin said. “We just want the kids to come in and have a good time.”

Child Watch is open five days a week with the possibility of six days a week, depending on need, she said.

Safety

A Community Advisory Committee made up of local leaders and community members has been meeting this year and will look to approve 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 advisory committee will need to approve the plan.

The tribe also paid $100,000 to the city for the first of three years of a social services navigator contractor contract, Simcosky said. 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.

For more information about the clinic, visit jamestownhealingclinic.org.

The Jamestown S’Klallam Tribe’s Healing Clinic at 526 S. Ninth Ave. features encouraging statements on it walls of its clients, patients seeking treatment for opioid-use disorders.

A sample amount of how much methadone (pictured is water) is distributed in the Healing Clinic dosing rooms. Sequim Gazette photo by Michael Dashiell

A hallway at the Jamestown S’Klallam Tribe’s Healing Clinic at 526 S. Ninth Ave. leads to several meeting rooms, where patients with opioid-use disorder (OUD) will receive counseling.

Sequim Gazette photo by Michael Dashiell Tribal artwork lines the walls at the Jamestown S’Klallam Tribe’s Healing Clinic.

The Healing Clinic features several conference rooms, where patients with opioid-use disorder (OUD) treatment will receive counseling. Sequim Gazette photo by Michael Dashiell