Under construction: Inside Jamestown’s MAT clinic

Health director talks safety, support of community, patients

During a tour of the Jamestown S’Klallam Tribe’s medication-assisted treatment (MAT) clinic, Brent Simcosky, director of tribal health services, reiterated what he told Sequim city councilors at their most recent meeting: the facility won’t see patients realistically until March 2022.

“We’ll tentatively finish construction by the end of the year,” he said last week in an interview. “We won’t see patients immediately because (crews) have to move in furniture and staff have to get ready to come in.

“We’ll tentatively see patients at the beginning of March.”

Branded the Jamestown Healing Clinic, the 16,806-square-foot facility has remained a divisive talking point in Sequim for more than two years. However, Simcosky said the clinic’s purpose remains the same since being announced — to help patients with opioid-use disorder (OUD) through treatment with daily doses of methadone, Suboxone and Vivitrol, along with wrap-around services such as dental care, counseling and more.

The clinic has faced opposition, in part because of its types of treatment, location on South Ninth Street behind Costco, and its size.

“The capacity is 250 to 300 but it’ll be closer to 200 to 250 patients,” Simcosky said. “By the end of the first year (in operation) it could be up to about 200.”

But as he and other health officials testified during hearings for the clinic, about 100 OUD patients are already being treated through a Suboxone prescription program at the Jamestown Family Health Clinic on North Fifth Avenue, while demand for OUD services continues to grow.

“We’re seeing about 12 more new patients added each month since the pandemic began,” Simcosky said.

“Overdosing is going through the roof. People have been falling off the wagon, and it doesn’t take much stress to do that particularly during a pandemic.”

Safety

Through the public comments, emails and calls, Simcosky said he and tribal leaders continue to hear people’s calls for safety.

“We understand people’s concerns; that’s why we agreed to all the mitigation and offered many solutions that weren’t required like a Social Services Navigator,” he said. “We want to cause people less stress and successfully help people without hurting the community.”

With one position still to fill on a community member to the Community Advisory Committee, Simcosky said they’ll likely open up applications late this fall. That resident will help a group of local law enforcement, city officials and health officials form mitigation to measure potential negative impacts from the clinic on local services, he said.

“It has to be very exact; things we can measure,” Simcosky said.

Tribal leaders are considering additional community outreach efforts to hear more community concerns and share more about the clinic.

“We want to talk to people about what we’re doing and what we can work together on solutions,” Simcosky said.

He added that tribal members met with neighbors to hear concerns with some wanting fencing and/or lighting installed.

Once open, the facility will host three security staff, two inside and one outside during regular hours, and the site will be monitored after hours by additional trained security staff, he said.

The clinic will also have emergency buttons throughout, a safety feature Simcosky said is standard protocol for clinics like this.

As for concerns about tent camps and an increasing homeless population, he said they have “no interest in tent camps” and already escorted one individual off the site.

“While most of the people won’t be patients, we do have an interest in meeting with city officials in helping these people find a solution,” Simcosky said.

The clinic sits on about 45 acres now owned by the tribe, he said, with no additional plans for any of the property other than a goal to connect the property to River Road potentially years from now.

Early in the clinic’s application, tribal leaders nixed a proposed 16-bed hospital, an evaluation and treatment facility. Simcosky said it’s not directly related to MAT services and would require a conditional use permit, a lengthy application process and more funding from the legislature.

Construction

Construction on the clinic has seen some delays for various reasons, Simcosky said, including court action against the facility and the COVID-19 pandemic.

Tacoma’s Korsmo Construction leads construction and Rice Fergus Miller serves as master planner, architect, interior designer and medical planner of the tribe’s approximate $16 million project — with about $9 million of the tribe’s own funding along with state and federal grants for the difference.

One decision Simcosky said they’re especially proud of is buying the clinic’s lumber last year before this year’s price increases, which saved them hundreds-of-thousands of dollars.

As for the infrastructure, the clinic’s outside will feature a retention pond, totem carvings by Bud Turner and more than a dozen carved cedar logs. Many rooms face the Olympic Mountains, too.

“People ask us why we chose this property, and we say it’s so people can reflect on life,” Simcosky said. “We want a peaceful environment without stress.”

W. Ron Allen, tribal council chairman, has had a hands-on role throughout the building process, Simcosky said, with Allen picking out the types of landscapes for the property and the Native American art throughout the facility.

With only patients allowed inside the main clinic, Simcosky said they want the outside to look beautiful because many won’t be able to see the facility inside.

Inside, a carving with tile throughout the clinic’s flooring shares the idea that if someone takes a rock out of a stream, that person can change the flow of their life.

“That’s what our patients are doing,” Simcosky said.

More inside

With efforts to better accommodate patients’ treatment plans, child watch is offered next to the entrance separated from the rest of the clinic.

Patients sign in at a kiosk where they’ll see their schedule, Simcosky said.

They’ll be randomly selected for urinalysis about 18 times a year, an average of 1.5 times a month, he said, with staff monitoring to prevent false tests.

The clinic hosts three dosing rooms where a patient will show their identification to a nurse before a computer distributes the dosage.

“We have to account for every drop,” Simcosky said.

“All methadone and other daily medications is locked in a $35,000 safe that’s inspected by the DEA (Drug Enforcement Administration) in the pharmacy, too.”

Along with the chemical side, each patient will receive a mental health analysis by the medical director and behavioral analysis staff, he said.

The tribe received a $1.5 million grant over three years from Indian Health Services to develop a program that merges counseling programs for behavioral health and substance abuse treatment, Simcosky said.

The grant will also help staff do outreach to help patients better integrate back into family life, he added.

With 10 counseling rooms, and four meeting rooms, he said there’s space for individual and group therapy sessions, on topics such as behavioral health triggers, introduction to treatment and more.

The tribe also plans to hire dentists to offer on-site x-rays, treatments and surgeries as needed.

In total, there will be upwards of 40 staff in the building once at full capacity, Simcosky said.

The executive staff has yet to be announced, he said, but they’re all local to Sequim and the northwest.

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

Workers prep a hallway inside the Jamestown Healing Clinic last week with a tentative completion date from Tacoma’s Korsmo Construction by the end of the year. Sequim Gazette photo by Matthew Nash

Workers prep a hallway inside the Jamestown Healing Clinic last week with a tentative completion date from Tacoma’s Korsmo Construction by the end of the year. Sequim Gazette photo by Matthew Nash

Multiple meeting rooms and counseling offices face the Olympic Mountains on purpose says Brent Simcosky, director of Jamestown’s tribal health services. “People ask us why we chose this property, and we say it’s so people can reflect on life,” he said. “We want a peaceful environment without stress.” Sequim Gazette photos by Matthew Nash

Multiple meeting rooms and counseling offices face the Olympic Mountains on purpose says Brent Simcosky, director of Jamestown’s tribal health services. “People ask us why we chose this property, and we say it’s so people can reflect on life,” he said. “We want a peaceful environment without stress.” Sequim Gazette photos by Matthew Nash

The lobby of the Jamestown Healing Clinic will feature a kiosk for patients to log in, Native American Art, a canoe hanging from the ceiling and a carving with tile through the facility that shares the idea that if someone takes a rock out of a stream, that person can change the flow of their life.

The lobby of the Jamestown Healing Clinic will feature a kiosk for patients to log in, Native American Art, a canoe hanging from the ceiling and a carving with tile through the facility that shares the idea that if someone takes a rock out of a stream, that person can change the flow of their life.

The front of the Jamestown S’Klallam Tribe’s medication-assisted treatment (MAT) clinic, aka Jamestown Healing Clinic, will feature carved wood art, a retention pond, and plentiful landscape, says tribal leadership. Sequim Gazette photo by Matthew Nash

The front of the Jamestown S’Klallam Tribe’s medication-assisted treatment (MAT) clinic, aka Jamestown Healing Clinic, will feature carved wood art, a retention pond, and plentiful landscape, says tribal leadership. Sequim Gazette photo by Matthew Nash

Safety is a major concern for leaders with the Jamestown S’Klallam Tribe, said Brent Simcosky, director of tribal health services, standing next to the Jamestown Healing Clinic’s future security offices. “We understand people’s concerns; that’s why we agreed to all the mitigation and offered many solutions that weren’t required like a Social Services Navigator,” he said. “We want to cause people less stress and successfully help people without hurting the community”. Sequim Gazette photos by Matthew Nash

Safety is a major concern for leaders with the Jamestown S’Klallam Tribe, said Brent Simcosky, director of tribal health services, standing next to the Jamestown Healing Clinic’s future security offices. “We understand people’s concerns; that’s why we agreed to all the mitigation and offered many solutions that weren’t required like a Social Services Navigator,” he said. “We want to cause people less stress and successfully help people without hurting the community”. Sequim Gazette photos by Matthew Nash

Jamestown S’Klallam tribal leaders met with neighbors, says Brent Simcosky, director of tribal health services, to address safety concerns with some asking for fencing and/or extra lighting. Sequim Gazette photo by Matthew Nash

Jamestown S’Klallam tribal leaders met with neighbors, says Brent Simcosky, director of tribal health services, to address safety concerns with some asking for fencing and/or extra lighting. Sequim Gazette photo by Matthew Nash

A covered area sits atop the west side of the Jamestown Healing Clinic next to child care services and the entrance to the facility. Sequim Gazette photo by Matthew Nash

A covered area sits atop the west side of the Jamestown Healing Clinic next to child care services and the entrance to the facility. Sequim Gazette photo by Matthew Nash

Multiple meeting rooms and counseling offices face the Olympic Mountains on purpose says Brent Simcosky, director of Jamestown’s tribal health services. “People ask us why we chose this property, and we say it’s so people can reflect on life,” he said. “We want a peaceful environment without stress.” Sequim Gazette photos by Matthew Nash

Multiple meeting rooms and counseling offices face the Olympic Mountains on purpose says Brent Simcosky, director of Jamestown’s tribal health services. “People ask us why we chose this property, and we say it’s so people can reflect on life,” he said. “We want a peaceful environment without stress.” Sequim Gazette photos by Matthew Nash