SEQUIM —Nearly one year after starting services in Clallam Bay, leaders with the Jamestown Healing Clinic in Sequim say the mobile medication unit, a retrofitted RV, is a success.

A team from the Sequim Healing Clinic, 526 N. Ninth Ave., began traveling weekdays last March to Clallam County Fire District 5’s fire station at 60 Eagle Crest Way in Clallam Bay. The RV, largely paid for with a state grant, brings a staff of five or six people to help patients with treatment for opioid use disorder and other medical conditions.

Depending on a patient’s needs, trained staff distribute doses of methadone or buprenorphine/naloxone (Suboxone) with counseling and primary care also offered. Dental care and other health services are referred to the Sequim clinic or other specialists.

Brent Simcosky, Jamestown S’Klallam Tribe’s health services director, said he’s heard only good news about the mobile unit.

“It got up to a larger number of clients faster than we anticipated,” he said.

Molly Martin, executive director of the Jamestown Healing Clinic, said the mobile unit has between 30-40 patients.

Last year, she said 20 patients would make the program sustainable.

“It’s more than enough to make the service sustainable, (and the amount of patients) keeps us busy the entire time,” Martin said.

Previously, she said health officials had known about an unmet need on the West End to treat opioid use disorder, and the state grant allowed the tribe to push up the mobile clinic from a long-term goal to a short-term solution.

Clallam County continues to have one of the highest rates of overdose in the state, which in part continues to be linked to opioids. County officials reported 47 overdose deaths in 2023, making Clallam the fourth-highest rate of overdose per capita in the state.

Dr. Allison Berry, health officer for Clallam and Jefferson counties, said Clallam had 27 confirmed overdose deaths and two suspected overdose deaths with toxicology still pending.

“Even if those suspected overdoses turn out to be confirmed, that would represent a 33 percent reduction in opiate overdoses in Clallam County in the last year,” she said.

“We’ve seen our overdose death rates drop faster than other counties in the state, leading to us dropping to the 10th highest overdose death rate in the state.”

An opioid epidemic came into prominence locally, according to The Washington Post, from 2006-2012, when Clallam County patients received more than 37.8 million pain pills or about 76.6 pills per person per year.

Efforts were made to reduce opioid prescriptions and funding became available to help combat opioid use disorder. However, tribal medical officials said each patient is different and it can take years to treat those afflicted.

Berry said last year’s totals are more overdoses than health officials “like to see and far more lives lost in our community, but it is a hopeful improvement from when we were No. 1 in the state a few years back.”

“Our county has been working very hard to turn around our rate of overdose deaths with focused investments in increasing access to treatment, Naloxone and harm reduction education, and those efforts appear to be starting to pay off,” she said.

“We do suspect that the expansion of Jamestown’s Healing Clinic into the West End with the help of Rediscovery assisting with transportation has been a big part of this improvement as we’ve seen a marked reduction in overdose deaths on the West End in the last year and a strong interest in accessing treatment.”

Process

Through the mobile clinic, counseling is available four days a week and primary care five days a week.

Without a permanent certified facility to store the RV and medications overnight in Clallam Bay per the Drug Enforcement Administration, medications are transported and stored in the Healing Clinic in Sequim, Martin previously said.

The RV leaves Sequim about 6 a.m. and the mobile clinic is open from 8:30 a.m. to 1 p.m. Monday through Friday to allow for travel, set up and take down. It features a private exam room, lab, enclosed medicine dispensary and a counseling area.

Martin said the fire department has been welcoming and its space has allowed for a “high quality rather than rushed service.”

“It’s close to the bus line and a central location for Forks, Clallam Bay and Neah Bay so that no one has to drive a disproportionate amount of time,” she said.

Tribal administrators said they continue to explore options for permanent storage and/or a facility for operations as transport in the winter can take longer and increase wear on the RV.

Martin said their primary focus is on stabilization and supporting patients by continuing to address other needs as they stabilize, such as mental health and/or physical conditions.

She said there’s been no safety or security issues with the clinic, and security guards who drive the RV also help set up the clinic.

Prior to the mobile clinic starting last year, Simcosky said medication-assisted treatment was often a last resort for people afflicted with opioid use disorder, but it stops cravings and gives “medical professionals the opportunity to help them with anything going wrong in their life.”

“They can’t easily do it when they’re craving opioids,” he said. “They’ll wake up and go to bed thinking about the cravings.”

Healing clinic

The Jamestown Healing Clinic, also centered on treating opioid use disorder, opened in July 2022 and now treats nearly 200 patients on weekdays, Martin said.

Of those, 90 percent are from Clallam County and the other 10 percent from Jefferson County.

Martin said concerns about people from outside of the two counties traveling to Sequim for treatment has subsided and that opioid treatment programs like the tribe’s are readily available in and around the Seattle area.

Martin said the Sequim clinic does not have a threshold for capacity and that, with staffing levels and hours available, it could “easily handle 300 people” with the caveat that no patient is the same and it takes different levels of work to stabilize someone.

There are no waits for service, she said.

For intensive outpatient services, Martin said some patients receive up to nine hours of counseling a week, and that it’s not uncommon for people to spend three hours a day in the clinic.

Administrative staff said demand for the mobile and Sequim clinic have been steady with one to two people inquiring about services daily.

About two-thirds of patients who do intake are still retained after 90 days, Martin said.

However, she said those who “choose to disengage with services or are lost to followup” are not banned from coming back.

She said opiate patents generally try to engage more than once before they’re successful.

“Substance use and drugs are challenging and complex to treat,” Martin said.

“Some programs used to give three strikes, and that’s absolutely not us. If someone is ready to try, then we’re ready to try.”

Martin said patients come for services voluntarily, and while they may have “external drivers” such as court-ordered treatment or a parenting plan, the clinic is not a law enforcement agency and won’t force them to stay.

“Anybody who comes here wants to be here,” she said.

Future

Prior to approving the Healing Clinic, a Sequim-appointed hearing examiner required the tribe to support a social navigator and a committee to oversee any impact to the community’s first response programs.

Simcosky said the committee has moved to quarterly meetings and wants to continue to meet to be kept up-to-date, and that the impact of the clinic has been minimal with their few 911 calls unrelated to the treatment of opioid use disorder.

“It’s been a very safe operation,” he said.

A three-year contract for the tribe to fund the social navigator for the city and be managed through Peninsula Behavioral Health ends this summer. Simcosky said he’s going to discuss with Jamestown tribal elders whether or not they want to continue funding it.

Martin said the navigator has referred fewer than five people to the Healing Clinic but is doing excellent work connecting people with other services as they seem to be struggling with acute mental health and other issues.

Simcosky said the tribe continues to work on a workflow plan with Clallam County Sheriff’s Office for its jail reentry program to help prisoners by assessing them for substance use disorder and beginning treatment while incarcerated.

Work also continues on the tribe’s $31.25 million, 16-bed psychiatric evaluation and treatment facility adjacent to the Healing Clinic which will tentatively open around February or March next year.

The approximate 20,000-square-foot center will offer a treatment space for patients experiencing a mental health crisis who may be of harm to themselves or others, and be voluntarily or involuntarily admitted with an average visit anticipated to be 10 to 14 days before being discharged to family or long-term services decided upon by staff, Simcosky said.

For more about the Jamestown Healing Clinic and its medical mobile unit, call 360-681-7755 or visit jamestownhealingclinic.org. Administrators said to call in advance for a new intake as assessments can take several hours.

________

Matthew Nash is a reporter with the Olympic Peninsula News Group, which is composed of Sound Publishing newspapers Peninsula Daily News, Sequim Gazette and Forks Forum. He can be reached by email at matthew.nash@sequimgazette.com.