canada africa partner reservation The Spokane Regional Health District will explore transforming its opioid treatment services into an independent organization

The Spokane Regional Health District will explore transforming its opioid treatment services into an independent organization


For more than 30 years, the Spokane Regional Health District has provided direct health care to city residents struggling with addiction. Now the public health department is conducting a study to see if the public can be better served if the Opioid Treatment Services department is independent.

Health district board members approved the study last week at the request of administrative assistant Alicia Thompson, who started in her position about six months ago.

“The opioid and fentanyl crisis has everyone wondering what else we can do. How can we make a bigger impact,” Thompson said during last week’s board meeting. “Treatment services have evolved into a standalone direct service provider and must have the ability to be agile and responsive to community needs.”

Regardless of the outcome of the investigation, the public health agency will continue to provide services for sexually transmitted diseases, tuberculosis and other areas where required by law.

Before the board unanimously approved the study, Spokane Board of Health member and City Council member Michael Cathcart praised the planned study as “exactly” what the health district needs to focus on amid the opioid crisis.

“I believe that not conducting this feasibility study, especially when there is so much need in this area, would be a disservice to both existing patients, future patients and the community as a whole,” he said.

The vote does not guarantee that opioid treatment services will be privatized and incorporated into a private nonprofit or for-profit corporation. But it sets in motion a process to answer what has been a question for the health district since it first began directly treating opioid addiction.

Division Director of Treatment Services Misty Challinor said conversations surrounding the privatization of her department go back more than a decade. The district’s direct services began in 1990 in the methadone clinic and has since grown so much that it moved last year to its own building south of downtown.

Despite the District’s 30-year history of treating opioid addiction, such direct health care services typically do not fall under the purview of a public health agency.

“We got into this business because no one else would. And that is no longer true,” Thompson said, pointing to other providers in the community and the increased attention to the opioid epidemic in recent years. “Is it time to step back and not provide the direct service and let the community do it? The vast majority of opioid treatment programs are private entities.”

Due to its constitution as a public entity, the District does not provide grants to the federal government. All federal funds must first pass through the state and then be distributed to public health agencies. This restriction limits some of the federal subsidies for which treatment services would otherwise be eligible, Thompson said.

However, there would only be a transition if it turns out that the privatization directly benefits treatment services and there is broad community support behind it.

“It is crucial for us that our patients are well cared for. That they get the standard of care that they get now,” she said.

In the coming months, the health district will hold community meetings to better understand what the community wants. Thompson will report her findings to the health board, which will decide whether to move forward with the search for a buyer and conduct an external valuation of the treatment unit.

The new health care administrator has held preliminary discussions with two private entities that may be interested in such a purchase, including a private for-profit company.

Asked whether the effort to privatize was motivated in part by the costs to the health district in running treatment services, Thompson said the program is not supported by the district’s general fund and is “self-sustaining” through reimbursements for its services and subsidy funds.

Even if privatization does not happen, it is a question that needs to be answered, she added. Thompson realized early in her tenure that there would always be “instability” in treatment services if this long-standing issue was never resolved.