Spokane Regional Health District to study spinning off its Opioid Treatment Services into an independent organization

For over 30 years, the Spokane Regional Health District has provided direct health care services to the city’s residents struggling with addiction. Now, the public health agency is conducting a study to see if the public might be better served if its Opioid Treatment Services division is independent.

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

“The opioid and fentanyl crisis has everyone asking what else we can do. How can we make a greater impact,” Thompson said at last week’s board meeting. “Treatment services has grown to where it is a direct service provider in its own right and must have the ability to be nimble and responsive to the needs of the community.”

Regardless of the study’s outcome, the public health agency will continue providing services for sexually transmitted diseases, tuberculosis and other areas where they are legally required .

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

“I think to not conduct this feasibility study, especially right now when there is so much need in this area, would be a disservice both to the existing patients, future patients and the community at large,” he said.

The vote does not guarantee opioid treatment services will be privatized and absorbed into a private nonprofit or for-profit company. But it begins 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 around the privatization of her department go back over a decade. The district’s direct services began in 1990 in its methadone clinic, and it has grown since to the point of moving to its own building south of downtown last year.

Despite the 30-year history of the district’s treatment of opioid addiction, such direct health care services do not usually 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 service providers in the community and an increased focus on 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.”

Because of its makeup as a public entity, the district does not direct grants from the federal government. Any federal funds must first go through the state and then are divvied out to public health entities. This restriction limits some of the federal grants for which treatment services would otherwise be eligible, Thompson said.

Still, a transition would only occur if privatization is found to directly benefit treatment services and there is broad community support behind it.

“It’s critically important to us that our patients are cared for and cared for well. That they receive the standard of care that they’re receiving now,” she said.

In 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 trying to find a buyer and conduct a third-party valuation of the treatment services division.

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

Asked if the effort to privatize was in part motivated by the cost to health district in running treatment services, Thompson said the program is not supported by the district’s general fund and is “self-sufficient” through fees for its services and grant funds.

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