Lack of site delays PBC emergency room dedicated to opioid overdoses

6:12 a.m. Saturday, Feb. 10, 2018 Politics
A roundtable to discuss the opioid crisis in Palm Beach County at Palm Beach State College in Lake Worth on Aug. 8, 2017. (Meghan McCarthy/ The Palm Beach Post)

A plan to open an emergency room dedicated exclusively to opioid overdoses suffered an unexpected setback this week when inspectors rejected the county’s first proposed site.

Born of a brainstorming session, the proposed Addiction Stabilization Facility promises to be a “cutting edge” way to address an epidemic that is killing thousands across the United States, including 600 people last year in the Palm Beach County.

The county is working closely with the taxpayer-supported Palm Beach County Health Care District, which would oversee the facility. They just need to find a place to put it.

County officials thought they had a location — in the shuttered stockade next to the South Florida Fairgrounds — and planned to bring it to the County Commission for approval on Tuesday. But the vote was canceled after an engineering consultant’s report, released earlier that day, concluded the stockade upgrades would be too expensive.

“I am heartbroken this didn’t happen (Tuesday), but I remain optimistic that we will open this center somewhere in our county because we have a committed Health Care District on board and legislative interest in helping to fund it,” said County Mayor Melissa McKinlay, who has led the charge in the county’s response to the epidemic.

The county plans to “move aggressively” in finding a location for the facility and options could include other land owned by the county or the Health Care District, said Deputy County Administrator Jon Van Arnam.

“It’s a little bit of a setback,” Van Arnam said, “but certainly the commitment and enthusiasm for the project is not diminished at all and we may end up with a better facility in the long run.”

The plan calls for the county to help launch and the district to operate a free-standing addiction treatment emergency room and a medication-assisted treatment clinic that could accept up to 14 patients at a time.

Instead of taking overdose patients without other health issues to the nearest hospital, paramedics would take them to the addiction emergency room and clinic connecting addicts with therapy, rehab and outpatient treatment.

“We have a model that we believe is very cutting edge,” said Darcy Davis, the Health Care District’s chief executive.

The facility also would offer relief to emergency rooms at area hospitals that have been inundated with “high resource-demanding overdose patients,” according to a district memo. Paramedics last year responded to about 5,000 overdose calls in the county.

“This program can shunt some of that burden away from the emergency departments, thus freeing those community resources to better care for all the other myriad community threats while our specialized center provides the highest level of care for the substance abuse disorder patient,” the district wrote.

The center also will offer a key component that hospitals don’t when overdose patients arrive — a psychiatrist to talk to patients “immediately in that life-changing moment” about treatment programs, Davis said.

With help from peer counselors from Rebel Recovery, a private advocacy group that helps addicts, the center will link patients with medication-assisted treatment services such as the HCD’s successful Suboxone program that has had a 56 percent success rate since it started in 2017.

“Right now, there are a lot of people recycling through detox units and not receiving treatment on the end. This is an opportunity to change how we’ve been doing business and get them into medication-assisted treatment, which has a high level of effectiveness,” said Becky Walker, director of the Southeast Florida Behavioral Health Network.

Davis said the idea for a one-stop shop for addiction services came to her after visiting an Orlando facility that was more of a jail-diversion program.

“While that is a great program they have, it is not what we need,” she said. “We were really just brainstorming and we said, ‘What we really need is an ER and to get them into treatment.”

Davis thought of how sexual assault victims are sent to one emergency room that specializes in their care in Palm Beach County — the Butterfly House at Wellington Regional Medical Center. She wondered, why not do the same for addicts?

She later discovered Columbus, Ohio, has set up a similar addiction stabilization facility centered around an emergency room.

The Health Care District had hoped that its stabilization center would be ready to go in the fall, but now the best hope is the end of the year if a location can be settled.

“It is what we need here in this community,’ Van Arnam said. “We remain committed and convinced that this Addiction Stabilization Facility not only will it be state of the art, it will be a model for this state and beyond, possibly.”

State lawmakers this year will consider earmarking $1 million toward the project. Commissioners on Tuesday agreed to pledge $500,000 — money that will come from a $3 million pot approved in April to fight the epidemic.

“I don’t know that this will solve the entire issue,” McKinlay said about the concept, “but it’s a heck of a lot better than what we have today.”

The county this week plans to advertise for a high-level staff position, a “drug czar,” to lead its response to the epidemic.