A new “sobering center” in Clark County’s Center for Community Health aims to be a place where people can spend up to 12 hours safely returning to their senses.
It’ll also be a smarter use of resources, officials say. That’s because people whose substance abuse lands them behind bars or the hospital emergency department are famously costly for taxpayers. But jail and hospital are often the only options for police, emergency medical technicians and other first responders called in to handle someone who’s in a drug- or booze-fueled crisis.
“Now they’ll have this new option,” said Jared Sanford, executive director of Lifeline Connections, a nonprofit agency that contracts with Clark County and Washington to provide intensive substance abuse and mental health treatment here at the community health building, 1601 E. Fourth Plain Blvd. near Interstate 5.
Lifeline has offered a range of services here for years, with one ideally leading to the next: from “medically monitored” five-day physical detoxification to 30-day cognitive and behavioral treatment to 90-day outpatient counseling and support. But those programs require reservations and scheduling, and they’re often full to capacity. “We do turn people away from detox,” said Sanford.
Meanwhile, the free, first-come, first-served sobering center will open for business on Monday. Such a facility was recommended by professionals including Vancouver Police Lt. Kathy McNicholas, who now chairs a governing board formed to make sure the sobering center meets community needs and that all relevant systems are in the loop. The board includes representatives from the PeaceHealth Southwest Medical Center Emergency Department, the Clark County Sheriff’s Office, the Council for the Homeless and others.
“Share is very excited to see the sobering center open,” said board member Amy Reynolds, Share’s program director. “One of the issues that our clients who are experiencing chronic homelessness struggle with is substance abuse, so being able to detox in a safe way as an alternative to jail is better for the clients and the community. We intend to work closely with the sobering center and the police to identify people to target with more intensive services and break the cycle of chronic homelessness.”
Bed, meal, conversation
The sobering center will be open 24 hours a day, seven days a week, Sanford said. It will be staffed by medical assistants and certified nursing assistants, and supervised by a licensed practical nurse. They will monitor patients’ vital signs as needed, but the sobering center will not administer any medications. It’ll be open to Washington residents who are at least 18 years of age and under the influence — and can follow the rules.
The ground-floor facility is launching with 16 beds and private cabinets in eight shared bedrooms. You get in by buzzing a locked, video-monitored exterior back door. Sanford said he expects that police providing door-to-door service will be doing the majority of that buzzing, and mostly on evenings and weekends. (The staff considered opening for what may well have been their heaviest-use day of the year — New Year’s Day — but couldn’t get everything ready in time, they said.)
There’s a dining area where patients will get a small hot meal, Sanford said, and laundry facilities too. And the place will offer case management and offers of other services, from housing help to Lifeline’s in-house detox programs — for those who decide that they’re ready to sober up not just for now, but into the future.
Meanwhile, the rule is that you can stay for up to 12 hours. You must leave for at least four hours. Then you can return, said sobering center manager Shalyn Crimmel, a registered nurse.
Doesn’t that mean Lifeline is simply setting up a new revolving door for some folks who — even if they’re not winding up in jail or hospitals — will still prove quite costly to taxpayers?
Sanford agreed that there are some “heavy users of services or ‘frequent fliers’ now in the system.” They’re already costing taxpayers money, “whether we like it or not,” he said. But treating them at Lifeline is far less expensive than incarceration or hospitalization, he said.
The cost to Lifeline for a single 12-hour stay in the sobering unit will be $84, and the daily cost for full detoxification service is $252, Sanford said; he figures the total cost would be just under $1 million per year if the place was at full capacity at all times — which it won’t be.
The average daily cost of dealing with a substance abuse problem in hospital is over $1,300 a day, according to the Washington State Hospital Association. And a study published in 2013 in the Journal of the American Medical Association estimates that $38 billion is spent annually on emergency department “overuse” nationwide — and that a tiny fraction of people actually account for approximately one-quarter of all emergency room usage.
Now, police will be able to buzz that back door, drop off their passenger and get back to more serious matters, Sanford said. He added that in-house security and safety are paramount. The medical staff is highly trained in de-escalation techniques and motivational interviewing, he said, and the whole building is secure and well-guarded.
Nicer than others
Sanford said he and his staff visited similar sobering centers in Portland, Seattle and Spokane. Calling them “spartan” is putting it mildly, he said.
“We saw concrete floors and mats on the ground,” he said. By comparison, the sobering center at the Community Health building is institutional but not unattractive. The tile flooring is new, and so is the paint on the walls. The bedrooms feel like college dormitory doubles, not jail cells. This isn’t the “drunk tank,” Sanford said.
“We think ours is a lot more comfortable,” Sanford said. “Our mission is to serve the least among us with respect and dignity.”
Many of the workers at the sobering center and throughout Lifeline are former drug abusers in recovery themselves, Crimmel said.
“They are some of the most devoted individuals,” said spokeswoman Shannon Edgel. “They know that addiction is a disease, not a character flaw.”
The real goal of the new sobering center, Sanford said, is to get its patients to proceed into detox and start turning their whole lives around.
“Our goal is to engage these folks and motivate them. When they’re ready to engage in services, we are ready,” Sanford said. “We believe in meeting people where they are. We’ll be able to sit and ask them, ‘What’s the next step for you?’ “
