Medical staff work on computers while Health Services Administrator John Ackerman, center, changes the paper on a medical table in the Lewis County Jail's clinic Wednesday afternoon in Chehalis.
Captain Chris Tawes, left, and Health Services Administrator John Ackerman, right, review an inmate information sheet in the Lewis County Jail's intake area Wednesday afternoon in Chehalis.
Captain Chris Tawes talks about they type of information they collect in the Lewis County Jail's intake area in May in Chehalis.
Health Services Administrator John Ackerman pulls out a box of Narcan nasal spray, Wednesday afternoon at the Lewis County Jail's medical clinic in Chehalis.
Licensed Practical Nurse Kim Heberer checks the contents of a cabinet in the Lewis County Jail's medical clinic Wednesday afternoon in Chehalis.
Health Services Administrator John Ackerman, left, checks in with Licensed Practical Nurse Kim Heberer, right, as she checks the contents of a cabinet in the Lewis County Jail's medical clinic Wednesday afternoon in Chehalis.
Health Services Administrator John Ackerman talks about inmate information on a test template on his computer in the Lewis County Jail's medical clinic Wednesday afternoon in Chehalis.
Health Services Administrator John Ackerman talks about the type of medications they keep on hand, Wednesday afternoon at the Lewis County Jail's medical clinic in Chehalis.
County officials have been surprised by the number of inmates who have signed up for a program that provides opiate withdrawal medication and counseling for inmates both during and after incarceration, less than two months after the measure was put in place.
With a new funding boost from the program’s partner last week, Lewis County Sheriff’s Office Corrections Chief Chris Sweet said he’s confident the jail’s Medication Assisted Treatment operation is set up for long-term progress.
“I anticipate there’s going to be a heck of a lot of successes with this program,” he said. “We don’t want them back here (at the jail), we want them to recover.”
The MAT program, which was implemented in March, allows inmates to opt into a system that provides them with medication for opioid withdrawals and counseling. When they’re released, they are provided with the opportunity to continue that care, in hopes that will help avoid relapses.
As of two weeks ago, 34 people have received treatment through the program, a higher number than expected. Sweet said there have already been success stories. He was told of one individual, who has already been to Drug Court three times, who is finally seeking treatment and counseling as a result of MAT.
The program was initially funded in February as a demonstration project with Cascade Pacific Action Alliance, a program created by the CHOICE Regional Health Network, which provided $90,000 to the county to get it set up. That funding helped provide an extra nurse at the jail as well as prescriptions. Now that it’s been set up, CPAA is providing an additional $176,000 to keep it operational going forward. Those funds are money CPAA distributes through the state’s five-year Medicaid Transformation Project.
“The hope of the achievement here is that we will be able to help these individuals, so they will be successful in the community, so they’re not reentering the judicial system or harming themselves or others,” said CHOICE CEO Jean Clark.
CHOICE currently has 22 partners working on opioid-related issues in its seven-county region. Sweet said that funding was expected, and it will prove necessary as prescription costs have been higher than anticipated, as well as the number of participants. The county does not plan to use all of the money this year, as it’s unclear how much money from Medicaid — the program’s ultimate funding source — will be available in 2020.
“We didn’t realize that we were going to have 30 people already that met the requirements for this program and volunteered for this program,” Sweet said. “With more people, it’s going to cost more money.”
The county expects that it will have a better idea of its costs the longer it operates the program, which will allow it to make specific requests with CPAA in future years.
“We have to perform, we have to make sure it’s a worthwhile program and hopefully we get that financial reimbursement,” Sweet said.
Sara Rainer, opioid response program manager with CHOICE, said few jails have MAT programs established so far, but they could prove a vital part of fighting the opioid crisis.
“It’s a really impactful program. There are few jails that have this sort of program,” she said. “It’s really fantastic to see the criminal justice system as a pathway to treatment. We want to be able to provide support to our community members any way that we can provide that support.”
The program is slated to run until at least 2022, but county leaders hope it continues even longer. Sweet has singled it out as an important tool in the county’s fight against opioid addiction.
“We’ve got to set our baselines to figure out what the prescription costs are going to be, what limits we’re actually going to be facing here,” Sweet said. “It’s also showing them the need financially of what a proper Medication Assisted Treatment program is going to cost us to have at this jail. ... They gave us enough funding to actually figure that out now. If we see there’s a more increased need for having more inmates involved, then I definitely will be going back to CPAA for additional funding support.”
Sweet said it’s generally pretty straightforward to treat inmates who are incarcerated, but making sure they don’t relapse once they’re released can be a challenge. That’s why the program is so important.
“One thing I want to see is when they get released and the individual is handed over to (outside treatment), that right there is going to be the true sign of success for this program,” he said. “We have that bridge now from incarceration to outpatient treatment. That right there is where we need to concentrate.”
According to Rainier, one early issue identified by the program is the fact that inmates have their Medicaid coverage suspended when they’re in jail, and it can take 12 to 24 hours to reactivate once they’re released — a crucial window for those who need treatment. For now, the jail is paying out of pocket when it needs to to make sure those they release are able to get help. Long-term, they’re hopeful a better solution will be found.
“It’s causing a little bit of a challenge, and it’s really a key time to be able to access those services,” Rainer said. “Everybody is doing what they can to provide that support and make sure there is no gap in service. … It will be important for the state to take a look at this.”
