Opinion by Sue Runyan of Sequim: Part 1
Author Sue Runyan
I am a New Activist of sorts. I worked. I retired. I expected to read books and walk and grow old. But there is still work to be done. I love my Country, warts and all.
“No need. Only Greed.” The Peoples $$$
Proposed MAT Facility for Sequim:
In mid 2019, the citizens of Sequim were told there was to be a Medication Assisted Treatment facility (MAT) in Sequim, next to COSTCO, on almost 20 acres recently purchased by Jamestown S’Klallam Tribe of Indians. “Fait Accompli.” This announcement also included that $7.2 million was in the State budget for the building of the facility. Coming as a huge surprise, a non-political group of citizens, calling themselves SOS, saveoursequim.org, quickly came together in opposition to 1. the placement of this regional facility and 2. that the elected officials did this to a sleepy, rural retirement town without public input. In the uncovering of facts, it was disclosed that there is an obscene difference in medicaid reimbursement rates given to an Indian tribe compared to a non- Indian group. Our quest for knowledge led us to write the following letter to the Sequim City Council. (Sidebar – The backroom quid-pro-quo, unwritten promises and wink-winks did not happen under the watchful eye of the current Sequim City Council.)
To: All Sequim City Council June 15, 2020
We wondered why the discrepancy was so disparate between MAT needs as reported by our PDN and the Save Our Sequim group. We read. In our process of discovery, we found 2 items that explain this disparity. Item 1 is the 2016 Substance Abuse Mental Health Services Administration Map for addressing service gaps for opioid treatment at the height of the opioid problem in our Country. Look, this is a clear statement by the State of Washington that there is no need for a MAT facility in Sequim, (marked in lime-green below). We are in a “Non-Optimal Area”. This designation means “No need for service or investment in a facility.”
Why would anyone build a MAT Facility where there is no need? Why would this happen? We believe that milking Medicaid, funded by federal taxes, is that reason and not for the benefit of the citizens of Sequim or Clallam County.
Map of the area to be served shown by red rectangle in a “Non-Optimal Area”:
Why would we say that? The Salish Behavioral Health Organization, Executive Board (SBHO EB) minutes of June 2018 specify “a contract was finalized with BayMark” Health Services which operates Opioid Treatment Programs nationwide. The minutes state that “BayMark is in negotiations with property owners in Clallam and Kitsap counties” for a place for their treatment centers in Port Angeles and Bremerton, respectively. (Note – BayMark was not interested in a clinic in Sequim. They can read the map.) The SBHO Executive Board meeting (August 17, 2018) specify that “soon after achieving contract signature (from BayMark) the SBHO was informed that the Jamestown S’Klallam Tribe also planned to open their own OTP (Opioid Treatment Program) which would be open to the public. Tribes in Washington State are allowed to charge the current “encounter rate” for each service rendered to a patient, with the current encounter rate being $427. For Substance Use Disorder services, these funds are paid with 100% Federal funds regardless of the ethnicity of the individual being served (emphasis is mine). BayMark was very concerned about this development as they cannot compete with a Tribal program due to the vast inequities in payment (we will be paying BayMark approximately $20 per day).” In the SBHO Executive Board minutes of October 19, 2018, “SHBO agreed to pay BayMark a guaranteed monthly rate until BayMark reached the ongoing patient population listed in the contract for each site.” The SBHO seems to have turned their backs on a proven and inexpensive treatment process in favor of the much more expensive Jamestown S’Klallam Tribe proposal.
Item 2 is an email response from Mark Ozias, to an SOS facebook post on July 23, 2019. A part of his response states “Our region is in great need of additional MAT resource, and the facility and program the Tribe is considering has the chance to really make a difference.
Because of the way that reimbursement rates work, the Tribe is really the only partner who could make this type of program “pencil out” and I am grateful they have taken the risk to do so.” Mark Ozias has clearly stated that this MAT, as a business, can only succeed because of the absurd Medicaid reimbursement paid only to Indians. There is not enough need in this “non-optimal” area to justify a MAT, on its own, except by pretending there is a need.
Pricing of service: Tribe $427.00 vs BayMart $20.00
We urge you to request a Federal Investigation because Federal Medicaid reimbursements to the Tribe are predicated on the fraudulent premise of need. It is a demonstrably false premise. No need; just greed!
In our opinion.
T/S Runyan, Sequim, landis3@yahoo.com 2020
Whatcom County Republican Party endorsements:
to Ted Shanks – I posted this on Real News on the Olympic Peninsula facebook page. It will do here just as well. When the Tribe made the announcement of their own MAT in the fall of 2018, this MAP was available and appropriate. This map means no additional services needed in Sequim. Since you consider old info inappropriate, you will consider the opioid numbers used for the basis of the Capital Budget just as inappropriate. The numbers used were from 2012-2016. This is to address comments on my post with the 2016 SAMHSA Map. One on the comments stated that the SAMHSA Map was out dated and therefore not a viable argument. Picture 1 is of the Capital Budget Request, dated March 2019, the basis for the $7.2 million request for the MAT clinic. Picture 2 is page 5 of this budget request. Please note that the latest information provided by the Jamestown S’Klallam Tribe is from 2012 – 2016 even though the presentation was made in 2019. Screen shot 3 is of the January 2019 Clallam County Opioid Surveillance Dashboard. Data was available thru 2018 but not used by Jamestown S’Klallam Tribe. From 2016 to 2017, the data shows a drop of 38% in opioid deaths. So, the SAMHSA MAP was a viable argument in 2018, when the Tribe made the decision to open a second MAT. And it was still viable in 2019, when the Capital Budget Request was given to Representative Steve Tharinger, Chair of the Capital Budget Committee. The reason it was and still is viable is because deaths from opioid use have continued to decrease in Clallam County. If there wasn’t any need for additional services to begin with, and the opioid deaths continue to decline, there is still no need for a Regional Medication Assisted Treatment facility. (actually the photos did not copy to this page but they can be found on facebook, Real News on the Olympic Peninsula.)
Typical Trump acolyte: use an 8 year old map to justify your anti “Indian” rant.
Doesn’t the T in MAT stand for ‘Treatment’?
Our own Sheriff supports this facility for our local addicted population. Would you rather they get money to buy street drugs by theft and robbery?
Excellent description of our situation in Sequim. This entire big business phenomenon designed to build taxpayers for millions each year was organized outside of public view. Now the courts want to say we have no standing to protest this mega facility. The only way the facility stays in business is by creating a population of drug treatment commuters being busef into Sequim or worse, driving themselves. Please visit our website for more information. http://www.saveoursequim.org