The city of Sequim is in the midst of a fiery public discussion on the Jamestown S’Klallam Tribe’s proposal to build a Medically Assisted Treatment Center in city limits, but doctors with Jefferson Healthcare say substance abuse disorder is a regional issue, not just a Sequim issue.

The Jamestown S’Klallam Tribe submitted building permits for the clinic to Sequim city officials in January. Now, following Sequim’s permitting procedure, the application is open for public comment until Feb. 24.

The clinic will help widen treatment services for people suffering from substance abuse disorder across both Jefferson and Clallam counties.

In the past, treatment for substance abuse disorder has been done in the primary care setting, said Joe Mattern, Chief Medical Officer with Jefferson Healthcare. But some patients need more acute care than what is already available in regional hospitals.

“When you think about people with opioid or any substance abuse disorder it’s easy to think that there’s a one-size-fits-all kind of treatment,” Mattern said. “I look at what they’re trying to do in Sequim as a regional offering to fill in a gap where we have some patients who are really integrating well and receiving that care in a primary care setting, but we have other folks who drop in and out who need a higher level of intensity.”

That’s why Jefferson Healthcare, Olympic Medical Center and the Jamestown S’Klallam Tribe partnered nearly two years ago to begin talking about regional solutions for substance abuse disorder challenges that the whole region was facing, said Mike Glenn, CEO of Jefferson Healthcare.

The Jamestown S’Klallam “Healing Campus” will be located behind Costco in Sequim. The clinic will be approximately 15,000 square feet and serve around 250 patients. The clinic will start with around 25 patients when it opens, according to the Jamestown S’Klallam Tribe website, and then grow its services over a period of two years.

The clinic will offer physical and mental health assessments and treatment plans set according to patient needs. For some patients, this may include medically-assisted treatment using one of three possible medications—methadone, Suboxone and Vivitrol—which are used to help patients overcome opioid abuse disorder.

Members of the public can submit their comments on the permit application by mail to Sequim’s Department of Community Development, c/o Tim Woolett, 152 W. Cedar St. Sequim, WA. Comments can also be emailed to twoolett@sequimwa.gov.

According to Woolett, a Sequim city planner, he has already received more than 160 public comments on the proposal.

The majority of the comments are against the proposal, he said. These comments likely come from members of the group “Save Our Sequim,” which opposes the clinic. The group is led by Jodi Wilke, a Port Hadlock resident who ran unsuccessfully for a seat in the state House of Representatives in the 24th District in 2018.

The group’s lawyer, Michael Spence, argued that the city was not following proper procedure with the permit application and that the clinic should be permitted only with a majority vote from the Sequim City Council. But that argument was rebuked by Sequim City Attorney Kristina Nelson-Gross.

“I am disappointed in your admittedly unfounded allegations that city staff are ‘misunderstanding or … consciously ignoring express language in the code.’ These statements are simply false, unprofessional and irresponsible,” Nelson-Gross wrote in a letter to Spence, who is an attorney at Helsell Fetterman in Seattle.

Now, many of the group members, who consist of residents and business-owners in Sequim, are submitting public comments disapproving of the tribe’s permit application. The group also plans to appeal the city’s final decision, which will require it to go before a hearing examiner.

The reason the city does not have to go to its city council for approval of the permit application is because the land the Jamestown S’Klallam Tribe is proposing to build the clinic on was already zoned for medical use, Woolett said.

Save Our Sequim proponents worry about how the clinic will change the neighborhood and affect local businesses.

“There’s a lot of fear that suddenly you’re becoming the ‘destination’ for people who are struggling and therefore that they will come and that crime will come with them and other things that negatively impact your community, but the evidence really supports the opposite,” Mattern said. “We know that getting people medically-assisted treatment is far more successful than abstinence-only treatment.”

The option for medically-assisted treatment, including methadone treatment, is important because for years, patients from Jefferson and Clallam counties have had to travel to Seattle or Everett for treatment, Mattern said.

“There is a larger number of patients who would probably benefit from daily methadone treatment for their opioid abuse disorder who just can’t access that because they can’t make that commute,” he said.

He hopes the conversation around substance abuse disorder can evolve into one of greater understanding: that the disorder is a medical condition, not a moral failing.

“Nationally, we don’t fully understand substance abuse disorder,” he said. “People start making more moral judgements about folks as opposed to viewing this as a medical condition.”

The reason Jefferson Healthcare has partnered in the initiative is to grow a more regional response to larger issues such as substance abuse disorder that communities like Port Townsend, Sequim, Port Angeles and Forks don’t have enough resources alone to address.

“I think when the three organizations, or the communities get together and find a way to partner for solutions like this it really leads to the best answer,” Glenn said.

The Jamestown S’Klallam clinic aims to take a holistic approach to helping patients with substance abuse disorder. According to the tribe’s website, the plan is to offer not only chemical dependency relief, but primary care, dental care, childcare assistance and even transportation help. The clinic will also be available to help connect patients with social services such as securing food, housing or job training.

Between 2012 and 2016, Clallam County had the second-highest drug overdose death rate in the state, and overdoses were the leading cause of accidental deaths. But by being located in Sequim, the services at the clinic will be available to residents of both counties.

“These are people who are in your community who are suffering,” Mattern said. “Whether you build something or not, those folks are there. The question is, as a community, are you trying to be part of the solution?”