Delays for St. Albans treatment clinic ‘troubling,’ state official says

ST. ALBANS — Thursday was opioid overdose awareness day at the statehouse, a day for officials and members of the public to mourn the lives lost and focus attention on continuing efforts to curb drug deaths.

Tuesday also marked an important, though far less visible day in Vermont’s struggle to come to grips with a public health crisis that claimed a record number of lives In Vermont last year.

It was the day the Vermont Division of Fire Safety approved a construction permit for 242 South Main Street in St. Albans Town, the location where a private company plans to open a medication assisted treatment hub for people addicted to opioids.

The company, BAART Behavioral Health Services, Inc., said it expects the clinic to open in late spring or early summer. When Gov. Peter Shumlin announced the new clinic last June, he said there was “a clear need for more capacity in the northwest corner of the state,” and his administration said the facility would open in January.

Experts say that access to treatment medications — primarily methadone and buprenorphine — reduce the likelihood of a fatal overdose. State officials credit Vermont’s system of hub clinics and spoke medical practices with helping to keep the rate of growth in overdose deaths below the rates in neighboring states.

The same officials have repeatedly suggested that opening the St. Albans hub will greatly reduce, or possibly eliminate, a persistent waiting list for treatment. Despite other efforts, there are still more than 100 people waiting for access to medication assisted treatment.

The waiting period has been exacerbated by the closing earlier this year of Maple Leaf Treatment Center, which is under multiple state investigations for a variety of problems including allegations of Medicaid fraud and sexual harassment of workers.

For years, hundreds of people in Franklin and Grand Isle counties have had to make daily trips to South Burlington or Newport, often using public transportation, to get treatment medicine. The new clinic is expected to serve 250 people.

A year ago, when the treatment hub in St. Albans was first announced, Franklin County Sen. Dustin Degree said it was long overdue. “I think this is honestly something we could have used five years ago,” he said.

‘Mysterious and troubling’ delays

The state construction permit granted Tuesday comes five months after local officials signed off on the project, and four months after Gov. Phil Scott highlighted, during his budget address, money that is allocated to pay for treatment at the clinic once it’s open.

Scott spokeswoman Rebecca Kelly said the governor was briefed earlier this week on where things stand in opening the St. Albans hub. The governor called BAART officials on Friday to “convey this was a priority” for the administration, Kelly said.

“Certainly we are disappointed in the delays,” she added.

Deputy Health Commissioner Barbara Cimaglio described the delays that as “troubling and mysterious.” She said the state’s contract with BAART only covers payments for services at the clinic, and it’s the company’s responsibility to get it off the ground.

After this experience, Vermont may consider including construction guarantees in service contracts that involve opening a new facility going forward, she said.

State officials were initially confident BAART could meet the January timeline because it has opened new clinics expeditiously in the past, Cimaglio said. BAART already operates hubs in Newport, St. Johnsbury and Berlin.

Much of the delay in opening the St. Albans clinic resulted from difficulties finding a suitable location, said Jason Gougen, BAART’s regional director.

It took months after they signed an agreement with the state in June for the private-equity backed firm to settle on the former Knight’s of Columbus property on South Main Street. Cimaglio said a previous building BAART considered for the project proved unworkable.

The St. Albans Town Development Review Board approved the project after one meeting on Dec. 15. The building sale was finalized on Jan. 2, according to Gougen.

Then BAART learned it would need a variance for an elevator to meet accessibility requirements. The variance was granted at the end of February by the Vermont Access Board, which meets once a month to rule on such matters.

BAART doesn’t plan to tear down the existing structure, but it needed a construction permit to renovate the interior for its new purpose. The company applied for a construction permit on March 13.

Jeff Bryant, assistant state fire marshal, said it wasn’t until Tuesday at noon that he was told “this (permit) needs to get out today.” Bryant said the application was initially assigned to someone else.

Bryant’s boss, Michael Desrochers, executive director of the Division of Fire Safety, said he called the Williston office where Bryant works to deliver that message after realizing that the project was nearing the 30 day limit for application review.

“I’m not going to be bashful about this. This project is very important for the state, and this type of instruction is not rare,” Desrochers said, referring to directives for his staff to complete a review before the 30 days are up.

Desrochers said he was aware of the project’s importance based on a February conversation with his boss, Commissioner of Public Safety Thomas Anderson.

The review for a small project such as the St. Albans hub should only take 45 minutes to an hour, he said. Asked why it took the entire 30-day window for that review to occur, Desrochers said his division has “excessive amount of permits” to review. There are five full-time staff that review 3,500 construction permits annually, he said.

Kelly, the governor’s spokeswoman, said the episode is emblematic of why the administration wants to overhaul the state’s permitting system. “This case shows why we need to streamline those processes,” Kelly said.

Scott has asked the Agency of Human Services and Department of Public Safety to review how operations might run more smoothly in the future, Kelly said.

With a permit now in hand, Gougen said BAART has hired a contractor, and the necessary renovations will begin in two to three weeks. The clinic will be open in “late spring or early summer,” he said, without providing a more specific timeline.

Meanwhile, Burlington Police Chief Brandon del Pozo, who is outspoken in his demands for the availability addiction treatment, says the lack of hub capacity continues to put his officers in trying situations.

“Our officers get tired of responding to the same incidents again and again knowing nothing will change. Whether it’s domestic incidents or overdoses, treatment without delay is something we need to steer drug users away from their current path, so we don’t keep finding them in the same situations,” he said.

Cimaglio said the Health Department is working with BAART and other health service providers in the St. Albans-area to see if there’s a way for the company to start seeing patients in Franklin County before their clinic officially opens.

“It’s just not OK that this is going to have to wait until summer,” Cimaglio said.

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