Rutland had hoped to see a methadone clinic up and running by now. Rutland Mental Health Services had been preparing to run it, but negotiations with the state fell apart in November.
Now state health officials hope Rutland Regional Medical Center will step in and begin offering methadone treatments by July. But even that’s not certain.
Tom Huebner, president of Rutland Regional Medical Center, knows how badly the city needs a methadone clinic. "We’re going to try very hard to get that methadone clinic up and running,"
But Huebner says before the hospital can commit to the project, administrators need to make sure it’s financially viable. "We are right in the middle of running all those numbers," says Huebner. "And we hope to get back to the state in the next two weeks to see if it is in fact financially sustainable. But we believe very, very strongly that a methadone clinic is absolutely imperative for our area."
For years, Rutland residents fought the idea of opening a local methadone clinic. But opinions have changed and the community has even agreed upon a downtown location.
Rutland Mental Health Services had been expected to run the clinic. But Dan Quinn, Rutland Mental Health’s president, says the state’s demand that it serve 400 patients the first year or face funding cuts became a deal breaker.
"I don’t know of anyone," says Quinn, "I know of no one in Vermont who’s had that expectation put on them."
Baart Behavioral Services, which operates methadone clinics in Berlin, St. Johnsbury and Newport, serves about 250 patients. Clinic president Alan Aiken says it took them several years to reach that number.
Aiken says expecting Rutland to ramp up to 400 patients so quickly seems like a recipe for failure.
"Just because of all the safety concerns. You have to recruit staff," says Aiken, "qualified staff; that’s a challenge in and of itself. There’s so much to learn and all of your clients you’d be bringing in would be brand new and that’s when there’s most instability." Aiken says "Two-hundred patients in the first year in itself is a big challenge, but 400 I couldn’t see that."
The shortage of primary care doctors in Vermont raises another challenge because anyone who wants to begin methadone treatment has to be seen by a doctor, nurse practitioner or physician assistant — all of whom are in short supply in Rutland.
But state health officials say the benchmarks they set for Rutland are valid. Barbara Cimaglio is Deputy Health Commissioner and oversees of Vermont’s Alcohol and Drug Abuse program. She says 400 patients is the goal "Because that is the need as we’ve identified it from looking at what is currently happening in the treatment world and the waiting lists."
While Cimaglio says a lot of details still need to be worked out, budgeting and planning requirements forced them to set certain goals.
"We already have probably close to 100 people who are getting services now in other places in Vermont that live in that Rutland-Bennington area," says Cimaglio. "So we start with the people who are already in the system and go from there."
While Rutland Mental Health Services was unable to meet the state’s requirements, Cimaglio is hopeful that the hospital, with its larger medical staff and recruiting capabilities, may be more able to manage a methadone clinic. She says a hospital may also be better equipped to deal with the funding irregularities that go along with Medicaid and some federally funded programs.