Ada County sheriff wants detox solution

Without an Ada County 'drunk tank,' the jail or an emergency room are the only options - and they aren't good ones, Gary Raney says.

cmsewell@idahostatesman.comApril 30, 2013 

Since late 2011, the Allumbaugh House "sobering station" has sat empty for lack of money, leaving police with two unattractive choices.

When a police officer has a drunk person who is a threat to themselves or others, the cop can take that person to jail to sober up - which drains jail resources - or take them to a hospital emergency room. The ER is costly, and generally way more treatment than the intoxicated person needs. It also means the officer spends a bunch of time on the hospital admission.

"Emergency rooms and jail cells are not only very costly but, in the case of the jail, it is not the right service for these people," said Ada County Sheriff Gary Raney. "The jail is built and staffed to deal with offenders who commit crimes - not people who need medical monitoring while they sober up."

Frustrated with the demands on his staff and lack of state and local money available for community treatment, Raney wants to start talking about a permanent solution to divert these people away from ERs and jail cells.

SOBERING STATION SHORT-LIVED

In May 2010, Ada County, the Idaho Department of Health and Welfare, the cities of Boise and Meridian, Saint Alphonsus Regional Medical Center, St. Luke's Health System and United Way of Treasure Valley pooled resources to open Allumbaugh House. The joint partnership contracts with Terry Reilly Health Services to operate the 9,200–square-foot facility, which has beds for up to 16 people.

Allumbaugh House, which gives priority to clients with low incomes or a lack of health insurance, provides mental health and detoxification programs, with clients staying several days.

Under Idaho code, all of Allumbaugh's mental health patients must be referred by a doctor. For clients seeking detox, about a third make appointments for themselves; about one-third are referred from St. Al's; about 20 percent are referred from St. Luke's; and the remainder are referred from other organizations.

The sobering station operated differently. Police or hospital staff brought overly intoxicated people to the facility for a six- to eight-hour stay - "a sort of timeout so they could become sober enough to care for themselves in a way that was safe," said Terry Reilly Executive Director Heidi Hart.

On Oct. 1, 2011, Allumbaugh closed the 18-bed sobering station to focus its resources on detox and mental health - programs that have been at capacity, or close to that, since the center opened.

"If we are going to do it, we want to do it right," said Hart.

TWO OBSTACLES: MONEY AND RULES

There might be a shortage of money, but there is a definite need for a sobering station, said Paul Woods, who serves as the city of Boise's representative on the board overseeing Allumbaugh House. "Closing it was not an easy decision and it was not a permanent decision," he said.

Last year, the Ada County jail booked 123 people on public intoxication. The jail also takes a couple people a month on a detox hold with no charges filed.

St. Luke's has seen a marked increase in the number of alcohol-related ER visits in recent years. Between 2010 to 2012, such admissions increased 29 percent to 1,520. The hospital was unable to say how many of those patients were brought to the hospital by a police officer.

Allumbaugh operated the sobering station only on Friday and Saturday nights. The limited hours didn't help police officers, who can come across an intoxicated person in need of medical care at any time.

Even if Allumbaugh did have the money to open its sobering station every day, Idaho code limits the effectiveness.

People have to consent to voluntary treatment at Allumbaugh House. If a person is highly intoxicated - more than .20 blood alcohol content - or unconscious, Allumbaugh can't take them because consent can't be given. Also, the staff can't make them stay even if they shouldn't be leaving, said program manager Cindy Miller.

Because hours were limited and the rules were narrow, it was often simpler for an officer to take the person to jail or an ER.

Allumbaugh and city officials welcome Raney's offer to get the discussion started, but said changing state code needs to be an option.

"Maybe it is time to resurrect the conversation and get everybody back to the table and talk about what officers are experiencing and what, as a community, we can do to be part of the solution," Hart said.

ONE MORE CHALLENGE: TOO SUCCESSFUL

Eleven days after Allumbaugh House opened in 2010, it was full.

If 14 of the 16 beds are occupied, that's considered full. For 11 of the past 12 months, the average has been 14.8 beds in use.

"We could easily have another eight to 16 beds if we had the funding," said Dr. Charles Novak with Sage Healthcare, co-medical director at Allumbaugh.

Last year, Allumbaugh had 1,215 patients stay an average of 6.3 days. About two-thirds of those patients were in the detox program, although that and mental health treatment often overlap, Hart said.

With a $1.8 million annual budget, Allumbaugh gets half its financing from the Idaho Department of Health and Welfare.

Commissioner Dave Case says Ada County's $250,000 annual contribution is money well spent. An overnight stay in the hospital can run $1,500 - not counting lab tests and medications. An overnight stay at Allumbaugh House averages $247, including lab tests and medication.

In Idaho, counties pick up part of the medical-care tab for people who cannot afford it. If one of those people goes to Allumbaugh instead of the ER, that saves taxpayers money, Case said.

"I think it is clear that Allumbaugh House is a good service and a benefit to the community," he said.

Cynthia Sewell: 377-6428, Twitter: @CynthiaSewell

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