Beltrami County won't renew a host county contract with Northern Lakes Clinic, a move sending 180 drug addicts to seek treatment elsewhere.
But about 75 clinic patients and supporters who crammed into the County Board Room on Tuesday night didn't like that decision, and spent nearly an hour unsuccessfully trying to change commissioners' minds.
A hope may come, however, as a Twin Cities representative of methadone clinics said he was negotiating to purchase the Bemidji clinic and seek a new host county contract.
One woman, crying and supported on the arm of a man, said she was homeless last August and how lives in a home and is pregnant. She also uses methadone to help with her drug addiction.
"I'm scared to death," she told commissioners. "This is my family."
County Board Chairman Jim Lucachick opened the meeting by reading a carefully crafted statement stating the board's decision Tuesday night before a packed County Board room.
"After thoughtful consideration of all the discussion and information presented, the county is still unwilling to renew the host county contract for Northern Lakes Clinic," Lucachick read in part.
He and Commissioner Quentin Fairbanks met Friday with Dr. Lois Schlutter, a Twin Cities doctor who owns the downtown Bemidji methadone clinic, about concerns that first caused the county announce its intention at its Feb. 17 meeting not to renew the contract. The statement Lucachick read arose from that meeting.
"During the meeting, county staff was able to share general concerns for a wide range of topics, including the clinic's history and impact on the community, license violations cited in the Minnesota Department of Human Services Correction Order from August 2008, continuing concerns by County Health and Human Services staff regarding communication and information sharing, and transition planning for clinic clients," Lucachick read.
Commissioners during the meeting didn't stray far from the statement, citing numerous privacy laws and confidential matters as the clinic apparently is still under investigation by the state.
"The decision not to renew the host county contract for Northern Lakes Clinic has been very challenging," Lucachick read. "Medical privacy concerns, business privacy considerations and respect for the processes of other government regulators and referring agencies has required the county to address the host county renewal process in only the most general, policy-oriented manner."
While Lucachick said Tuesday's meeting would not be a public hearing and that commissioners only intended on hearing a response from clinic management, near pandemonium broke out with a rush to speak at the podium or from members of the audience, some shouting.
Despite several efforts by Lucachick to cut off the proceedings, people spoke for more than 40 minutes, asking for a reprieve from the County Board in the form of a second chance for the clinic or by putting it on probation.
"You don't want to hear us," came a shout from the audience. "What's the real reason?" came another. "No one else has the same certified treatment" said a third. "We're begging you to reconsider."
Larry Robinson, a Vietnam-era veteran who said he was addicted to morphine said the clinic's impending closure could send addicts back onto the street, stealing from cars or worse.
"People who come (to the clinic" see hope," he said. "You guys, just to take it away ... there will be downfalls, but that's no excuse to turn your backs on all these people."
"You see these people crying for help," said Dr. Bhupinder Singh, a recovering alcoholic who said he was an advocate for the clinic, not a patient. "You are their elected officials and you owe them the responsibility. ... These heartwarming and heart rendering stories behooves you to listen to these people."
Part of Lucachick's statement said that refusal to issue a host county contract would mean the clinic could no longer receive public funding, but it could seek a host county contract from another county. Also, the clinic could continue to serve self-pay and insurance-pay clients.
"Contracting allows a service provider to access state funding for services," said Jane Phelps, a licensed alcohol and drug counselor at the clinic, adding that 75 percent of Northern Lakes clients are funded through tribal, county or managed health care.
In addressing communication problems cited by the county, Phelps said Northern Lakes held an open house shortly after it opened in 2007 and has regular contacts with county and mental health assessors from the tribes, child protection, probation and doctors, and others.
Staff turnover is common in the industry, she said, citing another apparent county concern. To another, a lack of focus on groups and individual sessions, Phelps said the clinic holds group sessions four times a day, 20 times a week, and has regular individual sessions.
"All violations that were violated in the summary from 2008 were corrected prior to Beltrami County becoming aware of them," she added, "which was over six months ago. Are there any current issues, that's what we wonder."
Patrick Plemel, another licensed alcohol and drug counselor at the clinic, said he didn't "want to give our clients false hope that their private insurance will indeed cover them." Most insurance companies and managed care will only work with facilities that have host county contacts, he said.
"The single, most important communicator of successful treatment is the relationship with either the counselor or the facility, and it's very evident to me that relationship exists at Northern Lakes Clinic," Plemel said. "We're throwing that out the window. I am deeply moved and hurt at the decision of this board to not renew that contract."
"There are things you don't know," said Fairbanks. "Things that can no longer go on. We've taken the brunt of something we didn't cause and can't say because of confidentiality."
Daniel Kern, a former clinic worker and licensed alcohol and drug counselor, backed up the commissioners, despite catcalls of "disgruntled employee" from the audience.
"The anger at the board is misguided," he said. "Dr. Schlutter is an absentee landlord who stirred the pot and got these people to come here. ... If the patients would look at the situation, perhaps they could respect the position of the board for the time being."
"Where is Dr. Schlutter?" Lucachick asked. "It is her clinic and she is not here."
That's when Charles Hilger stepped forward, saying he was a founder and licensed social worker with Metro Treatment Minnesota, which owns five methadone treatment clinics in the state, including one in St. Cloud and Lake Superior Clinic in Duluth -- the two clinics the Bemidji patients will now have to travel to in order to receive methadone treatment.
He said he was negotiating with Schlutter the purchase of Northern Lakes Clinic.
"I don't know if this is a political issue or a care issue, but would the board extend a host county contract to an existing facility with an ownership change/" Hilger asked.
Fairbanks asked how soon such a change could be effected, and Hilger thought perhaps 60 days but added that Schlutter is talking to other potential buyers.
County Attorney Tim Faver, however, advised commissioners not to answer the question about extending a host county contract, that such a request go through normal channels before reaching the board with a recommendation.
"I know the hardships, especially for patients who need this the most," Hilger said. "It will be a 2½-hour drive for them to Lake Superior or St. Cloud. We will be looking for 140 patients -- but will that many actually make it?
"We have spent hours and hours reviewing information before us," said County Health and Human Services Director Mary Marchel. "At this point in time, we are focusing our attention on a tailored transition plan for clients. Our Health and Human Services staff have been in continued contact with Northern Lakes staff, offering help in the transition of our clients from the program."
She urged clients to contact a county case manager to begin that process, with individually tailored alternative plans that may or may not include methadone treatment.