seven counties services

Seven Counties Services says they were “blindsided” by news that a for-profit company has applied to open a medication-assisted treatment clinic in the same downtown building where the regional nonprofit currently has one of its own addiction treatment facilities, which Seven Counties’ CEO called “a terrible idea” on Friday.

As IL reported on Wednesday, Texas-based addiction recovery company BayMark Health Services filed a pre-application with the city three weeks ago for a conditional use permit to open a methadone clinic at 708 Magazine St. The company’s vice president of development Dominic Spano told IL that in addition to methadone — which is administered daily to patients to treat opioid addiction — the company typically offers other types of medication-assisted treatment (MAT), such as Suboxone (containing buprenorphine) and Vivitrol, combined with therapy.

However, Seven Counties CEO Tony Zipple sent an email to Metro Government officials on Friday morning calling BayMark’s plan a “terrible idea,” as his nonprofit already provides comprehensive outpatient treatment for patients addicted to opioids at their clinic located in the same building, saying BayMark’s clinic could undermine their efforts.

“If (BayMark) had bothered to talk with us in advance, they would know that,” wrote Zipple. “And we offer MAT in the context of a comprehensive, evidence based, recovery oriented, non-profit program. We get great results without the use of methadone. Again, far superior to the approach proposed by this commercial clinic. In addition, Metro Corrections and we have talked about expanding re-entry services in this location, modeled after the LEAD program. Eating up space for a use like this does not help with that goal.”

Zipple sent the email to the directors of the city’s health department, Criminal Justice Commission, Office of Safe and Healthy Neighborhoods, Department of Community Services and Metro Corrections. He noted that Seven Counties officials planned on attending a public meeting Monday evening on BayMark’s proposal, asking “Are there things that you might do to affect the outcome of this unfortunate proposal?”

Stemming from a Metro Council ordinance passed in November, Metro Planing and Design Services currently is drafting regulations that might limit where new methadone clinics could be located in Louisville, with assistance from the Jefferson County Attorney’s Office to ensure that it complies with the Americans with Disabilities Act. Once finished, the proposed regulation would go before the Planning Commission, which would then send recommendations to Metro Council for final approval.

Councilman Brent Ackerson, D-26, led the opposition to a South Carolina company’s efforts to open a methadone clinic in his district last year, describing for-profit companies as less interested in patient outcomes than being a “cash cow, money maker.” In a meeting of the council’s Democratic Caucus two weeks ago, Ackerson mentioned BayMark’s application and floated the idea of a moratorium on new methadone clinics until Metro Council was able to pass an ordinance specifying where they would be allowed. He suggested that such clinics should not be allowed near residential or commercial areas, but instead near medical facilities or in industrial parks.

Seven Counties spokeswoman Gwen Cooper says they have reached out to the office of Ackerson and Councilman David Tandy, D-4, whose district includes the Magazine Street building. While noting that they are not against methadone as a form of treatment for those addicted to heroin and prescription painkillers, she criticized the “audacity” of BayMark attempting to move into their building without first notifying Seven Counties.

“Yes, there’s open space at 708 Magazine Street, but this is a Seven Counties location with a Seven Counties sign on it, and you’re going to confuse our clients right away,” said Cooper. “So we don’t need that in a place where we are already the experts at this and can provide services.”

Seven Counties Services is one of several addiction treatment providers in the region to make the leap to offering MAT to patients this year — beyond just an abstinence-only 12 steps model of recovery — beginning with their new outpatient program in Bullitt County that includes the medications Vivitrol and Suboxone. This Bullitt County program uses the COR-12 model that first brought great results for opioid-dependent patients in Minnesota, and was developed in part by Seven Counties’ new director of addiction services Scott Hesseltine.

Hesseltine tells IL that Seven Counties recently began utilizing Suboxone and other medications to help patients with short-term detox in their Jefferson County residential facilities, which provided the nonprofit with the necessary medical infrastructure to soon expand its COR-12 program throughout all of their outpatient clinics in Louisville. This would include their clinic on Magazine Street, but he noted that BayMark’s move “really blindsided us” and could undermine those efforts.

Hesseltine is not opposed to methadone treatment — which must be administered daily in person, as opposed to monthly Vivitrol injections and Suboxone taken daily by patients on their own — noting that Seven Counties has a collaborative relationship with the city-run MORE Center, a methadone clinic that he says provides excellent care. Instead, his issue is that for-profit methadone clinics do not always have a good reputation.

“Historically you look at the for-profit clinics, the track record is somewhat spotty in terms of practices,” said Hesseltine. “That’s not to say that’s the case with this one or every one, but that’s a legitimate concern, that when there’s the profit motive the intent isn’t necessarily a recovery-oriented approach to get someone off of the medicine when that medicine is tied directly to your revenue stream.”

Asked if Louisville should be willing to accept any type of new MAT clinic — considering the scale of the heroin epidemic and the lack of access to treatment — Hesseltine said “you can’t always make that leap. Because if you don’t have an operation that’s well run, the risk for abuse and diversion and escalating problems is far greater.”

Hesseltine says he doesn’t know much about BayMark, noting there wasn’t “any real effort to collaborate with providers in the community ahead of coming in and trying to launch services.”

Methadone has been a common and accepted form of treatment for opioid addiction for decades, but experts in the field and the federal government have recently made a large push to expand access for MAT that includes Suboxone, citing research showing positive results for patients prescribed the medication amid the nation’s growing epidemic of heroin overdoses and deaths.

The neighborhood meeting on BayMark’s application to open a new clinic will be held Monday at 6 p.m. in the Louisville Western Branch Library, 604 S. 10th St. Spano from BayMark will be in attendance, as will representatives from Seven Counties.

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Joe Sonka
Joe Sonka is a staff writer at Insider Louisville focusing on government, politics, education and public safety. He is a former news editor and staff writer at LEO Weekly and has also freelanced for The Nation and ThinkProgress. He has won first place awards from the Louisville Metro chapter of the Society of Professional Journalists in the categories of Health Reporting, Enterprise Reporting, Government/Politics, Minority/Women’s Affairs Reporting, Continuing Coverage and Best Blog. Email him at [email protected]