CEDAR HILLS TREATMENT CENTER IN PERIL

Closing It Would Cut Options For Drug, Alcohol Abusers

MAPLE VALLEY -- Three men play basketball on an outdoor court while ducks
nibble in the water nearby and nap in rare fall sunshine.

Sidewalks meander through neatly trimmed shrubs and gardens and past a
small library, cafeteria and simple dormitories for men and women.

At this quiet, 10-acre campus in the woods near a King County landfill,
residents of Cedar Hills Addiction Treatment Facility struggle to reclaim
their lives.

"I was dying," said Robert Wilbur, a 49-year-old former journeyman
machinist at Boeing who is fighting a methamphetamine habit. "I just had to
do something with my life."

In the future, other low-income or indigent addicts like Wilbur might have
to look elsewhere for help as King County considers closing the financially
struggling operation.

Treatment providers predict that some will end up in emergency rooms, jails
or the morgue.

King County isn't alone in facing tight fiscal times.

Looming state budget cuts drew about 150 people to a legislative forum last
month where some shared their stories of dealing with substance abuse or
mental illness and their fears of losing treatment options.

Substance abuse treatment historically has been underfunded, but budget
cuts will make things worse, said Ken Stark, director of the state's
Division of Alcohol and Substance Abuse.

The division was told to cut 15 percent, or about $5.8 million. To do that,
the agency would eliminate six assessment programs called Treatment
Accountability for Safe Communities, including one in King County;
eliminate 10 pilot projects aimed at the most seriously disabled people
before the programs could even begin; and cut 71 recovery house treatment beds.

Under Gov. Gary Locke's budget proposal, the division would have to figure
out how to cut an additional $1.7 million, Stark said. And those cuts don't
take into account reductions in other agencies that will affect chemically
dependent clients.

"They won't get services, and essentially, they will deteriorate," Stark
said. "Some will die, some will bounce around in the streets selling drugs
to get more money to buy drugs, some will drink themselves into oblivion
and end up bouncing in and out of shelters and emergency rooms.

"Some of them will be so incapacitated that their behaviors will begin to
mimic mental illness and impact that system. All of those costs are more
expensive than treatment."

Treated With Respect

Wilbur was shooting methamphetamine into his arms twice a day before he
came to Cedar Hills in October.

In and out of jail over the last four years, cut off from his adult
children and finally homeless, Wilbur decided to seek help. Although he
still drank, he stayed off drugs for nearly two weeks, calling every
morning at 9:30 to see if a treatment bed was available.

"I'm finally learning to get my self-respect back," said Wilbur, dressed in
a crisp, blue button-down shirt. "The staff and other clients and
counselors all treat me with respect."

Wilbur plans to stay at Cedar Hills until April, and then move to a halfway
house for another year and a half.

For years, King County has had to subsidize Cedar Hills. Under Washington
law, the state is responsible for the treatment of indigent or low-income
drug and alcohol patients. It contracts with the county, paying $38 to $65
a day for three types of residential treatment at Cedar Hills. The actual
cost for the beds is between $86 and $93 a day. King County pays the
difference.

About 80 percent of the clients are from King County, although some come
from around the state.

The county had planned to close Cedar Hills by the end of next June. But
now it is considering whether it might be used as a treatment alternative
to jail. A study is due back to the Metropolitan King County Council by May.

In Washington state and King County, officials estimate that only 20
percent of the low-income and indigent people who need treatment actually
get it, because there's not enough money for programs.

"Alcohol (and) drug treatment tends not to be a real popular area. Part of
that is because there's a huge stigma," Stark said. "A number of people in
the community and in government don't understand drug addiction as an
illness. They still see it as a bad behavior."

If people with addictions commit crimes, they're further stigmatized, he said.

In about 14 years on the job, Stark said, he has never seen proposed cuts
this deep. "This is bad. This is devastating."

Many in the treatment arena argue that cutting money actually ends up
costing more through higher use of jails and emergency rooms.

"We either fund the primary service, or we fund the consequences. And I
guarantee you the consequences are more expensive," Stark said.

A state study found that in 1996, the estimated economic cost of drug and
alcohol abuse in Washington was $2.54 billion, including losses associated
with premature death, crime and property damage from auto accidents. Last
year in King County, there were 234 drug-caused deaths, matching the record
set in 1998, according to Public Health -- Seattle and King County.

A Last Hope

Michelle Hunter, a 38-year-old mother with an 11-year-old son, said that
without Cedar Hills she would have gone "to the cemetery."

A former medical insurance analyst, she tried to do her drinking and drugs
on weekends. But she couldn't stop, and she lost job after job, as well as
her apartment in Renton.

"Coming here, I didn't know what to expect," she said. But she's learning
something new every time she hears a lecture or watches a video. "It's been
great."

Even if Cedar Hills doesn't close, it's sure to lose some of its "recovery
house" beds, treatment that prepares people to return to the community.
Originally, the Cedar Hills closure would have absorbed all 71 of the state
bed cuts. Now, they are likely to be spread among other facilities.

Cedar Hills' situation complicates its future.

Because of the uncertainty, people don't want to start working there, and
agencies don't want to refer clients, said administrator Jodi Riley-Kauer.
As a result, the 208-bed facility is currently licensed for 150 beds, most
of which are state-funded.

Stark said Cedar Hills' costs are too high, and he believes other private
facilities will bid on the state-funded beds if it closes.

Nan Busby, executive director of Seadrunar, a private Seattle-based
long-term drug and alcohol treatment facility, said she has already put in
an informal bid for state-contracted beds if Cedar Hills closes.

Twenty-two of Seadrunar's 74 beds are state-funded. The rest are subsidized
by the organization's recycling business.

"I need some of those beds," said Busby, who estimated that her daily cost
at $57.62 per bed, well below the county's costs at Cedar Hills. Seadrunar
recently remodeled half of a large facility; when it's done, it will have
room for 150 beds.

Cedar Hills' costs reflect higher wages and benefits for county employees,
as well as an on-site medical clinic, said Jackie MacLean, manager of King
County's Mental Health, Chemical Abuse and Dependency Services Division.

Several physicians at Harborview Medical Center said they doubted that
anyone would bid for the beds because of the low reimbursement rates, and
they are bracing for the spillover.

"If Cedar Hills goes away, you're going to wind up with a lot of those
folks on the streets, in our ER, in our crisis triage unit," said Dr.
Richard Ries, director of outpatient psychiatry and the chemical dependency
program.

Benny Paz says his second stay at Cedar Hills in two years will be his
last. The 28-year-old says he is serious about staying clean and out of jail.

His first visit to Cedar Hills was ordered by his probation officer. "I
played along with it," he said. This time, he is regaining self- respect
and working on his GED.

"This is my first time doing it for myself. I ain't doing it because
somebody's telling me to do it," he said, eyes welling with tears. "I know
when I get out, all the doors aren't going to be open. I know that. I'm
taking it one day at a time."