March 15, 2008
Bethel Detox Alternatives
YKHC Public Relations
Executive Summary and Recommendations
From October 2007 through January 2008, stakeholders from agencies and organizations around Bethel convened in a process to confirm the scope of the substance abuse problem in the community and region and also to identify ways to address the problem, particularly as it presents in emergency situations.
The situation is grim. More than 4,400 individuals have been in the YKHC Hospital Emergency Room (ER) or in the Yukon-Kuskokwim Correctional Center (YKCC) under a Title 47 hold or protective custody in the last 10 years. And, from research data, less than half of those requiring emergency assistance were from outside of Bethel.
Most of the individuals (80 percent) who end up at YKCC or the ER do so only once in six years, indicating that they are not one-time abusers of alcohol but are more likely to have family support that cares for them, most of the time, when they become intoxicated. "Frequent flyers" or "high flyers," people who have been in the YKCC or ER more than four times in the same research time period, account for 20 percent of admissions, or almost 900 between 1997 and 2007. Unlike the others, these men and women have few family or social supports.
It has taken a long time for the problem to become this severe. It will take a long time for the solution to be complete.
ER is not capable of responding to demand
YKHC's Emergenc Room has 11 beds, two of which are reserved for people requiring observation, admitting all youth, many women and fewer men-generally three to four people for protective custody each day, sometimes as many as 13 per day, totaling over 1,000 in 2006. Most of these people have another problem aside from alcohol, such as being suicidal or injured, requiring special attention. Since 2004, state law has not allowed youth to be admitted to the Bethel Youth Facility for sleep-off; they must go to the ER instead.
Yukon Kuskokwim Correctional Center has insufficient resources
YKCC has two 12-hour holding rooms with one for each sex, five people per room. The severely intoxicated must go to the YKHC ER for medical clearance. When the women's room at YKCC is needed for men due to overflow, women must be referred to the ER. A jail upgrade is imminent, with funding to modify the existing facility by adding three to five cells. These will be available for Title 47 holds and associated medical care. With this, a 15-bed sleep-off addition to the jail is recommended, benefiting all agencies that interact with inebriates.
Six-Month Plan for Emergency Services (submitted to the Alaska Legislature)
- Sleep-off/social detoxification center planned, $1.5 million capital budget request.
- Fund and operate a community services patrol, $333,800 FY09 operating budget request.
