Last week, Sheriff Terry Maketa was poised to yank his proposal for a new detox facility in El Paso County. Local hospitals, he complained, were dawdling over funding, and his plans for two new domed structures near the county jail needed to move forward, with or without them.
Fast-forward a few days: Penrose and Memorial hospitals are standing obediently in line, and Maketa's saying the first dome could open by fall, with 40 beds for the drunk and drugged to get sober.
There's also something new: The county had appeared likely to lose the second half of the current year's $800,000 detox grant from the state, but Maketa is now saying he could tap those funds by opening a smaller, temporary downtown detox facility before the fiscal year ends June 30. That would give him some wiggle room for getting the new detox center running on an annual budget that, for now, comes to about $1.4 million — less than half the cost of running the detox facility that closed a few months ago.
Though Maketa sounds impatient talking about the delays, he says grimly, "We'll make it work."
At least for now. Despite wide recognition that the county needs a safe place for addicts and binge drinkers to get sober, local detox history is marked by shifts in both strategies and funding sources.
Ten years ago, El Paso County chipped in about $1.3 million to help what is now the Pikes Peak Behavioral Health Group build the Lighthouse Assessment Center, which provided 20 detox beds. Fountain Mayor Jeri Howells, who was a county commissioner back then, remembers being optimistic.
"I thought, once the county made that kind of expenditure, that was going to keep us covered," she says.
But faced with an out-of-control budget and the failure in November of a proposed sales tax that would have routed some money to detox, PPBHG announced in December it would remove the Lighthouse's detox beds.
Maketa acknowledges his plan could face the same fate even more quickly if the funding picture changes.
"A year from now," he says, "we could be without one again."
As president and chief executive officer of PPBHG, Morris Roth oversees a network of nonprofits that provides mental health care, addiction counseling and other services. The organization started running detox for the county in the 1970s, moving in the '80s to a building near the jail. In the late '90s, pressure grew to use that building for sheriff's training needs and to shift addiction from the criminal sphere to the medical.
The $4 million Lighthouse building opened in 2000 with 28 beds of "medical" detox, though Roth notes that only 20 were ever funded. Via medication and careful monitoring, the goal was to ease patients to sobriety and toward counseling and other services.
Even with state grants and contributions from the county, local hospitals and others, Roth says, the expenses quickly mounted.
"We were upside-down over a million a year every year," he says, adding that the county has recovered its initial $1.3 million investment: "That bill has been paid back many times."
El Paso County started last year paring back its $200,000 annual contribution to the Lighthouse. Then the proposed 1-cent public safety sales tax — and its promise of nearly $1 million for detox yearly — failed in November. PPBHG closed detox Feb. 1.
Roth says the Lighthouse building still serves the community. Its 16-bed "locked unit" treats suicidal patients and others facing psychiatric emergencies, and its crisis response team helps hospital personnel diagnose and treat psychiatric patients.
Detox programs can benefit the community by eliminating unnecessary ER visits, reducing costs and wait times, but Roth acknowledges they lack "curb appeal."
"I think it's hard for the community to get its arms around detox and what that means," he says.
Maketa's plan is less about treating drunks and addicts than it is about giving them a safe place to come down. Though medical staff will be on hand and addicts will be routed to counseling, it will fall under the "social" detox model, making it more of a stereotypical drunk tank.
Some worry about it moving back near the jail, since hardcore addicts and those with outstanding warrants might avoid the facility for fear of arrest. But Maketa's plan was the only one on the table.
"The way I look at it," he says, "the community wouldn't support a medical model."
The temporary detox center will operate out of the old Metro jail, recently renovated to become a work-release facility. Meanwhile, construction of the first dome and the foundation for a second — a $1.6 million job — will be covered by money already accumulated through the sheriff's contract to hold immigration detainees for the federal government. The space will be split between detox and 72 extra jail beds, and cost savings will come from sharing security, food and medical services.
For now, operating expenses will be covered by that $800,000 of yearly funding from the state, and pledges of $400,000 from Memorial Health System and $170,000 from Penrose-St. Francis Health Services. If funding dries up for detox, Maketa has a simple answer to what he'll do.
He'll close it.