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Boston to shutter drug treatment facility

More than 400 opiate addicts in Boston who receive daily doses of methadone from a public clinic on Frontage Road will be steered to a for-profit facility by summer, health officials said.

In a 6-to-1 vote last week, Boston’s Board of Health decided to end more than 40 years of city-run methadone treatment, which uses the narcotic to wean addicts from heroin and other opiates. The addiction services will now be handled by Community Substance Abuse Centers as the state confronts a startling rise in heroin overdoses and deaths.

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The move is designed, in part, to shift $300,000 in city spending on the clinic to the proposed Office of Recovery Services, which Mayor Martin J. Walsh envisions as an umbrella agency to address a wide range of substance abuse and prevention needs.

Another reason for the move is that methadone treatment has become more prevalent, with a wider array of providers, than it was four decades ago, health officials said.

Rita Nieves, director of addiction services for the Boston Public Health Commission, said most Frontage Road clients are expected to transfer by July 1 to the new facility, near the Suffolk County House of Correction at South Bay.

“This is a complex transaction, and we will work this plan until the last client has been transferred,” Nieves said. “We’re not married to a particular date. . . . The more important thing here is that the transfer happens with no interruption” in service.

The plan needs approval by the state Department of Public Health, which has been closely involved in the ongoing discussions, Nieves said.

Community Substance Abuse Centers, known by the acronym CSAC, operates nine opiate treatment programs in Massachusetts, including one in Jamaica Plain with 210 clients, most of whom were transferred from the former RoxComp opiate clinic. The company also operates clinics in Connecticut, Maine, and New Hampshire.

Matthew Davis, chief executive of CSAC, said the company’s mission is to “ensure that every patient that desires to go to our program is transitioned safely and effectively.”

The switch has generated concerns that a private company might sacrifice quality for profit and that clients without insurance coverage might be denied continued service. The state currently provides an annual grant to cover much of the methadone program’s $2.4 million budget to ensure that the uninsured and underinsured are treated. The city’s share of $300,000 is used mostly to pay for overhead, health officials said.

The transaction will not result in an exchange of money between CSAC and the city, said Nick Martin, spokesman for the Public Health Commission.

Nieves said discussions with CSAC have resulted in a guarantee that all clients can transfer seamlessly to the new facility on Bradston Street. The state health department would reimburse CSAC for shortfalls in insurance coverage, just as it did with the Public Health Commission, Nieves said.

She said CSAC has agreed to interview any of the 23 employees in the city’s methadone program who are interested in jobs at the new clinic. Nieves said she does not know yet whether any workers would be subject to layoffs by the health commission.

The lone vote against closing the clinic was cast by Celia Wcislo, vice president of Local 1199 of the Service Employees International Union.

Wcislo said she thought the board had moved too quickly on a change that will affect some of the city’s most vulnerable residents.

“I want to make sure that if we move ahead, we have some oversight over what we actually do, because it will fall back on the city eventually,” Wcislo said. “We want to make sure all the patients are accepted and that if they want to go somewhere else because they don’t like the place, we have a responsibility to them.”

Davis declined to answer questions about staffing at the new facility, which at 17,000 square feet is nearly seven times the size of the Frontage Road clinic.

The company will offer on-site counseling and other recovery services for methadone clients, in addition to daily doses of the drug.

Those clients currently shuttle between the city clinic at Frontage Road, off the Southeast Expressway near Massachusetts Avenue, and health commission offices on nearby Albany Street for counseling and other services.

“The big story here is that our clients will go there under one roof in a one-stop-shop model,” Nieves said. “They’ll be able to receive primary care in one site, to get comprehensive services in one site.”

CSAC also will continue the city’s partnership with Boston Medical Center to serve pregnant and postpartum women, and to treat pregnant inmates at the Suffolk County House of Correction.

Brian MacQuarrie can be reached at macquarrie@globe.com.
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