Clinic endures growing pains
Camino Nuevo, Albany at odds over how many, who to treat for drug addiction
Albany
There were two distinct occasions that brought Micky Jimenez and her staff at Camino Nuevo to tears.
The first was on April 22, 2015, when the brand new methadone clinic opened its doors on Central Avenue in Albany and its very first patient walked up for a dose of medicine.
The methadone eventually helped the man reclaim control of his life after a long battle with opioid addiction. But on that day, all Jimenez and her staff knew was that he was the first in a long line of patients who needed help and would finally get it.
For four decades Albany had only one methadone maintenance program for people battling opioid addiction, run by Whitney Young Health on Dewitt Street. The next nearest program was in Amsterdam. But as communities nationwide began to see a rising toll of deaths from prescription painkiller and heroin overdoses, the
city’s single clinic reached capacity. By 2015, it had a waiting list of nearly 250 people.
Camino Nuevo’s arrival to the scene brought immediate and palpable relief. But ask city, law enforcement and business officials, and they’ll tell you it also brought traffic, loitering and crime to one of the city’s busiest commercial corridors. They want it to relocate to an isolated area of the city, or out of the city altogether.
That’s why three years later, on a recent April day, Jimenez was moved to tears again. The state Office of Alcoholism and Substance Abuse Services told the clinic it could no longer accept an unlimited number of patients. It must stop accepting patients when it hits 581, it was told, in order to placate community concerns. Currently the clinic is a few dozen shy of that total, and the vast majority of its patients must visit the clinic daily to receive their medication.
“When you have a mom come into your office and drop on her knees, begging you to take her son who’s in ICU for the third time with an overdose — you don’t care about traffic, you’re gonna take them,” said Jimenez, director of the clinic and regional director of its parent organization, Acacia Network, which runs similar programs in Buffalo and New York City.
Here’s the problem, as city officials see it: Camino Nuevo offers a service their community and others nearby desperately need. But it’s in the worst possible location.
Occupying the first and fourth floors of a five-story building at 175 Central Ave., the clinic operates in close proximity to a school, barbershop, grocer, tax preparation company, phone retailer and auto repair shop. It also happens to sit directly opposite the Central Avenue Business Improvement District headquarters, giving Anthony Capece, its executive director, a firsthand view of the operation.
“If you can imagine three or four people being dropped off every few minutes, you can imagine the number of vehicles we get through here,” he said. “You’ll see cabs doing U-turns, letting people out in the middle of the street, double parking.
You almost have to see it to believe it.”
That wasn’t the case when the Times Union visited the clinic during its busiest time on its busiest day — Tuesday between 8 and 11 a.m. Traffic was sparse. Two security guards patrolled a mostly empty sidewalk in front of the clinic, at one point instructing two people who had lingered at the corner to move along. A white van the clinic had recently purchased idled at the curb.
But that visit also came after the clinic had taken various steps to appease community concerns. It hired more security guards, who cracked down on loitering, double parking and idling cabs ignoring parking meters. It bought two vans to transport patients after their appointments — a move it predicts will cut down on loitering among patients waiting for cabs, as well as traffic congestion.
“Whatever the city wants, we’re trying to just make it happen,” said Program Director Jasmine Guerrero-wiggs. “Whatever suggestions they have, we’re trying to make it happen. Even with my budget, which isn’t a lot, we got more guards and police enforcement. We’re not saying we’re perfect and have no issues. But we’re trying, that’s all I can say.”
Addressing crime
Mayor Kathy Sheehan went to the clinic herself one day to see the problems she had been hearing about first hand. Standing across the street, she says she watched “large amounts of cash” exchanging hands among people exiting the building.
Police Chief Robert Sears confirmed that crime has risen in the area since the clinic’s arrival. The city’s other clinic on Dewitt Street has had fewer issues, he said, because it’s in a less visible, relatively isolated area of the city near the Interstate 787 overpass.
Between 2014 and 2017, Sheehan said the city saw a 76 percent increase in EMS and police calls to the area, a 53 percent increase in calls for fights, a 130 percent increase in calls for “annoying people” and a 55 percent increase in calls for “annoying groups.”
“The issues that have occurred have been significant, with acts of violence erupting,” she said. “So I don’t see how this methadone clinic is really meeting the needs of those who are seeking recovery and it certainly is negatively impacting the businesses and residences in and around this location.”
Donald De Pass, the clinic’s head of security and a retired State Police major, disagrees.
He joined Camino Nuevo in October 2015, six months after it opened, and was brought on specifically to handle issues of crime that had arisen around the clinic. Police have been called occasionally in the years since, he said, but on a limited basis.
The statistics the mayor cites, he said, are culled from a four-block area and all hours of the day and night.
“We’re only open from 7 to 2,” he said. “Is there gonna be an increase in activity? Yes. I will admit that readily. But when you blame us for all the crime, that just doesn’t make sense.”
Guerrero-wiggs said she’s talked to families in the area who said they feel safer since the clinic moved in, because of the increased police and security presence.
“I talked to one woman who says she now lets her daughter play in the front yard because she sees police patrolling, our guards out there,” she said. “So she feels safer now than before the clinic came in.”
An out-of-town refuge
For Sheehan, a key concern is that once again, the city of Albany, as the region’s largest population center and state capital, seems to be taking on more than its fair share.
Roughly 72 percent of Camino Nuevo patients hail from outside the city, while 48 percent are from outside Albany County, according to statistics provided by the clinic. Some patients come from as far away as Fulton County and Vermont, for lack of services or capacity in their own communities.
To city officials, the growth seemed to happen
overnight.
“This is a site that originally had roughly 50 patients and has since ballooned to 600,” Sheehan said. “They’re coming on a daily basis to a small clinic on Central Avenue in a commercial district that is not designed to handle that volume of individuals.”
Camino Nuevo was originally certified to serve 400 patients — more than any other clinic in the area. In the middle of an epidemic, it didn’t take long to reach capacity. In December 2016, the state lifted its cap. But as the patient load neared 600, outcry from city and community officials grew.
In response, the state again imposed a cap — setting it at 581 patients this past April. Only about 300 of those patients come on a daily basis, Guerrerowiggs said. The others are patients who have been in the program a long time and followed the rules. They’re given a monthlong supply of methadone as a result.
“The underlying issue is that people need treatment and they need treatment options in their communities,” Sheehan said. “So the frustration for me is that for a population that overwhelmingly lives outside of the city of Albany, we are yet again the epicenter for having to solve that problem.”
But for staff at Camino Nuevo, what municipality a person comes from is irrelevant. If they’re in need, and the clinic has space, they’re going to take them.
“It’s only right,” Jimenez said.
Meeting the need at home
As the opioid epidemic has grown, so too have local treatment options — but not nearly enough,
advocates say. Deaths from opioid overdose are far outpacing available treatment options, and state funding to enhance these efforts has fallen short, many say.
In the years since Camino Nuevo opened, the state certified two more methadone clinics to operate in the region — Conifer Park opened facilities in Troy and Schenectady, but it is certified to treat just 75 patients and 25 patients at each, respectively.
Whitney Young
Health’s clinic has a cap of 350 patients. And St. Mary’s Healthcare in Amsterdam has a cap of 100 patients.
Caps are set based on need, as well as a provider’s past performance, said Rob Kent, general counsel at the state Office of Alcoholism and Substance Abuse Services. They also cannot exceed a building’s certificate of occupancy, which is determined by local code.
The state is trying to encourage clinics to open in more communities as a way of offsetting the density that places like Albany have seen. But gaining local support is a major barrier, Kent said.
“Local communities have to sign off,” he said. “(Acacia) worked with the city of Albany to site (Camino Nuevo), so I don’t know what their process was but this was not snuck in. It was done in full view.”
“Siting a treatment program is difficult to begin with, and for some reason when you make it one that offers methadone — even in the midst of an opioid epidemic — it’s really difficult,” he added.
To open a clinic, a provider needs state approval from OASAS and federal approval from the Drug Enforcement Administration. It also has to meet stringent security guidelines enforced by the DEA, and they don’t come cheap.
“This is not an easy process,” Jimenez said. “(The DEA) kept coming in with something new we had to address, whether it was the thickness of the wall, the types of screws that went into the wall. We actually had ... to put this special coating on a window because when the sun was peaked at 1 o’clock we really couldn’t see the face of the nurse in the dispensing window on our security cameras. And then they said, ‘Wait a second, what if somebody goes up onto your roof and comes down on a rope and
breaks into your window?’ So we had to put sensors in every window. It was $5,000 just to pour the cement for the vault that stores the methadone.”
All told, she said it cost $3 million to meet DEA requirements for such security enhancements.
“So what we’re trying to convey to the city is, ‘Listen, we hear you, but it is not like we can just pick up right now and go somewhere else.’ ”