The first rehab for heroin addiction didn’t work, nor the second. She left a 28-day program on day 24.
But after facing a judge and coming to a realization — “Either I was going to die or I was going to get well” — Kiyoka Tamesue finally ended up getting treatment that worked for her, including an outpatient program at Arapahoe House.
For decades, Arapahoe House has served as the largest provider of and a last line of defense against addiction in the metro area, a place where the most in need can receive help. On Tuesday, after what its leaders say was years of financial struggle to keep up with demand, it will close its doors for good.
“It’s a tragedy,” said Tamesue, who now receives methadone-assisted therapy at a different facility. “The crisis in this country has reached epidemic levels, but I don’t see enough money going toward it. With Arapahoe House closing, that’s just going to make the situation worse.”
Arapahoe House’s shutdown has sent a jolt through Denver’s community of treatment providers and those in recovery from addiction. Given short notice of the decision, which was announced a little more than two weeks ago, other facilities have been rapidly trying to make space for new patients and hire new treatment professionals to care for them. There are questions about whether every one of Arapahoe House’s patients — it served about 5,000 people a year at multiple facilities — will have a smooth transition to a new provider.
“In the metro area, it has a profound impact — I think made much more profound by the incredibly short notice,” said Daniel Darting, the CEO of Signal Behavioral Health Network, which helps manage treatment services across the metro area. The organization has been at the forefront coordinating the transition of Arapahoe House’s services to other centers.
“I think everyone is left scrambling,” he said.
Officials at Arapahoe House, after providing an initial statement earlier this month, declined to discuss further the reasons for its closing, saying they were focusing all efforts on making sure their patients would have continuing treatment.
Those places that are working to pick up where Arapahoe House is leaving off say they are optimistic they can handle the burden.
“You’ve got everyone stepping up to the plate,” said Rick Doucet, the CEO of Community Reach Center, which will be taking over some of the services Arapahoe House offered in Adams County. “And that will more than easily cover all of the services Arapahoe House is currently providing.”
But others, like Darting, say they are still worried.
The opioid and heroin crisis in Colorado is deepening, and the number of providers in the metro area that serve the kinds of low-income patients that Arapahoe House did are few — a subset of a subset of addiction treatment programs, as Darting put it. Some of those say they are already overwhelmed.
Denver Health, which has a clinic providing medication-assisted therapy for opiate addiction, says it has no room for more patients.
“We turn away about as many people as we see every day,” said Josh Rasmussen, a spokesman for Denver Health. “The line looks the same every day. As long as we’re open, we’re at capacity.”
Darting says he hopes five to 10 providers will pick up pieces of Arapahoe House’s work. And, in a way, it could be a good thing to spread the burden more evenly.
In announcing its closing, Arapahoe House blamed years of low payments from Medicaid and other government programs that it says did not keep up with the actual cost of providing treatment. But, with those services shared over a larger group of providers, Darting said the entire systems will hopefully be more stable.
When Arapahoe House announced last year that it would be ending all of its detox services, the Jefferson Center for Mental Health picked up the services for Jefferson County. Arapahoe House, which operated in multiple counties, said it hoped that ending its detox program would help create financial stability. But Harriet Hall, the Jefferson Center’s CEO, said the portion of detox that her organization absorbed hasn’t been a financial drain.
She expects that taking on other Arapahoe House services in Jefferson County will be similar. She said she is looking at increasing the Jefferson Center’s capacity for medication-assisted therapy or adding capacity in other treatment programs.
“I guess we’ll end up being more of a resource for substance use disorder treatment than we have in the past,” she said.
Like Hall, Community Reach Center’s Doucet said he is confident he will be able to remain financially stable while taking on a share of Arapahoe House’s work. The biggest problem, he said, is something else.
On Friday, Community Reach Center hosted a job fair for soon-to-be former Arapahoe House employees aimed at helping them find new treatment jobs. But Doucet said the background checks required of new hires mean that he won’t be able to increase his staff before Arapahoe House’s doors shut for good.
“Everybody is working overtime to make sure the consumers have a place to go,” he said.
“The biggest impact is timing. When you’re given 2-and-a-half weeks notice at Chirstmas, that’s a problem. So it’s a timing issue.”
Editor’s note: Due to a reporting error, the original version of this story contained incorrect information about Kiyoka Tamesue’s treatment. She currently receives methadone treatment in Denver. Arapahoe House was among the treatment centers that helped her recover. The story was corrected on Thursday, Jan. 4.
