The Downtown Emergency Service Center (DESC) recently celebrated the grand opening of its new Downtown Behavioral Health Clinic. Located at 515 Third Avenue, across from the King County Courthouse and a block away from the Pioneer Square light rail stop, the clinic officially opens its doors for service today, September 2.
This new outpatient facility will offer a range of important services, previously available at DESC’s former location. These services include psychiatric assessment, treatment for substance use disorder, medication prescribing, nursing services, case management, and peer-led support services. Additionally, DESC’s street outreach program will primarily operate from this new space. Amenities to help build rapport with clients will include showers, laundry facilities, snacks, and various group activities.
At the grand opening, DESC Executive Director Daniel Malone expressed the clinic’s mission to assist individuals facing complex psychiatric conditions and substance use disorders. “We will use this space to provide our array of outpatient behavioral health services to people with complicated and long-standing psychiatric conditions, to people with hard-to-treat substance use disorder, and people whose lives have been beset by challenges, traumas, and setbacks too numerous to count,” Malone stated. He emphasized the organization’s approach to meeting individuals where they are, while still guiding them toward recovery.
A significant addition to DESC’s offerings is the Opioid Recovery & Care Access (ORCA) Center. This center will provide 24/7 post-overdose stabilization for up to eight individuals and will offer walk-in treatment for opioid use disorder every day from 9 am to 11 pm.
Malone explained the enhancements the ORCA Center will bring, noting, “It’s going to really enhance our capabilities in treating opioid use disorder, because we will be available 24/7, not just during the daytime, and able to receive people really in the immediate aftermath of having had an overdose event.” The services at the ORCA Center will focus on medically stabilizing those who have just survived an overdose, ensuring their physical comfort as they deal with withdrawal symptoms.
Many people may be hesitant to visit an emergency room after an overdose, but the ORCA Center is tailored to their unique needs, often providing a quicker alternative. The concept for a post-overdose stabilization center originated with Dr. Caleb Banta-Green of the University of Washington Addictions, Drug and Alcohol Institute (ADAI), who collaborated with Dr. Michael Sayre from the Seattle Fire Department’s Medic One to address the gaps in care for overdose survivors.
ADAI has played a crucial role in designing the new ORCA Center and will also be responsible for conducting evaluations. Jon Ehrenfeld, the Mobile Integrated Health Program Manager at SFD, expressed strong support for the new facility, noting its essential role in diverting clients from unnecessary hospital stays. He remarked, “Crisis centers are absolutely essential resources for us and unquestionably provide comprehensive, trauma-informed, wraparound crisis services.”
The ongoing opioid crisis remains a significant concern. Data from Public Health–Seattle & King County (PHSKC) showed a spike in overdose deaths in early 2023, followed by a reduction and subsequent plateauing, while the numbers still remain elevated in comparison to 2020 and earlier years. Fentanyl was identified as the primary cause of overdose fatalities from 2021 to 2024.
Sharon Bogan, a spokesperson for PHSKC, emphasized the need for continued public health interventions to combat overdose deaths, stating, “We don’t know all the factors that may be driving the fluctuations, but it’s clear that we need to continue to advance public health approaches to preventing overdose across our communities.” King County is actively supporting measures like the ORCA Center and other crisis care facilities, alongside launching a 24/7 buprenorphine prescribing hotline in partnership with the UW Department of Emergency Medicine. The County has also introduced vending machines stocked with naloxone and fentanyl test strips to enhance community access to life-saving tools.
Bogan mentioned that the dynamics surrounding overdose rates might be influenced by changes in drug supply, suggesting that shifts could result in an increase in fatal overdoses down the line. Earlier this year, SFD implemented a pilot program allowing paramedics to administer buprenorphine in the field— a groundbreaking initiative for the country. A single dose of buprenorphine can protect patients from opioid overdoses for up to two days, and SFD has celebrated its 100th successful administration of the medication.
At the ORCA Center, patients will be provided with medication options for opioid use disorder, including buprenorphine and methadone. While methadone requires daily administration, it can be more manageable for certain individuals, whereas buprenorphine offers a monthly injection following an initial course of treatment. DESC has developed a new protocol for buprenorphine treatment that reduces discomfort significantly. By gradually increasing the injection dose over three days, they aim to enhance patient compliance and ensure better outcomes.
Recent research published in the Journal of the American Medical Association indicated a notable improvement in treatment completion rates under this new protocol. Approximately 75% of individuals completed the initial three-day treatment course, compared to only 35% for a traditional oral protocol, with 64% returning for a second monthly dose. The less painful experience is a key factor contributing to this uptick in success rates.
However, patients will only be able to stay at the ORCA Center for a maximum of 24 hours. Consequently, they will need to return for their second and third injections to complete the initial treatment regimen. Malone underlined the critical need for housing solutions to support individuals engaging in this treatment, stating, “We are extremely interested in increasing the opportunities to be able to refer people to places and get them in very quickly.”
Despite the positive developments, DESC faces challenges in sustaining operations due to impending budget constraints. Federal Medicaid cuts could leave DESC with insufficient funding, as many outpatient behavioral health services rely heavily on Medicaid reimbursements. These cuts will not only affect individuals losing their coverage due to new requirements but will also strain the overall healthcare system, impacting hospitals, clinics, and behavioral health services throughout King County.
Funding for the ORCA Center currently comes from a mix of sources, including the state, the City of Seattle, and Medicaid. With projected Medicaid cuts arriving in 2026 and Washington State facing a $15 billion budget deficit over the next four years, coupled with current budget deficits in Seattle, the financial future of DESC and its facilities is uncertain.
Malone has articulated the organization’s commitment to ensuring essential services will continue amidst these pressures. One potential funding avenue could be the recently approved 0.1% public safety tax, which aims to allocate up to 25% of collected funds toward addiction treatment services. The feasibility of launching this tax in Seattle during the upcoming budget season remains to be seen.
The proposed Seattle Shield Initiative, backed by Councilmember Alexis Mercedes Rinck, could also provide additional financial support if it gains approval in November, potentially bridging gaps in DESC’s funding.
Katie Wilson, a leading candidate in Seattle’s mayoral race, emphasized the need for ongoing investment in opioid treatment and recovery housing by stating, “It’s worth celebrating that we are investing in this critical stage of overdose care, but it’s also not an endpoint. We need to deepen investments in opioid treatment and recovery housing to support long-term recovery, which evidence shows requires investments in basic needs like housing alongside ongoing wraparound services.”
Wilson’s strong performance in the August primary, where she led sitting Mayor Bruce Harrell by nearly 10 points, indicates a shifting political landscape. In comparison, Harrell has faced criticism for not meeting key commitments, including his promise of 2,000 new shelter beds in his first year, resulting in a net loss of shelter beds since taking office.
Throughout his tenure, Harrell has struggled with budget challenges, controversially transferring JumpStart tax funds originally earmarked for affordable housing to cover budget gaps, undermining efforts to expand supportive services. The recent voter approval of a funding source for a new social housing developer further underscores the need for more equitable housing solutions.
Despite the challenges facing DESC and local leadership, the establishment of the new behavioral health clinic and the ORCA Center reflects the immense potential of grassroots initiatives to address urgent community needs. “This ORCA Center, a larger sobering center, King County’s first crisis care center, a new residential treatment facility, and the STAR Center all opened within the past 12 months,” remarked King County Executive Shannon Braddock. “So despite the grim federal landscape that we are seeing, locally we have been able to make headway and, quite literally, open doors.”
image source from：theurbanist
