Mercy Hospital plans to close its substance abuse recovery center in Westbrook, cutting 45 jobs, in part because of low reimbursement rates for addiction services, hospital officials said.

The closure of one of Maine’s largest recovery centers will affect about 250 patients, restricting treatment options for some of them at a time when overdose deaths are at an all-time high in the state.

“This is not something we wanted to do. This is something we needed to do,” said Dr. Scott Rusk, Mercy’s chief medical officer. “We regret we have to make these changes. This program has been losing money for many years.”

The Mercy Recovery Center in Westbrook will be closed and some of its services – inpatient and outpatient – will be moved to Mercy’s State Street location in Portland. The recovery center, in the same building where Mercy Express Care is located, will be shut down by the end of August, with some outpatient services ending by June 30.

About half of the 90 employees affected by the center’s closing will likely be placed in other jobs within the hospital system. The other affected employees – about 45 – are being encouraged to apply for available jobs within the Eastern Maine Healthcare system, the parent company of Mercy Hospital.

Most of the 250 clients at the Westbrook center are being treated for opiate addiction. Rusk said one-third of them – mostly acute patients who need inpatient services or closely monitored outpatient service – will be moved to State Street and be treated by other Mercy addiction specialists. The remaining two-thirds will be referred to other health care providers, such as primary care doctors, he said.

“We are aware of the closure and will be working closely with Mercy Hospital in order to identify alternative treatment options for its patients,” David Sorenson, spokesman for the Maine Department of Health and Human Services, said in an email Wednesday night.

Jim Cohen, a Portland attorney and a consultant for substance abuse treatment centers, said it’s hard to know whether Mercy’s situation will be replicated with other hospitals, but there’s no doubt that low reimbursement rates have made it difficult for addicts to find treatment.

“It’s going to be a challenging situation,” Cohen said. “As the opiate epidemic in Maine grows, there are not enough treatment options. We need to re-evaluate the ways in which we provide reimbursement for treatment.”

ONE LESS OPTION AS OVERDOSES RISE

A record number of Maine residents died of drug overdoses in 2014, according to an analysis released by the Maine Office of the Attorney General this month. The analysis was conducted by Marcella Sorg of the Margaret Chase Smith Policy Center at the University of Maine in conjunction with the Office of the Chief Medical Examiner.

The analysis found that 208 people died of drug overdoses last year, an 18 percent increase over the 176 people who died from overdoses in 2013. The drugs involved ranged from cocaine to heroin and other opioids. The number of heroin deaths jumped from 34 to 57 in 2014.

“I think it (the closure) is going to put more addicts on the streets and more people will die from overdoses,” said Daniel Vassie Jr. of New Gloucester. Vassie, 37, is being treated with Suboxone for a heroin addiction. At one point, he received treatment at the Mercy Recovery Center.

“Taking one more place away from people who are trying to get better is not going to help,” Vassie said. “It’s hard to get to the point where you want to get better, rather than the other choice, which is doing drugs.”

Rusk said most of the Mercy Recovery Center patients use Suboxone, an alternative to methadone treatment for some patients recovering from heroin or prescription opiate addiction. Those prescribed Suboxone tend to have less serious opiate addictions than those receiving methadone treatment, research shows, because Suboxone does not work for those with severe opiate addictions.

The LePage administration has proposed shifting methadone treatment to Suboxone, but medical professionals have argued that in most cases one medication can’t be replaced with another. Also, doctors testified at a hearing this spring before the Legislature’s Appropriations Committee about the difficulty of finding doctors willing to wade into substance abuse treatment and prescribe Suboxone.

Dr. Ann Dorney of Norridgewock is among those who has taken it on. The former state legislator, who serves on the state’s substance service commission, is seeing about 40 patients for opiate addictions at her family practice in Skowhegan. Dorney has been practicing for more than 30 years, and has been a Suboxone provider for nine years.

“It’s very worrisome,” she said, referring to the Mercy Recovery Center closure. “We have a growing opiate addiction problem in Maine. This seems like the wrong way to go.”

CONCERNS PATIENTS WILL RELAPSE

Rusk said the long-term trend in health insurance, especially private insurance, of increased out-of-pocket costs for patients has made substance abuse treatment an expensive proposition for people. Meanwhile, reimbursement rates for health care providers continue to plummet, he said.

That’s a difficult combination, and has left Mercy looking for ways to provide treatment. One of the changes, Rusk said, will be to restrict the geographic boundaries for those seeking treatment. For instance, a Caribou patient would not be permitted to use outpatient services at Mercy Hospital.

“I am tremendously disappointed” about the recovery center closure, said state Rep. Drew Gattine, a Westbrook Democrat who also serves as House chairman of the Legislature’s Health and Human Services Committee.

“There are 250 clients, who rely on these important services to fight this terrible disease (opiate addiction),” he said. “That means there are going to be 250 people who are going to be looking for another place to go for treatment.”

Gattine suspects factors in Mercy’s decision to close the recovery center included the financial loss stemming from the combination of providing “charity care” treatment to patients who could not afford a drug such as Suboxone, and declining MaineCare reimbursement rates.

He said there is cause for public concern.

“What I am really concerned about is that people will relapse,” he said. “Let’s be honest, this could have fatal consequences for people who are addicted to opiates.”