A nonprofit outpatient drug treatment facility in Sanford soon will become the second clinic to close this year and cite a lack of government support in Maine as a reason.
Spectrum Health Systems’ Sanford outpatient facility will close as soon as its 100 patients are transferred to other treatment facilities, company officials said Monday.
Mainecare and substance abuse
MaineCare – Maine’s Medicaid program – provides the bulk of government funding for addiction treatment in Maine.
MaineCare enrollment declined from 355,000 patients in 2011 to 287,000 this summer as Maine tightened eligibility requirements.
Substance abuse providers say this decline has hurt access for low-income, uninsured patients who need treatment. Most outpatient programs do not accept uninsured patients.
The number of heroin users seeking treatment has tripled from 1,115 in 2010 to 3,463 in 2014.
Total state spending on substance-abuse programs increased from $57.5 million in 2007-08 to a peak of $76.7 million in 2011-012 then dropped to $71.6 million in 2014-15.
Source: State of Maine
The announcement of Spectrum’s closure comes as overdose deaths in the state are on the rise and more Mainers are seeking treatment for heroin and prescription painkiller addiction. The surge in opiate overdoses included 14 in Portland – two of which were fatal – during a 24-hour period this month.
“We know our services are needed, but in the absence of governmental support for treatment, our hands are tied in this decision, and that’s tragic,” Kristin Nolan, Spectrum’s vice president of outpatient service, said in a statement announcing the closure.
Officials at Mercy Hospital announced in May that its Westbrook Recovery Center would close by the end of August, affecting nearly 250 patients. Mercy officials said the program had been losing money for years and that part of the problem was declining government reimbursements and people on private health insurance plans who couldn’t afford their high deductibles.
The number of Mainers seeking treatment for heroin addiction increased from 1,115 in 2010 to 3,463 last year, while the number of heroin overdose deaths climbed from seven in 2011 to 57 in 2014.
In 2014, 100 Maine deaths were attributed to either heroin or fentanyl, a synthetic opiate often mixed with street heroin to increase its potency. There were 63 overdoses linked to those opiates in the first six months of 2015.
Those statistics reflect national trends prompted by increased availability of low-cost heroin at a time when prescription opiate painkillers are becoming harder to find and more expensive to buy. Many users become addicted to painkillers first, then turn to lower-cost heroin.
The Sanford drug treatment facility, run by Massachusetts-based Spectrum Health Systems, opened in January 2014 on Eagle Drive. It is the only methadone clinic in York County, according to Spectrum.
Company spokesman Brendan Melican said the organization wanted to stay open in Maine, but “constant cuts” to Medicaid – or MaineCare – and tighter limits on who is eligible for coverage made it impossible for Spectrum to provide a sustainable model for treatment. He said 95 percent of clinic patients rely on MaineCare to pay for their treatment.
“In Massachusetts, we’re seeing law enforcement helping addicts get into treatment,” said Charles Faris, Spectrum’s president and CEO. “In Maine, Gov. LePage is discussing calling in the National Guard to combat the state’s drug epidemic while leaving multimillion-dollar grant opportunities for funding treatment on the table. As a not-for-profit, we rely upon our partnerships in government. Unfortunately, we feel the current administration lacks interest in supporting the evidence-based solutions we provide.”
John Martins, spokesman for the Maine Center for Disease Control and Prevention, said the state spent $13.9 million on methadone treatment for 3,858 patients in the 2014 fiscal year.
“Spectrum has made the business decision to close its only methadone treatment clinic in Maine after a short time in operation,” Martins said in an email, noting that Spectrum served 38 Medicaid patients in the 2014 fiscal year and 85 in 2015. “We are not certain if treating just 2 percent of those receiving treatment in Maine had a bearing on the decision to close.”
Substance abuse providers say a decline in MaineCare enrollment has hurt access for low-income, uninsured patients who need treatment and contributed to the closure of treatment facilities. MaineCare enrollment has declined from 355,000 patients in 2011 to 287,000 currently as the LePage administration has tightened eligibility requirements.
Treatment has long been seen as a less-expensive option than dealing with the consequences of continued addiction, especially overdoses and crime. Every dollar spent on treatment saves as much as $12 in medical care and crime-related costs, Maine’s Office of Substance Abuse said in 2011.
Despite the criticism of the administration, the Maine Department of Health and Human Services has said it is spending more on substance abuse – $77 million in the current fiscal year compared to $75 million two years ago – as part of a shift away from specialized clinics and toward treatment by primary care doctors.
Maine’s drug problem has gotten the attention of the state’s leaders.
Sen. Angus King is hosting a roundtable Tuesday with the U.S. drug policy chief to discuss strategies for dealing with the addiction crisis, and Gov. Paul LePage will hold a summit on Wednesday that will include people who work in law enforcement and addiction treatment.
LePage spokeswoman Adrienne Bennett said the governor is taking a holistic approach to addressing the drug issue in Maine, which includes addressing the flow of drugs into the state. If people believe there is a shortage of funding, they should address that with the Legislature, which appropriates funding, she said.
“(The governor is) focusing heavily on disrupting the supply, but we are not ignoring the addiction side of things,” she said. “The problem seems to be increasing no matter how much money we throw at treatment.”
Democratic leaders in the Legislature renewed their criticism of the administration Monday, sending a letter blaming the limits on MaineCare and cutbacks in funding for closing at least one treatment center. In the letter, Speaker of the House Mark Eves and Justin Alford, the Senate Democratic leader, said the Legislature passed a bipartisan budget that added new drug enforcement agents and positions in the judicial system to handle drug cases.
“While we made efforts to bolster law enforcement, we’ve seen your administration cut health care, including access to drug treatment, for thousands of Maine people,” they wrote. “Cuts in MaineCare coverage and low reimbursement rates have already led to the closure of one of the largest treatment facilities in the state, while others struggle to remain open.”
Melican, the Spectrum spokesman, said the treatment facility in Sanford will stay open until its existing patients are placed with other treatment providers. Patients were notified of the closure early last week and Spectrum told state officials Friday, he said.
Spectrum’s departure leaves Maine with six providers operating 10 methadone clinics, including two in Portland and one in South Portland, Martins said.
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