Spectrum CEO hopes Maine closure prompts treatment-funding turnaround
Courtesy
Chuck Faris, CEO of Spectrum Health Systems, disagrees with Maine Gov. Paul LePage's approach to funding addiction treatment services.
When Spectrum Health Services shuts the doors to its only outpatient methadone clinic in Maine, it will be a first for the 46-year-old Worcester-based substance abuse treatment services provider.
“This is the first time we’ve ever had to (voluntarily) close a service,” said Chuck Faris, CEO of Spectrum.
Although officials in Maine weren’t notified of the impending closure of the Sanford, Maine, facility until last week, Spectrum officials could see it coming almost before doors even opened about a year-and-a-half ago.
When the organization first explored expanding to the state, reimbursements for Medicaid patients (which make up about two-thirds of their outpatient clientele in Maine) were $100 per patient per week for methadone treatment (a commonly method used to help opiate-addicted people get off the drugs) as well as at least two counseling sessions per week.
But under Gov. Paul LePage, Medicaid reimbursement for addiction services soon dwindled to $80 per patient, then $60, by the time Spectrum was ready to open the clinic. Faris said he and his colleagues worried about solvency when the Sanford facility opened in January 2014.
“At the same time, we were so far down the road,” Faris said. “You get to a certain point where it’s too late to turn back.”
Spectrum is redirecting its 100 patients in Sanford to other treatment centers in Maine, as well as to primary care physicians who are able to provide Suboxone, another drug used to treat opiate addiction. But the nearest methadone treatment center is in Portland, which is too far for many patients to travel, Faris said.
Now, Faris said he hopes the closure will act as ammunition as addiction treatment advocates in Maine call for better Medicaid funding. In a statement to the media Monday, Faris criticized LePage on his approach to managing the opiate crisis, which is widespread in Maine, New England and elsewhere.
LePage has supported cuts to MaineCare, the state Medicaid program, in recent years. Meanwhile, he’s called on law enforcement to address illegal drug use and is focusing instead on providing addiction treatment services through primary care doctors. Faris also noted that LePage declined a multi-million-dollar federal grant that was meant to bolster funding for addiction treatment.
Faris said LePage views the opiate crisis as a legal and moral problem — not a public health issue. But he believes law enforcement efforts to crack down on the drug supply are misguided.
“Somebody’s going to fill the vacuum; I think that’s the naivete on his part” Faris said.
Adrienne Bennett, LePage’s spokeswoman, responded by suggesting the Medicaid funding is an issue for the state legislature.
“The allocation of all state funds is an authority vested in the legislature. Perhaps Spectrum should have had a conversation with legislative leaders earlier this year if they knew they were facing such economic hardship as a result of (continued) cuts from the federal government,” Bennett said in an e-mail.
A tale of two states
Meanwhile, Faris praised Gov. Charlie Baker and his predecessor,Deval Patrick, for treating the opiate addiction crisis as a public health issue.
Massachusetts and the four other New England states have expanded Medicaid programs through the Affordable Care Act, which increased coverage for low-income residents, and the state provides reasonable Medicaid funding for outpatient treatment services, according to Faris. But he noted that a shortage of beds for inpatient treatment remains an obstacle in the Bay State. Baker has proposed adding 100 beds at Massachusetts facilities, but Faris said inpatient service providers are finding it tough to expand because federal reimbursements for inpatient services are low.
Maine methadone spending down
According to an e-mail statement from the Maine Department of Health and Human Services, Medicaid funding levels for substance abuse treatment services have increased steadily in the last five years, climbing from $70.5 million in 2010 to nearly $76.1 million in 2014.
But spending on methadone treatment has declined steadily. In 2014, the state spent $13.9 million, compared with $15.5 million in 2013 and $19.1 million in 2011.
Spokesman John Martins provided a statement on the state’s decision to manage the addiction crisis through primary care.
“The state’s commitment to investing in primary care extends beyond one particular area of treatment. We believe that successful patient care is delivered in a system where physical and behavioral health treatment is integrated, and that the patient-provider relationship must be at the center of care.
“Free-standing clinics do not support this care coordination, as they are prohibited from reporting that a patient has entered into substance abuse treatment without patient consent,” Martins’ statement continued. “As a result, a primary care doctor might not know that his or her patient is receiving methadone, leading to further fragmented care.”
Faris, meanwhile, said that often, patients receiving treatment through a primary care physician don’t receive the counseling they need to help them stay off drugs. In Massachusetts, less emphasis has been placed on delivering addiction treatment through primary care offices, though a number of primary care doctors have been approved to treat patients with Suboxone as a result of the opiate crisis.
The steady decline in Medicaid funding for methadone treatment in Maine meant Spectrum operated in the red for months, probably longer than it should have, Faris conceded, before it decided to close up shop in Sanford.
“It’s very discouraging,” Faris said.
WBJ Web Partners
Most Recent
Most Recent
0 Comments