As Maine providers struggle to meet an overwhelming demand for addiction treatment services, the state has yet to move forward on seeking proposals to initiate at least three programs, all funded and two of which lawmakers funded as long as a year ago.
In September, the Department of Health and Human Services declined to award a contract for an eight-bed treatment facility for women. More than eight months later, the department has not resubmitted a request for proposals.
The state also has not sought proposals for a new drug court program in Bangor, which was approved a year ago, or for a detoxification facility in eastern or northern Maine, part of an emergency drug bill passed in January.
DHHS spokeswoman Samantha Edwards did not explain Tuesday what was causing the delays, but said requests for proposals for all three programs would be issued soon.
Meanwhile, treatment providers across the state privately expressed concerns about the lack of urgency, although they declined to comment on the record out of fear of retribution. If and when the money ever does get released, they said, they don’t want to jeopardize their chances of getting the state contract.
The delays could be an example of the gears of government moving slowly, but there is widespread agreement that the addiction crisis is dire and prompt action is needed. Just this week, the Bangor region suffered a blow with the sudden closure of Manna, a faith-based drug treatment facility that was forced to shut down because of mismanagement.
Another local provider, Wellspring, will take some of those clients but not all. More beds are a critical need.
Rep. Drew Gattine, D-Westbrook, a co-chair of the Legislature’s Health and Human Services Committee, said Tuesday that he is concerned about the lack of progress.
“(Lawmakers) treated this, appropriately, like it’s a public health crisis,” he said. “I’d like to see this money awarded so people can get help.”
The failure to award bids for drug treatment options comes at a time when Maine is dealing with a particularly deadly crisis, fueled in large part by the rise in the use of heroin and other opiates.
In 2015, 272 people died from drug overdoses, the highest number on record and a 31 percent increase over the previous year. Of that total, 107 died from heroin. In 2011, only seven of the state’s 155 drug overdose deaths were attributed to heroin.
The heroin crisis has spurred a debate among treatment experts and lawmakers about the most effective use of resources. The LePage administration has not been vocal about where it thinks treatment dollars should be spent.
“I honestly don’t know what is going on up there,” said one provider, who asked not to be identified. “The lack of communication from the administration to treatment providers is astounding.”
One major sticking point in the debate has been finding treatment options for Mainers who don’t qualify for MaineCare and don’t have the money to pay out of pocket.
State Sen. Eric Brakey, R-Auburn, the other co-chair of the Health and Human Services Committee, said he was unaware of the delay in bid awards and did not want to comment until he researched the matter further.
Last summer, as part of a push to address the growing opiate addiction crisis, the DHHS published a request for proposals for a halfway house for pregnant women or women with young children who are seeking treatment.
Less than a month after the bids were due, the state sent a letter to applicants indicating the DHHS would not be awarding a contract for a new facility. Instead, the state withdrew its request for halfway house proposals and said it was “considering a stronger service model for the future,” but did not specify what it was seeking.
The state still has not republished the request for proposals or any other like it for a women’s treatment facility. Asked to explain the delay, Edwards said the state received only two bids for the eight-bed facility and neither was acceptable.
“One applicant was disqualified due to not providing the proper budget forms, and the other agency due to a budget exceedingly well beyond the available funding,” she said in an email.
Edwards said the department is rewriting the request and would release it in the next few weeks.
“Although this RFP has not been reissued yet, there are still substance abuse treatment services available for pregnant women and women with children,” she said.
Maine has one in-patient treatment facility for pregnant women and women with children – Crossroads in Portland – and a relative scarcity of treatment options for women overall.
According to data provided by the DHHS, there are twice as many in-patient and detox beds for men as there are for women. However, among those seeking treatment for abuse of heroin or other opiates in 2014 – the most recent period for which full-year data is available – 54 percent were men and 46 percent were women, according to the state Office of Substance Abuse.
Crossroads CEO Shannon Trainor said her organization was one of the two applicants for last year’s funding to create eight beds for pregnant women or women with children.
“They said the cost was too high, but this is what we do already and we thought our cost estimates were accurate,” she said. “In-patient treatment is expensive. We’ll apply again if the (request) goes out.”
In the continuum of substance abuse care, in-patient treatment – often a 30- or 60-day stay in a residential setting – is the most expensive option, but it is also among the most effective.
Patricia Kimball, who runs Wellspring in Bangor, said her organization was the other applicant for the eight-bed halfway house last year. She said the state told her its application was missing one page. She also said she would consider reapplying if there’s a new RFP, but that the process requires a lot of work for a small agency like hers.
Neither Trainor nor Kimball knew what the state meant when it withdrew the request so it could propose a “stronger service model,” and Edwards would not provide specifics.
The state also has yet to publish a request for proposals for an adult drug treatment court in Bangor, which was approved with $300,000 in funding by the Legislature nearly a year ago.
It also has not sought bids for a drug detox facility in eastern or northern Maine, which was authorized and funded through emergency legislation passed in January. Those funds must be distributed by the end of June.
Right now, there is only one dedicated detox facility in all of Maine – Milestone in Portland, which has 13 beds for men and three for women.
Edwards said the drug court request is “in the final drafting stage and will be released in the next few weeks.” She said the request for a detox center “should be released in mid- to late summer.”
The LePage administration has emphasized the need for accountability among providers who offer state-funded treatment services and questioned whether all dollars available are being spent.
Edwards said DHHS is committed to helping women and “the increasing number of children born drug-affected here in Maine.” She pointed to the recent launch of a 211 hotline specifically for pregnant women seeking treatment.
She said some of the services for women include the Next Generation medication-assisted treatment program at Mid Coast Hospital in Brunswick; the Women’s Project at Opportunity Alliance in Portland, which offers individual recovery planning in nine counties; and the Maine Mothers Network, run through TriCounty Mental Health Services, which provides targeted case management.
Crossroads, though, remains the only residential option for pregnant women or women with children.
CORRECTION: This story was updated at 7:13 a.m. on May 25, 2016 to clarify the timing of the funding of three programs that have been delayed.
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