St. Francis in Auburn cuts half its beds; changes to come statewide

AUBURN — St. Francis Recovery Center, a rehab and halfway house for men recovering from addiction, will cut its number of beds in half — from 32 to 16 — by the end of the month in an effort to keep its funding. 

Sun Journal file photo

Ryan Moon of Topsham reads the Bible in his room that he shares with two other men at St. Francis Recovery Center in Auburn. Moon became a resident after serving jail time for stealing to support his drug habits. "I jumped at the chance to come here," said Moon.

Sun Journal file photo

Nathan Brewer, right, and Dan Bell work in the kitchen while helping the cook prepare lunch for 32 residents at St. Francis Recovery Center in Auburn. Residents share chores throughout the home and on this particular day, Brewer and Bell chose to be kitchen aides.

Sun Journal file photo

"Recovery is a gift, because some guys don't get recovery," said substance abuse counselor JR Pelletier, center, during a group gathering at St. Francis Recovery Center in Auburn. Residents working toward recovery from left are: John Waters, 60, Dan Bell, 27, Justin Goulet, 28, Kyle Ruona, 41, Alan Lewis, 36, and Ryan Moon, 25.

Sun Journal file photo

St. Francis Recovery Center in Auburn is a residential program that serves chemically dependent men over 18.

Other mental health facilities may quickly have to do the same.

And soon, hundreds of agencies serving thousands of residential MaineCare patients may find themselves facing an altogether new system of state funding.

St. Francis, which is run by Catholic Charities, is one of three organizations recently told they have too many beds for federal Medicaid guidelines. If they want to keep serving patients with MaineCare — which is largely funded through federal Medicaid dollars —  they must cut their inpatient operation.

The other two organizations are the Milestone Foundation, which runs a 41-bed emergency shelter and an 18-bed detox facility in Portland, and Serenity House, which runs a 33-bed residential treatment program in Portland for men dealing with addiction. To keep getting MaineCare funding, all must cut their programs to 16 beds or fewer.

St. Francis will make that cut. Beginning Nov. 1, it will provide 16 beds, some in the short-stay rehab house and some in the longer-stay halfway house, and focus more on outpatient services. It is working with the 32 men living there to figure out who will stay, who will go, and what will happen to them. For those who leave the center at 24 Dunn St., some will go home or to temporary, subsidized housing. Others might get one of the few beds available at another substance-abuse facility. But some, especially those living at St. Francis as part of court-ordered rehab, could have trouble finding a place.

"There may be some that end up going back to jail," said Carolee Lindsey, director of services for St. Francis. "Anybody who's come along and they've been mandated here and they're doing a good job, we're going to try to avoid that."

Even before the cuts, St. Francis had a waiting list. Lindsey worries it won't be able to provide the help its men need, even with additional outpatient services. 

"These folks are not going away," she said. "They'll end up in the criminal justice system, many of them. And that costs more. If we don't have viable treatment options for folks and they're falling through the cracks, their brains will still be screaming for the drugs."

Although St. Francis and the two Portland organizations are the only ones struggling to cut beds now, other mental-health facilities soon may follow. That's because the federal government recently told Maine it had incorrectly interpreted the definition of an "institution for mental disease," or IMD. Such IMDs are not allowed to get Medicaid — or, in Maine's case, MaineCare.

St. Francis and the two Portland organizations are considered IMDs because they each had more than 16 beds under one roof. Other mental-health facilities might also be considered IMDs if they have more than 16 beds among different buildings. The state is still talking with the federal Centers for Medicare and Medicaid about that.

If the decision isn't in Maine's favor, other residential mental-health facilities might have to make the same cuts as St. Francis if they want to keep their MaineCare funding. Maine gets $2 from the federal government for every $1 it puts in, and the state couldn't afford to make up that federal money. 

Maine has been paying for those mental-health facilities on behalf of MaineCare patients for years, since its overall plan for funding private, non-medical institutions — such as detox facilities, halfway houses, crisis intervention and children's residential treatment facilities — had been approved by the federal government in 2004.

But now that specific payments to IMDs are being questioned, Maine's $260 million plan for funding all private, nonmedical institutions is being questioned, too. That means the way Maine pays for and provides residential care, including care for the elderly, children, recovering addicts and the disabled, could change.

The change could affect 400 agencies serving 6,000 people.

Maine is one of only two states that bundle costs together, paying one agency to provide multiple services to a MaineCare patient in a residential setting. The 1999 federal Olmstead Act requires states to place people with mental disabilities in community settings and in the least restrictive environments possible. Institutions are out. Outpatient care is in.

So Maine's way — paying an agency to provide multiple services in a residential setting — is a problem.

The Maine Department of Health and Human Services met with providers this week in Augusta to outline the situation. It will hold six regional meetings in November to discuss options and possible new funding models. One meeting will be held Thursday, Nov. 17, in Lewiston. The time and specific location had not been announced.

But no matter what, DHHS officials say, the way Maine pays for residential services — and which residential services are available — will soon look different.

"It's changing; it's changing as we speak," said Guy Cousins, director of the Office of Substance Abuse and acting director of the Office of Adult Mental Health Services. "It's how much further do we need to change in order to comply with a service that meets the needs of clients and is reimbursable?"

ltice@sunjournal.com

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Comments

Garry Robitaille's picture

so open 2 seprate units

I had to reread the artical after I read the comments.
Folks as a user wiht ADHD can we focus on the News, Dan everythgin is not a Repulican conspericy, we are not cutting music for schools, and I don't think Mr lapage joined the taliban, Robin the world does not hate you, but as the nice bumper sticker says, wag more bark less,
and everybody else let's all play nice and try to mocwe things forward. Comments sections have such potential.

 's picture

the governor acted just like

the governor acted just like the taliban when he removed and destoryed the murals, like the taliban who blew up and destroyed the huge Buddha statues.

Mark Elliott's picture

As usual, Dan is speaking

As usual, Dan is speaking through the wrong orifice.....

Mark Elliott's picture

Ah, Dan is back. I got my

Ah, Dan is back. I got my "disagree"......

GARY SAVARD's picture

Dan, these cuts are due to

Dan, these cuts are due to federal regulations, it has NOTHING to do with Governor Lepage or anyone else in Augusta. Of course, you knew that already, I'm sure.

 's picture

If your governor had NOT

If your governor had NOT given his wealthy pals enormous tax cuts, there would be fund to continue these programs. Now, it will probably result in higher costs associated with the criminal justice system, and other peripherals.

 's picture

Isn't this typical of taliban

Isn't this typical of taliban paul, throw the ill out on the streets, if necessary, and to hell with them. While the wealthy continue to receive HUGE tax breaks, with more on the way. This is what the right wing clods are like, they don't care about anything but their wallet. Hell has a special place for you , taliban paul.

Jessie Fields's picture

If that's the case, I hope

If that's the case, I hope you are banning the repeat liberal bashers as well. Also the racist commenters. I'm appalled by some of the comments Sun Journal let's pass.

 's picture

no, Jessie, that only applies

no, Jessie, that only applies to me, the liberal bashers have a free rein, that's what I was told what I asked.

 's picture

That is correct, however you

That is correct, however you also said that people who attacked me would not be held to the same standard. Remember when I mentioned them you say their comments were OK.

Joe Morin's picture

Dan

Please take responsibilty for your actions as much as that may conflict with your ideaology...I know its much more comfortable to play the role of the victim for you but acting like a man would garner much more acceptance from your peers

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