BANGOR, Maine — The group of health care officials that pushed for a new 10-bed social detoxification facility in the Bangor area is trying to adapt after the state issued a call for proposals that don’t quite fit the model the group envisioned.
The Department of Health and Human Services issued the request for proposals last month and held a pre-bidders conference on July 25 in Augusta.
The request calls for a group to start a “residential social setting detoxification center.” The social detox model brings a small group of people starting a path to recovery from drug or alcohol abuse to a residential facility for a short period, usually three days to a week. There they receive counseling and access to medical treatment and are set up with longer-term treatment and recovery programs. It’s intended to be a stepping stone, not a solution on its own. With 10 beds, the facility should be able to serve more than 700 people each year.
It’s the result of a push by Bangor’s Community Health Leadership Board, a group of public health officials who have worked for the past two years to identify and pursue solutions to the region’s drug abuse crisis.
The proposal also contains some unanticipated requirements that could make it difficult to accomplish this goal.
“But I think we can make it work,” Patty Hamilton, chairwoman of the CHLB, said during an interview Thursday.
A bipartisan law passed earlier this year calling for the new detox facility stipulated that it be located in eastern or northern Maine in “an area of the state with high rates of opioid use and accessible to related services and supports.” Presumably, that place would have to be Bangor or a nearby community, because of its existing medical and social services.
Hamilton said the facility outlined in the RFP is “more medicalized” than the group expected, requiring more staff to operate. For example, the state is requiring a registered nurse, staff to administer Suboxone and other medications, counselors and clinicians, as well as a physician available 24 hours a day by phone. The Suboxone would be used to help some patients cope with severe withdrawal symptoms.
In the model envisioned by CHLB, the facility would have required less medical staffing, relying more on providing counseling services in a social setting. By partnering with local hospitals and emergency rooms, Hamilton said the state’s requirements likely could be met, but could significantly increase the costs.
The law set aside $3.7 million to increase law enforcement and support treatment programs. About $900,000 was earmarked for the social detox effort. There’s some uncertainty whether that will be enough to set up the sort of facility the state is seeking.
In addition, the law requires that 40 percent of the individuals entering the detox facility not be insured, meaning it could be a challenge for an agency to make the facility financially viable with the amount of state funding suggested.
However, a significant number of people struggling with addiction do so without insurance, and likely couldn’t afford the treatment on their own. If that treatment isn’t available quickly, addiction officials say people often give up and return to using illicit drugs.
After their release from detox, there’s another problem for the uninsured, Hamilton said: “Where do they go from there?” Without insurance, it’s difficult for a person to find admittance into a longer-term treatment option, making relapse more likely.
Currently, there’s only one other detox center in Maine — Portland’s Milestone Foundation. Federal statistics indicate the need for more addiction treatment options and capacity in Maine is vast, with 25,000 to 30,000 Mainers wanting some sort of recovery, but not having access to it.
Many addiction experts say a person’s best chances of successful recovery come from long-term treatment paired with counseling and strong support systems. There is widespread criticism of medication-assisted treatments from those who argue it’s just replacing one drug with another, but treatment officials argue that for many people struggling with addiction, methadone or Suboxone bring stability. Bangor is in the midst of a contentious debate over whether or not to allow a local methadone clinic to expand its capacity from 300 to 500 patients.
Interested organizations have until Aug. 24 to submit a notice of intent to file a bid, and until Sept. 27 to file the proposal itself. The winning bid, according to the requirements of the RFP, likely would have to come from a local organization with previous treatment experience, such as Wellspring, Acadia Hospital or Community Health and Counseling Services.
Once a bid is accepted and a contract ironed out, it could take half a year to set the facility up, hire staff and finally open, Hamilton said.
Follow Nick McCrea on Twitter at @nmccrea213.