Portland's Mercy Hospital to lay off 45, close Westbrook addiction center

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PORTLAND — Mercy Hospital announced Wednesday it will close its addiction recovery center in Westbrook and transfer services to its State Street location.

The move will affect about 250 patients and 90 employees at the Westbrook clinic, which provides Suboxone treatment and counseling for patients recovering from heroin, prescription painkiller and alcohol addiction.

While Mercy patients will continue to receive care, the hospital will stop accepting patients referred by other health practices throughout Maine for outpatient addiction treatment, said Scott Rusk, vice president and chief medical officer for Mercy. Health providers throughout the state, from Down East to north of Bangor, now rely on Mercy for those referrals.

“We really want to keep it open and be that statewide resource, we just can’t afford to subsidize that program anymore,” Rusk said.

Mercy plans to lay off 45 employees, while another 45 employees who staff the inpatient and day programs of the Westbrook addiction center will move to the State Street campus on July 1, Rusk said.

The Westbrook clinic, which offers Suboxone treatment for opiate addiction, will stay open through Aug. 31. Rusk said hospital officials in the meantime will work to find other ways for patients to fill prescriptions through primary care providers.

“We will be sure to find them a provider in the community over the next three months,” Rusk said.

About a third of the Westbrook clinic’s patients will remain with Mercy and get care under a new model, with teams of doctors and nurses treating their addiction as part of their overall health, Rusk said. The other two-thirds either have doctors outside the Mercy system or have no doctor and will receive help finding care and filling prescriptions, he said.

“We’re not going to abandon any of our patients from the clinic,” Rusk said.

The standalone addiction clinic is a small part of Mercy’s broader treatment program for substance abuse, which also includes detoxing patients admitted to the hospital, Rusk said.

Most health insurers won’t reimburse hospitals for detoxing patients from opiates in the hospital, Rusk said. While the process is difficult, it’s typically less dangerous than detoxing from alcohol or other drugs, he said. That, along with rising demand for heroin addiction treatment, was among the forces pushing Mercy to close the Westbrook clinic, he said.

“I can’t tell you how upset the staff is to have to be making these changes,” Rusk said. “We can’t support the size and scale of this program, and for people who have been doing addiction treatment for over three decades, it’s an absolutely tragic day.”

Rusk said closure of the Westbrook facility, opened in 1999, will allow better integration of Mercy’s inpatient and outpatient addiction services with primary care providers at the State Street hospital, but it comes at a difficult time.

Dr. Mark Publicker, a nationally recognized addiction expert who practices at the Westbrook center, called Wednesday’s announcement a “shocking turn of events.”

“It’s a huge loss,” he said. “Right in the middle of this severe drug crisis, the last thing the state needed to do was lose us.”

Publicker is among two full-time physicians at the clinic who prescribe Suboxone to about 280 patients, as well as medication for alcoholism. Publicker and the other physician will lose their jobs.

Rusk said human resources officials are seeking other positions for the other 45 employees elsewhere within the Eastern Maine Healthcare System, which acquired Mercy in 2013.

Employees were notified at noon Wednesday, Rusk said.

Rusk said the move is part of a larger plan to consolidate the hospital to one location, at its campus on Fore River Parkway, by 2018.

Under the new arrangement, Mercy will still accept patients who need emergency or intensive care treatment related to drug abuse or detoxification. But stable patients who are already part of the Mercy system will be candidates for opiate withdrawal treatment as outpatients, instead of in hospital beds, Rusk said.

“This is the model that the experts are suggesting,” he said.

Patients with providers outside the Mercy system will have to find another outpatient program. A patient from Caribou, for example, can no longer get Suboxone treatment and counseling from Mercy, Rusk said. Mercy is working with other hospitals and physician practices to coordinate services for those patients, Rusk said.

“Anytime a substance abuse program closes, it hits hard because there’s just so few of them,” said Pat Kimball, president of the Maine Association of Substance Abuse Programs. “It’s not like there’s one on every street corner.”

Because it’s affiliated with a hospital, the Mercy center must offer charity care to patients who can’t pay for their treatment. But many other substance abuse programs can’t afford to offer free treatment, which could leave some Mercy patients who need to find other options in the lurch, Kimball said.

Rusk said Mercy will continue to treat its charity care patients.

Kimball also worried that some Mercy patients will be set back by the changes. Patients develop relationships with their counselors over time and may be unwilling to switch to a new provider or unable to find transportation, she said.

“It’s one thing to refer you, but do you really go?” Kimball said. “Your counselor is someone personal.”

She also questioned how many Mercy employees will find other jobs, with substance abuse programs already fighting to remain open in the wake of MaineCare cuts.