ELLSWORTH — Tributes and worries poured in this week after Open Door, the substance abuse disorder treatment center in Ellsworth that has been operating for more than 30 years, closed on Friday.
“How can we afford to lose this resource?” said Chris Whalley, an attorney whose clients were frequently sent to Open Door for testing and treatment.
“I think it’s going to really hurt the community.”
The facility shut down last week after state regulators refused to reissue an operating license for the nonprofit, citing “numerous regulatory deficiencies,” according to Department of Health and Human Services spokeswoman Jackie Farwell. Many of the issues were related to documentation.
Barbara Royal, who ran the organization for decades before resigning recently, said she had been in over her head in recent months trying to keep the organization afloat and care for aging family members.
“I got further and further and further behind in documentation and things that are required, administratively speaking,” Royal said.
“The state asked me if I’d be willing to step aside. I said yes to protect Open Door, if that’s what it takes. Right after that they shut it down. If I had known that I would have hung in there.”
Royal continued: “Because you’re underfunded, you’re understaffed and it’s not humanly possible to cover all those bases.” In addition, said Royal, she cares for her elderly parents, who have recently fallen ill. “It was like the perfect storm.”
State officials made several visits to Open Door in the past six months.
They documented a variety of alleged issues, including failure to conduct background checks on some employees, gaps in progress notes and an 11-year-old child signing off on a treatment plan and other documents without a guardian’s consent.
Regulators warned the nonprofit about the problems and issued a conditional license that was set to expire at the end of July.
When the problems weren’t addressed, the state announced that it would let the license expire and would not provide additional funding the nonprofit had requested.
Many residents lamented in particular the loss of Hills House, a center for pregnant women and mothers to undergo substance abuse disorder treatment and stay with their children. It was one of the few such programs in the state.
Jamie Thompson, who went through treatment at Hills House while living there with her daughter, said the center helped her learn how to connect with her daughter, budget, apply for school and transition to living on her own.
“In a community so overrun with addiction, a community who is in such disarray and epidemic crisis, this closure is a loss of hope,” said Thompson in a message.
“I had the unique opportunity to focus on being a mom in recovery. Most people put their lives on hold, uproot everything that is familiar, and in an effort to change people, places and things, they have to start all over when they graduate treatment.”
Thompson continued: “Oftentimes, what I see is people who get their kids back after they graduate, and all of a sudden they have to learn how to be parents, and run households, and get jobs and or go back to school all at once. Hills House was a crucial stepping stone in affording me the experience piece by piece.”
Thompson said it also was one of the only places she felt supported in her decision to recover without being assisted by medication.
Many treatment programs focus on medically assisted treatment, and much of the federal money available is geared toward those services.
State regulators found in their review that Open Door had clients sign contracts for admission to Hills House that prohibited medication, including Suboxone and methadone, which is against state policy. The Hills House admission policy had been revised but the contracts had not been updated, according to paperwork provided by the state.
While the contracts may have prohibited the use of medications, at least one Hills House client had been prescribed Suboxone by a local physician as recently as May, according to state filings.
Royal said that while the organization’s mission did not focus on medication-assisted treatment, it did offer medication to those who wanted it and worked with a local physician to administer it.
“We’ve never not done it,” Royal said. “We were the first ones in Hancock County to do Buprenorphine.”
“We have always believed that the medication is just one piece of that puzzle,” Royal said. “There has to be a whole circle of services.”
“It’s going to be a huge loss,” said Valerie Moon, who worked with one of the women during a job training program.
“It’s going to be really hard for those young mothers to break those cycles and make those changes in their lives without the help that they’re getting from Hills House,” Moon said. “It’s an important piece of the puzzle.”
The organization still owns its property in Ellsworth and is working with a consultant who said he will work with state regulators to try and get its license reinstated.
“We’re trying to keep a bare-bones staff together and we’re working on financing for that right now,” said Bob Worrell, who is board president of an organization similar to Hills House in Omaha, Neb., and splits his time between Omaha and Maine.
“We’ve got 100 different tentacles out there right now. We’re reaching out to the rest of the recovery community in Hancock County,” Worrell continued. “We’re getting the opinion and advice of other agencies of what they think an appropriate niche for Open Door would be.”
Worrell said he is particularly interested in reopening Hills House as soon as possible.
“All of the protocols and regiments and treatments will come under review,” he said.
CORRECTION: A previous version of this story contained errors. The state declined to provide additional funding above and beyond Open Door’s regular MaineCare reimbursements. Open Door had been receiving MaineCare reimbursements prior to the facility’s closure but the state did not provide additional funding outside of that given licensing concerns. In addition, Bob Worrell is working as a volunteer for Open Door.