An Ellsworth addiction treatment center closed Friday due to “numerous regulatory deficiencies” and news that the state wouldn’t renew its operating license. But a consultant working with the program said Monday he planned to lead an effort to resurrect it.
Open Door Recovery Center and its Hills House program shut down in the wake of the Maine Department of Health and Human Services’ decision against renewing its license, which followed multiple inspections over the past year that turned up the deficiencies, said Jackie Farwell, the department’s spokeswoman.
The center — which former Gov. Paul LePage had championed throughout much of his tenure as governor — had been operating under a conditional license since Dec. 31 and had not made changes department inspectors had required, according to a statement of deficiencies from DHHS’ licensing and certification division.
“Given the department’s documented concerns about the facility over the last six months and the failure to address them, we will not be providing additional funding to support its operation,” Farwell said.
Workers at Open Door on Monday referred comment on the center’s closure to Bob Worrell, who said he was a part-time resident of Sorrento working as a consultant to Open Door.
Worrell said he planned to lead an effort to resurrect Open Door that would involve replacing the organization’s board of directors and executive director, and reapplying for a state license. A board meeting is set for 5:30 p.m. Wednesday at which Open Door’s future will be discussed, he said.
“We have a team that is working right now, going through a myriad of steps to re-establish the service protocols that Open Door provides to the addiction-recovery community,” Worrell said.
He called the center “a critical piece of the recovery community and what it serves.”
“A lot of this is a work in progress right now,” he said.
Open Door had outpatient and residential treatment programs, but it stopped its outpatient program in September, said Worrell. The programs provided counseling and, under Open Door’s license, were supposed to refer clients to other services as needed. They did not provide medication-assisted treatment, which researchers consider to be the standard of care for opioid addiction.
Worrell said eight residents at the recovery center’s Hills House, where mothers in recovery lived with their children, had been moved to other programs.
The deficiencies documented by inspectors from DHHS included a failure to conduct background checks on all employees before they started working with clients and no evidence that employees received required training in clinical issues and treatment methods. They were required to receive at least 20 hours of such training each year under Open Door’s license.
Inspectors also found incomplete treatment plans, patient records that did not document the treatment patients had received and some records that listed treatment for dates before the patients had even been admitted to Open Door programs. Other patients’ records had no evidence that they had received individual counseling, a requirement under the facility’s license.
In addition, according to the statement of deficiencies, Open Door had no contracts with outside organizations to provide educational services — meaning the organization was unable to comply with a license requirement that it provide educational services.
Open Door also had patients admitted to the Hills House program sign contracts that forbade them from using medication-assisted treatment, such as Suboxone or methadone — a violation of state policy. State inspectors said Open Door had revised its admission policy so it no longer prohibited Suboxone and methadone, but inspectors found it continued to use the contract that banned the medications.
Open Door found itself in the spotlight on a few different occasions during LePage’s time in office.
In July 2013, LePage directed $50,000 to Open Door from a discretionary fund he controlled after he met with officials from the recovery center and program graduates. The recovery center at that time was trying to reopen the Hills House program and was struggling financially.
At the time, Open Door’s executive director, Barbara Royal, said the organization served 20 to 40 clients per week from Hancock, Washington and Penobscot counties, and provided treatment to prisoners at Hancock County Jail.
In May 2017, during a visit to Maine by then-U.S. Health and Human Services Secretary Tom Price and senior presidential adviser Kellyanne Conway, LePage and the Trump administration officials heard from a woman who had graduated from the Hills House.
A nonprofit, tax-exempt organization since 1984, Open Door listed total revenues of $740,642 in 2017, the most recent year available, against total expenses of $738,177 — creating a net income of $2,465.
About three quarters of Open Door’s revenue that year came from either government grants or payment for its treatment services. The other quarter came from contributions, gifts or grants, according to the organizations tax filings. Its net income had fallen off sharply compared with previous years.
DHHS licensing inspectors visited Open Door on Nov. 7, 2018, Dec. 6, 2018, and again on June 17. Its license was due to expire July 1, but the department extended the license to July 31 to help the center’s clients find other treatment options, Farwell said.
The only source of state funds Open Door was receiving when it closed came from reimbursement for services to patients covered by MaineCare, the state’s version of Medicaid, according to Farwell.