By: Taylor Carins
PORTLAND (WGME) — Some Maine recovery service providers say this summer has been especially busy for new clients.
“We turn people away from the Milestone Detox program because we just don’t have enough beds,” Milestone Recovery Executive Director Bob Fowler said.
He says a large wrench in their capacity problems is a federal law that places restrictions on the number of beds in a facility.
“It’s part of what is called the Institute for Mental Disease (IMD) exclusion,” Maine Department of Health and Human Services Communications Specialist Jackie Farwell said.
She says that the law states that any facility with more than 16 beds will be exempt from accepting medicaid and medicare coverage.
“The U.S. Centers for Medicare and Medicaid Services does not allow states to receive any matching federal funds for services to members aged 21 to 64,” Farwell said.
Some service providers in Portland say this creates a problem where they can’t help some clients if they have too many beds, or they could be forced to turn some people away.
“Organizations like Milestone primarily serve people who have public insurance or no insurance,” Fowler said. “So we operate within those perimeters.”
He says it wasn’t always like that at Milestone.
“Before the caps, it was an 18 bed detox program,” Fowler said. “Our other facility in Old Orchard Beach had 20 beds before the cap.”
This restriction impacts both state owned and privately owned facilities according to Nate Cermelj at Libery Bay Recovery.
“It’s almost like this invisible handcuffs that no one really understands,” Cermelj said.
He says that Libery Bay Recovery holds 21 beds, and says if they go any lower, they risk turning people away just to accept Medicaid.
“We can’t limit our current bed space just to accommodate another group,” Cermelj said. “We are already full, we usually have no more than one to two beds open a night.”
Farwell says that Maine is hoping to get rid of this policy.
“Earlier this year, Maine DHHS began the process of seeking a waiver to allow the Medicaid program (MaineCare) to begin reimbursing for substance use disorder treatment services in facilities with more than 16 beds,” Farwell said.
She says if the waiver is approved by the federal government, the 16-bed restriction would be lifted.
Some recovery experts say they fully support the waiver.
“If it were to be pushed through, that’s five more beds we could offer everyday to the state of Maine,” Cermelj said.
“I’m heartened that is the direction we are going in this state,” Fowler said. “There is clearly an unmet need, and this seems like a relatively easy way to quickly increase the resource that is available.”
To learn more about the waiver, click here.
Farwell says the waiver is still in the drafting stages, but says more updates about the waiver will be posted here.
This story appears on WGME 13‘s website.