Governor Mills Announces Nearly $2 Million to Expand Substance Use Disorder Treatment in Rural Maine

Federal funding is part of a slate of actions from the Mills Administration this summer and fall to support Maine people with SUD through strengthened Opioid Health Homes, support for parents, and naloxone distribution

Governor Janet Mills announced today a new $1.9 million initiative to expand treatment of substance use disorder (SUD) in rural Maine. The funding can be used by behavioral health providers to invest in start-up costs, such as staff training and development, that will allow them to increase the number of patients they serve in rural areas of the state.

This new initiative complements State funding for renovation and capital costs announced by the Governor in July to increase the number of available beds for residential SUD treatment and medically supervised withdrawal in Maine. The Maine Department of Health and Human Services expects to issue final awards for those grants in late September.

The new rural SUD expansion grants are Federally-funded and offered by the Maine Department of Health and Human Services? Office of Behavioral Health.

Both new opportunities to expand residential SUD capacity follow the Mills Administration?s significant investment inMaineCare reimbursement rates for residential SUD treatment, which averages 37.5 percent since November 2021.

?Maine is within the crushing grip of an unrelenting epidemic, worsened by the effects of the pandemic and the increased presence of highly lethal fentanyl. It?s killing a record number of Maine people ? people who are our family, friends, and neighbors,? said Governor Janet Mills. ?We are putting these funds to work to expand the availability of substance use disorder treatment in rural Maine so that we can save lives, put more people on the road to recovery, and, in time, turn the tide on this deadly epidemic.?

?The COVID-19 pandemic compounded the challenge of addressing substance use disorders in rural Maine, increasing stress on Maine people while straining the already challenged behavioral health workforce,? said Jeanne Lambrew, Commissioner of the Maine Department of Health and Human Services. ?This new funding, along with the unique capital grants offered in July, will help to strengthen Maine?s behavioral health system in tandem with the Mills? Administration?s expansion of health coverage, investment in provider payments, and other targeted efforts to fill gaps. Saving lives from substance use and mental health disorders requires this all-hands-on-deck approach as Maine and the nation recover from the pandemic.?

?Today?s announcement complements the state?s efforts to enhance treatment capacity, a critical component of Governor Mills? Opioid Response Strategic Plan,? said Gordon Smith, Maine Opioid Response Director. ?By strengthening treatment in tandem with prevention, harm reduction and recovery support, as we have since 2019, we can save lives from substance use disorder and help more Maine people on the path toward recovery.?

Today?s announcement is the latest of several actions by the Maine Department of Health and Human Services over the summer to improve Maine?s behavioral health system, which includes both substance use and mental health services. These actions include:

• This month, MaineCare adopted an updated rule that further expands access to Opioid Health Home (OHH) services, increases provider flexibilities, and strengthens quality of care. The OHH model uses a team-based approach to support both the individual in treatment as well as the providers delivering care. The rule changes incorporate a ?medication first? option where members can get stabilized with treatment and immediately access the multidisciplinary care team. It also allows members receiving methadone as well as other types of medication-assisted treatment to access OHH services. The changes additionally tie payment to achievement of performance outcomes such as MaineCare members sustaining treatment, connecting to primary care, and engaging in employment, education, or community activities as recovery supports. Under the Mills Administration, DHHS has vastly expanded team-based treatment of opioid use disorder for eligible MaineCare members and uninsured individuals through OHH, from 19 service locations serving 781 individuals a month at the beginning of 2019, to 110 locations serving 3,200 individuals a month in 2022. DHHS plans to extend the Opioid Health Home model to other substances in the coming year.
• In July, the Office of MaineCare Services received further federal approval to expand services for MaineCare-enrolled parents with SUD who are at-risk of or are involved with Child Protective Services (CPS). The expanded services are available through three pilot programs under a Medicaid SUD 1115 Waiver first approved by the Centers for Medicare and Medicaid Services (CMS) in 2020, which allows federal Medicaid reimbursement for SUD treatment in facilities with more than 16 beds. The pilots are intended to address current gaps in coverage for services fundamental to parents? successful recovery and relationships with their children, such as home-based skill development, parenting support services, and, as directed by the Legislature (PDF), maintenance of MaineCare coverage during the CPS assessment process. With this waiver, Maine is the first state in the nation approved to offer continued Medicaid coverage for members who might otherwise lose access during the CPS process due to changes in household size. Parents who are successfully engaging with the Department through the rehabilitation and reunification process can continue their coverage, supporting them in accessing SUD treatment and other critical medical care.
• This complements the Department?s MaineMOM program, which focuses on improving care for pregnant and postpartum Mainers with SUD, along with their infants. As of the end of July, MaineMOM had served 84 parents and families and trained 125 clinicians and staff statewide to provide evidence-based and recovery-focused health care through a Statewide learning community. MaineMOM delivers services based on a ?no wrong door? system of screening, welcoming, and engaging people in care through partnerships with 19 health care sites across Maine. MaineMOM also includes MaineMOM.org, a website with information on available services.

Looking ahead, the Department?s Office of Behavioral Health will increase its naloxone purchase by 36 percent this state fiscal year to expand distribution in response to the rise of overdose deaths, largely involving fentanyl. Saturating communities with the opioid overdose reversal agent naloxone is one of the most effective public health interventions to prevent overdose death.

Maine, like the rest of the nation, has seen an increase in overdose deaths in recent years, exacerbated by the COVID-19 pandemic and the proliferation of the lethal opioid fentanyl. The expanded distribution of naloxone comes as Maine recognizes International Overdose Awareness Day today, August 31, 2022.

Governor Mills has invested in behavioral health in every one of her budgets. In state fiscal years 2022 and 2023, the budget invests an historic $230 million in behavioral health to support the workforce, capacity, and resilience of substance use and mental health providers as well as sustainable MaineCare rates into the future. She additionally directed that the $20 million included in her Maine Jobs & Recovery Plan to strengthen Maine?s health care workforce prioritize behavioral health.