Maple Leaf Farm, a 41-bed treatment center for drug and alcohol addiction in Underhill, is laying off eight staff and shuttering its primary care unit as the result of a budget shortfall.
From now on, patients will receive medical care at walk-in clinics instead of treatment on site at Maple Leaf. Executive Director Bill Young said the nonprofit’s board of directors decided to cut the program because “we were basically not being paid for it.”
Maple Leaf gets the bulk of its funding from the state, which pays for roughly three-quarters of its clients. Money from insurance companies and individuals fills in the rest, and subsidizes the state rate, which, according to Young, is too low to cover all operational costs.
“In recent years as our cost has gone up, our reimbursement has not,” Young said. “Over the last six years, we’ve gradually built a very broad-based medical program. We like providing that care, but it’s not essential to a treatment program.”
Facing a budget shortfall of $300,000, the board opted to scale back non-essential components.
Maple Leaf will have one full- and one part-time physician and a psychiatric nurse, but the “robust nursing presence,” and the eight positions that go with it, will disappear.
Maple Leaf Farm employs about 72 people, some on a part-time basis.
Treatment services will remain intact, according to Young. In fact, he says he thinks they’ll improve, which he sees as a “silver lining.” Some resources will be redirected to the treatment program, which will bring it “into alignment with rapid changes in addictions medicine, research and the changing needs of people struggling with addiction to alcohol and other drugs,” Young said.
That means more one-on-one time with case managers, more gender-specific treatment, and a greater focus on co-occurring disorders.
But while he thinks the change makes sense for clients, Young acknowledged the toll it’s taking on staff. “For the people being laid off, who are good people doing great work, these things are painful.”
The state budget for the current year included a 3 percent increase in the rate the state pays to Maple Leaf. “But that’s not enough,” Young said. He said the last rate increase was more than five years ago — “It’s been so long I can’t even remember.”
Even so, Young, who spent 18 years as commissioner for the state’s child welfare agency, doesn’t blame the Legislature.
“It’s easy in this circumstance to sit back and say the state ought to fix it,” he said. “I’ve never have trouble advocating for money for services for people but you also have an obligation to look in the mirror and say, ‘What are we responsible for?’”
Maple Leaf has other expenses that don’t get reimbursed, such as capital costs. Part of the facility consists of a farmhouse and barn, which are both over 100 years old, and the upkeep can be pricey. Young says they spend “several hundred thousand dollars” on capital costs.
Last July, Maple Leaf backed out of its plan to purchase the former Pine Ridge School in Williston because the price of the project had grown too high. Young said the board still wants to expand, to help meet the high demand for treatment, but it’s not financially viable.
Maple Leaf’s decision comes at a time when lawmakers and the Shumlin administration have said addressing the “opiate epidemic” will be a cornerstone of their 2014 legislative agenda.
In years past, 78 percent of Maple Leaf clients had an alcohol addiction, and 22 percent were addicted to heroin, oxycontin or other opiates, according to Young. Today, those percentages have nearly reversed — 60 percent grapple with opiate addiction.