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2016-08-08 16-290 Council Documents (9)
• Penobscot County Metro Treatment Center 659 Hogan Road Bangor,ME 04401 June 9,2016 City Council City of Bangor 73 Harlow Street Bangor,ME 04401 RE: Application for Patient Number Increase Dear Councilors: Metro Treatment of Maine,LP d/b/a Penobscot County Metro Treatment Center ("Metro") submits this application to fulfill the requirements of Section 93-3 of the Code of the City of Bangor("Code")to increase from 300 to 500 the number of patients we can treat at our facility at Suite 3, at the Maine Square Mall,659 Hogan Road. Metro has been operating at this location continuously since 2005, and throughout this timeframe has held all required licenses and certifications. Over recent years,we have seen our patient census grow, and our waitlist numbers of inquiries have grown significantly as well,to the point that we determined in 2015 to engage in additional construction sufficient to accommodate 200 additional patients to bring us within the 500 authorized under state licensing rules. We are simultaneously filing an application with the Division of Licensing and Regulatory Services of the Maine Department of Health and Human Services to amend our current license for Opioid Supervised Withdrawal and Maintenance Treatment to incorporate this increase in patients. We expect that it will be approved in the near term and we will update this filing accordingly. Our attorneys in this matter,John Doyle and Holly Lusk,have been in contact with City Solicitor Heitmann and Assistant Solicitor Niklas,who have explained in greater detail the Council's process for addressing requests of this nature. They explained that the Council's Committee review at upcoming meetings is central to your review process. We look forward to working with the Council and its responsible Committee to ensure fulfillment of all pertinent standards and obtaining approval to provide needed services to additional patients. Section 93-5 of the Code lays out the requirements for obtaining Council approval to increase the number of authorized patients. This filing lays out how our proposal meets these standards. 10602970.2 • 93-5.A. The property is adequate to accommodate the proposed increase, including providing sufficient interior space to avoid patient queuing on sidewalks,parking area, and other areas outside of the facility. Metro is located at 659 Hogan Road in northeast Bangor,in the Maine Square Mall,close to the Bangor Mall and many retail and service establishments. It is in a small complex of offices and service establishments among several others at the Maine Square Mall. Our neighbors in our complex include Quiznos Subs,Natural Nails,Asian Bistro and Bar,Cubita Libre Cafeteria and facing our front door is Dr. Colson's office. Metro occupies approximately 6,270 sq. ft. of first and second floor office space. We recently completed construction to upgrade our facilities,and to better accommodate the additional patients. This upgrading included enough office space to accommodate 11 counselors, a clinical supervisor, our medical director, a separate office for the nursing department and up to 3 rooms that can be used to provide groups for our patients . . .see Tabs 1 and 2 showing the room configuration and improvements. Because there is ample interior space,patients will not queue on the sidewalks. With the renovation,we have added two more dosing windows that will further improve patient flow in and out of the facility. With the additional windows,there will be no increase in waiting times for patients and will permit them to enter and leave the facility smoothly. It is our understanding from a review of the provisions of Sec. 165 of the Code that medical service and retail establishments require one parking space for each 300 square feet of interior space. There is ample parking area for our complex,totaling 100 spaces. To further limit the impact on the spaces in front of our structure, our staff parks in the center spaces,not directly in front of the clinic leaving all those in front our facility available for patients including 2 handicap spots. We have worked with the Code Enforcement Officer for the City of Bangor and obtained signoffs on March 26, 2016 that our construction has now fulfilled all pertinent City requirements,including the Land Development Code and Construction Codes, including parking provisions in Sec. 165. See Tab 8 Over the past 11 years,we have worked with the Owner Bob Connor and other tenants in the strip mall to achieve a safe, efficient,and orderly flow of traffic on the site. We have changed the flow of traffic so patients are coming to the side of the building that faces Dr. Colson's office to be less conspicuous to passing traffic. Our clinic has dosing hours from 5:15 a.m. to 11:30 a.m. We see approximately 120 patients on a typical day,with roughly 40%coming to Metro before 8:00 a.m. before many of the other adjacent establishments are open for business,thereby mitigating impacts. We acknowledge that from time to time one of our neighbors,Dr. Colson,has expressed concern about double parking,which has occurred in isolated instances. We have worked diligently on patient education to limit problems in this area. Because our front door now faces his parking lot we are able to see if one of our patients accidently parks in his area and are able to request they move their vehicle prior to services. 2 10602970.2 ' i Metro has security personnel on duty at all times when patients are present. These employees help with traffic flow and any parking issues that may develop. These people also enforce our policy that any outdoor smoking be restricted. These people would also intervene in any situation where patients were loitering outside the facility and when occasionally they become unruly. After we have received all approvals,we will not immediately ramp up to 500 patients. We would anticipate increasing at a rate of approximately 8 to 16 clients per month. ,$93-5.B. The treatment program is able to hire and retain adequate numbers of qual f ed staff to meet applicable state and federal standards of care. Throughout our 11 plus years at the Hogan Road location,Metro has been able to hire the various professionals needed to meet state and federal standards of care and pertinent regulations. Currently our staff includes several medical and treatmentP rofessionals: 8 substance ubstan e abuse counselors, 1 certified clinical supervisor, 1 registered pharmacist,and 3 licensed physicians specializing in addiction. Serving as our main Medical Director is Dr. Patel,who has at least 10 years' experience working directly with our population at several facilities, 3 dispensing nurses, including a Registered Nurse Manager,3 security persons and one Program Director. This totals 20 full-time and part-time or subcontracted employees. Each of our associates meets state and federal licensing requirements to practice their respective discipline. • Based upon our past track record,we expect to be able to continue to hire and retain qualified staff to continue to provide quality services to our clients. The State regulations governing our facility have requirements regarding the number of counselors for patients, at least one counselor for each 50 patients. We now have 8 counselors, and will hire 3 additional counselors upon receipt of approval of our expansion. Following I completion of the construction,,our facility now has sufficient rooms to accommodate these counselors. 1 §93-S.C. The applicant has demonstrated a need for increased services that cannot be reasonably met except by the increase in the permitted number of patients at its existing location. As of June 1, 2016, our total patient census is 300. It was also 300 on May 1,and 300 on April 1. We presently have a waitlist numbering 173 patients and we are contacted daily by at least 3-5 individuals seeking treatment. Many of these have been waiting for over 120 days to be admitted. Recognizing that many of these are in urgent need of treatment,many who were on our list previously awaiting service have dropped off,who are longer reachable. Over the past couple of months,we were contacted by at least 65 individuals seeking treatment. See, also the attached letter from Dr. Patel, Tab 9. • 3 10602970.2 • 93-5.D. The applicant is in compliance with all state or federal laws, rules or regulations regarding its opioid treatment program. Metro is fully compliant with all applicable state and federal requirements. We have attached the opioid treatment program certification from the U.S. Department of Health& Human Services, Substance Abuse and Mental Health Services Administration; Controlled Substance Registration certificate from the U.S. Depat(uient of Justice,Drug Enforcement Administration; Certificate of Licensure from the State of Maine, Department of Health& Human Services. Also attached is a summary of the three-year accreditation survey outcome conducted by the Commission on Accreditation of Rehabilitation Facilities(CARE International),an accrediting agency for opioid treatment programs. Copies of current licenses, certificates, and accreditation documents are attached at Tabs 3-7. Metro is simultaneously filing with Maine DHHS Division Licensing and Regulatory Services an application to increase its licensed treatment slots under its Alcohol and Drug Treatment license from 300 to 500. Based on discussions our counsel has had with Sarah Taylor, Assistant Director of DLRS,we anticipate this will be approved in the near term, We will keep you posted on this approval. 93.5.E. The applicant is in compliance with all City codes and ordinances. Metro is in compliance with all City codes and ordinances. With respect to our most recent renovations,the City has issued several Certificates of Occupancy noting our compliance withall pertinent p rtment standards. See Tab 8. See, also, discussion under above Sections. We have 41), never received any notices from the City about any code violations. The City of Bangor Fire Department has helpfully provided our required annual fire extinguisher and fire prevention training again in 2016,and the Fire Department confirms internal inspections and checks our emergency lights and fire extinguishers annually. 93-6. Geographic location allowed for consideration. Notwithstanding the provisions of§93-5 above, the City Council may consider the geographic locations of patients and potential patients and may deny the application if it determines that there is sufficient patient demand to warrant a treatment facility in an area geographically closer to current and potential future patients. As set forth above under § 93-5.C,we have set forth many factors amply justifying the need for additional treatment slots at our facility. We also provide the geographic distribution of our patients for whom we have residence information as of June 1. See attached Tabs 10 and 11 showing patient residences by city,town and aggregated by county. This summary,by county,is as follows: Penobscot: 201 (67%) Hancock: 42 (14%) Waldo: 23 (7.33%) Piscataquis: 12(3.99%) • 4 10602970.2 • Washington: 5 (1.66%) Somerset: 5 (1.66%) Aroostook: 4(1.33%) Knox: 2(.66%) Lincoln: 1 (.33%) More than two-thirds of our clients live in Penobscot County,and over 88%live in Penobscot and the adjoining two counties of Waldo and Hancock. Notable regarding patient distribution by cities and towns are the following: Bangor: 62 Brewer: 12 Hermon: 11 Old Town: 14 Winterport: 10 Milford: 18 See attached Tabs 10 and 11 for further breakdowns. Responses to other criteria above show that: • • Our current waitlist is 173 patients; • Many of these have been waiting for over 120 days to be admitted. • We are contacted daily by at least 3-5 patients a day; and • Over the past couple of months,we were contacted by at least 65 individuals seeking treatment. Conclusion We look forward to working with the Council's Committee, and meeting with the Council to review this application. We welcome the opportunity answer any further questions the Council may have and to work with you to achieve approval. Respectfully submitted, Metro Treatment of Maine, LP, d/b/a Penobscot County Metro Treatment Center By: •. . c � , _ Lisa D avis, Director • 5 10602970.2 COLONIAL MANAGEMENT • List of Attachments to Application • 1. Colonial Floor Plan 321 —A-2.1 Second Floor Plan with Life Safety Notes Revised and Digitally Signed 2. Colonial Floor Plan 311 —A-1.1 Ground Floor Plan with Life Safety Notes Revised and Digitally Signed 3. DEA Certificate with Expiration Date of 01/31/2017 4. State of Maine Certificate of Licensure Effective through 11/06/2016 5, SAMHSA Opioid Treatment Program Certification with Expiration Date of 11/30/2018 6. CARF Survey Report for Colonial Management Group d/b/a Penobscot County Metro Treatment Center with Expiration Date of 11/30/2018 7. State of Maine Board of Pharmacy License No. PH50001237 with Expiration Date of 12/31/2016 •- 8. City of Bangor Certificates of Occupancy dated 03/26/2016 9. Letter from Dr. Patel in support of Application dated 06/23/2016 10. List of Metro patients broken down by county and percentage 11. List of Metro patients brown down by cities,towns, and percentages • 10604664.1 • Colonial Floor Plan 321 — A-2.1 Second Floor Plan with Life Safety Notes Revised and Digitally Signed III g3 1 _'t4, . IOW 3N 46.ii GW�4i[89 I b; • ,i a 8. , HI l91N3O1N3FLLY341 k 4 dl'd'K1le SlEPL-9YVM1 MN0'IOD 1I' s gill �R , S310N A13AVS 3d11 . 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Certificate • with Expiration Date of 01/31/2017 5 • • • 1/132016 Printable IDEA Certificate •; CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE DEA REGISTRATION THIS REGISTRATION FEE UNITED STATES DEPARTMENT OF JUSTICE NUMBER EXPIRES PAID DRUG ENFORCEMENT ADMINISTRATION RM0331556 01-31-2017 $244 WASHINGTON.D.C,20537 ZM0331556 SCHEDULES BUSINESS ACTIVITY DATE ISSUED 2 MAINT&DETOX 12-15-2015 METRO TREATMENT OF MAINE,LP Sections 304 and 1008(21 U.S.C.824 and 958)of the Controlled 659 HOGAN ROAD Substances Act of 1970,as expended,provide that the Attorney BANGOR, ME 04401 General may revoke or suspend a registration to manufacture, distribute,dispense,Import or export a controlled substance. THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF • OWNERSHIP,CONTROL,LOCATION,OR BUSINESS ACTIVITY, AND IS NOT VALID AFTER THE EXPIRATION DATE. CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE UNITED STATES DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION WASHINGTON,D.C,20537 DEA REGISTRATION THIS REGISTRATION FEE NUMBER EXPIRES PAID RM0331556 01-31-2017 $244 ZM0331556 SCHEDULES BUSINESS ACTIVITY DATE ISSUED �. 2 MAINT&DETOX 12-15-2015 METRO TREATMENT OF MAINE,LP Sections 304 and 1008(21 U.S.C.824 and 958)of the a 659 HOGAN ROAD Controlled Substances Act of 1970,as amended,provide BANGOR, ME 04401 that the Attorney General may revoke or suspend a rst cv registration to manufacture,distribute,dispense,import or export a controlled substance. THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF OWNERSHIP,CONTROL,LOCATION,BUSINESS ACTIVITY,OR VALID AFTER THE EXPIRATION DATE. • • https:I/www.deadiversion.usdkJ.gov/webforms/dupeCertPrintCert.do 111 i 4 • ti State of Maine Certificate of Licensure Effective through 11/06/2016 t�t ri i a iiiir"--.-------------- •. 0 v t Ch veael E W r .CM CM x 2 ! • qI M ni F+i.\.,,.., JCS ill F a1 .4 d-� Li t•-• *� a ;; wy N Fs ii is g '\ E z i��.ire , W ` : CA• • fX7'S 41II 111 A ! Ce 'V z c3 0 Luta cks € C NI a m a W s `rid = co t— . chi y c = t a w 4.4 w 4 0 f II. v w w Ce O^ F o o H o' ...a p E_. N= [p...i 7. E.. c fi} ba Cn'G F �o\ G 4 G n 0 • f i 1 s t 1_ 4 _ y Department of Health anti 1"lunlan St'rvit'es ., 1e 7stro,v t eliv , L'si<<nsi 'and Regulatory raters lei ti • J f ` -„f-,. f fid t#tlr�url�, vrc 41 Anthony Avenue T��, � f' s e �� w _ 11St:to Hous'St.tion r. .. ) .., `! ltia iio 6O- !Firm f I�,%%- S fe� aidfi :- Augusta,Maine 04313-0011 b J '4":',i'''.'".:''''' Tial:(207)287-tY_t00 lax:(207)287-`)307 - .-' , - '4. mss s?"-.: Pool R,LePage,L'gjVNI1()/ eery C A ayheii:CcvaMisskuler Thil Free(8110)7511-4080,TTY Us.rs: Dull 711(Maine Repay) r• t November 17, 2014 • i i i John Steinbrun, CEO Colonial Management Group. LP.; Metro Treatment of Maine, L.P. 8529 SouthPark Circle,Suite 270 Orlando, FL 32819 Y Dear Mr.Steinbrun: 5 In accordance with the Maine Revised Statutes and the rules pertaining thereto, as promulgated by the t Department of Health and Human Services, a Full License to operate a Substance Abuse Agency is hereby issued to Metro Treatment of Maine dlbla Penobscot County Metro Treatment Center. This license is valid from 11/0612014.1110612016. This license is to provide the following services at the locations indicated: ' Site Locations: 659 Hogan Road,Suite 3, Bangor, Maine Module: Outpatient Care �' Service: Opioid Supervised Withdrawal and Maintenance i 1111 Treatment € A renewal reminder will be sent to you prior to the date of expiration of the license. If you do not receive a v reminder, it is the agency's responsibility to contact licensing and actively seek to renew the license. The issuance of this license carries with it the right of the Department to supervise the operation of the facility for the purpose of assuring continued compliance with the rules. Failure to maintain continued compliance may result in a recommendation for suspension, revocation or modification of the license as provided for in the Maine Statute. Renewal of the license will be based on continued compliance and performance. The agency must have a contract with the appropriate office before billing Maine Care. if you have any questions or need assistance please do not hesitate to call me at 287-5810 or email me at 1 Marietta.d'agostino@maine.gov. Sincerely, �lki :� 0 6 r, . Marietta D'Agostino I Program Manager Substance Abuse/Mental Health Licensing Division of Licensing&Regulatory Services Enclosures 41, 0, SAMHSA Opioid Treatment Program Certification with Expiration Date • of 11/30/2018 o0 0 N Z en o 0 o cp p i., 5 o E* '2 ...) 0 I g (1).'-'4 § wd Z r4 > 2 o w0o0n _ p w a x o V Q U E3 ti Hr 4 •g a kEa* N ' --i CO V 0 C m 'W o0 Z. GO tiO c) g 4 g C4 0 N Co• 74 re a0 0 col � wwov tetatai: o 11J zit-71 a. 4a. T p > y O H CCS \Q . 0) 'O W Lid w Q Z 0 ) � as -0 x N D 0z o x w w o +' J = F J a *g = m = w o � ¢ N CO c I- hr1 - w } F C Or2 3 N COz e12 7) [6 0 a .cc N i a. c "° E p •I ai v{ v W N � snia -!, .—I U O cn at cz • 0 4.8,7,,,,1$° LF • 4C R I) t( r CARF Survey Report for Colonial Management Group d/b/a Penobscot County Metro Treatment Center 0_ with Expiration Date of 11/30/2018 S • • C[ z C 4 z W I CARF SurveyReport C for Colonial • Management Group, LP dba Penobscot County Metro Treatment Center • f �u�vvr.carf_or,� � 3 i 4 1, z Organization t.t0 EXCe,, 41.4'0 Colonial Management Group,LP dba61n --- Penobscot County Metro Treatment Center ® a i"'" 659 Hogan Road 4 car Q Bangor,MF 04401 Z * ACCRTEDITED pe Organizational Leadership W * Mike Ford Z * 4 Director of Accreditation/ Z Three-Year Accreditation Corporate Compliance "... Survey Dates Lima September 17-18,2015 C3Survey Team 0 Lesley J.Levin,LCSW,Administrative Surveyor Karen S.Garrett,MA,CPLP,CAP,CMHP,CPP,Program Surveyor Programs/Services Surveyed Outpatient Treatment Opioid Treatment Program (Adults) Previous Survey October 18-19,2012III Three-Year Accreditation Survey Outcome Three-Year Accreditation Expiration:November 30,2018 vnmcarf.aob°� • i t • i r SURVEY SUMMARY L Colonial Management Group,IT dba Penobscot County Metro Treatment Center has strengths in many areas. t I. E? • Administrative,medical,and clinical staff members are committed to treating persons starved with empathy,dignity,and respect Staff members recognize the importance of collaboration, coordination,and communication on an internal as well as external basis to best meet the needs of persons served. • Persons served report satisfaction with the organization and feel all staff members are readily t accessible,willing to listen,and responsive to their needs. € • The program facility is currently being expanded and renovated.This is in response to the � increased need for services in the community. • Funders praise the organization for how well it collaborates with other organizations in the ` community.It has strong ties to area hospitals and psychiatric treatment programs. III The organization recognizes the importance of families to the continued recovery of persons served.it provides programming for family members,including both adults and children. • The program director knows every person served and greets them by name.She inquires about 1 their health and the health of their family members. III ■ Recovery services offered enable persons served to preserve their basic human rights,dignity, E health,and safety while enhancing their independence,self-sufficiency,self-esteem,and quality of life.Persons served praised the organization for the difference it has made in their lives. i • Services are provided in a warm and welcoming environment located in the central part of the !. city for easy access. • The staff is very cohesive and strives to provide the best services possible to the person served. Penobscot County Metro Treatment Center should seek improvement in the areas identified I by the recommendations in the report. Consultation given does not indicate nonconformance to standards but is offered as a suggestion for further quality improvement. ! On balance,Penobscot County Metro'Treatment Center provides compassionate and professional 1 opioid treatment services in the Penobscot County area of Maine.Services arc provided in clean and I welcoming offices that are conveniently located.Staff members work we11 together and collaboratively with other organizations in the community.The commitment to provide quality services can be seen throughout the organization.The organization has a few areas for improvement,including ensuring that data collected are related to objectives established in the strategic plan and collecting additional information for the assessment that includes efficacy of current or previously used medication,gender expression,and history of witnessed trauma. Leadership has expressed a commitment to address the recommendations noted in this report. Colonial Management Group,LP dba Penobscot County Metro Treatment Center has earned a 1 Three-Year Accreditation.Leadership and staff members are commended for this achievement and encouraged to continue applying CART standards. 1 III car [ INTERNATIONAL 2 •y SECTION 1 . ASPIRE TO EXCELLENCE® A. Leadership Description CARP-accredited organizations identify leadership that embraces the values of accountability and responsibility to the individual organization's stated mission.The leadership demonstrates corporate social responsibility, Key Areas Addressed • Leadership structure • Leadership guidance • Commitment to diversity • Corporate responsibility • Corporate compliance Recommendations There are no recommendations in this area. Consultation • The organization has a comprehensive policy and procedure that include a code of ethics that addresses all the appropriate areas in the standards.The code that is provided to employees and posted in the office does not include all the elements in the policy and procedure.It is suggested that the code of ethics given to employees be the same as the one in the policy and procedure. C. Strategic Planning Description CARP-accredited organizations establish a foundation for success through strategic planning focused on taking advantage of strengths and opportunities and addressing weaknesses and threats. Key Areas Addressed • Strategic planning considers stakeholder expectations and environmental impacts • Written strategic plan sets goals • Plan is implemented,shared,and kept relevant • car l INTERNATIONAL 3 k , 0 r C 8 L Recommendations Thcre are no recommendations in this area. D. Input from Persons Served and Other Stakeholders Description CARP-accredited organizations continually focus on the expectations of the persons served and other stakeholders.The standards in this subsection direct the organization's focus to soliciting, collecting,analyzing,and using input from all stakeholders to create services that meet or exceed the expectations of the persons served,the community,and other stakeholders. Key Areas Addressed ■ Ongoing collection of information from a variety of sources • Analysis and integration into business practices • Leadership response to information collected f • Recommendations ' There are no recommendations in this area. ; E. Legal Requirements Description CARP-accredited organizations comply with all legal and regulatory requirements. Key Areas Addressed • Compliance with all legal/regulatory requirements i Recommendations x There are no recommendations in this area. `- I 1 I . car I INTERNATIONAL 4 • F. Financial Planning and Management Description CART-accredited organizations strive to be financially responsible and solvent,conducting fiscal management in a manner that supports their mission,values,and annual performance objectives. Fiscal practices adhere to established accounting principles and business practices. Fiscal management covers daily operational cost management and incorporates plans for long-term solvency. Key Areas Addressed • Budget(s)prepared,shared,and reflective of strategic planning • Financial results reported/compared to budgeted performance t Organization review • Fiscal policies and procedures • Review of service billing records and fee structure • Financial review/audit S Safeguarding funds of persons served Recommendations • There are no recommendations in this area. G. Risk Management Description CARF-accredited organizations engage in a coordinated set of activities designed to control threats to their people,property,income,goodwill,and ability to accomplish goals. Key Areas Addressed ■ Identification of loss exposures ■ Development of risk management plan • Adequate insurance coverage • car f INTERNATIONAL 5 • • Recommendations G.1.a.(1) through G.1.b.(2) The organization has a written policy and procedure for risk reduction.It is recommended that this result in a risk management plan that includes identification and analysis of loss exposures, identification of how to rectify identified exposures,implementation and monitoring of actions to reduce risk,reporting rtin results of actions taken to reduce risks,and inclusion of risk reduction in performance improvement activities.The plan should be reviewed at least annually for relevance and updated as needed. • H. Health and Safety Description CARF-accredited organizations maintain healthy,safe,and clean environments that support quality services and minimize risk of harm to persons served,personnel,and other stakeholders. Key Areas Addressed • Inspections • Emergency procedures • • Access to emergency first aid • • Competency of personnel in safety procedures • Reporting/reviewing critical incidents • Infection contro). Recommendations H.9.e. The organization's policy and procedures for critical incidents should provide for timely debriefing of personnel involved following these incidents. H.13.b.(1)through H.13.b.(3) • The organization was inspected by the local fire department,but a written report was not completed. It is recommended that the annual inspection by a qualified external authority result in a written report that details areas inspected,recommendations for areas needing improvement,and actions taken to respond to the recommendations. c • ar 1 INTERNATIONAL 6 11 Consultation • The building's front door is difficult to open if a person uses a walker, crutches,or wheelchair,It is suggested that staff members receive training on helping persons with disabilities open the door.It is also suggested that the organization install a buzzer at the front door that is identified as a way for persons with disabilities to receive assistance in opening the door. • It is suggested that the posted evacuation routes include an indication of"you are here"to aid in reading and using the escape routes. I. Human Resources Description CARE-accredited organizations demonstrate that they value their human resources. It should be evident that personnel are involved and engaged in the success of the organization and the persons they serve. Key Areas Addressed • Adequate staffing ■ Verification of background/credentials • Recruitment/retention efforts • Personnel skills characteristics • • Annual review of job descriptions/performance • Policies regarding students/volunteers,if applicable Recommendations There are no recommendations in this area. J. Technology Description CARF-accredited organizations plan for the use of technology to support and advance effective and efficient service and business practices. • car r 1 INTERNATIONAL 7 • • Key Areas Addressed • Written technology and system plan ll Written procedures for the use of information and communication technologies (ICT) in service delivery,if applicable i Training for personnel,persons served,and others on ICT equipment,if applicable 17 • Provision of information relevant to the ICT session,if applicable f • Maintenance of ICT equipment in accordance with manufacturer recommendations,if applicable • • Emergency procedures that address unique aspects of service delivery via ICT,if applicable Recommendations There are no recommendations in this area. K. Rights of Persons Served • Description CARF-accredited organizations protect and promote the rights of all persons served.This commitment guides the delivery of services and ongoing interactions with the persons served. Key Areas Addressed • Communication of.tights • Policies that promote rights • Complaint,grievance,and appeals policy • Annual review of complaints Recommendations There are no recommendations in this area. L. Accessibility Description CARP-accredited organizations promote accessibility and the removal of harriers for the persons >i served and other stakeholders. car I INTERNATIONAL 8 1 411 Key Areas Addressed • Written accessibility pla-n(s) • Requests for reasonable accommodations Recommendations '.There are no recommendations in this area. M. Performance Measurement and Management Description CART-accredited organizations are committed to continually improving their organizations and • service delivery to the persons served.Data arc collected and analyzed,and information is used to manage and improve service delivery. Key Areas Addressed x. ■ Information collection,use,and management • Setting and measuring performance indicators 411 Recommendations ':There are no recommendations in this area. N. Performance Improvement Description The dynamic nature of continuous improvement in a CARF-accredited organization sets it apart from other organizations providing similar services. CARR-accredited organizations share and provide the persons served and other interested stakeholders with ongoing information about their actual performance as a business entity and their ability to achieve optimal outcomes for the persons served through their programs and services. Key Areas Addressed • Proactive performance improvement • Performance information shared with all stakeholders • car r INTERNATIONAL 9 s 1 P i I0 . Recommendations .. N.1.b.(1)through N.1.c.(3) The organization currently collects data primarily from satisfaction surveys of persons served. However,these data are not consistently related to objectives stated in the strategic plan.It is F recommended that the organization analyze performance indicators in relation to performance targets,including business functions;service delivery,including effectiveness and efficiency of services, service access,and satisfaction and other feedback from persons served and other stakeholders;and extenuating or influencing factors.This written analysis should identify areas needing performance improvement,result in an action plan to address improvements needed to t reach established or revised performance targets, and outline actions taken or changes made to ' improve performance. SECTION 2. GENERAL PROGRAM STANDARDS H Description • For an organization to achieve quality services,the persons served are active participants in the planning,prioritization,implementation,and ongoing evaluation of the services offered.A III commitment to quality and the involvement of the persons served span the entire time that theF. persons served are involved with the organization.The service planning process is i.ndiv-idnaii>ed, r establishing goals and objectives that incorporate the unique strengths,needs,abilities,and preferences of the persons served.The persons served have the opportunity to transition easily i through a system of care. • A. Program/Service Structure Description A fundamental responsibility of the organization is to provide a comprehensive program structure. The staffing is designed to maximize opportunities for the persons served to obtain and participate in the services provided. i Key Areas Addressed a Written program plan II Crisis intervention provided • Medical consultation • Services relevant to diversity ■ Assistance with advocacy and support groups a 'Team composition/duties 0 car I INTERNATIONAL 10 • Relevant education • Clinical supervision • Family participation encouraged Recommendations There are no recommendations in this area. B. Screening and Access to Services Description The process of screening and assessment is designed to determine a person's eligibility for services and the organization's ability to provide those services.A person-centered assessment process helps to maximize opportunities for the persons served to gain access to the organization's programs and services.Each person served is actively involved in,and has a.significant role in,the assessment process.Assessments are conducted in a manner that identifies the historical and current information of the person served as well as his or her strengths,needs,abilities,and preferences. Assessment data may he gathered through various means including face-to-face contact,telehealth, or written material; and from various sources including the person served,his or her family or significant others,or from external resources. •' Key Areas Addressed • Screening process described in policies and procedures • Ineligibility for services • Admission criteria • Orientation information provided regarding rights,grievances,services, fees,etc. ■ Waiting list ■ Primary and ongoing assessments • Reassessments car I INTERNATIONAL 11 • a Recommendations B.24.i.(2) B.24.m.(2) B.24.n.(1)(b)through B.24.n.(2)(d) It is recommended that the assessment process gather and record information regarding efficacy of current or previously used medication;gender expression;and history of witnessed trauma,including abuse,neglect,violence,and sexual assault. ) G. Person-Centered Plan Description Each person served is actively involved in and has a significant role in the person-centered planning process and determining the direction of his or her plan.The person-centered plan contains goals and objectives that incorporate the unique strengths,needs,abilities,and preferences of the person served,as well as identified challenges and potential solutions.The planning process is person- directed and person-centered.The person-centered plan may also be referred to as an individual. service plan,treatment plan,or plan of care.in a family-centered program, the plan may be for the family and identified as a family-centered plan. Key Areas Addressed • Development of person-centered plan • Co-occurring disabilities/disorders II Person-centered plan goals and objectives • Designated person coordinates services Recommendations There are no recommendations in this area. D. Transition/Discharge Description Transition,continuing care,or discharge planning assists the persons served to move from one level of care to another within the organization or to obtain services that are needed but are not available within the organization.The transition process is planned with the active participation of each person served.Transition may include planned discharge,placement on inactive status,movement to a different level of service or intensity of contact,or a re-entry program in a criminal justice • system.- car I INTERNATIONAL 12 for The transition plan is a document developed with and..f the person served and other interested participants to guide the person served in activities following transition/discharge to support the gains made during program participation.It is prepared with the active participation of person served when he or she moves to another level of care,after-care program,or community-based services.The transition plan is meant to be a plan th2t the person served uses to identify the support that is needed to prevent a recurrence of symptoms or reduction in functioning.It is expected that the person served receives a copy of the transition plan. A discharge summary is a clinical document written by the program personnel who are involved in the services provided to the person served and is completed when the person leaves the program (planned or unplanned).It is a document that is intended for the record of the person served and released,with appropriate authorization,to describe the course of services that the program provided and the response by the person served. Just as the assessment is critical to the success of treatment,the transition services are critical for the support of the individual's ongoing recovery or well-being.The organization proactively attempts to connect the persons served with the receiving service provider and contact the persons served after information related to their post-discharge status. formal transition or discharge to gather neededp g Discharge information is reviewed to detennine the effectiveness of its services and whether additional services were.needed. Transition planning may be included as part of the person-centered plan.The transition plan and/or discharge summary may be a combined document as long as it is clear whether the information relates to transition or pre-discharge planning or identifies the person's discharge or departure from the program. Key Areas Addressed • • Referral or transition to other services • Active PP articr ation of persons served • Transition planning at earliest point • Unplanned discharge referrals • Plan addresses strengths,needs,abilities,preference • Follow-up for persons discharged for aggressiveness Recommendations There are no recommendations in this area. • I car INTERNATIONAL 13 E. Medication Management Description These standards address the practice of evaluating,prescribing,and dispensing opioid agonist treatment medications approved by the Food and Drug Administration for use in the treatment of opioid addiction. Key Areas Addressed • Individual records of medication I Physician review • Policies and procedures for prescribing,dispensing,and administering medications is • Training regarding medications N Policies and procedures for safe handling of medication •Recommendations There are no recommendations in this area. • F. Medication Use Description Medication use is the practice of handling,prescribing,dispensing,and/or administering medications to persons served in response to specific symptoms,behaviors,and conditions for which the use of medications is indicated and deemed efficacious. Medication use may include self administration,or be provided by personnel of the organization or under contract with a licensed individual.Medication use is directed toward maximizing the functioning of the persons served while reducing their specific symptoms and minimizing the impact of side effects. Medication use includes prescribed or sample medications,and may,when required as part of the treatment regimen,include over-the-counter or alternative medications provided to the person served.Alternative medications can include herbal or mineral supplements,vitamins,homeopathic remedies,hormone therapy,or culturally specific treatments. Medication control is identified as the process of physically controlling,transporting,storing,and disposing of medications,including those self administered by the person served. Self administration for adults is the application of a medication(whether by injection,inhalation, oral ingestion, or any other means)by the person served,to his/her body;and may include the organization storing the medication for the person served,or may include staff handing the bottle or blister-pak to the person served,instructing or verbally prompting the person served to take the 1 medication,coaching the person served through the steps to ensure proper adherence,and closely observing the person served self-administering the medication. car I INTERNATIONAL 14 • Self administration by children or adolescents in a residential setting must he directly supervised by personnel,and standards related to medication use applied. Dispensing is considered the practice of pharmacy; the process of preparing and delivering a prescribed medication(including samples) that has been packaged or re-packaged and labeled by a physician or pharmacist or other qualified professional licensed to dispense(for later oral ingestion, injection,inhalation,or other means of administration). Prescribing is evaluating, determining what agent is to be used by and giving direction to a person served(or family/legal guardian),in the preparation and administration of a remedy to be used in the treatment of disease.It includes a verbal or written order,by a qualified professional licensed to prescribe,that details what medication should he given to whom,in what formulation and dose,by what.route,when,how frequently,and for what length of time. Key Areas Addressed y. • Individual records of medication • Physician review • Policies and procedures for prescribing,dispensing,and administering medications • Training regarding medications • Policies and procedures for safe handling of medication Recommendations • There are no recommendations in this area. G. Nonviolent Practices Description Programs strive to be learning environments and to support persons served in the development of recovery,resiliency,and wellness. Relationships are central to supporting individuals in recovery and weiln.ess.Programs are challenged to establish quality relationships as a foundation to supporting recovery and wellness. Providers need to be mindful of developing cultures that create healing, healthy and safe environments,and include the following: • Engagement • • Partnership—power with,not over • Holistic approaches • Respect • Hope • Self direction • car I INTERNATIONAL 15 r. • Programs need to recognize that individuals may require supports to fully benefit from their services.Staff are expected to access or provide those supports wanted and needed by the individual Supports may include environmental supports,verbal prompts,written expectations,clarity of rules and expectations,or praise and encouragement. Even with supports,there are times when individuals may show signs of fear,anger,or pain,which may lead to aggression or agitation.Staff members are trained to recognize and respond to these signs through de-escalation,changes to physical environment,implementation of meaningful and engaging activities,redirection,active listening,etc.On the rare occasions when these interventions are not successful and there is imminent danger of serious harm,seclusion or restraint may be used to ensure safety. Seclusion and restraint are never considered treatment interventions;they are always considered actions of last resort.The use of seclusion and restraint must always be followed by a full review,as part of the process to eliminate the use of these in the future. The goal is to eliminate the use of seclusion and restraint in opioid treatment,as the use of seclusion or restraint creates potential physical and psychological dangers to the persons subject to the interventions, to the staff members who administer them,or those who witness the practice.Each organization still utilizing seclusion or restraint should have the elimination thereof as an eventual goal. Restraint is the use of physicalforce or mechanical means to temporarily limit a person's freedom of movement;chemical restraint is the involuntary emergency administration of medication,in immediate response to a dangerous behavior. Restraints used as an assistive device for persons with physical or medical needs are not considered restraints for purposes of this section. Briefly holding a person served,without undue force, for the purpose of comforting him or her or to prevent self- injurious elfinjurious behavior or injury to self,or holding a person's hand or arm to safely guide him or her from one area to another,is not a restraint.Separating individuals threatening to harm one another, without implementing restraints,is not considered restraint. Seclusion refers to restriction of the person served to a segregated room with the person's freedom to leave physically restricted.Voluntary time out is not considered seclusion,even though the voluntary time out may occur in response to verbal direction;the person served is considered in seclusion if freedom to leave the segregated room is denied. Seclusion or restraint by trained and competent personnel is used only when other less restrictive measures have been found to be ineffective to protect the person served or others from injury or serious harm.Peer restraint is not considered an acceptable alternative to restraint by personnel. Seclusion or restraint is not used as a means of coercion,discipline,convenience,or retaliation. In a correctional setting,the use of seclusion or restraint for purposes of security is not considered seclusion or restraint under these standards.Security doors designed to prevent elopement or wandering are not considered seclusion or restraint. Security measures for forensic purposes,such as the use of handcuffs instituted by law enforcement personnel,are not subject to these standards. When permissible,consideration is made to removal of physical restraints while the person is receiving services in the behavioral health care setting. S car I INTERNATIONAL 16 L Key Areas Addressed ■ Training and procedures supporting non-violent practices • Policies and procedures for use of seclusion and restraint ■ Patterns of use reviewed • Persons trained in use • Plans for reduction/elimination of use Recommendations There are no recommendations in this area. H. Records of the Persons Served Description A complete and accurate record is developed to ensure that all appropriate individuals have access to relevant clinical and other information regarding each person served. Key Areas Addressed ■ Confidentiality ■ Time frames for entries to records • Individual record requirements • Duplicate records Recommendations There are no recommendations in this area. I. Quality Records Management Description The organization has systems and procedures that provide for the ongoing monitoring of the quality,appropriateness,and utilization of the services provided.This is largely accomplished through a systematic review of the records of the persons served.The review assists the organization in improving the quality of services provided to each person served. car I INTERNATIONAL 17 i t i P 4 • ` Key Areas Addressed e • Quarterly professional review • Review current and closed records a Items addressed in quarterly review f: ■ Use of information to improve quality of services i Recommendations There arc no recommendations in this arca. f 4 x F I SECTION 3. OPIOID TREATMENT CORE PROGRAM STANDARDS t Description The standards and intent statements in this section address the unique characteristics of each type of • core program area. Opioid treatment programs provide rehabilitation and medical support for • persons addicted to opioid drugs.The duration of treatment should be based on the needs of the persons served and should take into consideration the benefits of medication.Medications used to achieve treatment goals include methadone or other opioid agonist treatment medications approved by the Food and Drug Administration for use in the treatment of opioid addiction.Some other nonopioid agonist drugs have been determined to be efficacious and generally acceptable in current practice. i Services arc directed at reducing or eliminating the use of illicit drugs,criminal activity,and/or the .i spread of infectious disease while improving the quality of life and functioning of the persons served.Opioid treatment programs follow rehabilitation stages of sufficient duration to meet the needs of the persons served. i • earl INTERNATIONAL '18 i •; G. Outpatient Treatment Description • Outpatient treatment programs provide culturally and linguistically appropriate services that include,but arc not limited to,individual,group,and family counseling and education on wellness, recovery,and resiliency.These programs offer comprehensive,coordinated,and defined services that may vary in level of intensity. Outpatient programs may address a variety of needs,including, but not limited to,situational stressors,family relations,interpersonal relationships,mental health issues,life span issues,psychiatric illnesses, and substance use disorders and other addictive behaviors. Recommendations There are no recommendations in this area. c 41). • • car f INTERNATIONAL 19 • tp State of Maine Board of Pharmacy License • No. P1150001237 with Expiration Date of 12/31/2016 • State of Maine • DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION , `, I OFFICE OF PROFESSIONAL AND OCCUPATIONAL REGULATION t BOARD OF PHARMACY License Number PH50001237 Be it known that METRO TREATMENT OF MAINE LP has qualified as required by Title 32 MRSA Chapter 117 and is licensed as: PHARMACY Doing Business As: PENOBSCOT COUNTY METRO TREATMENT Located at: 659 HOGAN RD BANGOR Pharmacist in charge ANDREW G. HANSCOM holding license#P(C29965 •`' " EXPIRATION DATE ISSUE DATE Commissioner November 30,2015 December 31,2016 X Detach _ STATE OF MAINE STATE OF MAINE DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION ,1� I OFFICE OF PROFESSIONAL AND OCCUPATIONAL REGULATION 35 State House Station w BDARD OF PHARMACY Augusta,Maine 04333-0035 ut4 " (207)624-8503 License Number PH50001237 METRO TREATMENT OF MAINE LP PHARMACY 1y14 Commissioner ISSUED 11/30/2015 EXPIRES 12/31/2016 • • tF qi City of Bangor Certificates of Occupancy dated 03/26/2016 • 03/28/2018 11:35Aif FAX 2070454449 BANGOR CITY HALL Ij 0001/0003 c�:yt CERTIFICATE OF OCCUPANCY • Ban or aine www.X13r1gorsn3ir e. ov TO.207-9924230 Permit /5110042 CODE ENFORCEMENT OFFICE 73 HARLOW STREET BANGOR,MAINE 0440 I This is to certify that the structure . X the portion(s)of a structure more fully described as follows: BL WOODS CONSTRUCTION,INC. Located at 687 HOGAN RD Bangor,Maine has now been finally inspected,found to be in compliance with the Land Development Code and Construction Codes of the the City of Bangor in effect at the date of this Certificate,and may now be occupied for the purposes of INTERIOR DEMOLITION OF EXISTING FACILITY WITH NEWLY CONSTRUCTED INTERIOR BUILD OUT.EXPANDING FIRST AND SECOND FLOORS INTO ONE OFFICE BY PHASING • THE WORK INTO 3 DIFFERENT AREAS RECEIVING A CERTIFICATE OF OCCUPANCY FOR EACH AREA. /9ald ►•/a Ernforc lent Officer Plum.' 4Building l ns•- or ta/., 144 A.MW/A _AAA. 1 LJ Fire inspector Electrical Inspector HVAC Inspector f • Date 03/28/2016 11:35AM FAX 2079454449 BANGOR CITY HALL [ 0002/0003 • CERTIFICATE OF OCCUPANCY Bali o. www.bangorrnaine.gov Tel,207-992-4230 Permit: 15030030 CODE ENFORCEMENT OFFICE 73 HARLOW STREET BANGOR,MAINE 04401 This is to certify that the structure X the portion(s)of a structure more fully described es follows: BL WOODS CONSTRUCTION,INC. Located at 687 HOGAN RD Bangor, Maine has now been finally inspected,found to be in compliance with the Land Development Code and Construction Codes of the the City of Bangor in effect at the date of this Certificate, and may now be occupied for the purposes of INTERIOR RENOVATION OF EXISTING FACILITY. EXPANSION INTO ADJOINING SPACE&EXISTING SECOND FLOOR AS PER PLANS SUBMITTED. . • • 2/1-tt. / a/4" A ) .JLC-'� C,�V2 Enforcement Officer PIu • • Building (nape «' I �.,..w.-� . lI/ _ .1 J _1J ire Inspector Electrical Inspector CAl."1-"L-A*1'. WAG Inspector • • 3 -14 - ((a Date 03/2$/2016 11:36Al[ FAX 2079454449 BANGOR CITY HALL gI 0003/0003 CERTIFICATE OF OCCUPANCY Bain" ` Maur • w:vw,b8 ngc rm a i n e.g ov 'Cel.207-992-4230 Permit: 18100169 CODE ENFORCEMENT OFFICE 73 HARLOW STREET BANGOR,MAINE 04401 F This is to certify that _ the structure X the portion(*)of a structure more fully described as follows: PEN.CO.CONTRACTING Located at 687 HOGAN RD Bangor,Maine has now been finally inspected,found to be in compliance with the Land Development Code and Construction Codes of the the City of Bangor in effect at the date of this Certificate,and may now be occupied for the purposes of install rear exit staircase 111` 7/1' 46:L) Enforce tOfficer Plumbing/Building Inep- + 4,4„fle4 Fire Inspector Electrical Inspector n HVAC Inspector Date • 03-28-16;11:27AM; ;207-992-4196 # 3/ 3 • crtyor CERTIFICATE OF OCCUPANCY k. ,,.Maine www.baogofmaine.gow Tel 207-0924230 Permit: 151001 69 CODE ENFORCEMENT OFFICE 73 HARLOW STREET BANGOR,MAINE 04401 This is to certify that the structure X the portion(s)of a structure more fully described as follows: PEN.CO.CONTRACTING Located at 687 HOGAN RD Bangor, Maine has now been finally inspected,found to be in compliance with the Land Development Code and Construction Codes of the r. the City of Bangor in effect at the date of this Certificate,and may now be occupied for the purposes of install rear exit staircase • gazLa aTai C�i•a Enfor•- = t Officer Plumbing/Building Ins!) IV4,11-C44 Fire Inspector Electrical Inspector .1,3„A.40 g HVAC inspector • Date 03-28-16;11 :27AM; ;207-992-4196 # 2/ 3 CERTIFICATE OF OCCUPANCY 410 Banizor 07 -Maine www.bangormain©.gov Tel,207-992-4234 Permit: 15030030 CODE ENFORCEMENT OFFICE 73 HARLOW STREET BANGOR,MAINE 04401 This Is to certify that the structure X the portion(s)of a structure more fully described as follows: BL WOODS CONSTRUCTION,INC. Located at 687 HOGAN RD Bangor,Maine has now been finally Inspected,found to be in compliance with the Land Development Code and Construction Codes of the the City of Bangor in effect at the date of this Certificate,and may now be occupied for the purposes of INTERIOR RENOVATION OF EXISTING FACILITY. EXPANSION INTO ADJOINING SPACE&EXISTING SECOND FLOOR AS PER PLANS SUBMITTED. / t/A,e�+T� O' �J (/W Co Enforcement Officer Plu • . Building Inspe •r ire Inspector Electrical Inspector Cp_Lt.„1"4....3 HVAC Inspector Date 03-28-16;11:27AM; ;207-992-4196 # 1/ 3 • CERTIFICATE OF OCCUPANCY r 13Joit.,,nwcayot 4�. cine •www.bangormalne,gov Tel,2V-9924230 Permit: 15110042 CODE ENFORCEMENT OFFICE 73 HARLOW STREET BANGOR,MAINE 04401 This is to certify that the structure X the portion(s)of a structure more fully described as follows: BL WOODS CONSTRUCTION,INC. Located et 681 HOGAN RD Bangor,Maine has now been finally inspected,found to be In compliance with the Land Development Code and Construction Codes of the the City of Bangor in effect at the date of this Certificate, and may now be occupied for the purposes of INTERIOR DEMOLITION OF EXISTING FACILITY WITH • NEWLY CONSTRUCTED INTERIOR BUILD OUT.EXPANDING FIRST AND SECOND FLOORS INTO ONE OFFICE BY PHASING THE WORK INTO 3 DWFFElENT AREAS RECEIVING A CERTIFICATE OF OCCUPANCY FOR EACH AREA. . A /90:6C•1eEnforc entOfficer Plurn•' 'aaulldingInsp=mor / miner IA/ Fire Inspector Electrical Inspector HVAC Inspector Date Letter from Dr. Fatel in support of Application dated 06/23/2016 • • • P Penobscot County Metro Treatment Center 659 Hogan Road Bangor,ME 04401 June 3,2016 City Council City of Bangor 73 Harlow Street Bangor,ME 04401 RE: Penobscot County Metro Treatment Center Application for Patient Number Increase from 300 to 500 Dear Councilors: I write in support of the application of Penobscot County Metro Treatment Center to increase from 300 to 500 the number of patients that can be treated at its Hogan Road facility. • I am the Medical Director of the Metro Treatment Center,and have served in this capacity for the past 5 years. Over the past several months,our waitlist has grown significantly- currently numbering 173 patients. Each week we hear from several dozen other individuals seeking treatment. It is unfortunate that many of those on our waitlist have been waiting for over 120 days to be • admitted, Many have been on our waitlist previously awaiting treatment have dropped off over time,and are no longer reachable at the phone numbers that they left with us. I have been involved in addiction medicine for many years, and have worked with several treatment providers over that timeframe such as Discovery House,Cap Quality Care and Turning Tide. I provide inpatient care at Dorothea Dix and Riverview psychiatric hospitals. Additionally,I am a surveyor for the Joint Commission International and I am on the family practice service of Eastern Maine Medical Center. iFg I have been most impressed with the approach taken by the Penobscot County Metro Treatment Center and its parent,Colonial Management Group,LP,which owns and operates facilities throughout the Country. Our Bangor facility provides high-quality services and has • been credited by CARE'since 2005,evidencing its attention to high standards and provision of high-quality of services. If our application to increase from 300 to 500 is granted,we will not immediately ramp up to 500 patients. Rather,we would increase at a rate of approximately 8-16 clients per month • 10592419.1 •I in order to assure that the intake process runs smoothly, and our clients understand and will comply with pertinent protocols and policies. • I urge the Council to approve this application,and I welcome the opportunity to respond to any questions members of the Council may have. I look forward to participating in the Committee process. The misuse of and addiction to opioids such as heroin,morphine,and other prescription .pain medicines is a serious national problem that affects public health as well as social and economic welfare.This issue has become a public health epidemic with devastating consequences including overdoses. On May 2nd Fox 22 reported two deaths from a dangerously potent batch of heroin. The Bangor Daily News reported on March 7th this year that 272 people died from heroin overdose in Maine.That's a 31%increase from the previous year. We have a responsibility to the public to treat those who are asking for our help. Very truly yours, Dr. Arvind Patel,MD • • 14592419.1 • gSn ' f g[FE List of Metro patients broken down by county • and percentage PATIENTS SERVED BY PENOBSCOT COUNTY METRO TREATMENT CENTER BY COUNTY AND PERCENTAGE Penobscot County #of Patients Percentage 201 67% Hancock County #of Patients Percentage F 42 14% Waldo County e #of Patients Percentage 23 7.33% t Piscatanuis County #of Patients Percentage 12 3.99% Washington County #of Patients Percentage 5 1.66% Somerset County #of Patients Percentage 5 1.66% Aroostook County #of Patients Percentage 4 1.33% • 10606592,1 • Knox County #of Patients Percentage 2 .66% Lincoln County #of Patients Percentage 1 .33% &[k[� • • 10606592.1 List of Metro patients brown down by cities, 01 towns, and percentages • S 5 i 1 3 I s t • CITIES AND TOWNS IN COUNTIES l SERVED BY > PENOBSCOT COUNTY METRO TREATMENT CENTER Penobscot County Cities l City #of Patients Percentage Bangor 62 20.27% Old Town 14 4.65% Brewer 12 3.99% Total Patients: 87 Penobscot County Towns Town # of Patients Percentage Alton 1 .33% Bradford 1 .33% Bradley 1 .33% Carmel 1 .33% Charleston 2 .66% Clifton 2 .66% ' • Corinna 1 .33% Corinth 1 .33% Dexter 1 .33% Dixmont 1 .33% . East Corinth 1 .33% East Millinocket 1 .33% Enfield 1 .33% Garland 3 1.00% 3 Glenburn. 5 1.66% Greenbush 8 2.66% Hampden 4 1.33% i Hermon 11 3.65% Holden 3 1.00% Howland 3 1.00% Hudson 3 1.00% K Kenduskeag 2 .6651/0 Lagrange 4 1.33% Levant 3 1.00% Lincoln 5 1.66% Little Deer isle 1 .33% 1 Mattamiscontis 1 .33% '' Township • Mattawamkeag 1 .33% e 10598930.1 s i r I Medway 2 .66% . Milford 18 5.32% • .66%/0 _Millinocket 7 2.33% Newburg 3 1.00% Newport 1 .33% r Arrington ,4 1.33% .Passadumkeag 1 .33% 1 Stetson 2 .66% P Stillwater 1 _ .33% , Veazie 2 .66% West Enfield 2 .66% Winn 1 .33% R Total Patients: 114 i Total Patients Penobscot County: 201 I Percentage of Patients from Penobscot County: 67% i E Waldo County Cities Town #of Patients Percentage P Belfast 1 .33% i Ali Total Patients: 1 F. P Waldo County Towns i Town #of Patients Percentage Brooks 2 .66% Frankfort 1 .33% Northport 1 .33% 1 Prospect 1 .33% Searsmont 1 .33% Searsport 1 .33% Stockton Springs 1 .33%/n Swanville 1 .33%/0 Thorndike 1 .33% i Waldo 2 .66% Winterport 10 3.33% Total Patients: 22 Total Patients Waldo County: 23 Percentage of Patients from Waldo County: 7.33% •. 10598930.1 i i • Hancock County Cities • • Town #of Patients Percentage Ellsworth 6 1.99% Total Patients; 6 i l Hancock County Towns Town #of Patients Percentage Blue Hill 3 1.00% Brooksville 1 .33% Bucksport 5 • 1.66% Dedham 1 .33% Deer Isle 5 1.66% € Eastbrook 4 1.33% • • Franklin 1 .33% Gouldsboro 2 .66% _ Hancock 3 1.00% Lamoine 2 .66% Mariaville 1 .33% I Orland 1 .33% • Otis 1 .33% Penobscot 1 .33% Stonington 2 .66% Surry 1 .33% Trenton 3 1.00% E Total Patients: 36 i Total Patients Hancock County: 42 , Percentage of Patients from Hancock County: 14% i F • i i • s 10598930.1 1 Piscataquis County Cities • Town #of Patients Percentage Dover Foxeroft 4 _ 1.33% Total Patients: 4 Piscataquis County Towns Town #of Patients Percentage Abbott 1 .33% Brownville 1 .33% Guilford(Gilford) 1 .33% Milo 1 .33% T Monson 1 .33% Sangerville 1 _ .33% 1 i Sebec 2 .66% Total Patients: 8 Total Patients .Piscataquis County: 12 g Percentage of Patients from Piscataquis County: 3.99% e Knox County Towns III Town #of Patients Percentage , Tenants Harbor 2 .66% i Total Patients: 2 Total Patients Knox County: 2 Percentage of Patients from Knox County: .66% Washington County Towns Town #of Patients Percentage Harrington 2 .66% Jacksonville 1 .33% Jonesport 2 .66% Total Patients: 5 Total Patients Wash. County: 5 Percentage of Patients from Washington County: 1.66% III 10598930.I • Somerset County Towns Town #of Patients Percentage Hartland 1 .33% Pittsfield 4 1.33% Total Patients: 5 Total Patients Somerset County: 5 • Percentage of Patients from Somerset County: 1.66% Aroostook County Towns Town # of Patients Percentage Benedicta 1 .33% I,inneus 1 .33% Sherman 1 .33% Sherman Mills 1 .33% Total Patients: 4 Total Patients Aroostook County: 4 Percentage of Patients from Aroostook County: 1.33% • Lincoln County Towns Town #of Patients Percentage Waldoboro 1 .33% Total Patients: 1 Total Patients Lincoln County: 1 Percentage of Patients from Lincoln County: .33% • 10598930.1