Chemical dependency clinic dissolving

The Flathead Valley Chemical Dependency Clinic is dissolving on June 21 after nearly 45 years of providing a wide scope of vital addiction recovery services, including addiction counseling and assessments.

Gateway Community Services, a nonprofit treatment center based in Great Falls, will be taking over operations beginning June 24. Mike Cummins, executive director of the Flathead Valley Chemical Dependency Clinic, who has been with the facility since 1992, said the clinic’s established offices in Kalispell, Libby and Thompson Falls will remain open and staff from those facilities will retain their jobs under the Gateway Community Services umbrella. Collectively, the office locations serve hundreds of clients in Flathead, Lincoln and Sanders counties and employ dozens of residents.

Cummins said he is hopeful Gateway will be able to provide the same services, plus additional services, while remaining a nonprofit.

“Great Falls shares some of the same core elements we do,” Cummins said. “When we knew we were going to dissolve, we wanted to find another organization that could take over that provides more services but has historically kept addiction treatment as its mission. And that was Gateway.”

Cummins cited two overarching reasons for the dissolving of the clinic: shifts in trends in the mental-health industry, which often go hand-in-hand with addiction treatment, and a lack of funding.

“It has just become more and more difficult, but over the years we were still holding our own. We have rode out a lot of different storms and trends and had always been able to continue providing services,” Cummins said.

He also cited the rise of integrated behavioral health in which clinics are now beginning to offer primary-care and mental-health services under the same roof, making it difficult for those other organizations, especially nonprofits with a more centralized focus, to stay afloat.

Cummins also pointed to the recent expansion of state-approval status, which is just one of multiple emerging trends that influenced the dissolving of the clinic. The change allowed for both nonprofit or for-profit organizations to apply for state approval and thus, gain access to public funding dollars.

“Those things meant more competition and less concern by the state about the quality of care and it was more just about the availability of care,” Cummins said.

He continued, stating that he believes many for-profit chemical dependency clinics and other facilities that offer such services opened their doors with good intentions, but that such entities tend to bring with them business-first mentalities.

“This is my bias, but many times when they [for-profit organizations] fold up, they are just closing their business. When a nonprofit does it, the community loses a resource. We’ve haven’t gone anywhere, we’ve been here year-in and year-out for more than 40 years,” Cummins said.

The two trends identified by Cummins, among others, led to a steep increase in competition.

About four years ago, Cummins said the Kalispell clinic alone used to employ six full-time counselors and this past year they had four. When there were six counselors, caseloads would average about 35 a person per month and now they are averaging 18.

“So not only did we have fewer people that we were providing services to, but we had drastic rate cuts. It was a double whammy,” Cummins said.

About four or five years ago the clinic, of which about 60% is financially supported by federal, state and county funds and 40% by charges for services, also began facing major financial hurdles.

In late 2017, Montana’s Department of Public Health and Human Services suffered a $49 million budget cut — a sweeping occurrence that led to a cut in Medicaid reimbursement rates to the tune of 3% and cued the closure of multiple mental-health facilities statewide, including two group homes in Kalispell.

And on the heels of this, in May 2018, came another sharp reduction in reimbursement rates that specifically took a toll on addiction providers. Cummins said the back-to-back cuts were “devastating” to the clinic.

For example, he said for diagnostic assessments, the clinic would receive a reimbursement of about $291.21 per assessment, but after the addiction treatment-specific cut went into effect, that dropped to $92.31.

For group counseling, a service Cummins said can be a lifeline to one’s recovery, the clinic received $25.02 per hour per client. That rate dropped to $18.01 per total group, regardless of how many hours.

“For awhile there we were using reserve monies to get by, but by February when the legislative session was getting close to an end, it was getting clear that nothing was going to change and that by May we’d be upside down. We just wouldn’t be able to keep going that way,” Cummins said.

Last year, the chemical dependency clinic made a last-ditch difficult decision to try to salvage funding by shutting down its Eureka location.

“We closed that office down last spring as an attempt to stay alive. We had to make a really drastic cut and that was the first place we could try it.” Cummins said. “Part of that logic was Eureka was in Lincoln County and we still had the Libby office.”

With the closing of one door and opening of another comes a mixture of sadness, hope and other emotions, but Cummins and others say they hope the community remembers Flathead Valley Chemical Dependency Clinic fondly for the decades of services it has provided.

“We have made a lot of progress during my time there,” said Sherry Baker, who has served on the clinic’s board of directors for about 15 years. “It’s a little sad that it had to end this way, but we can look back at all we’ve done and I’m optimistic that Great Falls will add something to the community.”

Over the years it has raised funds for different health-care related purposes around the Flathead Valley, opened up its multiple offices and launched the Women’s Recovery Home, among other lasting community additions.

“Again, my biases may be showing, but for years we provided a necessary service for this valley, and we were good at it,” Cummins said.

Reporter Kianna Gardner may be reached at 758-4439 or kgardner@dailyinterlake.com.