Wabanaki Health Group to Close Detox as MaineCare Pays Below Cost

Wabanaki Public Health & Wellness will close its detox services in Bangor as soon as the patients currently in its care finish withdrawal, co-CEO Lisa Sockabasin said Friday. The organization says the unit has cost about $1.5 million more per year to operate than MaineCare, the state's Medicaid program, reimburses for it since it opened in 2023.

The announcement landed in the same week the unit's own staff revived a man who overdosed outside the facility on Tuesday, according to the Portland Press Herald, which reported the closure. Sockabasin described the decision in an interview: "I know that lives will be impacted by this, and it breaks my heart."

The arithmetic behind the closure

Wabanaki opened the detox service in 2023 with $1 million from the state, part of a wave of expansion that Gov. Janet Mills encouraged as her administration built out a statewide response. Sockabasin said she expected the program to become self-sustaining. It did not. The organization's two recovery homes in Bangor are also losing money, she said, and withdrawal management drains faster than either of them.

The losses were covered with fundraising and grants until those sources thinned in 2025 and 2026. Sockabasin said the cost of carrying drug and alcohol treatment has now cut into the organization's other work, including food and water delivery to tribal members.

A Maine Department of Health and Human Services spokesperson told the paper the state has put $6.8 million toward residential recovery treatment. That figure describes state investment in the system, not the gap between what a detox day costs and what Medicaid pays for it.

The per-bed number at Milestone

Wabanaki is not an outlier. Milestone Recovery in Portland, which also serves mostly people on MaineCare or with no insurance, loses $210 per day for each bed occupied by a Medicaid patient in withdrawal, executive director Jayme Villanueva said. In 2024 Milestone tried to expand, and Mills cut a ceremonial ribbon on a renovation that took the facility from 16 beds to 30. A little over a year later, according to the account, the organization scaled back.

The mechanism is straightforward and unglamorous. MaineCare covers withdrawal management as a benefit — an improvement advocates credit to the 2019 Medicaid expansion, after which nearly 40,000 people on MaineCare received substance use treatment in 2025, according to the state health department. What the benefit pays per day, however, sits below the staffing cost of a medically supported detoxification bed, where nurses monitor vital signs and physicians manage withdrawal around the clock. The difference is absorbed by the provider or passed to donors.

What closes when a detox unit closes

"The closure of detox beds would be a critical loss on the front lines of the opioid crisis in the state," said Courtney Gary-Allen, executive director of the Maine Recovery Action/Access Project. Medically supported withdrawal management is usually the first step for someone who has decided to stop, and Gary-Allen said Wabanaki is one of the first three places she calls when she meets a person ready to detox.

The practical consequence is distance. Milestone in Portland is the other program she named, and Portland is roughly a two-hour drive south of Bangor — a trip that assumes a car, a day off, and a bed at the far end. For tribal members in Penobscot County, the alternative to a local detox bed is not another local detox bed.

Sockabasin said she raised the alarm with the state six months ago and spent the intervening months fundraising in the hope of avoiding exactly this. "There were many partnerships built to create a statewide system to catch people no matter what," she said. "And there are many of us within that statewide system today that are struggling to keep the lights on."

The state's opioid office expected this

Gordon Smith, who has led Maine's opioid response since Mills took office, told the Press Herald in an interview Tuesday that he is optimistic the recovery services built during his tenure will survive, but not surprised that some providers are struggling. "The sustainability of our entire healthcare system is at risk, so of course our addiction treatment facilities are fragile," he said.

That framing puts the detox closure inside a broader rural hospital problem rather than a single organization's mismanagement. Small facilities with fixed staffing costs and a payer mix dominated by Medicaid fail on the same math whether they deliver obstetrics, inpatient psychiatric care, or withdrawal management.

New beds are opening, for a different payer

The paper reported that several new detox and residential recovery facilities are scheduled to open soon, some of them aimed primarily at patients with private insurance who can pay more than Medicaid rates. That pattern is familiar from other states: capacity grows where reimbursement covers cost, and shrinks where it does not, which leaves the publicly insured concentrated in whatever beds remain.

Maine has been here before. This month alone, the state's largest residential program for pregnant and parenting women, the Letty Owings Center in Portland, announced it would close on October 31, and Portland has been redirecting opioid settlement money into a warming shelter as winter approaches.

What remains unresolved

No rate change has been announced, and the state has not committed to a timeline for one. Wabanaki's recovery homes remain open for now, but Sockabasin described them as losing money too. The detox unit will keep operating until the last patient now in the building completes withdrawal — a schedule set by clinical need rather than by a closure date.

For anyone in Maine trying to find a bed, the state's residential treatment directory and the SAMHSA National Helpline at 1-800-662-4357 remain the fastest routes. Substance use disorder treatment does not require a hospital system to be financially healthy to work, but it does require someone to be willing to run the unit at a loss.