A $3.5 million business model

McLean Hospital opens Borden Cottage rehab center, ‘ready to receive’ first clients

Wed, 03/18/2015 - 12:45pm

    CAMDEN — Borden Cottage, the alcohol and drug rehabilitation center at Fox Hill Estate, is ready for business. Floors are polished, staff is being trained, and a catering contract with Camden Harbour Inn is all but signed. What’s left for this Maine venture of the Massachusetts-based McLean Hospital is to admit clients seeking separation from drugs and alcohol, and who can pay up to $60,000 for a month of such treatment.

    “We are ready to receive them,” said Frederick Goggans, the Camden doctor who is heading up McLean’s Borden Cottage program.

    They will come, McLean is convinced, because the 14-acre facility, is secluded, serene and well-appointed, and staff members — counselors, social workers and nurses — are topnotch, they say, in the field of rehabilitative treatment. 

    The soft opening of Borden Cottage occurred March 16, when local reporters toured the house, took pictures, and heard more from McLean Hospital’s Philip Levendusky about the business model, and from Goggans, about the care clients — eight at the most — will receive during treatment.

    The effort to site a the facility at Fox Hill got off to a rocky start in 2013 when Fox Hill Real Estate LLC, comprising 24 investors, first introduced its fledgling partnership with the Belmont, Mass.-based McLean Hospital to Camden’s Planning Board. The intent was to establish a 12-bed treatment center on outer Bay View Street, in the town’s coastal residential zone. Almost two years later, after 11 public meetings, two municipal board votes, and a lawsuit (the outcome of which resulted in a ruling favorable to Fox Hill), McLean Borden Cottage came to fruition, albeit scaled down to eight beds.  And last November, the Maine Department of Health and Human Services issued McLean a one-year provisional license to operate a behavioral health facility at Borden Cottage.

    McLean Hospital, in Belmont, Mass., is an affiliate of Harvard Medical School and a member of Partners HealthCare (the umbrella nonprofit that owns a number of Massachusetts hospitals, including Brigham and Women’s, and Mass General). 

    This is the first program that nonprofit McLean has established outside of Massachusetts. It is leasing Borden Cottage from Fox Hill LLC, which purchased the land and buildings in 2013 from Ellen Simmons. Fox Hill Real Estate is a for-profit venture and will continue to pay property taxes to Camden on the 16,000-square-foot Borden Cottage, and the six outbuildings that include smaller cottages, office, gym, music studio, recreational center and large garage.

    Since acquiring the property, Fox Hill Real Estate has invested close to $2 million in physical plant repairs and improvements, according to Tom Rodman, one of the 24 investors and the primary proponent of the initiative. The cottage and grounds had sat unattended for several years, with sills rotting and stucco falling from outside walls.Currently, the property is assessed at $6.47 million. In 2014, Fox Hill Real Estate payed $93,323 in real estate taxes to Camden.

    When Philip Levendusky, senior vice president for business development and marketing, and psychology department director at McLean, stood before the Camden planning and select boards in 2013, he pledged that McLean would also contribute to the community by helping to advance mental health care in the Midcoast.

    He reiterated that March 16, in the Borden Cottage kitchen.

    “By being here we become part of the dialog,” he said. “It’s our area of expertise.”

    McLean, he said, has more than 200 years of experience with substance abuse and mental health issues.

    He said the hospital will be a resource for the region, and will bring senior McLean faculty to local healthcare seminars, community education efforts and professional training sessions.

    McLean is also banking that its business will generate almost $3 million in local economic activity. Projected revenues from the Borden Cottage program for McLean, he estimated, would be approximately $3.5 million, when operations “ramp up.”

    “It is a substantial infusion,” Levendusky said, into the local economy.

    He said Borden Cottage is budgeting approximately $1.5 million on salaries and benefits for 20 to 24 fulltime employees, and then another “six figures” on vendors — housekeeping, food, and the 10-12 speciality providers in the community, who offer classes in in subjects such as fitness, smoking cessation, acupuncture, nutrition, yoga, art, meditation and mindfulness training, and massage therapy.

    Friends and family visiting patients would be referred to area inns and restaurants, he said.

    Besides contracting with the Camden Harbour Inn for catering meals, Borden Cottage is contracting with Jensen Pharmacy, in Rockland.

    This week, the operation had 15 to 18 staff members and would hire more, Levendusky said, once it was running at full capacity. He said clients will be arriving in the next week or two.

    In July 2013, Levendusky told the Camden Planning Board that the facility would neither be an insurance nor a state-based facility. Clients would not be sent from court or the criminal justice system. Clients would seek treatment voluntarily, and such treatment is not covered by health insurance. 

    “This is a self-paid kind of program,” he said. “Unfortunately and fortunately, that will dictate the socio-economic status of the individual,” he said.

    He said then the facility’s programs would be directed to a national audience and likened it to McLean’s Fernside center in Princeton, Mass

    In a March 17 press release, McLean said its Camden initiative is part of a larger effort to expand. 

    McLean recognizes the tremendous need for high-quality mental health and substance abuse care and we are continuing to explore opportunities for expanding our programs to different areas of the country,” said Levendusky, in the release. “We want to broaden our access to people nationally and internationally."

    How is the Midcoast to benefit?

    While Borden Cottage is affordable only to those with substantial income, both McLean and Fox Hill have consistently repeated that the McLean — and Harvard Medical School — presence in the Midcoast will elevate awareness and treatment modalities.

    Goggans, who was educated and trained in Texas and California, has been in the Midcoast for the past 16 years, practicing as a psychiatrist and as chairman of the Pen Bay Medical Center. He is also director of the Psychiatric and Addiction Recovery Center, more commonly known as PARC. It is where people go for acute psychiatric care and detox treatment.

    “Alcohol and substance abuse has only grown in the time I’ve been here,” he said. “Opiates are the worst.”

    He said that the presence of McLean will open the door to more resources for local efforts. Goggans also sits on the board of the Rockland-based Knox Clinic, which offers free care to area residents — “populations not reached by other nonprofits,” he said.

    Sixteen years ago, domestic violence and alcoholism plagued the Midcoast.

    “I think that’s still the case today,” said Goggans.

    According to the 2014 Many Flags Community Needs Assessment, 17 percent of Knox County adults drink excessively and the county has the highest percentage of chronic heavy drinking of any Maine county, at 7.3 percent. The county also has the state’s third highest rate of misuse of prescription drugs in past 30 days, at 2.8 percent. It also has the second highest suicide mortality rate in Maine, high psychoses hospital admissions among adults (18 and older), and high hospital admission rates for major depressive disorder, schizophrenia, and anxiety.

    And as doctors and pharmacies rein in the distribution of, and ease of access to, prescription opiates, users are returning to heroin and illicit drugs, said Goggins.

    Borden Cottage and McLean will help, he said, “stimulate greater awareness of this as as community health issue.”

    Beyond stimulating awareness, what else?

    Education, said Levendusky. He is optimistic that McLean’s collective knowledge will seep into local practices through collaboration, and education about addiction medicine.

    The emphasis at Borden Cottage is on 30-day treatments, and both Goggins and Levendusky said the five- to 10-day detoxification regimens are not enough. 

    Goggans said Borden Cottage is a project that defines alcoholism and drug abuse a “disease” model of addiction, as opposed to character failure. Borden Cottage will be treating psychological disorders associated with substance abuse; e.g., depression, panic attacks and anxiety, bipolarism. Those co-occurring disorders are common, according to prevailing thought. 

    “There are people who have complicated types of disorders,” said Levendusky.

    The focus, said Goggans, is on integrating total health — mental and physical. With Pen Bay, there is now discussion about starting day hospital routines, where patients are treated in a medical environment and then return home each night, he said.

    And meditation and mindfulness classes, acupuncture, massage therapy and yoga are no longer regarded as flaky New Age. 

    Those “evidence-based therapies,” said Goggans, are important to the success of the treatment.

    “They are all fairly mainstream these days,” he said. 

    At the same time, the 12-step programs are also effective, and Borden Cottage will host two of the area’s six 12-Step programs currently underway.

    "Borden Cottage is modeled clinically after McLean's other programs,” said McLean, in its news release. “The goal is for patients to achieve and maintain abstinence from drugs and alcohol and to learn how to manage the stresses of an active life. The seven-day-a-week program focuses on recovery and relapse prevention, and a 30-day minimum stay assures full benefit from the program.”

    It also goes beyond 30 days, according to Levendusky. Borden Cottage intends to keep in touch with its clients for the first year after the program. The goal is to make personal changes and continue those changes, said Goggans.

    “That is where the battle is won or lost,” he said.

    With Goggans remaining on the staff at Pen Bay Medical Center, Levendusky anticipates collaboration with local health care.

    “Rick will continue to grow the Knox Clinic task force,” said Levendusky. “And at any time, he might call Boston, and ask ‘what resources might you have?’”

    Those resources can include the philanthropic, he said.

    Together with programs such as Restorative Justice and other programs that seek to empower individuals to stay out of the legal system, and find employment, “all of this will ultimately tie together,” said Levendusky.

    In the meantime, Borden Cottage will continue advertising for clients on the Internet, and in print, in magazines such as the New Yorker and New York Times magazine. And when the clients arrive, there will be no fanfare on Fox Hill.


    Related stories:

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    Camden Planning Board agrees town citizenry should vote on Fox Hill amendment language

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    Editorial Director Lynda Clancy can be reached at lyndaclancy@penbaypilot.com; 706-6657.