June 22, 2013

Future unclear for Maine dental clinic for mentally ill

Officials await a signed budget from the state before they set up a new clinic after the Portland one shuttered due to budget uncertainties.

By JOE LAWLOR Staff Writer

PORTLAND - While the Maine Legislature restored $1.6 million to fund dental services for the mentally ill, the Portland clinic that patients went to has closed, and the service faces an uncertain future.

click image to enlarge

In this January 2013 file photo, dental hygienist Torey Richard conducts a teeth cleaning for patient Rick Hagan at Clinical Services in Portland. While the Maine Legislature restored $1.6 million to fund dental services for the mentally ill, the Portland clinic that patients went to has closed, and the service faces an uncertain future.

John Ewing / Staff Photographer

After advocates and legislators rallied around the clinic this spring, the money was included in a compromise forged for the 2014-15 budget. But the dental clinic, Clinical Services at 63 Preble St., closed June 14, although the state Department of Health and Human Services has indicated the specialized service will likely be revived in a few months under a contract with a nonprofit agency.

Still, there's no guarantee that a new clinic will open, due to continued uncertainty with the state budget. Gov. Paul LePage has promised to veto the budget, and it's unknown whether the veto would withstand an override attempt by the Legislature.

State officials said the back-and-forth over the budget is making planning problematic.

"We still don't have a signed budget," said John Martins, a spokesman for DHHS.

Martins said without an approved budget, the state can't sign a contract with Community Dental, the nonprofit that has indicated it would pick up the dental services. Officials with Community Dental couldn't be reached for comment this week.

So even though state officials are making plans, it's all still in limbo, Martins said.

Meanwhile, two state legislators told the Press Herald that they were surprised at the circumstances behind the closing of Clinical Services, which had been operated by the DHHS-owned Riverview Psychiatric Center in Augusta. Trucks arrived June 14, and workers removed equipment and fixtures for a clinic that had 3,000 patients.

"I thought the dental clinic was staying open," said Rep. Drew Gattine, D-Westbrook, who serves on the Legislature's Health and Human Services Committee. "I didn't think that by Friday they would be pulling the fixtures down. It seems like it could have been handled in a better way."

Gattine said the transition is awkward, and there shouldn't be such a long gap in dental services for a vulnerable population.

Rep. Ben Chipman, I-Portland, whose district includes the dental clinic and who has been lobbying to preserve the clinic since early this year, said he was "in shock" when he heard the clinic was closing.

"I never heard any speculation about closing it down (once the money was restored)," Chipman said. "If that's what they had in mind, they should have told us that."

But Bonnie Smith, the DHHS deputy commissioner for programs, said that no one, including state legislators, had been left in the dark about the plans for the clinic.

"We've been in constant communication about this," Smith said.

Dr. Mary Dowd, a physician who had been in charge of anesthesia services at the clinic, said the plans kept changing over the final weeks.

"The plan originally was that we were going to be closed for a few weeks and then reopen," Dowd said. "We had booked appointments for patients well into the fall."

Smith said another reason the state couldn't keep the clinic open in the interim was a lack of dentists. Longtime dentist Timothy Towle left the practice this spring when LePage's budget included eliminating funding for the clinic, and a fill-in dentist had to leave by mid-June. Other efforts to bring dentists in were unfruitful, Smith said.

"We could not find dentists," Smith said.

But two former employees at the clinic said it didn't seem like the state was trying that much to find fill-in dentists.

"We weren't given any money to advertise for dentists. They (state officials) weren't really interested in finding other dentists," said Beryl Cole, a former dental hygienist.

Towle, who now works in Augusta, said he believes the state might have been able to find a recent dental school graduate to fill in for a few months.

Martins, in an email response to a question, said that while it's true the state didn't advertise for dentists, it was more focused on a longer-term solution. And, Martins said, there were other reasons for closing the clinic.

Martins said the dental clinic didn't fit the mission of Riverview Psychiatric Center, which is focused on meeting the mental health needs of its patients, not dental services. And, he said, in most cases DHHS does not directly provide services, but rather contracts out services for the public.

Also, for the few hundred dental patients who needed to be sedated in order to receive care, the Preble Street location was inadequate and did not meet federal building requirements, Martins said. The sedation services are now in Bangor.

Exactly where the non-sedation dental services for the bulk of the 3,000 patients will be located is still being worked out, Martins said, as Community Dental determines how to expand its clinics to meet a new influx of patients. A state official told the Press Herald last week that Community Dental would offer the service at clinics in Biddeford, Augusta and Bangor.

Martins said, however, that a Portland location is still possible. They're also still waiting to see what happens with the state budget.

Cole said if there's no Portland location, it would be difficult for many patients, who lack transportation and money.

"Many of them walk to the clinic," Cole said.

Martins said the state is also working with Community Dental to open up some Saturday appointments during the transition.


Joe Lawlor can be reached at 791-6376 or at


Twitter: @joelawlorph


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