Inside the campus of the former Salvation Army Rehabilitation Center in Southwest Baltimore, dormitory-style beds, activity rooms and even a chapel sit empty and unused. No longer does it serve as a haven for those seeking treatment for substance use disorders.
It’s one of a number of Salvation Army sites shut down by the nonprofit in March 2020 as it laid off 59 employees in Maryland, including two sites in Baltimore and one in Cockeysville.
Now a year later, a group founded by a man who himself was treated for substance abuse and worked at Baltimore’s Helping Up Mission is looking to start a new treatment center at the West Patapsco Avenue location, with a goal of creating a campus that provides a variety of services beyond detoxification and group counseling.
Tom Bond, founder of the newly created Summit Maryland, said the group is waiting for the U.S. Small Business Association to process a $7 million loan. Loans and other financing aspects of the project are being worked out, but Bond and his partners are optimistic.
Summit is a hybrid organization consisting of a nonprofit side, called Summit Community Foundation, to solicit and disperse donations and a for-profit entity, Summit Community Health, which has investors.
The nonprofit side is pulling a number of industry veterans to serve as advisers and on the for-profit’s board of directors. Josh May, the founder of The Nicholas House halfway house in East Baltimore, is collaborating with Bond as one of the leaders of the project, and Thomas J. Senker, CEO and president of MedStar Montgomery Medical Center, will serve on the for-profit side’s board of directors.
Summit is looking to raise a total of $4 million to pay for a $1.4 million down payment, renovations to the building and additional operating capital for the facility’s first 18 months. Bond said the group is a little less than $1 million short of its goal and is seeking additional investors.
Bond said it is an opportunity to create something larger than just another detox and group counseling center.
“This could then become the standard-bearer in that this is the way it should happen,” Bond said.
The former Salvation Army location is 78,000 square feet and Bond says he wants to devote the space to clients who are Medicaid-eligible. He plans to use 88 beds at the outset and potentially expand to 120. The organization wants to secure more partnerships before allocating beds to more patients, Bond said.
The group has also acquired a smaller house off Moravia Road to designate 12 beds for people who no longer need detox services or higher-intensity residential treatment services, but require weekly clinical services and a place to live as they recover further.
With its location in Southwest Baltimore, the West Patapsco Avenue site could also address an underserved section of the city’s population, said Adrienne Breidenstine, the vice president of policy and communications for Behavioral Health System Baltimore.
“Where he is looking to set up in Southwest Baltimore is definitely where we are lacking those types of services,” Breidenstine said.
She said Baltimore needs detox services there because people are unlikely to cross the Hanover Street Bridge, which is the main connector between Southwest Baltimore and the rest of the city, to seek treatment.
Addiction has grown during the coronavirus pandemic. State figures show there was an increase in overdose deaths in 2020 after the state spent years trying to slow down what Republican Gov. Larry Hogan once called a “heroin epidemic.”
In January, state health officials reported that Maryland had seen a 12.1% increase in drug and alcohol overdose deaths from January 2020 through September 2020, compared with the same period in 2019. Breidenstine said at the time that the increase was not surprising, given the rise in unemployment and its correlation to behavioral health emergencies, with suicides also spiking during that time.
The population of substance abusers is also more reliant on Medicaid for health care coverage. The Kaiser Family Foundation found that among adults aged 18 to 64 with reported opioid use disorders, 38% were covered by Medicaid in 2017, “more than double the share of all nonelderly adults covered by Medicaid [16%].”
According to Breidenstine, 4,107 people received some level of substance abuse treatment in Baltimore in fiscal year 2019.
To make the Medicaid-only model work, Bond said, the group needed a facility that could house a larger number of clients, as the site would be reimbursed for its services by the state at lower rates than what some private insurers can offer. The program’s revenue model is based around an expected average 85% occupancy rate. The center would be reimbursed from $132.88 per bed for the lowest level of care up to $414.63 per bed for detox.
“To do 10 to 20 beds wouldn’t be feasible. We need to be a large program,” Bond said. “The lowest we could’ve done this and broken even is at 45 beds. So, we knew we needed to go after a facility that could go after a larger population.”
Bond said the partners from the Summit Community Health side “are all philosophically aligned individuals who support mission over [profit] margin.”
“It’s a social impact investment,” he said. “Their capital is recycled over time with a modest return and a continued ownership in the company.”
He added that, as owner, he won’t receive any dividend payouts “until everyone is paid back” on their investments, but that he retains control of the company through ownership percentage and voting rights.
Bond hopes to partner with other organizations to offer more services like job training for those who are struggling to reenter the workforce.
“We’ve got to be able to create something where people don’t need to leave,” Bond said.
He said the idea partly comes from his path to recovery. Nearly two decades ago, he was in jail after being found guilty of a drug possession charge and thinking, “How’d I get here?”
Bond is hoping his center will provide so many different services that clients will be able to full their needs without having to go to multiple centers.
He said he spent 16 years working at Helping Up Mission locations after going through its program. Helping Up initially offered a range of recovery services, eventually partnering with organizations like Johns Hopkins Hospital to become a more comprehensive program as it grew.
“As we grew, we would refer people out for stuff and guys wouldn’t come back,” he said.
Stacy Fruhling, a licensed clinician who joined the Summit Maryland group after working for CareFirst, said that other programs sometimes don’t offer enough services to help those who are in recovery reintegrate into their communities.
“There are those things like legal issues and family reunification and being able to find gainful employment and figuring out how to handle grief and all of those other pieces,” she said. “You’re not coming in and doing 28 days [of treatment eligible for state reimbursement] ... and then going back out and trying to maneuver your way in the world.”
Breidenstine said that her organization has talked with Summit Maryland to set up a referral system between the two organizations once the West Patapsco Avenue site is open, so that Behavioral Health Systems Baltimore can send people connected to Crisis Response Services to Summit’s available beds if they’re found to be suffering from a substance use disorder.
She said Summit’s program “is spot on with best practices” but understands the challenges of trying to run a facility solely on state reimbursements.
Bond said he wants to create a program that can aid individuals for an indefinite period of time, meaning people would be allowed to stay beyond the point where the center is reimbursed for services like detox or high-intensity residential treatment.
“It is a challenging financial model because the reimbursement model is so low,” Breidenstine said.
But Bond and his group are confident their model can work and want to address what has been a growing problem during the pandemic.
“It’s not that it can’t be done ... it’s that it requires a certain skill set and to be creative in some of the staffing solutions,” Fruhling said.