AUGUSTA — Advocates who say Gov. Paul LePage’s proposed cuts to community mental health and substance abuse services would exacerbate problems in central Maine will meet with Kennebec County legislators on Friday in an effort to restore state budget funding.
In its two-year budget proposal, the Maine Department of Health and Human Services has recommended more than $45 million in reductions in state and federal spending on reimbursement for medication management and outpatient mental health services for patients covered by MaineCare, the state’s version of Medicaid, the federal health care system for the poor, according to March testimony to legislators.
MaineCare patients served by medication management in 2014: 19,000
Proposed state and federal spending cut in that program: $17 million over two years
Current state reimbursement rate for adults: $56 per 15 minutes
Proposed state reimbursement rate for adults: $24 per 15 minutes
Current state reimbursement rate for children: $64 per 15 minutes
Proposed state reimbursement rate for children: $24 per 15 minutes
The department says the cuts are needed to better align Maine’s reimbursement rates with lower rates for comparable services, as well as with the rates paid by neighboring states, but advocates worry that the cuts would put patients on waiting lists for services and that providers could shut their doors, leaving many untreated in service centers, especially Augusta.
“We’re going to have a huge crisis on our hands,” said Simonne Maline, executive director of the Consumer Council System of Maine, a Augusta-based group advocating for people getting mental health services.
On Friday morning, local legislators plan to attend a State House meeting organized by Rep. Charlotte Warren, D-Hallowell, and health care providers who will make their case for funding alongside other advocates largely concerned with the proposal to spend $17 million less over two years in state and federal funds on medication management services supplied to more than 19,000 people in 2014.
Doctors now are paid nearly $56 per 15 minutes of service to manage adults’ medication under MaineCare. For children, it’s nearly $64. The department wants to cut both rates to about $24. Tom McAdam, the CEO of Kennebec Behavioral Health, said that would mean a cut of $2.4 million in one year for the Waterville-based agency, which provided the services to 4,200 adults and 1,650 children last year.
“Statewide, these cuts would create waiting lists for thousands of people,” McAdam said. “No exaggeration.”
The department also has proposed cutting $28 million in state and federal money for counseling on behavioral health and substance abuse problems over two years by reducing reimbursement rates 10 percent, saying many of Maine’s rates are higher than those in other places.
“Like other initiatives in this budget, this proposal will bring Maine’s reimbursement rates closer to other New England states, further enhancing our commitment to control spending while still providing crucial services to Maine’s most vulnerable,” said DHHS Commissioner Mary Mayhew, who has been the face of the Republican governor’s welfare reform effort, in written testimony on the proposal.
But Maline, who gets medication management under private insurance for bipolar disorder and post-traumatic stress disorder, doesn’t think the state recognizes the cuts’ potential effect. Kennebec County Sheriff Randall Liberty called it “an archaic approach to mental health.”
Because of the presence of Riverview Psychiatric Center and other services, Augusta in particular struggles with police problems stemming from mental illness. About 50 percent of inmates in Liberty’s jail take psychotropic medication, and he said that left untreated, mental health issues “morph into larger, broader problems” for society.
“If we don’t have substance abuse and mental health treatment, people are going to be incarcerated, and there’s no money to be saved there,” Liberty said.
However, LePage’s proposal could be changed by the time the budget is final. The Legislature’s Appropriations Committee now is working to finalize its budget proposal by June. Sen. Roger Katz, R-Augusta, a member of that committee, said he’s taking providers’ concerns seriously and wants to make sure they can continue to provide services.
“This is one of the more serious issues we’ll have to consider, but no decisions have been made,” Katz said.
Michael Shepherd — 370-7652
Twitter: @mikeshepherdme
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