Maine’s top health official will brief lawmakers Thursday on a host of fiscal issues specific to her department, including Medicaid expansion and the wait lists for services for disabled adults.

Health and Human Services Commissioner Jeanne Lambrew is scheduled to appear before the Appropriations and Financial Services Committee, which is meeting before the start of the 129th Legislature’s second session in January.

“She welcomes the opportunity to address areas of interest to the Committee and our progress on health and human services issues,” said DHHS spokeswoman Jackie Farwell.

The meeting agenda provides only a brief summary of Lambrew’s remarks, but Rep. Drew Gattine of Westbrook, the committee’s House chair, said he expects the conversation to be open-ended.

“There were a few things we identified as things we’d like updates on, but it’d be great if she had a bunch of other stuff she wants to talk about,” he said, adding that for the previous two years before Gov. Janet Mills took office, no HHS commissioner appeared before the budget committee. “It’s a good opportunity for us to talk about things not in the context of specific bills.”

Farwell said the commissioner plans to talk about how she’s strengthened the department through hiring, improved access to health care and promoted education and job training programs.

Medicaid expansion has been a major development in the first year of the Mills’ administration. Although Maine voters approved expansion in 2017, former Gov. Paul LePage refused to implement it. Since Mills authorized expansion on her first day in office, 40,000 people have signed up. Thousands more are expected to enroll in Medicaid in the coming months, including those who have switched from Affordable Care Act plans to Medicaid.

Mills, in an op-ed published in the Press Herald last week, wrote that, “(Medicaid) spending remains within our projections, and Maine stands to receive nearly $700 million in federal matching funds through state fiscal year 2021.” The current budget includes $125 million in additional Medicaid funding for 2020-21.

Lambrew may address a need for additional funding in other areas, though, particularly in Medicaid programs that provide home and community-based care for adults with intellectual/developmental disabilities or autism spectrum disorder.

The current budget included funding for an additional 167 people for comprehensive services but there is still a significant gap. As of Oct. 8, the state provided services through Medicaid to 5,700 individuals with intellectual or developmental disabilities or autism spectrum disorder and another 1,918 were on a waitlist, 85 percent of whom were waiting for comprehensive services.

Sen. Rebecca Millett of Cape Elizabeth has submitted a bill for next session to eliminate the wait list but it has not yet been drafted.

Lambrew has cautioned against putting too much emphasis on the waitlist, pointing out that nearly two-thirds of those individuals are receiving other services. The waitlist also includes individuals who may not need services currently but will soon age out of child services.

Still, community service providers have been saying for months that a growing workforce crisis has hampered their ability to offer quality care. That issue has come up more recently in response to the death of Norman Fisher in August. Fisher, 62, was an intellectually disabled adult and ward of the state who died at a home managed by Biddeford-based Residential and Community Support Services.

Although state officials have not identified Fisher or answered questions about his care, citing privacy laws, they have confirmed that the late August death of a patient in RCSS’ ultimately led the state to terminate its Medicaid contract with the for-profit company. The state is now in the process of finding new homes for the more than 60 clients of RCSS who had been housed in 38 one or two-bedroom homes throughout southern Maine.

Lambrew has said that while the Mills administration has increased capacity to serve disabled adults, demand has increased at an even greater pace. She said many families and providers have asked for more flexibility in providing services and that’s something her department has been discussing.

 

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