Health officials have relocated 49 of 67 disabled adults who were affected by the state’s decision to terminate a Medicaid contract with a Biddeford-based community service provider that failed to correct deficiencies after one of its clients died in August.

Maine Department of Health and Human Services spokeswoman Jackie Farwell said Monday that most former clients of Residential and Community Support Services have stayed in southern Maine.

“We remain committed to supporting the remaining 18 residents in selecting a placement of their choice,” she said in an email. “Community case managers are working closely with residents to provide them with information and support them in reviewing their options moving forward.”

Farwell also said DHHS has given the company another chance to file a plan that meets the state’s approval.

The state took the unusual step of ending its Medicaid contract with RCSS in late October. The company, founded in 2013, had failed to make improvements DHHS required following the death of a client in August, officials said.

“This company’s unacceptable failure to ensure the well-being of its residents has led us to take immediate steps to safeguard residents’ health and welfare and transition them to alternative homes,” DHHS Commissioner Jeanne Lambrew said at the time. “We will do all we can to help ease the disruption and distress caused to residents and their families as we hold the company accountable.”

Although the state, citing privacy laws, has not identified the client whose death led to its decision, RCSS administrators have confirmed that it was Norman Fisher, a longtime Biddeford resident.

Norman Fisher died in August, three days after the state placed him with Residential and Community Support Services without his medication. Photo courtesy of the Art Certificate Program of Biddeford

Fisher, 62, died on Aug. 27 in a home in Portland managed by RCSS. He had been there less than 72 hours. His death is still under investigation by Portland police.

Christine Tiernan, CEO of Residential and Community Support Services, criticized the state and said her company was being used as a scapegoat in Fisher’s death. She said the state, as Fisher’s legal guardian, failed to ensure his safety when it left him in RCSS’s care without the insulin he needed to treat his severe diabetes.

Advocates and other community service providers said it’s likely that both the state and RCSS failed Fisher, but it was RCSS that was penalized.

RCSS employees and some of its clients have protested the state’s decision. The company also requested an informal review of the state’s termination.

Neither Tiernan nor Angie Marquis, the company’s director of clinical, crisis and intake, responded to messages left Monday, but Farwell said DHHS’s Office of MaineCare (Medicaid) Services responded on Nov. 25 to RCSS’s request for an informal review.

“This review included an examination of the events leading up to the department’s Oct. 21 decision to terminate RCSS’s provider agreement, and confirmed that decision,” she said. “RCSS has the right to appeal under standard departmental policy.”

Additionally, Farwell said the department has provided the company with another opportunity to submit an acceptable corrective action plan that could suspend the termination and allow it to continue providing services.

“To that end, the department reviewed and is providing constructive feedback on a revised plan RCSS submitted on Nov. 26,” she said. “We have also informed the company that MaineCare payments will temporarily continue as we seek alternative placements for RCSS residents, pending the submission of an acceptable plan.”

The 18 disabled adults who have not yet been placed with other providers are still under RCSS care or in RCSS housing.

Commissioner Lambrew had said in late October that the state hoped to find suitable placements for RCSS’s clients within 30 days. However, she and others also have acknowledged longstanding challenges of providing residential care to adults with intellectual and developmental disabilities and autism spectrum disorder who are eligible for services under Medicaid. One of the biggest factors has been the state’s ongoing workforce crisis, which has made it challenging for service providers to recruit and retain direct care workers.

As of October, the state provided Medicaid services to slightly more than 5,700 disabled adults, including 3,186 who receive comprehensive residential services. Another 1,913 were on a waitlist for some services, although nearly two-thirds of that group is receiving other services.

Approximately 1,000 of the adults receiving residential services live in small one- or two-bedroom homes managed by community service providers – just like the home where Norman Fisher died. This April, months before Fisher’s death, DHHS notified providers that those small homes – 560 in all – would need to comply with new licensing requirements.

It wasn’t clear Monday which providers have taken in Residential and Community Support Services’ clients. Farwell said the state could not provide the names of providers.

Laura Cordes, executive director of the Maine Association for Community Service Providers, couldn’t address specific placements, but said “members have worked quickly with the state and each person’s Person Centered Planning (PCP) team to respond to requests for specific supports and services including home placement in the community of their choosing.”

Beth Sullivan, state director for Granite Bay Care, which operates more than 70 residential programs in Maine, most of them two-bedroom group homes, said her company has taken in six former RCSS clients.

“Each one of these clients is happy, healthy and excited to be in their new home,” she said.

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