The Maine Supreme Judicial Court this week vacated a lower court’s termination of a mother-child relationship after the justices found that the state failed to provide critical nursing services that the child was legally entitled to receive and could have made a difference in the case.
The Law Court ruled Wednesday that the state wrongly terminated parental rights after determining that the mother, who was recently widowed, was unfit because she could not address the child’s complicated medical needs. However, the Maine Department of Health and Human Services never provided 24-hour care and support for the child that was legally required under MaineCare, the state’s version of Medicaid.
“The child has severe medical needs that entitle him to full-time private nursing care under federal and state law,” the justices found. “The department never provided that care, and its reunification and rehabilitation plan did not afford the mother any opportunity to demonstrate that – with the medical services the child is entitled to receive – she is able to care for the child.”
The justices found that the department’s records contain “vague references to nursing shortages and problems surrounding the COVID-19 pandemic, but there is nothing indicating that the department made any attempt to secure 24/7 nursing care, or anything close to it, for the child.”
The justices also noted that neither the mother’s attorney nor the child’s court-appointed guardian sought to compel the department to provide adequate care.
“Rather, the most the child received was 60 hours per week of nursing care, provided only on weekdays,” the justices wrote. “Because of this failure, the mother has never been afforded the assistance necessary to care for her child.”
The mother’s parental rights were terminated in Lewiston District Court in March 2023. The justices found that department records repeatedly stated throughout the child protection proceeding that, although the child was entitled to round-the-clock private nursing care, there were inadequate resources to meet his needs.
Maine Supreme Judicial Court justices hear oral arguments in December 2023 in Augusta. Derek Davis/Staff Photographer
“Inadequate resources do not excuse a state’s obligation to provide benefits under Medicaid,” the justices concluded.
In vacating the termination, the justices remanded the case to the trial court to determine whether the mother has an intellectual disability and how it might impact both parental fitness and the department’s reunification obligation.
Moreover, the justices asked the trial court to determine whether the mother would be unfit regardless of the department’s failure to provide skilled nursing care, and whether there is an alternative to termination of the mother’s parental rights that meets the best interests of the child.
“The Law Court’s decision highlights challenges in service availability that the Department continues to address. We welcome partnership with the Legislature, advocates, and others in finding solutions to support the needs of Maine children and families,” DHHS said in a statement.
Disability Rights Maine and the ACLU of Maine said in a statement Thursday that the Law Court’s decision is a victory for disabled parents and children, finding that families should not be separated when the state fails to provide legally required services and accommodations.
In challenging the termination last August, the organizations argued the state effectively punished the mother for the state’s own failure because she was unable to provide complex nursing care on her own.
“The parent-child relationship is one of the most fundamental, and the Constitution protects that right for all people, including people with disabilities,” said Carol Garvan, legal director with ACLU of Maine. “The state of Maine is now on notice from its highest court that there is no excuse for denying necessary services to parents and children, and that the state can no longer blame and punish families for the state’s own failures.”
The organizations’ amicus brief also raised the issue that the mother may be entitled to reasonable accommodations because of a possible intellectual disability.
Lauren Wille, managing attorney with Disability Rights Maine, said Wednesday’s decision is a long-overdue reminder that the department must accommodate parents with disabilities throughout the reunification process.
“Necessary services must be more than simply authorized,” Wille said. “They must actually be provided.”
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