Child advocates say proposed rule changes by the Maine Department of Health and Human Services would cause some children with disabilities to lose access to Medicaid services.

The department is seeking changes to a portion of the Medicaid program that offers behavioral and developmental services for children. Lindsay Hammes, a spokesperson for DHHS, said in a statement that the intent is to “update outdated references and clarify vague language” in the existing rules.

Nancy Cronin, executive director of the Maine Developmental Disabilities Council, and others have warned that the move would reduce eligibility. Cronin said the proposed changes would leave children with certain diagnoses, such as attention deficit disorder and cerebral palsy, ineligible for services.

Erica Boudette, children’s program coordinator for Choices Are For Everyone, Inc., a Westbrook nonprofit, said she believes six of the 15 children in the program she oversees would likely lose services if the revisions take effect.

“What they are proposing would make it much harder to qualify for services,” Boudette said. “This has a high likelihood of putting a lot of kids in crisis.”

The agency is limited in what it can say because state law restricts officials from commenting about pending rule changes, Hammes said in a written response to questions. She said DHHS realizes that “there are some aspects of the proposed rules” that “will require clarification and revision to align with the department’s intent.”

DHHS has held two public hearings on the proposed changes and is accepting written comments through Friday. The department is expected to make a decision on the rule changes by the end of April, Hammes said.

A public notice says the rule changes are intended to comply with a November 2024 settlement agreement between the U.S. Department of Justice and Maine DHHS that aims to improve access to Medicaid services for children. The Justice Department filed a lawsuit against Maine in September 2024 for failing to provide adequate services for children with behavioral health disabilities.

Services offered under the program, known as Section 28, help children learn social and life skills, such as ordering food at restaurants, how to listen and how to interact with other children.

Thousands of children in Maine receive those services, Cronin said. How many could lose the benefits is unclear but the changes would not impact the benefits for children with autism and intellectual disabilities, she said.

“These services literally provide the gateway for these children on how to interact and live in the world,” Cronin said. “It’s learning how to communicate, for example how to not run away when you’re asked what you need.”

She said the services “are the treatments that prevent kids from being stuck in emergency rooms with mental health crises.”

Amanda Blake, of Glenburn, said her 4-year-old son, Atlas, has attention deficit disorder and receives Section 28 services, which have helped him with his impulse control and social skills. Blake said she doesn’t know what she would do if her son no longer qualified.

“He’s gifted academically, but he has no idea if someone is angry or scared because he can’t read faces,” Blake said. “The therapy has really helped him relate to his peers.”

Carrie Woodcock, executive director of the Maine Parent Federation advocacy group, said the rule changes would go against the goal of the 2024 Department of Justice consent agreement, which was to improve access.

“It doesn’t make any sense to do this,” Woodcock said.