March 10, 2013

Dental clinic's funding cutoff stirs backlash

Clinical Services, which serves mentally ill people from across Maine, will close in June if its budget is not restored.

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

PORTLAND - Portland legislators are leading a push to preserve a state-funded dental clinic in the city that serves more than 3,000 mentally ill and intellectually disabled people across southern Maine.

click image to enlarge

Dental hygienist Torey Richard cleans a patient’s teeth at Clinical Services. Closing the clinic will ultimately prove more costly for the state, said Rep. Denise Harlow.

John Ewing/Staff Photographer

Clinical Services at 63 Preble St. is scheduled to close in June because its funding was eliminated in the 2014-2015 biennial state budget proposed by Gov. Paul LePage.

The sudden decision to close the clinic shocked many of its patients, their family members and clinic employees, including its longtime dentist, who has resigned to take a job elsewhere.

Rep. Ben Chipman, I-Portland, is among several Portland legislators and others who are sponsoring a bill that would appropriate $1.6 million to keep the clinic's doors open for two more years.

"The clinic is not only important to Portland, it's important to the whole state" Chipman said Friday. "It just happens to be in Portland."

The Legislature's Health and Human Services Committee will hold a public hearing on L.D. 499 at 1 p.m. Wednesday.

Chipman plans to speak at the hearing. When he visited the clinic recently, he met family members of a young man from Fairfield, near Waterville. Like many of the clinic's patients, who have various behavioral, cognitive and physical disabilities, the man requires sedation and specialized dental care delivered with both compassion and understanding.

"The family was pleading with me to keep the clinic open," Chipman said. "They said they didn't mind driving down from Fairfield, but they didn't know what they would do if the clinic closed. It really hit me how important this clinic is to many Mainers."

If legislators decide to restore funding for the clinic, it will be too late for Timothy Towle, who has been the clinic's dentist for nearly 20 years. Towle has accepted a position at another dental practice, according to members of the clinic's seven-person staff. His last day will be Thursday.

Towle didn't respond Friday to a request for an interview.

The planned elimination of the $800,000-a-year dental program is among $52 million in cuts that the LePage administration has proposed for the Department of Health and Human Services in a two-year, $6.2 billion state budget that starts July 1.

The clinic opened in 1996 as an arm of the Augusta Mental Health Institute to serve patients who moved out of the institution and former residents of the former Pineland Center in New Gloucester, clinic staffers said. When AMHI closed in 2004 and was replaced by Riverview Psychiatric Center, the clinic became an arm of the new facility.

The governor and his staff decided to eliminate funding for the dental clinic because it was part of Riverview's budget, according to a written statement from DHHS spokesman John Martins.

"The operation of a dental clinic was not closely aligned with the mission of a state psychiatric hospital," Martins said. "This is one of the difficult but necessary decisions that have been made in order to maintain priority services."

However, the clinic's link to Riverview has filled a dental-care coverage gap for its patients, all of whom receive MaineCare, the state's version of Medicaid.

While MaineCare doesn't cover routine dentistry such as cleanings and fillings for most people, the clinic can bill MaineCare because it's considered part of a hospital, clinic staffers said.

MaineCare does cover emergency dentistry, which addresses pain or infection, but many dentists won't accept MaineCare patients because the program reimburses dental care so poorly, clinic staffers said.

"If this clinic closes, its patients will be going to hospital emergency rooms and we'll wind up paying twice as much on the other end," said Rep. Denise Harlow, D-Portland, who presented the bill. "Dental care is basic health care. We should be helping people get the care they need, not casting them aside."

Sonya White of Scarborough worries that her daughter will be one of those cast aside.

At age 70, White has spent most of her life fighting to get proper care for her daughter Sandy, 50, who was born with profound mental disabilities, is nonverbal, has seizures and uses a wheelchair.

Sandy was a resident of the Pineland Center for 23 years and now lives at a residential nursing facility in Scarborough. She resists dental care, even gentle cleanings, if she's not sedated.

"I'm so upset over this," White said. "It's the only place someone like my daughter can go for dental care. People just don't understand. She's human. She has feelings. She deserves better than this."

Kelley Bouchard can be contacted at 791-6328 or at:



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