Agencies that serve mentally ill clients say they’re worried about potential cutbacks to MaineCare reimbursements that could slash services for about 30,000 people.

“The whole mental health community is in a panic,” said Rep. Drew Gattine, D-Westbrook, and co-chair of the health and human services committee.

A Maine Department of Health and Human Services spokeswoman said no decisions have been made on reimbursement rates, which are still being studied.

One agency, Merrymeeting Behavioral Health Services in Brunswick, announced Monday that it was closing in April based on a separate decision by DHHS – not related to reimbursement rates – to restrict services for mental health patients needing community support, according to a Merrymeeting employee. About 180 people will lose their jobs, according to WCSH TV.

Jenna Mehnert, executive director of the Maine chapter of the National Alliance on Mental Illness, said the proposals, as presented by DHHS consultant Burns and Associates Inc., would debilitate community-based mental health services in Maine.

“This is not a plan. This is sucking the money out of mental health services,” Mehnert said.

But Samantha Edwards, a spokeswoman for Maine DHHS, said Burns and Associates has merely done a rate study, and that the department is still gathering input for the reimbursement rates on a number of mental health services.

“Since the department has not completed its review – nor proposed final rates – it would be premature to discuss the draft rates in detail,” Edwards said in a statement. “The department is eager to receive feedback … and looks forward to thoroughly considering, and responding to, all substantive comments submitted.”

The proposal comes at a time when many national experts are calling for an increase in mental health services.

Dale Hamilton, executive director of Community Health and Counseling Services, a Bangor-based mental health agency, said he was present when DHHS rolled out the consultant’s rate study on March 14, but he doesn’t know if the state is committed to the rate cutbacks, which could be 20 percent to 40 percent for some services. For instance, case management for troubled youth could be cut by 31.5 percent, according to an analysis of the proposal by the Maine Council of Child and Adolescent Psychiatry.

“What has been proposed would be pretty drastic,” said Hamilton, who estimated 30,000 people would be affected by the changes. “But they may come back with revised rates.”


Separately, Maine DHHS announced in mid-March that there would be new restrictions on community support services for mentally ill patients, under Section 17 in the MaineCare code. MaineCare is the state’s name for Medicaid, which is operated by the states and funded with federal and state dollars.

Mentally ill patients who had been receiving community support would be barred from receiving Section 17 services unless they had schizophrenia or a similar disorder or successfully appealed to DHHS.

Community support services help mentally ill patients with daily living – such as buying groceries, reminding them to take medications, bringing them out in social settings and doing laundry.

DHHS does have an appeal process so nonschizophrenic patients could still receive Section 17 services if their doctor writes an appeal letter and the agency approves it.

Mary Beth Freeman, a mental health rehabilitation technician for Merrymeeting, said employees were notified Monday that the agency would close in April because of the Section 17 changes. Freeman said they received a letter from the agency and there was an emergency staff meeting.

Merrymeeting officials declined to comment when contacted Tuesday.

Freeman said she has 20 clients that she helps with daily tasks, and she said they will be put in a precarious position when they lose their services.

“They will end up in crisis,” Freeman said. “They will end up in the hospital. What we’re doing is helping them maintain their independence.”

Freeman said part of the social worker’s job is teaching clients coping skills, which will be eliminated by program cutbacks.

Don Hinds, 67, of Brunswick and a Merrymeeting client of Freeman’s, said he has post-traumatic stress disorder and severe depression and needs help to function.

“I am really ticked off and frustrated,” Hinds said. “They’re going to take away something that means everything to me.”

Donna Deigan, 49, of Brunswick, also a Merrymeeting client, said that she has PTSD, bipolar, anxiety and obsessive-compulsive disorder, and the cutbacks will have negative consequences on her life.

“They get me out in the community and socializing with other people,” Deigan said. “Sometimes I just need someone to play cards with and help me focus.”

Health and Human Services Commissioner Mary Mayhew has previously told the Press Herald that those who need Section 17 help will still receive services. But she said many people don’t need Section 17 services, which are unlimited. People who need less intense help than Section 17 services allow can receive scaled-back help from other MaineCare services, Mayhew has said.


Gattine, who believes substantial reimbursement rate cuts are likely, said that the health and human services committee, on a 6-5 party-line vote with Democrats in support, recommended a bill Tuesday that would lead to a moratorium on changes to reimbursements for mental health services. The moratorium would expire April 1, 2017.

Currently, the administration can reduce reimbursement rates without the Legislature’s approval, Gattine said.

“We can’t afford to go backwards,” he said. “Maine has spent the past 40 years building a mental health system. These would be devastating cuts to our mental health safety net.”

The Department of Health and Human Services has paid Burns & Associates Inc. over $520,000 for actuarial analysis studies since 2013, according to state spending data. The Phoenix-based company has performed a number of analyses for other states, including a 2011 report concerning Vermont’s decision to develop a health insurance exchange under the Affordable Care Act.

Stephen Pawlowski, a senior budget analyst for former Arizona Gov. Janet Napolitano, a Democrat, has conducted most of the analyses for Maine, according to reports and webinars published on the company’s website.

Staff Writer Steve Mistler contributed to this report.


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