AUGUSTA — Lawmakers struck a bipartisan compromise Wednesday aimed at “softening” the transition of mentally ill patients at risk of losing some of the community-based services they currently receive under MaineCare.

The compromise came less than a week after an estimated 300 people converged on the State House to warn that proposed changes to a part of the MaineCare program known as Section 17 could lead to more hospitalizations, suicides or incarcerations of people with chronic mental disorders.

The proposal, which received unanimous committee support Wednesday, would direct the Maine Department of Health and Human Services to extend the transition period from 90 days to 120 days for clients now receiving help from case managers assigned to help them with daily living.

But committee members also directed the department to offer additional 90-day extensions – through June 30, 2017 – if clients can “reasonably demonstrate” that they would be unable to access other programs within MaineCare. Additionally, Section 17 clients now receiving rental assistance would be grandfathered.

DHHS representatives were involved in the negotiations. If the committee’s resolve is passed by the full Legislature – a likely outcome given the unanimous vote – the department would be required to change the rules.

“Obviously we stand by the original rules and the process we went through, but what’s included in the resolve will not hurt the integrity of the program,” DHHS spokeswoman Samantha Edwards said Wednesday evening.

Mary Lou Dyer, managing director of the Maine Association of Community Services Providers, was pleased about the extended transition period and the opportunities for additional extensions. She praised members of the Legislature’s Health and Human Services Committee for working in a bipartisan fashion to address the concerns.

“The committee members … obviously took into account all of the testimony they heard last week over 8½ hours,” Dyer said. “Clearly, the people coming to share their important stories were heard.”

Lawmakers spent much of Tuesday holed up in private meetings trying to respond to those concerns. The consensus reflected in the proposal contrasts with the partisan positions staked out on some other social services and welfare issues before the committee this year.

“Our time was certainly, I believe, well spent in making sure that there is an alleviation of some of the angst that was surrounding this,” said Rep. Deborah Sanderson, R-Chelsea. “There is now an understanding that, going forward, there is a soft landing, there is no threat to total loss of services and there is a commitment on the part of the department to make sure that appropriate services are going to be received in an appropriate amount of time.”

Under new rules scheduled to take effect Friday, the “community support services” now offered under Section 17 would be restricted to patients with schizophrenia disorders or who meet several key criteria. Community support services include such activities as transportation for grocery shopping trips and assistance in dressing and managing medications.

According to DHHS, the number of clients receiving services for depression, post-traumatic stress disorder and anxiety have ballooned by 50 percent in five years. Department officials argued the changes were necessary to better target such “high-intensity services” to patients with serious and persistent mental illnesses, such as schizophrenia.

Patients with less intensive needs would be redirected toward other MaineCare programs more appropriate to their needs. And the department’s new rules would allow continued services for individuals who have received treatment at a psychiatric hospital within the past two years or who doctors attest are at risk of homelessness, hospitalization, residential treatment or committing a crime because they lack assistance.

But mental health service providers and clients raised concerns during last week’s public hearing that many people could fall through the cracks, causing them to lose services they need to cope with their mental disorder.

Rep. Drew Gattine, a Westbrook Democrat who co-chairs the committee, said the June 30, 2017, cutoff date for continuation of services will allow lawmakers to see what happens to current Section 17 clients who are deemed ineligible for the services.

“If we pass this resolve, we are going to give this an opportunity to be as successful as possible,” Gattine said. “And if it’s not, we’ll be able to see more clearly where the rough spots are and continue to work on them.”

Sen. Eric Brakey, an Auburn Republican who serves as the other committee co-chair, said the proposed changes will provide a “softer landing” for those transitioning out of the program.

“Any time you have such a contentious issue and you can get a unanimous (committee) report, that’s good,” Brakey said.

The department’s changes to the Section 17 eligibility rules were cited by one provider, Merrymeeting Behavioral Health Associates, as the reason it closed its doors in anticipation of losing many of its clients. The Brunswick services provider had originally told employees it would close on April 8 – the date the new rules take effect – but actually closed last Friday.

DHHS officials estimate that about 50 of Merrymeeting’s 500 clients would eventually be affected by the changes to Section 17. But state officials and former Merrymeeting employees also have publicly questioned claims from Merrymeeting that the rule changes caused the closure, saying that the agency had not suffered any cutbacks yet so there wouldn’t have been any immediate reductions in revenue.

 

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