From psychiatric therapy to housing subsidies, from crisis intervention to special education, from wound care to vocational support to the management of high-risk pregnancies — Community Health and Counseling Services does it all.
This year, the Bangor-based agency marks its 125th anniversary, celebrating its growth from a local church-based charity with a budget of about $1,500 a year to one of the largest social service agencies in the state with offices in 17 communities, an eight-county service area, almost 700 employees and a budget this year of more than $41 million.
Gov. John Baldacci has declared Oct. 15 “Community Health and Counseling Services 125th Anniversary Day,” and both the Maine Senate and the Maine House of Representatives also have honored the agency. A number of communities served by CHCS have sent official messages of congratulation and recognition, and business leaders, government officials and social advocates are expected to pony up big time for an upcoming gala dinner and fundraiser to benefit the organization.
There are rumors that Joe Pickering, the agency’s sometimes-irascible executive director for the past 30 years, will be the target of more than a few barbs and jests at that anniversary dinner as he prepares for his anticipated retirement in December. (Caution: In a recent conversation, Pickering warned that “those who roast are toast.”)
Mental versus physical?
CHCS is one of just a few agencies nationwide that provide both home health care — including hospice care — and comprehensive mental health services. The two departments inhabit separate sections in the imposing compound of historic buildings the CHCS home office occupies on Cedar Street in Bangor, and their respective budget streams and reporting requirements flow in separate channels.
The division between the two departments is emblematic of what Pickering says is a “superficial” schism in public perceptions of health care.
“When we talk about mental illness, we’re talking about a brain disorder,” he said. “Schizophrenia is a brain disorder. Bipolar is a brain disorder. Severe depression is a brain disorder. And yet we’re all caught up in this notion that a mental health problem is not a physical problem. It does a great disservice to public understanding of mental illness and a great disservice to the people who have these disorders.”
Nonetheless, until more enlightened minds prevail, CHCS offers the two distinct branches of health care services. On the home health and hospice side, nurses and other direct-care professionals make regular visits to patients of all ages who need more care than their families can provide, but who don’t need to get that care in a hospital setting. Intravenous pain control, cardiac care, chemotherapy, nutritional assessments, post-surgical care and myriad other services are provided, including homemaking services, physical therapy and diabetes education. Advanced wound care is a specialty, as are the specialized comfort and support services associated with the end of life.
On the mental health side, the services are even more diverse. A legion of social workers, psychologists, psychiatrists, case managers, crisis interventionists, foster care specialists and other professionals offer their services to adults, children and families in private homes, in group homes and shelters, and in clinical offices located at the Cedar Street headquarters and other sites throughout the agency’s service area.
In the Bangor area, one of Maine’s few Assertive Community Treatment, or ACT, teams is available every day to make sure especially hard-to-manage clients take their psychoactive medications, show up for therapy sessions, comply with the activities that keep them functioning safely in society and out of hospitals or correctional facilities.
In Brewer, CHCS manages an eight-bed crisis stabilization center that offers a safe place to stay and counseling services to adults over 18 who are experiencing acute mental health difficulties. A nearby apartment complex provides affordable longer-term housing for people with chronic mental health diagnoses with on-site staff available to help as needed.
CHCS also runs Stillwater Academy in Brewer, a private school for young people from 5 to 20 years old whose performance in public schools has been affected by “emotional, social, behavioral and developmental challenges,” according to its brochure. The agency manages 11 supervised group homes for adults and children with mental illness and provides a variety of other housing support and subsidy programs.
Challenges now and ahead
About 65 percent of the total CHCS budget comes from MaineCare, the state- and federally funded Medicaid program for low-income and disabled individuals. Another 15 percent comes from Medicare, the federal health care program for the elderly and disabled, while the remaining 20 percent comes from state and federal grant programs and other sources.
Recent state budget cutbacks and other changes in MaineCare funding for community-based mental health services have seriously affected CHCS and the population it serves. Citing just one example, Pickering said that a $2 million cut in the current MaineCare budget for mental health services provided to children in therapeutic foster care has not only negatively affected children and their families, but also resulted in the loss of 47 full- and part-time jobs at CHCS.
Pickering said such changes reflect inadequate planning at the state level and a lack of appreciation for the importance of mental health services. Also, he said, while the state is trying to save money by cutting funding to agencies like CHCS, policy-makers have failed to take into account the economic impact of agency job losses, not only at CHCS but across the agency sector.
“There have been several thousand jobs lost [due to the budget cuts], and no one is looking at the true economic costs or the true human costs,” he said. “The budgeting process is not the place to plan.”
Pickering said Maine should be proud of its high ranking in a recent state-to-state comparison of mental health services conducted by the National Alliance on Mental Illness.
“There are desperate conditions [in Maine],” he said. “It’s not a question of whether the taxpayer will pay; it’s a question of how much do they want to pay.” Acknowledging that the Bangor area attracts those in need of mental health services, he said it is cheaper and more effective to support people in the community setting than in institutions.
Despite the many challenges to providing medical and mental health services, Pickering said community-based agencies like CHCS would continue to serve the people of Maine.
“Community health agencies are the mainstay of human services throughout the state,” he said. “The services they provide are cost-effective and valuable to so many Mainers. They are an incredibly important part of the Maine economy. They are one of Maine’s greatest hidden treasures, and they should be valued and supported.”
Tickets to the 125th CHCS celebration dinner and roast are available by calling Diane Nelson at 947-0366, ext. 260.
On the Web: www.chcs-me.org