AUGUSTA, Maine — It’s an issue that likely will cause the new Legislature and administration some heartburn. It’s how to pay for needed services for Maine children who suffer from mental illness or learning disabilities.
Education Commissioner Angela Faherty and Brenda Harvey, the commissioner of Health and Human Services, were questioned Monday by members of the Legislature’s Education Committee about changes in the Child Development Services system being implemented this year that determine how services are financed.
“That is the essential question that keeps coming up,” Faherty said. “It is the most important question. Whether or not they get services is determined by the eligibility criteria under the education act. If [services] are not medically necessary, they cannot be reimbursed by Mainecare.”
That difference can mean a lot of money to local school districts because Mainecare, the state’s name for Medicaid, gets roughly two federal dollars for every state or local dollar. The services must be provided, so if they are not reimbursable under Mainecare, local schools must pay the entire bill.
“The services will be provided,” Faherty said. “The question is how they are paid for.”
New state rules were implemented in September to meet federal requirements, but several school districts told lawmakers they cannot get answers to questions and have not received reimbursement for bills they have submitted to DHHS under the new computer bill paying system that went online Sept. 1.
“I just get a sense from a lot of school districts, especially small school districts, that they feel very unprepared,” said Rep. Patricia Sutherland, D-Chapman, House co-chairwoman of the committee. She questioned Jaci Holmes from DOE on the implementation process and whether the state agencies have heard from the schools about their frustration with the process.
“We are flying the plane and we are modifying the engines at the same time,” Holmes said. She said her agency and her counterpart at DHHS have been dealing with questions from school districts. DHHS Commissioner Harvey agreed that while questions have been answered, she would have staff review the list of school districts that say they have unanswered questions.
“I don’t know how to answer a generic question about people not getting their questions answered,” she said. “We will make calls this week to those districts that have said they are not getting their questions answered.”
While some representatives of school districts told committee members they are not getting their questions answered, others are worried about penalties if they do not file claims under the new system.
“If we do not bill for services that should be billable, we will be penalized,” said Frank Sherburne, superintendent of RSU 57 in the Waterboro area. “One of the things we have debated since I have become superintendent is whether we should continue to bill, because it is a very paper-heavy bureaucratic way to get money. But if we don’t, we are penalized. We are stuck between a rock and a hard place.”
Timothy Luff, director of Special Services in the Oxford Hills area, said while his questions have been answered, his concern is the slowness of getting paid. He said the school district received about $548,000 last year, but has received no reimbursement so far this year.
“We are actually billing at this point, but we have yet to receive any payments, and it has been more than 30 days since we submitted our first bill,” he said.
Luff said uncertainty among special education directors has resulted in several districts delaying their submission of bills to DHHS.
Sen. Justin Alfond, D-Portland, co-chairman of the panel, said lawmakers have a lot of questions about CDS, and they look forward to the changes that will be proposed in the supplemental budget.
“It’s clear we have more work to do,” he said.
A study released in September found the problem of children with learning disabilities should be addressed early, but many children’s issues are not being diagnosed until they start school.
Only 22 percent of Maine children are being screened before starting school, according to U.S. Census data. In the last school year, 812 children were first identified as needing special services when they started school. There already were 875 children receiving services through CDS.