AUGUSTA, Maine — One of the most controversial cuts in Gov. Paul LePage’s proposal to overhaul MaineCare hit a roadblock Tuesday after Republican lawmakers refused to back the plan.
Rep. Patrick Flood, House chairman of the Legislature’s Appropriations Committee, said his colleagues oppose the governor’s proposal to save $60 million by eliminating funding for private nonmedical institutions, facilities that serve the elderly, the mentally and physically disabled and patients of substance abuse treatment programs.
The PNMI cut is among the largest LePage is proposing to close an estimated $220 million shortfall in the Department of Health and Human Services budget. Flood said the GOP caucus has agreed it won’t support the PNMI cut and will work with the administration to find another solution.
“We can’t support the proposal as provided,” he said.
Flood spoke at the second of two work sessions on LePage’s proposal held by the Appropriations and Health and Human Services committees to determine its economic and public health impacts. About 6,000 people would be affected by the PNMI cuts, including 4,000 elderly residents who would need to find new housing if Maine’s PNMIs are forced to close. Under the plan, funding for the institutions would cease July 1.
At public hearings last month that packed the State House, many singled out the PNMI cut as a serious threat to the state’s most vulnerable residents.
The LePage administration has said federal officials don’t approve of the state’s funding model for PNMIs, putting matching federal money at risk. The governor has recognized “all along” that an alternative would be needed, Adrienne Bennett, a spokeswoman for LePage, said in a statement.
“That is why he set aside $39 million in the budget stabilization fund that is available for the Legislature to use as they explore alternatives,” she said.
The statement drew the ire of Democrats, who accused the governor of using the PNMI proposal as a “bargaining chip in budget negotiations.”
“Twenty-five percent of his proposal is fiction,” Rep. John Martin, D-Eagle Lake, a veteran member of the panel, said in a statement. “Last week, the governor came to our committee demanding that we work faster to rubber stamp his devastating proposal, and now he admits he never intended those cuts to go forward. He’s playing a dangerous game of chicken.”
On Dec. 20, LePage made the unusual move of dropping by the first work session on the DHHS budget, saying during a break that lawmakers’ questions to DHHS Commissioner Mary Mayhew were unproductive.
LePage’s plan calls for tightening eligibility guidelines, eliminating services and repealing coverage for 65,000 recipients to bring MaineCare closer to national averages for the public health benefits.
Without his proposed reforms, MaineCare will run out of money by April 1, LePage has said.
Eliminating funding for PNMIs and dropping childless adults from the MaineCare rolls, another rollback in LePage’s proposal, would affect more than 1,000 of the state’s most mentally ill patients, Guy Cousins, head of the DHHS Office of Adult Mental Health Services, told lawmakers Tuesday. More than 180 individuals with poor impulse and anger control, among other problems, would be released into the community without supervision, he said. That includes some who pose a threat to the public and many with a history of criminal behavior, from trespassing to homicide, Cousins testified.
Nearly 500 childless adults would lose access to mental health services, he said. “This will create significant individual and public safety issues and require higher level services to continue to maintain safety,” Cousins testified.
Cousins addressed lawmakers to explain the MaineCare proposal’s impact on those with “severe and persistent mental illness.” That population is protected under a 1989 agreement that settled a class-action lawsuit filed by patients at the Augusta Mental Health Institute. Known as the AMHI consent decree, the agreement called for improving services and shifting more patient care to community settings.
Lawmakers will meet again on Friday to further analyze the DHHS budget shortfall. Committee members expect to parse how much of the budget gap is caused by one-time expenditures versus structural deficiencies.