AUGUSTA, Maine — Agencies that provide services to people with mental health and substance abuse problems started to assess the impact Friday of $13.4 million in cuts to the state’s health and human services budget as part of a $35.5 million curtailment order issued this week by Gov. Paul LePage.
The cuts hit health and human services and local school aid — the two areas that account for the largest portion of state spending — hardest. The curtailment is a temporary measure designed to keep the state budget in balance amid revenue collections that have fallen short of earlier projections.
The $13.4 million in Department of Health and Human Services cuts include $2.2 million in funding reductions for state contracts with providers that serve people with substance abuse problems and mental illness.
Bonnie Smith, DHHS’ deputy commissioner for programs, said the department tried to find as many areas to cut as possible without eliminating services.
“That process went on in depth for many, many long days and nights. None of this was taken lightly,” she said. “We’re doing everything we can to make sure that services are not interrupted, that we’re not having people without services who are in need.”
DHHS booked many of its savings by leaving vacant positions unfilled and by tallying up savings from several contracts with service providers this year that have come in under budget. But the cuts to mental health and substance abuse service contracts will have an impact, said Guy Cousins, director of mental health and substance abuse services at DHHS.
“What we’re going to have to do is to try to help providers mitigate that to the best of their ability,” he said.
For most providers, Cousins said, the curtailment will cut about 5 percent of state contract funds they haven’t yet received for this budget year, which ends June 30.
“It’s the services that help support people as they move into the community or are already in the community and trying to build recovery supports around them,” Cousins said. “Strategically, we have to work as best we can to help providers continue providing support to the level that’s possible with the funding they have.”
That level of funding has continued to diminish in recent years, Cousins said, as mental health and substance abuse service providers have been affected by previous rounds of state budget cuts.
Service providers on Friday didn’t yet know the size of the cuts they might sustain or the exact services they would affect. Cousins said his office is finalizing those details and will send them to providers next week.
Greg Disy, CEO of the Aroostook Mental Health Center, said the cuts likely would affect people receiving services who don’t have health insurance coverage because they don’t qualify for government-funded Medicaid coverage and can’t afford private insurance.
For people with mental health issues, Disy said, those services help them find and maintain housing, develop independent living skills and find jobs. For people with substance abuse problems, the services include access to outpatient addiction treatment.
The Aroostook Mental Health Center, based in Caribou, serves nearly 5,000 clients at 20 locations in Aroostook, Washington and Hancock counties. “These cuts mean an impact on the most vulnerable citizens that we serve,” said Jamie Owens, the center’s marketing and development director.
At Maine Mental Health Connections in Bangor, which works with adults suffering from mental health and substance abuse issues, a cut to its contract with DHHS would be difficult to absorb, said Angie Brown, who runs the organization’s food pantry and social club programs.
“Every time something is taken away, it affects people in a lot of different ways,” she said. “You’re going to see a rise in transients. You’re going to see a rise in the homeless. I don’t know what they expect for these people to do.”
Maine Mental Health Connections works with about 1,300 adults in the Bangor area, connecting them with jobs and helping them develop independent living skills, Brown said.
Within the Department of Health and Human Services, programs that fall under the Office of Child and Family Services will absorb about a third of the department’s $13.4 million in cuts, said Therese Cahill-Low, the office’s director.
The department will cut $1.4 million from an account that provides subsidies to families that adopt children from state care. Most families that adopt children in state care receive a federal subsidy; the $1.4 million state cut will affect the third of adoptive families who receive the subsidy from state — rather than federal — funds.
The reduction will affect about 1,250 children who are living with 850 families, Cahill-Low said. They’ll see a 50 percent cut to their subsidy during April, May and June, the last three months of the budget year. The maximum subsidy, Cahill-Low said, is $26.25 daily per child.
“We really looked at where our priorities lie in serving the most vulnerable,” Cahill-Low said. Children who have already been adopted are “not as vulnerable as children who are currently in [state] care.”
In addition, she said, children who have been adopted from the state foster care system will continue to receive health insurance through MaineCare, the state’s Medicaid program.
When we stop paying for expenses incurred because of healthcare harm (ie, Healthcare associated infections, surgical complications, injuries because of falls in Hospitals and LTC, etc) I think there will be plenty of money to go around. Why are we consumers and our insurers paying for healthcare harm?
That is being focused on to a greater degree now.When we have a gov with a heart who isn’t beholden to ALEC there will be more money for those who need it.
So our Governor doesn’t have a heart because he doesn’t spend money we don’t have?
We’d have the money if the rich weren’t living high on the hog after Paulie gave them even more tax breaks that they don’t need instead of raising their taxes a bit.
You are obviously a layperson to make such an absurd statement. That is no different than saying…”When we stop paying for expenses incurred because of automobile harm, i.e. rollovers, tire blowouts, chest injuries from steering wheels, etc, etc, I think there will be plenty of money to go around.” When millions of people are receiving health care every day, and millions of people are driving everyday…there are these these things called “ACCIDENTS.” That’s precisely what insurance is there for.
I am an RN and a patient safety activist. People are harmed and some die every day as the result of Hospital care. When a patient enters the hospital, like I did a year ago, for surgery or another problem, they expect safe high quality care. I got that…I had a tremendous outcome from my surgery. That is not so for everybody. Some studies reveal that up to 1 in 4 patients suffers harm while being cared for in a Hospital. When a patient is harmed because the correct steps, or time out, our check list was not used, or an incorrect medicine was given, or nobody came to help them get out of bed and they fell, or they were infected because they were roomed with someone who had MRSA, or any number of other preventable healthcare blunders occurs, they (and their insurers) should not be billed for the additional expenses that are incurred because of the harm. This is a double whammy to patients. The patient endures additional suffering and sometimes even death, and then they or their family gets a bill for unnecessary and preventable expenses because of the harm??? This is cruel, absurd and must stop. When reimbursement for medical harm stops, I believe that our Hospitals will become safer. More money will be invested in safer care.
You don’t throw out the baby with the bath water. You endeavor to fix the problem not eliminate the (essential) service.
I was not implying that we elimiate the essential services…just that we make them safer.
I was not implying that we eliminate essential services, only that we make them safer.
I an also an RN who actively works a unit. When you speak of “time outs” and “unused check lists,” and that all harm is preventable, it sounds like you have worked in Admin. too long, and are out of touch with the reality of working on a unit. I hear nothing about staffing ratios in your post – you *should* know that is the core of the problem. The old “an ounce of prevention…” still holds, but that requires that elusive element known as “effective staffing levels.”
I am a member of MSNA and I am completely in agreement with you that RN to patient staffing shortages are a huge part of the patient safety problem. Please don’t misinterpret me. Also, I did not say that all harm is preventable, but you know as well as I do that much if not most of it is. The part of my comment that addressed falls is an obvious example of the risks of short staffing. One of the most common complaints of patients is.waiting for pain medication or not getting the attention or help they need quickly enough. Some of those patients get up on their own and fall. These complaints are a symptom of short staffing and it is unacceptable. I have stood in picket lines and spoken out publicly about the dangers of short staffing and the need for nurse to patient ratios, and I will again. I have never worked in administration and I never will. I am retired, and now I work strictly on patient safety issues. During my career, I was an ER and Walk in care nurse and I almost always worked short staffed. Good bedside nurses are the greatest asset we have in Patient Safety work. Thank you for the work that you do.
I understand your issues about patient care since they are also mine, and we have walked in the same shoes. I don’t agree that if insurers were able to stop reimbursement for harm or nosocomial infections, that more money would be invested in safer care though. The insurers would have no motivation to do so if they didn’t have to pay for the injuries/infections. Thank you for the work you’ve done, and your continued advocacy for patient safety and staffing ratios!
My belief is that Hospitals, not insurers, will invest more money in Patient Safety (part of that being safer staffing levels) if they are no longer paid for the costs associated with healthcare harm. I agree…insurers would not have motivation to do so…unfortunately, their greatest motivation is profit.
you will get more Lanzas in the world as long as you cut programs more shootings
So in other words, if they don’t get what they want, they will shoot people??
It means people with untreated mental illness could be a danger to themselves or others.
If we eliminated the substance abuse program, and put that money towards mental health, problem solved.
Are you suggesting that substance abuse is not a mental health problem?
At one time for these substance abusers it was a choice. If I choose to shoot myself in the foot, should everyone else pay for it? I think not. If I choose to do drugs, should everyone else pay for it? No, how silly to think they should. People with true mental/emotional illness should have resources. As a working taxpayer, I get damned sick and tired of my small salary going to take care of people who choose to poison themselves with drugs.
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The psychologists who treat these people would disagree with you on the choice issue. What is more we all make mistakes. As for your analogous example, if you chose to shoot yourself and did not have insurance, or lost your insurance because you couldn’t work due to your injury, everyone else would in fact pay for your bad choice. They’d pay for the ER, for your upkeep, your treatment, and if necessary your funeral. They wouldn’t pay a lot and as such your life would be substandard, perhaps even causing further mental disorder and pain. But in the end the public would have to CYA for your bad choice.
This example by iknow2much highlights one of the foremost problems regarding the cost of healthcare. What iknow2much and those who believe likewise don’t understand is that one way or another we all pay for healthcare. The uninsured, the addicted, the mentally handicapped (who may shoot people because of their illness), the abused, the sick/tired/homeless, all these people are eventually going to cost society for their treatment and it’s going to cost a lot. As they say, the best defense is an effective offense and that is true in these cases also. So iknow2much, you and your compatriots should try to understand that treatment of these illnesses and conditions BEFORE they become disastrous is always much cheaper than paying for these problems after they’ve festered, gotten worse, and ruined too many lives. So though I understand and appreciate your reluctance to pay for other people’s foibles and misfortunes, refusing to pay up front will only cost us all more later. Such an approach to dealing with these problems is penny wise and pound foolish! For the life of me I cannot understand why the conservatives refuse to acknowledge this fact!
substance abuse is a mental health diagnosis. Like it or not, substance abuse is a brain thing, not a because I something for nothing thing.
It means that if they aren’t properly diagnosed and treated, that this is what has, and probably will, continue to happen. So, we go from two angles, getting the guns off the streets, and getting them the necessary help. All of this, to protect, all of us. Not really rocket science.
Cutting programs that serve the addicted and mentally ill may work in the short term, but they just mean that we’re going to spend more money on ER vists, court time and prisons later.
Agreed! Pound foolish. DDPC will have no alternative but to increase beds. ( need to keep society safe)Taxpayers will have to suck up the costs for this. Oh well , perhaps jobs will be created.
Unfortunately a great many people just cannot understand (or admit!) the connection. This same disconnect is pervasive thru-out the GOP culture as evidenced by their opposition to universal healthcare in the US.
after the newtown tragedy about the only thing the pro-gun and anti-gun advocates agreed on was expanded and comprehensive mental health services.
We need to stop sweeping mental illness under the rug. Get the drug addicts, who chose to do drugs, off the mental health program. Then there would be more money to help the ones who really need it.
Does something make you think that dual diagnoses patients don’t “really need” care? Do you realize that mental illnesses can take years to accurately diagnose, and people often self-medicate to alleviate the symptoms. That’s why mental health programs and addiction programs are intertwined for so many people.
So where are the mental help people at the methadone clinics?
There is no funding! That is why they are not there. Gosh.
Patients are referred there from Clinicians, e.g. Psychiatrists and Psychiatric N.P.’s, since recipients need a prescription for methadone. The patients simply go to the Clinics to receive their meds., and for monitoring. They are also drug tested for illegal drugs, and are not allowed to participate if they are using. The Methadone Clinics work with the medical community (who gradually taper doses), and patients (ideally) have counseling services. Patients with all three factors in place have a better chance of recovery. Each person is different, and has an individual plan of care – our Governor and Mary Mayhew @ DHHS are playing Doctor, something they are immensely unqualified for.
The program is not being run the way you are claiming. It is a for profit company. I personally know many people who use this program. For over 10 yrs. Mainecare has been paying for one couple to participate in this program. After 10 years their dose is the same as when they started. I know one person who, against the clinics advice, took themselves off suboxin after being on it since 2001. Of the 20 sumodd people I know on the program none have been weened off the program. Again it is a for profit business. Do you really think they want to loose customers?
Captiin – if the world was a simple as you think it to be, we’d also be able to pick gumdrops off of trees and play in the chocolate river.
But the reasons why they agree are very different. The Pro-gun advocates, as history shows, have successfully directed attention of proposed gun laws towards an issue related to their uses; whereas, the anti-gun advocates are using this issue to legitimize tougher gun laws. It is a starting point, but both seek different directions, hopefully something can be done somehow to stop this. The same type of weapon was used in rage killings, within two weeks? Newtown, and the NY firefighters….something has got to change.
UNCONSCIONABLE!
Its going to be tough for everyone. Cuts have to be made. Substance abuse crap like the methadone clinics can go. People that are truly in need of mental health services will still get them. They need to make mental illness a top priority. Long term hospitals need to happen. This “entitlement” thing needs to come to an abrupt halt as well. As it is, they teach our young that they can have anything and everything with doing absolutely nothing for it. God forbid they should have to work for things. That would be discrimination, or being way to harsh, after all, today’s youth is just misunderstood. Example….. A kid breaks into an elderly ladies home and steals all her pain medicine, rapes her, and then beats her to near death. He didn’t do it on purpose, they totally misunderstood that he just wanted to do these things. He didn’t mean to harm anyone, he just wanted what he thought was fine for him to take, after all, we owe these kids that much. He probably had a rough childhood which is a good reason for these actions. (Just a scenario people, don’t get all worked up over it)
I’m quite sure that someone who has a mental health illness, doesn’t feel that it was an “entitlement”. And you blame, kids, and substance abuse, and people meaning well. What you don’t point a finger at is the refusal to do something about it, because, it costs money. Well, guess what? bombs and guns costs money too, and we have used plenty of them over the last 10 years.
Isn’t it ironic that our sociopath governor is using his own incompetence as a way to reduce the odds that he gets locked up.
Not a surprise.No cuts in the fat man’s office where there’s plenty of fat to trim.I hope those in need will be okay.I doubt things will get better until 2014 when we get a real Gov. again.
I asked why the govna gets to live in a mansion with servants and all the finest things, while his peasants are scrapping just to feed themselves. Nobody answered me. All they gave me was dislikes. How much does it cost to run the Blaine house? Why don’t we start cutting there?
That description should include the Obamas, Bidens and all. Be fair.
The article is about Maine. Trying to stay on topic.
Hey, it was just too easy to include Obamas and the other elected , Obama gave the VP and others, Raises on Thurs. Elected are Nationwide if you want to pick on Maine gov. then pick on the others.
I am sure he knows they all have to be “picked on”. They should start right at the top with the president and work their way down.
Your right it could.
It is a horrible answer though.
Two wrongs don’t make a right.
People need to stand up and demand ALL government entitlement spending be stopped.
No more free lunches for our public servants.
These people are paid for time spent -they can pay for vacations, transportation and meals just like the rest of us.
Cuts should be made starting with him and then his daughter’s pay. That’s only fair.
A friend has had to stop his counseling sessions because he can’t afford to pay the full cost now that cuts have been made. He also stopped all his medications. I can’t imagine what LaPage hopes to accomplish by cutting things that really hurt people, that previously had been helped. One of the big causes of so much gun violence is said to be caused by mental illness. Closing the state mental institutions certainly hurt the treatment of the mentally ill and put so many on the street. Why aren’t we doing more instead of less?
That is a tragedy. Some of those medications shouldn’t be suddenly stopped. I hope he will be okay and something can be done.
It just is not right to take medication, etc… from those who need it to function.
After 30 days in office, Ronald Reagan announced he would be cutting funding of the National Institute of Mental Health. He did not need congressional approval. 2 years later he dissected federal mental health programs into block grants, which states had to compete for, and were underfunded. The national mental health programs have never been the same since. Institutions were closed, health care centers locked, and people were put out onto the street with a prescription and a good luck wish.
Why does it take gun violence, homelessness, PTSD, and other impacts upon society as a whole, to do something differently than what was started over 20 years ago? You can’t buy it away, you can’t wish it away, you can’t out source it’s resolution.. It’s a national issue, it’s also a state issue, however, this is one issue that affects us nationally and should be treated and funded as such.