AUGUSTA, Maine — In the first salvo of what’s shaping up to be a protracted political battle over Republican Gov. Paul LePage’s $6.57 billion two-year budget, the Democratic House chairwoman of the Legislature’s Appropriations Committee said the proposal would “shred” Maine’s “safety net” for people with mental illness.
In a statement released late Thursday, Rep. Peggy Rotundo, D-Lewiston, said a proposal by LePage’s administration that would reduce by 10 percent the Medicaid reimbursement rates for outpatient mental health service providers, including counselors and psychologists, held “grave implications for public health and public safety.”
“It’s beyond irresponsible to play games with people’s lives and public safety like this,” Rotundo said. “The governor has presented us with a series of false choices. We do not need to pit one group against another.”
Rotundo said the reimbursement rate cuts, coupled with a shift that would reduce dramatically how much some mental health care providers are paid to manage patient medications, could be a crippling blow to those providers.
That could result in untreated mental health patients whose care would raise costs and stretch resources for other service providers.
Also Thursday, Tom McAdam, chief executive of Kennebec Behavioral Health, reminded lawmakers of a 1996 tragedy in Waterville in which a mentally ill man bludgeoned to death two elderly nuns and left two others severely injured.
At the time, McAdam said, the case galvanized the state’s mental health community and the Legislature.
“Frankly, many of us that are in the provider community are confused by some of the initiatives in this budget,” McAdam said. “Really, next to housing, for people to be successful, (medication) management — access to medication management — is important.”
Some Republican lawmakers criticized Rotundo on Friday, claiming that she violated an informal agreement to complete the public hearings on LePage’s budget proposal before taking their political gloves off.
Rep. Deborah Sanderson, R-Chelsea, called Rotundo’s comments “obviously, as disingenuous as they could possibly be.”
“Maybe they are making reductions to certain areas, but there is a huge investment being made in this budget for mental health services,” Sanderson said, citing the administration’s proposals to increase spending for mentally disabled residents of state-run institutions in Bangor and Augusta.
“We’ve got $40 million going toward the waitlists and some of that is certainly for folks with mental health illnesses,” Sanderson said. “To say that we are shredding the safety net … what they are doing, it appears to me, is picking at individual pieces and saying, ‘you are shredding the net,’ without looking at the comprehensive wrap-around programs that we are investing in that are going to actually treat the whole individual.”
Sen. James Hamper, R-Oxford, Senate chairman of the Appropriations Committee, said he was disappointed the attacks on the budget proposal were starting so soon.
“Because I think I’ve been pretty quiet and pretty even about the process,” Hamper said.
He countered accusations that LePage and Health and Human Services Commissioner Mary Mayhew were pitting vulnerable groups of Maine residents against one another.
Instead, he said, Democrats are pitting funding for services to disabled Mainers against other equally important parts of the budget.
“We have watched over the years how much of the state’s general fund budget DHHS has been absorbing,” Hamper said. “So you could say you are pitting DHHS and its expansion against everything else that the state budget does — transportation, education, the environment, everything else.”
LePage’s $6.57 billion budget proposal goes well beyond balancing the state’s books for the next two years, as required by the state constitution. The proposal includes sweeping reforms for the state’s tax system — cutting income taxes and expanding sales taxes. It also seeks to shift, in some cases dramatically, how the state spends its money.
As thick with policy reform as it is with financial reforms, the budget is meant to realign the state’s spending priorities with a focus on those with physical and developmental disabilities who have been left behind, stranded on waitlists for state-funded health care and other support services, the governor’s staff has said.
Until Rotundo’s statement Thursday, lawmakers from both parties — especially those serving on the traditionally cordial Appropriations Committee — have taken diplomatic and wait-and-see positions.
But after a week of testimony in opposition from immigrants, doctors, mental health professionals and advocates for poor, disabled and mentally ill Mainers, Rotundo and state Sen. Linda Valentino, D-Saco, issued some of the strongest-worded statements of the budget discussion so far, noting the harm they believe the budget would bring if enacted as is.
“These drastic cuts would prevent Mainers with mental illness from getting needed care and push them toward crisis,” Valentino, the Senate Democrat on the committee, said in a prepared statement. “Providing sufficient services is not only compassionate, it makes economic sense. Severely mentally ill people who cannot access the services they need often wind up in emergency rooms or in jail, much more expensive and traumatic experiences that can be avoided.”
Rep. Tom Winsor, R-Norway, the ranking House Republican on the budget committee, said he agreed the testimony this week may have revealed some of the flaws in LePage’s budget proposal, but he felt it was premature to start dismantling it.
“Our job, I think, is not to send out press releases,” Winsor said, “but to sit back and calmly look at what he’s trying to do.”
Winsor, who has served on the Appropriations Committee in the past, said its members should remain objective as they gather input on the governor’s budget proposal.
“All we can do is make our choices on the best information that we have,” Winsor said. “Hopefully we can come together and do it wisely and with respect for everybody.”