Of all the sensitive, complex systems that state government is responsible for, few are as important as the one that makes sure children, many of whom live in poverty, get help for their mental and behavioral health diagnoses.
These are children with autism, developmental and intellectual disabilities, depression, extreme anxiety, histories of trauma and neglect, conduct disorders, post-traumatic stress, and a number of other disorders who need help getting to school, learning to communicate, and dealing with the challenges that life has dealt them.
Services for these children on Medicaid are important not just because they can’t fend for themselves but because early treatment can change the course of their trajectory, which often bends toward psychiatric institutions or incarceration.
It is also important for Maine government to ensure children have timely access to mental and behavioral health care because it’s the law.
Federal law requires that young people receive help “generally within an outer limit of 6 months after the request for screening services.” In addition, Maine has regulations spelling out in more detail how it will follow this law. And, after being sued twice over not ensuring timely access, it has told a judge it would follow the law.
But it hasn’t.
Recent reporting by the BDN found that more than 800 children are waiting for three different services in the home: non-specialized services under MaineCare Section 28, specialized services under MaineCare Section 28, and home- and community-based services under Section 65.
There is overlap between the lists. There are also additional services not represented here because they do not have centralized waiting lists.
While it’s not clear the exact number of children who have waited longer than six months for help, it is clear that many have. That’s why Disability Rights Maine has been negotiating with the Maine Department of Health and Human Services since the fall, in lieu of a lawsuit, to compel the department to comply with the law.
We hope that this approach of negotiations will work, and we appreciate the effort of both parties to find solutions. History offers reasons to be cautious, however, and we hope Disability Rights Maine will not hesitate to bring a lawsuit if it reaches an impasse. The legal route has proven useful in the past to hold the state to its obligations.
Indeed, much time has already passed while children wait.
Disability Rights Maine and other important advocates have stressed the importance of not just ensuring DHHS follows the law but creating a system of quality. Too often, they say, the help available — sometimes after waiting for months or years — is not enough. Medicaid reimbursement rates surely are part of the problem. Workforce shortages are a related, additional challenge.
We agree that Maine needs a plan to serve kids with mental and behavioral health needs. It needs a strategy that is funded.
But the government’s first, basic priority should be to follow the law. If it can’t do that, and help young people who are struggling to function, then what is it there for?
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