AUGUSTA, Maine — A Biddeford company that runs group homes for people with developmental disabilities and brain injuries is appealing the state’s decision to end its contract with the agency after a client died in its care.
The Department of Health and Human Services earlier this week ended its agreement with Residential and Community Support Services that allows the agency, which runs group homes throughout much of southern Maine, to collect payments from MaineCare, the state’s version of Medicaid.
In addition to appealing the decision, the company on Friday also asked DHHS to keep the contract in place while the company’s appeal is reviewed.
In terminating the contract earlier this week, DHHS alleged the company failed to provide a resident with “critical” medication and did not call for emergency services when the same client had a medical emergency. The resident, identified by Residential and Community Support Services as a man with diabetes named Norman Fisher, 62, died in late August.
State law allows a service provider to request an informal review of an emergency termination within seven days of receiving notice. The Office of MaineCare Services is then responsible for conducting the review and issuing a decision. Residential and Community Support Services also has 30 days to request a formal administrative hearing. That hearing would be scheduled after all residents in its care have been removed, DHHS spokeswoman Jackie Farwell said.
The state’s decision to end its MaineCare agreement with Residential and Community Support Services means the organization will no longer be able to receive payments from MaineCare to care for clients. DHHS said it will continue to pay the organization until all residents find new housing. The company has contracted with DHHS since 2013 and recently began providing emergency housing for the department as well.
Kelly McDonald, an attorney representing Residential and Community Support Services, said DHHS failed to cite a specific standard or regulation the company did not meet before terminating its contract. The department’s decision to transfer the remaining residents “fails to accommodate the Members’ right to a location of its own choice and puts the health and safety of those Members at unreasonable risk,” he wrote in the appeal.
McDonald also said that transferring the patients out of Residential and Community Support Services residences before the termination decision is reviewed will “effectively” put the company out of business.
DHHS stood by its decision Friday and reiterated that there is an ongoing criminal investigation into Fisher’s death. Farwell said that two other Residential and Community Support Services residents died this year, but the department found no further action was necessary after investigating those deaths.
Angie Marquis, Residential’s clinical director, said the two men died in June and October after experiencing medical emergencies. Both had been hospitalized prior to their deaths, which meant they were no longer in the company’s care, Marquis said. She declined to specify at which of the company’s homes the men lived.
DHHS said its Adult Protective Services office opened an investigation into Residential and Community Support Services when it learned of Fisher’s death in August. His death was also the subject of a law enforcement investigation.
At the same time, DHHS conducted a program audit and required Residential and Community Support Services to submit a corrective plan. In the course of the audit, DHHS said it found the company’s staff failed to administer medications to other residents and did not demonstrate an effective quality management and monitoring program. The organization also failed to ensure that it met overall health care standards, the department alleged.
The company had 65 residents in its care as of Monday. The department had already transferred four residents to different residences. No new residents have been admitted since Aug. 30, according to DHHS.
Residential and Community Support Services said Wednesday that DHHS was at fault in Fisher’s death. The company said Fisher was transported by the department out of his previous residence without insulin and doctor’s orders, and with little documentation. The company said he died 72 hours after the transfer.
DHHS’ termination of the contract came after the company told the department it had failed “to properly safeguard the health and safety” of Fisher, McDonald said. He said the termination constituted retaliation against the company.
In 2017, a federal audit found DHHS, during then-Gov. Paul LePage’s administration, had failed to investigate the deaths of 133 people with developmental disabilities between January 2013 and June 2015. The audit also found the department only accepted 5 percent of suspected cases of medication errors; physical, verbal and sexual abuse of group home residents; and neglect and exploitation for investigations by the state’s Adult Protective Services division.
Since then, the department says it has made changes to its system, including entering each death involving a client who receives services into an electronic database that then triggers a report to DHHS’ Adult Protective Services division. It is also implementing a new requirement that one- and two-bed homes be licensed, and it has created a dedicated crisis intake phone line for adults with intellectual or developmental disabilities, autism and/or brain injuries.