AUGUSTA, Maine — Gov. Janet Mills dedicated parts of her $127 million spending plan toward programs in the Maine Department of Health and Human Services, but her administration is resisting bigger-money bids in the Legislature to fund expensive waitlists.
Lobbying for parts of the Democratic governor’s spending plan has kicked off in earnest this week as the Legislature’s budget began hearings on the proposal on Tuesday. Agencies are competing amid high-priority requests for more education and transportation funding.
At the same time, the Mills administration has been resisting two legislative efforts to inject money into expensive programs with waitlists — one that serves adults with intellectual disabilities or autism and another for children with behavioral health disorders.
Two policy experts say those on the waitlists will suffer if the department doesn’t pursue an interim measure for Section 29, a waiver program funded by state and federal Medicaid dollars that provides home and community support to eligible recipients, and the more-expensive Section 21, which provides more comprehensive services that include housing.
The Mills administration opposes a bill from Sen. Rebecca Millett, D-Cape Elizabeth, to reduce both waitlists over time, saying the department is considering a change to put waiver recipients on a more flexible, lifelong waiver. The department has argued fully funding the current system would “cast it in concrete.”
It’s been estimated it would take up to $80 million more to fund the waitlists completely, while the Mills administration has proposed $2.6 million in the supplemental budget that it says will eliminate a Section 29 waitlist with 368 people on it as of Jan. 1 even after the state funded an additional 167 slots last year.
But Alan Cobo-Lewis, who directs the University of Maine’s Center for Community Inclusion and Disability Studies, estimated the supplemental funding would only reduce the waitlist by half. He said waiver-eligible recipients would backslide without services, echoing the arguments of parents who have argued for funding before the Legislature.
“The concept that people will get nothing while the state redesigns the system, that’s unacceptable,” Cobo-Lewis said. “There’s a higher need here.”
The department had a similar opinion on a measure from Rep. Lori Gramlich, D-Old Orchard Beach, to raise rates paid to providers of adolescent residential services and substance use treatment facilities under MaineCare, the state’s Medicaid program, whose director said the department does not support “major changes” until it completes a comprehensive rate review of its rates.
MaineCare Service director Michelle Probert said finding “a rational reimbursement methodology” is in the state’s best interest, but that may not be completed until March 2021, according to request for proposal documents.
Malory Shaughnessy, executive director of the Maine Behavioral Health Foundation, said there “won’t be providers left” to provide specialized, intensive treatments for children with behavioral health disorders if the department doesn’t raise its rates. The state has 500 children now waiting for home- and community-based therapies.
“We’re going to be in a world of hurt if we don’t invest something now,” Shaughnessy said.