Court master issues budget warning

AUGUSTA – Budget-trimming proposals under discussion at the State House have raised concerns from the court master overseeing the state’s compliance with a decree governing services for the mentally ill.

In a periodic update filed last week, former Maine supreme court Chief Justice Daniel Wathen noted that the Baldacci administration has called for $34 million in budget reductions for the coming two years, including $10 million in each year that would be saved by standardizing rates for mental health services paid by the Department of Health and Human Services.

As Wathen said in his report, state spending under the Medicaid program known as MaineCare is matched by federal spending in a ratio of about 2-1, so that cuts in spending on services resulting from the proposed state actions could be around $100 million.

“At a minimum,” Wathen wrote, “I am not convinced that such reductions could be accomplished so quickly without adversely affecting the department’s efforts to implement its comprehensive plan and achieve compliance with the settlement agreement.”

The court master went on to refer to a proposal to cap participation in a MaineCare program for low-income childless adults in an effort to save another $30 million.

“It should be noted,” Wathen wrote, “that in 2004 this program was one of two that the law Court suggested must be considered in evaluating “the good faith and seriousness of the state of Maine’s commitment to provide and improve institutionalized and community-based treatment for individuals with mental illness.”‘

Wathen said curbs on the program had already been imposed and that “this latest proposal would represent a further and more substantial withdrawal of program funding for community mental health services.”

Last fall, the state began implementing a newly approved plan to deliver mental health services in the state.

A 1990 consent decree resulted from a class action suit claiming that Maine had failed to provide adequate care for patients at Maine’s former state mental hospital, the Augusta Mental Health Institute. AMHI has been replaced by the Riverview Psychiatric Center, also in Augusta.

The new plan, which had been in the works since 2003, was designed to establish a new structure for mental health service delivery in Maine focusing on community service networks, performance requirements, flexible services and housing, and consumer councils and peer services.

The Legislature’s Appropriations Committee resumed its deliberations Monday.

Critics of human services reductions sought to emphasize their views, meanwhile, with a news conference in Portland. House Speaker Glenn Cummings, D-Portland, said the issue was a matter not only of economic fairness but also fiscal prudence.

“These costs will be passed to us one way or the other,” Cummings said, citing potential increases in insurance premiums for others if uninsured people receive uncompensated care.

Sen. Karl Turner, R-Cumberland, an Appropriations Committee panelist, said the long-term viability of the state’s social service safety net could be at risk.

“It’s pretty clear that our Medicaid system is way out of line … It’s not sustainable,” he warned.