Cuts to DHHS programs place many at risk

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AUGUSTA – The list of recent cuts in Maine’s medical, mental health and social services is a long one, but on Wednesday the Legislature’s Health and Human Services Committee heard them all.

Faces in the committee room were somber as Brenda Harvey, commissioner of the Maine Department of Health and Human Services, read through 11 pages of “curtailments” – most already in effect – that were demanded last month by the Baldacci administration to help the state end the current fiscal year with a balanced budget.

The cuts include:

. Mental health counseling for abused children.

. Assistance for victims of domestic violence.

. Health care services to help frail elderly people keep living in their homes.

. Respite for foster parents caring for special-needs children.

. Support for families affected by Alzheimer’s disease.

. Funding for the Special Olympics.

Altogether, more than $13 million of the $38 million total curtailment target has been cut from the DHHS budget, eliminating or reducing funding for dozens of programs that serve thousands of Maine residents every day.

Most of the cuts are expected to be incorporated into the supplemental budget under review at the State House and will likely set the stage for a significantly leaner, meaner DHHS budget next year and over the next decade, said the committee’s House chairman, Anne Perry, D-Calais.

“This is a really tough time,” Perry said after the committee briefing. “This is not a one-time loss; it’s a long-term economic resource issue.”

The loss of well-paid Maine jobs and the influence of global economics don’t bode well for tax revenues, she said, and at the same time they drive up demand for public services. Despite ongoing efforts to ramp up the state’s economy, Perry added, she’s “not feeling very optimistic” that things will improve.

Hardest hit by the recent reductions are Mainers who have just a little too much money to qualify for MaineCare, the state’s Medicaid program. Under the cuts, adults and children in this low-income population have lost coverage to mental health services, medical care, substance abuse treatment and other basic services.

Senior citizens and their families also bear the brunt of the cuts, with deep cuts in elder day care programs, home nursing and housekeeping services, Alzheimer’s support and other programs.

Some of the cuts are relatively small. State support for Pine Tree Legal Assistance, which provides legal advice and services to the low-income populations, was eliminated, saving $15,220. Defunding the Special Olympics shaved $10,000 out of the year-end budget. The statewide Maine AIDS Alliance got whacked for $10,250.

More dramatic savings of $392,911 were achieved by capping enrollment in a special Medicaid waiver program that provides services to low-income adults without dependent children. Enrollment, currently about 19,000, is expected to drop to 15,000 by June 2008 and to 12,500 by June 2009 – although there’s no expectation that the number of low-income adults will decline.

An additional $457,323 was saved by reducing funding for “community integration services” for mentally ill adults – services such as counseling, money management, transportation and personal assistance. And $762,572 will be saved by eliminating funding for in-home personal care assistance for about 400 elderly Mainers currently on a waiting list for such services.

An additional $7.4 million was booked for not filling existing vacancies at DHHS.

Harvey said the cuts followed a set of criteria that preserve services to MaineCare clients, maximize federal matching funds and comply with Maine’s ongoing mental health and mental retardation court decrees.

“These are the best decisions the department could make given the time we had and the target we had,” she told the committee. “Now it’s up to the Legislature to determine the way forward.”

Service agencies and consumer advocates filled the committee room and overflowed into an adjoining chamber. Because the event was a briefing and not a public hearing, feedback was limited to a few designated representatives selected by the groups to express specific concerns.

Most acknowledged that the state faces difficult financial times but urged the committee to take a longer view of the situation.

Brenda Gallant, an ombudsman for long-term care consumers, pointed out that in-home services keep hundreds of elderly Mainers out of nursing homes and other expensive residential care. Adult day care, she said, provides meals, medication assistance, transportation and a much-needed break for family caregivers – and “may be the one support that keeps an individual in the community” instead of in an institution, she said.

Chris Hasted of the nonprofit agency Maine Equal Justice urged the committee to “promptly pass a supplemental budget that mitigates the need for these cuts.” Eliminating coverage for non-MaineCare-eligible adults, she said, leaves them at risk for serious illness and increases the likelihood that they’ll require hospitalization – or even incarceration if they commit crimes because their mental health needs go unmet.

Lois Reckett of Family Crisis Services said the cuts mean battered women will get less help.

“They won’t get safety plans, they won’t get transitional services or follow-up support, and, frankly, more women will die,” she said.

Elinor Goldberg of the Maine Children’s Alliance cautioned the committee members that despite the painful cuts, “these are the good old days.” She urged lawmakers to recognize the state’s long-term economic challenges and plan accordingly to meet the needs of children and their families.

Several advocates also spoke at a news conference before the afternoon briefing, demanding that Gov. John Baldacci and the Legislature “find a better way” to maintain essential services for the people of Maine. Christopher St. John, executive director of the Maine Center for Economic Development, said lawmakers should consider using the state’s Rainy Day Fund to get through the current budget shortfall and implement longer-term savings through combining purchasing functions in public programs. New taxes, he said, should not be off the table, either.