AUGUSTA — The Maine Department of Health and Human Services on Thursday released a much-anticipated study by a controversial consultant, which presented analysis of and recommendations for the state’s welfare programs.
The 228-page analysis was the result of months of work by the Rhode Island-based Alexander Group, which received a $925,000 no-bid contract for consulting services from the Department of Health and Human Services in September. It was released without comment by DHHS or Gov. Paul LePage.
The report originally was due in December, but DHHS officials have said the Alexander Group had been given extensions to complete the work. On Thursday, the department provided a contract amendment showing that the consultant’s contract had been extended through July.
Despite missing several of the original deadlines outlined in the contract, the consultant has been paid more than $500,000.
An earlier report, on the feasibility of expanding Medicaid, was the subject of fierce controversy after its release in January. Democrats and other critics said the report was nothing more than a political document aimed at bolstering LePage’s position against Medicaid expansion. They also took aim at the consulting firm’s chief, Gary Alexander, who had been heavily criticized in Pennsylvania when he was that state’s public welfare chief.
Majority Democrats in the Legislature went so far as to pass a bill sponsored by Rep. Richard Farnsworth, D-Portland, that would have canceled the Alexander Group’s contract. LePage vetoed the bill.
Generally, the new report praised the efforts of LePage’s administration in working to reduce fraud, waste and abuse in the state’s welfare system, and it presented many of the same recommendations that the Republican governor and his allies put forward in the form of bills during the recently concluded legislative session.
Those efforts were summarily dismissed by majority Democrats in the House and Senate.
Included in the recommendations is a call for the state to request a global Medicaid waiver identical to the one Alexander was granted during the final days of George W. Bush’s presidency in January 2009, when Alexander ran the Rhode Island’s Department of Public Welfare. The waiver gave Rhode Island near-total flexibility in administering the federally funded health insurance plan.
It’s the only state to have received such a waiver, and many believe President Barack Obama will be much less likely to grant such a waiver than his predecessor — especially given Medicaid’s keystone importance in Obama’s signature health care law, the Affordable Care Act.
The Alexander Group also recommends tightening work and training requirements for welfare recipients.
That includes a suggested elimination of all exceptions to a requirement that recipients of Temporary Assistance for Needy Families, a cash benefits program, participate in volunteer, training or work programs. The law allows exceptions under specific extenuating circumstances — such as illness or responsibility to care for children younger than 6.
It also includes a recommendation that the state require food stamp recipients to participate in a work program by having Maine apply to be one of 10 states involved in a federal pilot program to test such a requirement.
General assistance — the joint state-local program administered by municipalities to provide short-term support to residents struggling to pay their bills — also was targeted for cuts and reform in the report, including an option for the state to take over and streamline the program.
The report also included a recommendation to require that some welfare recipients show proof of a job search before receiving benefits.
DHHS Commissioner Mary Mayhew said in an interview Thursday evening that the department had not received the final report until earlier that day, so she could offer little comment on the specifics outlined in its hundreds of pages.
Implementation of some proposals could happen quickly, she said, while others would require legislative or even federal approval.
“We are still processing it. I have not had the time with staff to thoroughly review the report, the analysis and its recommendations,” she said.
Mayhew said she’d be looking to identify the recommendations that aligned with the governor’s goal of integrating and streamlining welfare services with an eye toward savings. She said that’s the way to ensure the best use of available resources.
“I am very interested in looking comprehensively at these programs in our $3.4 billion annual budget to ensure we are able to align resources to more effectively serve individuals and families,” she said. “… We need to be looking at ensuring we have a culture focused on continuous quality improvement.”
Democrats on Thursday were quick to lash out at the Alexander Group and LePage, echoing criticisms they’ve lodged against the group and its contract for nine months.
“This is nothing more than a political document. It’s a continued waste of taxpayer dollars meant to bolster the governor’s election-year rhetoric,” said Farnsworth, House chairman of the Health and Human Services Committee, in a prepared statement.
“The taxpayers of Maine should be outraged. Gov. LePage has taken their money and used it to buy Tea Party talking points, not solutions,” said Sen. Margaret Craven, D-Lewiston, who leads the Health and Human Services Committee with Farnsworth. “Maine needs jobs, not more fodder for the governor’s attacks on the poor.”
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