AUGUSTA — The Democratic House chairwoman of the Legislature’s Appropriations Committee says the governor’s budget would “shred” Maine’s safety net for people with mental illnesses.
State Rep. Peggy Rotundo, D-Lewiston, said in a statement late Thursday that a proposal by Gov. Paul LePage’s administration that would reduce by 10 percent the Medicaid reimbursement rates for outpatient mental health service providers, including counselors and psychologists, holds “grave implications for public health and public safety.”
“It’s beyond irresponsible to play games with people’s lives and public safety like this,” Rotundo said. “The governor has presented us with a series of false choices. We do not need to pit one group against another.”
Rotundo said the reimbursement rate cuts, coupled with a shift that would dramatically reduce how much some mental health care providers are paid to manage patient medications, could be a crippling blow to those providers.
The results would be untreated mental health patients who could create greater costs and burdens on other public services.
Also Thursday, Tom McAdam, the chief executive of Kennebec Behavioral Health, reminded lawmakers of a 1996 tragedy in Waterville where a man with schizophrenia bludgeoned to death two elderly nuns and left two others severely injured.
At the time, McAdam said, the case galvanized the state’s mental health community and the Legislature.
“Frankly, many of us who are in the provider community are confused by some of the initiatives in this budget,” McAdam said. “Really, next to housing, for people to be successful, (medication) management — access to medication management — is important.”
Legislative Republicans were swift to respond Friday, saying Democrats and Republicans had an informal agreement to get through all of the public hearings on LePage’s two-year budget proposal before taking off their political gloves.
State Rep. Deborah Sanderson, R-Chelsea, said Rotundo’s comments were “disingenuous as they could possibly be.”
Sanderson added, “Because a lot of the work DHHS is doing — maybe they are making reductions to certain areas — but there is a huge investment being made in this budget for mental health services.”
She said LePage’s budget includes increased spending for people with mental illnesses, including those living in state-run institutions in Bangor and Augusta.
“We’ve got $40 million going toward the wait lists and some of that is certainly for folks with mental health illnesses,” Sanderson said. “To say that we are shredding the safety net … what they are doing, it appears to me, is picking at individual pieces and are saying, ‘You are shredding the net,’ without looking at the comprehensive wrap-around programs that we are investing in that are going to actually treat the whole individual.”
State Sen. James Hamper, R-Oxford, the Senate chairman of the Appropriations Committee, said he was disappointed that attacks on the budget proposal were starting so soon, “because I think I’ve been pretty quiet and pretty even about the process.”
He countered accusations that LePage and Department of Health and Human Services Commissioner Mary Mayhew were pitting vulnerable groups of Maine residents against one another.
He said Democrats were pitting the variety of services and functions the state is obligated to provide against one another by defending the status quo for a health and human services system that has increasingly consumed more of the state’s total budget.
“We have watched over the years how much of the state’s General Fund budget DHHS has been absorbing,” Hamper said. “So you could say you are pitting DHHS and its expansion against everything else that the state budget does: transportation, education, the environment, everything else.”
LePage’s $6.57 billion budget proposal goes well beyond balancing the state’s books for the next two years, as required by the Maine Constitution. The proposal includes sweeping reforms for the state’s tax system by cutting income taxes and expanding sales taxes. But it also seeks to shift, in some cases dramatically, how the state spends its money.
As thick with policy reform as it is with financial reform, Lepage’s top staff have said the budget is meant to realign the state’s spending priorities with a focus on those with physical and developmental disabilities who have been left behind, stranded on waiting lists for state-funded health care and other support services.
Until Rotundo’s statement Thursday, lawmakers from both parties, especially those serving on the traditionally cordial Appropriations Committee, have taken diplomatic and wait-and-see positions, neither panning nor praising the proposal overtly.
But after a week of testimony from immigrants, doctors, mental health professionals and advocates for the poor, disabled and mentally ill, Rotundo and state Sen. Linda Valentino, D-Saco, issued some of the strongest-worded statements of the budget discussion so far, noting the negative impact they believe the budget would bring if enacted as is.
“These drastic cuts would prevent Mainers with mental illnesses from getting needed care and push them toward crisis,” Valentino, the top Senate Democrat on the committee, said in a prepared statement. “Providing sufficient services is not only compassionate, it makes economic sense. Severely mentally ill people who cannot access the services they need often wind up in emergency rooms or in jail, much more expensive and traumatic experiences that can be avoided.”
And while state Rep. Tom Winsor, R-Norway, the ranking House Republican on the budget committee, agreed that the testimony this week may have revealed some of the flaws in LePage’s budget proposal, he felt it was premature to start dismantling it.
“Our job, I think, is not to send out press releases,” Winsor said, “but to sit back and calmly look at what he’s trying to do. Am I happy with all of the things in the budget? No. Am I learning a lot by sitting and listening to a lot of people? Yeah.”
Winsor said the Appropriations Committee would ultimately decide on which of LePage’s priorities they agree with and which they disagree with, but until then committee members ought to remain objective in gathering information.
“All we can do is make our choices on the best information that we have,” Winsor said. “Hopefully, we can come together and do it wisely and with respect for everybody.”
Send questions/comments to the editors.
