AUGUSTA — A legislative committee voted Thursday to move forward with a bill that would seek a moratorium on rule changes that could cut millions of dollars to agencies that provide services to children with autism and their families.
The Legislature’s Health and Human Services Committee voted 6-5 along party lines to block a Maine Department of Health and Human Services proposal that could dramatically reduce the reimbursement rates for dozens of agencies that serve thousands of families.
Democrats on the committee voted to move forward with the moratorium while Republicans voted against it.
Some estimates, including those from the Behavioral Health Community Collaborative, pegged the revenue loss at more than $28 million.
Michele Hathaway, director of the Margaret Murphy Center for Children in Auburn, wrote in a memo on April 4 that the proposed reimbursement rate changes would be “fiscally devastating” to her agency.
The programs at stake are paid for with state and federal funds through MaineCare, the state’s Medicaid program.
“If these cuts are accepted by our Legislature and go into effect, we will need to cut the programs offered by MMCC,” Hathaway wrote. “Our preschool and early intervention services would no longer be offered and we would need to increase the tuition of our elementary and secondary programming, becoming too cost-prohibitive for many school districts.”
Hathaway wrote that DHHS is using inaccurate information generated from a study purchased from an Arizona consulting firm that is “very flawed.”
“The report includes incorrect assumptions, funding formulas and information not accurate of Maine providers, including MMCC,” Hathaway wrote.
Rep. Drew Gattine, D-Portland, House chairman of the committee, said the proposed rate cuts, which would be implemented by department rule-making, without oversight of the Legislature, were asked for by DHHS as part of its 2015 budget. The Legislature rejected them, instead asking DHHS to prepare a report to the Legislature in January of this year.
That didn’t happen, Gattine said.
“I don’t think we can just walk out of here and implement new rates that are going to blow a huge hole in our community mental health system,” Gattine said. “We said no to some of these rate cuts last year and told them to bring us back more information, which they didn’t do. So now they are telling providers they are just going to do them.”
Gattine said the cuts are unnecessary because the state budget is in the black by a sizable amount and federal Medicaid reimbursement rates to the state are expected to increase by an additional $40 million in 2016.
“Normally, when we are talking about rate cuts, it’s because we are facing a funding shortfall, but what I’m saying is, since there’s no budget hole, let’s put a moratorium on this until sometime next year when we are back in session,” Gattine said.
By then, he said, “hopefully, the rate study will be finalized and providers will have an opportunity to fully assess it and can make a more rational decision about whether or not we are going to let the department go forward with that.”
How much the proposed rate changes would save the state or cost the agencies was not clear Thursday.
Samantha Edwards, a spokeswoman for DHHS, said some of the service providers, including the Margaret Murphy Center, are causing an unnecessary panic over the proposal, which is still only a draft.
“It seems MMCC is attempting to spread inaccurate information to incite fear in parents and guardians,” Edwards wrote in an email to the Sun Journal. “The letter they sent never acknowledges this is part of an ongoing review of rates by the department.”
Edwards also took issue with Hathaway’s reference to another agency, Merrymeeting Behavioral Services in Brunswick, which provides services to adults with mental health problems. It recently closed and partially blamed its closure on another DHHS proposal that aims to move some of those adults to different programs covered by MaineCare.
“It is important to point out (MMCC’s) reference to Merrymeeting Behavioral Health as an example,” Edwards wrote. “That provider also attempted to sound the alarms by citing a rule change that is not yet operational — causing panic among clients and employees. I believe it has been made clear by multiple news outlets and the information provided by Merrymeeting’s own employees that despite attempts to blame the department for the abrupt closure, the facts just do not add up.”
Edwards noted that under the proposed rate changes, providers will have until May 16 to provide feedback, which DHHS will take into consideration before implementing any final change. She said DHHS could adjust the rates after that feedback or would respond in writing to the agencies affected and explain why the department disagrees with them.
During a meeting on the moratorium Thursday, DHHS Deputy Commissioner of Finance Alec Porteous told committee lawmakers it was unlikely any final changes to the rates would be determined before January 2017.
Porteous noted that compiling the public comments on the rule and responding to them could take as long as eight months.
But Gattine said that without a guarantee in writing from DHHS, he was uncomfortable allowing them to move forward with the rate changes.
“When the department issued the draft, they said to providers you have X amount of time to respond and then they said you are going to have a different length of time to respond and tomorrow they could decide you are going to have no time to respond,” Gattine said.
Rep. Patricia Hymanson, D-York, said the agencies that provide the services are managing budgets, some on thin margins, and uncertainty about revenue would make it difficult for them to plan for services or programs.
“I would just really love to give this group of providers a smooth sail through this,” she said.
She and other lawmakers praised DHHS for the process it appeared to be using to garner feedback and make adjustments based on that feedback.
Prior to the vote, she and Sen. Anne Haskell, D-Portland, asked DHHS officials to promise they wouldn’t move on the rate changes until January 2017.
“It sounds like that’s what’s going to happen, anyway,” Hymanson said, “so just say it.”
Porteous had previously said the administration saw the Legislature’s efforts to block its rule-making process as an overreach in the powers afforded the executive branch of government.
Nick Adolphsen, the legislative liaison for DHHS, said Porteous had already answered the question about a promised delay.
“And that is where we stand,” Adolphsen said.
The Legislature will now have to decide whether it wants to move forward with a bill for the moratorium.
sthistle@sunjournal.com
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