At the Appropriations and Financial Affairs Committee hearing yesterday, DHHS presented the portion of the MaineCare budget that pays for services for many of Maine’s most vulnerable: people with developmental and intellectual disabilities.
In the budget, Governor Mills proposes collapsing 13 existing Medicaid accounts into four. Collapsing the accounts raises concerns about accountability and transparency, especially because these accounts include the six major waitlists for people with intellectual disabilities, Autism, brain trauma and those in need of other significant supports.
As of July 1, 2020, these waitlists stood at a combined 2,105 unduplicated persons.
MPBP believes the Mills Administration hasn’t made the case for this bookkeeping change. In particular, DHHS hasn’t shown how this will benefit people with disabilities.
At one point in the hearing, one of the committee chairs asked the DHHS staff person about the purpose of the account changes, wondering whether it’s just a “spreadsheet thing” and noting just realigning the spreadsheets won’t save money.
The DHHS representative responded that he liked the phrase “spreadsheet thing.” He stated that the current account alignment is causing a “cycle” problem where they cannot pay a provider when an account is low on funds. Consolidating the accounts would create a greater reserve to pay bills.
DHHS stated in the hearing that there will be no impact to the program by consolidating accounts and claimed that this is a “longstanding desire of the department.”
But that response begs the question, “Why are the accounts drained so often?” This is the question that the Mills Administration should be addressing in the budget, instead of offering a spreadsheet solution—a remedy that decreases transparency and accountability in these programs.
The Mills Administration is offering a band-aid for the real and significant problems: these programs are inadequately resourced and too many people remain on the waitlists.
One member of the public testified that of the people with disabilities on the waitlists, at least 1,000 people are not receiving any services at all.
DHHS brought no supportive materials to the hearing to explain why they want these changes. Neither did DHHS provide an updated count of who is on the waitlists.
DHHS’s proposals won’t take any more people off the waitlists than current law requires: 30 people with disabilities a month. In his testimony, one parent of children with disabilities called this “treading water.”
He noted that Section 21 program waitlist, which provides comprehensive services for people with intellectual or developmental disabilities and people with Autism Spectrum Disorder, is at an all-time high of 1,874 people. He claimed the waitlists have been allowed to “fester and grow.”
The lack of urgency around eliminating the waitlists is putting entire families’ lives on hold due to the often overwhelming need to care for their loved ones while waiting for services.
MPBP stands by the concerns we raised last month in our analysis of Governor Mills’ biennial budget proposal. The discussion yesterday should have centered on putting people first by eliminating the waitlist, not bookkeeping changes.