As many as 1,000 adults in Maine with autism and intellectual disabilities will receive Medicaid benefits as the result of a class action lawsuit settlement. And about half have already received those services.
Justice Michaela Murphy Monday approved the agreement, which will require the state to provide services mandated under the state's Medicaid program. Some of state's clients have been on waiting lists for more than five years.
The suit was filed two years ago in Kennebec County Superior Court on behalf of 18 Mainers with autism and intellectual disabilities. They demanded that the state deliver the approved support services they were entitled to under Medicaid.
But the Department of Health and Human Services claimed there was not enough money in the budget to cover those costs, and so deferred those services, using waiting lists. Bruce McLaughlin, one of the attorneys representing the plaintiffs, says that option has finally run out, and the Maine attorney general has conceded.
"The state has stepped up and done the right thing and decided that they will do the right thing and serve these folks," McLaughlin says. "And they've been able to put together a financial package with what looks to be sufficient funding. If the funding is not sufficient, they will go back to the Legislature and ask for more."
McLaughlin says the settlement carries a potential state share cost of about $7 million. It will pay for housing and other services for about 250 of the state clients who are classified as Priority One, the designation given to those who are urgently in need of services because they are at risk for abuse, neglect or exploitation. Another provision of the settlement is expected to provide services for hundreds of additional developmentally disabled adults.
The settlement agreement could not have come soon enough for the Priority One group, according to Nancy Cronin, executive director for the Maine Developmental Disabilities Council. "Individuals on the Priority One wait list, or who were on the Priority One wait list, were basically in a life or death situation," Cronin says.
The state never sought to prolong the the two years of negotiations between the state and the plaintiffs, according to defense attorney Gerald Petruccelli of Portland. He says the negotiations involved some highly complex Medicaid issues.
"It's not easy to make these systems work well," says Petruccelli. "We started with the view, which the state came to agree with, that people entitled to services were not getting them, and I think all of the state officials need to get credit for having recognized that this was a problem that needed to be solved."
And Maine Attorney General Janet Mills says Gov. Paul LePage and his top financial advisers played key roles in reaching the settlement. LePage has stated in the past that he wanted to make Mainers currently on waiting lists a priority for the state.
"We're very happy that the administration signed on, and that chief executive signed on with a commitment from the Appropriations Committee and a commitment in the budget to provide services and take many, many people of the so-called wait lists," Mills says.
A spokesman for DHHS Commissioner Mary Mayhew declined comment on the settlement.