AUGUSTA, Maine - The LePage administration says it wants to streamline the process of setting reimbursement rates for services sought by intellectually disabled adults by not requiring a public hearing. The bill was opposed Wednesday at the State House by more than a dozen families and support organizations, who say the lack of public input could have serious safety ramifications for the affected populations.
Anna McDougal of Wiscasset was among those who traveled to testify before the Legislature's Health and Human Services Committee. She urged the members to carefully scrutinize the LePage bill, which would affect people with intellectual disabilities, like her, and also people with autism who are covered by MaineCare.
McDougal says the proposal would eliminate the need for a public hearing and effectively silence the people who depend on those services. "People with disabilities, we have feelings, we are people and individuals -- like myself," McDougal said.
Opponents, including the families of affected Mainers, say they're concerned that the proposed changes could have a detrimental impact on the quality of services to individuals with significant needs.
"It's my belief that the Legislature not only provides a voice for the people who elect them to office, but also serves as an important part of our governmental system of checks and balances," said David Cowing. Cowing, of Woolwich, is the father of an adult son with intellectual disability and mental health issues. He says he relies on the public hearing process to ensure that his son receives the level of benefits he needs.
Cowing worries about what could happen if that process becomes less transparent and removed from legislative oversight. "I'm very concerned that this proposed rule change could result in a reduction in the quality of services currently being delivered to individuals who already receive supports, while leaving many others needing support services remaining on wait lists for an indeterminate length of time without formal legislative review."
Last year, the state reached a legal settlement with hundreds of adults with autism and other developmental disabilities who had been on a waiting list for services. Some opponents to the proposed change are suspicious that it's related to the waiting list issue.
Ray Nagel, executive director of the Independence Association in Brunswick, says he also believes that the state's intentions to utilize a SIS - or Supports Intensity Scale - to determine benefit rates, and the proposed switch eliminating legislative review, are both designed to save money to put toward the waiting list.
"I think that there is a correlation, possibly, between the new SIS allocation method and the waiting list," Nagel said. "It's actually on the DHHS website that a lot of the savings that they would derive from the SIS, that they would apply to the waiting list."
But Samuel Senft, director of MaineCare Policy for DHHS, says the change to the rulemaking process was intended to streamline the process. He points out that the current rulemaking for rate setting for services to people with intellectual disabilities and autism are governed by different sections of law.
"Processing these rules separately is an administrative and financial burden for the department," Senft said. "Relief from separate rulemakings will be administratively efficient and reduce noticing and printing costs. Providers would have a better opportunity to offer comments that will affect the rule."
And Senft said the new process would not silence providers or family members, as opponents have suggested. "The public would still have ample input during the regular rule-making process and before the rule was put into effect," Senft said.
Lawmakers on the committee will weigh the proposed changes further at a future work session.