New Rule May Limit Mental Health Services to Thousands

Apr 1, 2016

Mainers worried about the loss of mental health services asked the Health and Human Services Committee Friday to block a change to eligibility requirements planned by the LePage administration.

The new rule could potentially move thousands of Mainers with mental illness to less intensive services. Administration officials say individuals will still receive support, but those affected fear they will lose their ability to live independently.

Department of Health and Human Services Commissioner Mary Mayhew wants to be clear about the change in rules for mental health services. “People are not going to lose access to appropriate services. This has been framed as a cut, as opposed to how do we continue to ensure people are getting the most effective treatment to help support the best possible outcomes for the individuals,” says Mayhew.

The disagreement involves one section of MaineCare: Section 17. It provides daily living support and skill development services to individuals with mental illness. Mayhew says it’s designed to help people with the most severe forms of mental illness, like schizophrenia and schizo-affective disorder. But currently about 8,000 people who receive these services are diagnosed with other illnesses like depression, anxiety, and PTSD.

Says Mayhew, “We are certainly not suggesting that those are not serious mental illnesses that require treatment. What we are saying is the research suggests that the treatment is medication and psychotherapy.”

Mayhew also says that some of those individuals are likely better served under other, less intensive MaineCare services.

But Portland-based social worker Dawn Burley says for some, the change in eligibility will amount to no services. She’s on the front lines implementing the changes, which are scheduled to go into effect April 8th.

“Which means I’m the one taking the calls, listening to client’s stories, and unfortunately turning a lot of them away now. And there’s really not anywhere to send them,” says Burley. “It’s a big gap in service that this is going to be creating.”

It’s prompted enough concern that affected Mainers petitioned lawmakers to intervene. It’s a rare move that’s been done twice this session to halt proposed rule changes to MaineCare services.

At a public hearing on Friday, many consumers told committee members they fear losing services and the progress they’ve made. David Rand says he started receiving Section 17 services about four years ago because he was facing eviction from his apartment.

“Without staff help, I would not be able to do things for myself, like doing the laundry, going grocery shopping, and other things like that,” says Rand.

Rand also that says without those services, he risks losing his apartment.

Tiffany Murchison of Bath says that section 17 services helped her overcome PTSD and agoraphobia that was so severe she couldn’t even walk down her driveway to get the mail.

“Ten years ago, with the help of community support, I was able to step down from care and eliminate my need for services. I went on to become a Meals on Wheels volunteer, business owner, and my husband is able to work full time,” says Murchison. “Under the proposed changes, I would not have been eligible for the services that saved my life and help me be the wife and mother that my family needed.”

Others who spoke at the hearing, like Jack Comart of Maine Equal Justice Partners, say that it’s not the change in eligibility they object to, It’s the transition to other services they fear is too much, too fast.

“We do support moving people to more clinically appropriate services,” says Comart. “We have some doubts about whether this would really accomplish it in a smooth way, so we’re more recommending sort of a go-slow approach.”

Though the rule goes into effect April 8th, the Department of Health and Human Services says consumers will have up to 90 days after that to make the transition. Advocates want a transition plan and more time.