DHHS MANAGEMENT FAILURES AT CENTER OF COMMITTEE DISCUSSION

Staffing issues responsible for empty beds at Riverview, no solution to MaineCare ride debacle

AUGUSTA—The Legislature’s Health and Human Services committee met today to discuss a number of management failures at the Department of Health and Human Services (DHHS), including the state’s bungled MaineCare rides system and the ongoing concerns and loss of federal funds for Riverview.

No one from DHHS attended the meeting despite the committee’s request; however, when they began their meeting, the committee received packets of information partially answering some of the committee’s questions from nearly three weeks ago.

“These are serious, complex problems requiring immediate solutions, and we’re working with three-week old information,” said Democratic Senator Margaret Craven of Lewiston, who serves as the Senate chair of the committee. “Patients aren’t getting the care they need, staff are in danger, and instead of working to find a solution, the department sends a memo.”

AMHI consent decree administrator Daniel Wathen, former Chief Justice of the Maine Supreme Judicial Court, met with the committee to discuss DHHS’s handling of Riverview staffing and remediation efforts since the psychiatric facility was decertified by the feds in late September. Wathan explained that because of the needs of current patients, Riverview is understaffed and is unable to admit any new patients until the staffing is sufficient for current patient needs.

According to Wathen, there are currently 18 people on the waiting list for a spot at Riverview, and if not addressed, there could be another nine on the wait-list by the end of January. Wathen added that the wait list is not unexpected and that Riverview “predicted a year ago this would happen.”
“This isn’t a new problem. This has been coming down the pike for a year, and yet the Department hasn’t done anything to take care of it,” said Rep. Richard Farnsworth, D-Portland, House chair of the committee. “People are in need of help, and they are not able to get it because there is no place for them to go. I agree with Judge Wathen: it’s a shame to have the space but not the staffing capacity at Riverview.”

CMS’s decision to decertify Riverview resulted in the state losing $20 million in federal funding for Riverview. Since then, both the HHS and Appropriations committees have pressed the department for where and how the psychiatric facility will continue to fund its operations and has not received a response.

In prior communication with the committees, the administration has been confident that their appeal of CMS’s decision will be successful, yet CMS has filed two motions to dismiss the state’s appeal, and Justice Wathen felt “there was substance” to the motions and that the state’s argument “isn’t a slam dunk by any means.”

“There’s a good chance we’re going be on the hook for $20 million if the state’s appeal is not successful,” added Senator Craven. “The Department assures us they have it under control, but their track record suggests otherwise–and what’s worse, we are operating in the dark without any up to date information about what is really going on .”

The committee concluded its meeting with a discussion about the bungled MaineCare transportation contract with Connecticut-based Coordinated Transportation Solutions (CTS). This was the committee’s first meeting since CTS missed the December 1 deadline to improve its performance or lose its $28.3 million, one-year contract to broker rides to appointments for dialysis, mental health services, and other medical and nonmedical appointments.

“For months we’ve wanted to know: what is the plan?” said Senator Colleen Lachowicz of Waterville. “Patients are missing their medical appointments, the transportation providers are losing money and losing their ability to provide these much-needed services, and the Department has no plan.”

Senator Lachowicz is one of two lawmakers who have introduced bills to fix the MaineCare rides system. Her bill would create a more reliable and efficient system based on the Vermont model, and Senate Majority Leader Troy Jackson of Allagash is sponsoring a bill to cancel the failed contracts.

The committee will continue to review the situation at Riverview, and the MaineCare ride contracts, when the legislature reconvenes in January.

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