Mainers bring prayers and pleadings to budget debate

Posted Wednesday, December 21, 2011 in News

Mainers bring prayers and pleadings to budget debate

Hundreds crowd the Hall of Flags at the State House to protest cuts to DHHS.

By Marian McCue

AUGUSTA -- The atmosphere in the State House at one point resembled a religious revival as hundreds of Mainers gathered last Wednesday to protest proposed budget cuts which could cut 65,000 people from state-funded health care.

Jill Saxby, Executive Director of the Maine Council of Churches,  faced an audience holding signs including ‘Budgets are Moral Documents’ and concluded her revival-style speech with a question. She urged people to look at those around them, and to ask, ‘Are you my brother? Are you my sister? are you my grandparent?’ We are all one family and we are going to stick together now.”

 ‘Amen,’ she said, and the crowd roared ‘Amen’ .

The religious rally later ended in a political demonstration, with chants of ‘End the War’ and ‘Tax the Rich’ reverberating in the hallway, near the office of Governor Paul Lepage, left vacant for the day as he traveled to Franklin county for a public meeting.

After the rally, the crowds drifted into anterooms and prepared to testify on the budget cuts in front of the joint Appropriations and Health and Human Services Committes.

The cuts would hit a wide array of social programs, from Head Start to many others. LePage is aiming to avert a projected $220 million shortfall over the next 18 months in the budget of the Department of Health and Human Services.

LePage’s plan would end MaineCare insurance, the state’s Medicaid program, for an estimated 65,000 people, including those in certain catergories; 21,000 parents with incomes between 100 and 200 percent of the Federal Poverty Level (FPL); 18,000 childless, non-disabled adults living under the FPL; and 7,000 19- and 20-year-olds under 150 percent of the FPL. It will also cut many optional services, such as vision and dental care, for those continuing to receive MaineCare as well as many other programs and services, such as HeadStart.

The state proposes to end funding for the so-called PNMI program, which would affect 6000 elderly and disabled Mainers living in Private Non-Medical Institutions. The PNMI program has allowed the state to use MaineCare funding to help pay for residential services for many of the state’s elderly, mentally ill, and disabled. 

PNMIs were first used in Maine in the 1990s in order to create a cheaper, more attractive alternative to high-priced nursing home care. One executive of a company that runs several facilities, some focusing on Alzheimer’s disease care, said that half of his 400 elderly residents are paid for by MaineCare.

“The 200 MaineCare residents in our care would be discharged, 80 of which with Alzheimer’s disease,” Woodlands executive Matthew Walters told the Committee. “to where, nobody really knows … into what would at best be an inappropriate or less desirable placement and at worse an unsafe one.”

Noting that he was a Republican, and generally supported Governor Lepage’s efforts because he had agreed that “MaineCare as a whole has grown too big and far too generous for far too many,” Walters objected to the cuts.

“I can’t believe that he or anyone else that contributed to this plan truly understand the devastating effects that eliminating all funding for residential care for the elderly – with absolutely no alternative plan will have on the thousands of elderly residents their families and the thousand of staff member jobs.”

A Safe Place for the Mentally Ill

Also affected by PNMI cutbacks are the long term mentally ill.

One of the oldest providers of housing services for adults with mental illness is Shalom House, based in Portland, and founded to create housing options outside of a hospital setting for this population. (Disclosure. This reporter serves on the board of Shalom House.)

Executive Director Mary Haynes-Rodgers told legislators that their clients could be forced back to a hospital, or onto the streets, if the agency loses funding under PNMI, which serves a large number of their clients.

“If these cuts go through and we are unable to sustain our programming; as our doors close, our clients will immediately become at risk for re-hospitalization, arrest, sleeping on the strets and the the shelters and unfortunately, for some their very survival will become in doubt,” said Haynes-Rodgers.

Also noting the effect on Portland’s programs for the mentally ill and homeless was newly elected Portland Mayor Michael Brennan. Besides Shalom House, Brennan said the loss of  PNMI funding would be devastating to Serenity House, Milestone, and Opportunity Alliance.

Brennan reminded the Joint Committee that the state took on certain obligations when it closed down its state hospitals for psychiatric and developmentally disabled patients.

“In 1993, Pineland and AMHI were closed and we made a solemn promise to them that they could live in the community,” said Brennan.

 He also predicted under the proposed cuts the city might not be able to continue its Health Care for the Homeless Clinic and the Portland Community Health Center. The state’s plan to eliminate Targeted Case Management could mean that “hundreds of families will end up back at the shelter’s dorstep and the city will be forced to absorb the additional costs associated with providing emergency shelter,” warned Brennan.

Stuart Rogers from Vienna, suffering from end stage liver disease and waiting for a liver transplant, told legislators that if he was lucky enough to get a transplant, it would be unaffordable if he  did not get help from the MaineCare benefits that helps patients pay for Medicare co-insurance premiums.

Several groups of young people lined up to support programs, like Day One and Crossroads, that had helped deal with substance abuse issues. Two doctors testified that putting a two-year limit on the paying for Subaxone treatment would encourage relapse for addicted clients.

This week, the Joint Committees began their review of the proposed budget cuts, working on a short timeline as the administration has said that money will run out in the spring.

Senator Joseph Brannigan of Portland, a State House veteran of many budget battles, says this one could be “a real donnybrook.

It’s going to be a big brouhaha, pitting people against each other and pinning the blame on people who don’t deserve it,” said Brannigan.

He doesn’t disagree with the Governor that the state is in this situation because of the expansion of MaineCare to new groups of people under previous Democratic administrations.

“Did we go too far in trying to provide insurance?” asked Brannigan, “Maybe we did, but now we’re faced with taking insurance away from the 18,000 childless adults.” He added that he was not sure if the supplemental budget would require a two thirds vote, which would need the support of some Democrats. And Brannigan holds out some hope that Republicans will not want to be the sole agents of such drastic changes.

“They have a heart. They have constituents with real needs,” said Brannigan.

Also expressing guarded optimism was another Portland Democrat, Rep. Anne Haskell, who does not think the cuts will pass in this form.

“I’m hoping we can find some places of common ground,” she said, adding that her optimism is fueled by the fact that the Legislature was able to work together to get a two thirds majority to pass a budget back in June.

“There will be some tough changes, but I hold out some hope,” said Haskell. “But it’s going to be a torturous process.”

In the interests of full disclosure, reporter Marian McCue sits on the board of a nonprofit that is likely to be impacted by Gov. Paul LePage's proposed cuts.

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