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Maine faces mental
health cuts
(August/September
2005 Issue)
By Phyllis Hanlon
In a scenario that has become all-too familiar across the country,
the Maine legislature issued a proposal to slash approximately $26
million from its state services budget. Those cuts would directly
impact mental health care and prescription costs and availability.
Carol Carothers, executive director of the Maine chapter of the
National Alliance for the Mentally Ill (NAMI), says, "We believe
these cuts will further devastate a mental health system which is
already unable to adequately care for Maine's citizens with mental
illness and/or co-occurring substance use disorders." She says that
the proposed cuts follow four years of mental health spending reductions
in the state.
In addition, Carothers cites the ramifications of the reduced spending
for particular at-risk populations. "Maine's youth suicide rate
is higher than the national average and the highest in the northeast
as is its rate of incarceration of people with mental illness,"
she says. "We believe the newest cuts will exacerbate these difficulties."
According to Carothers, the situation is worsened by legislation
passed earlier this year that placed a two percent cap on county
government, restricting correctional facilities' ability to provide
adequate medical care for inmates. "NAMI Maine is working in coalition
over the next several months to collect data on the impact of the
cuts and to develop some alternatives," she says.
Christine B. Hatstedt, public policy specialist for Maine Equal
Justice, says that the current situation poses an "extremely dangerous
change" for citizens in Maine.
"The drug formulary cut was reduced to just under $14 and protective
language was added providing for an expedited hearing, a 10-day
emergency supply [of medications] and a handful of other protections,"
she says.
Ron Welch, executive director of the Maine Association of Mental
Health Services (MAMHS), is particularly concerned about the impact
these cuts will have on children. MAMHS represents more than 40
community mental health facilities that serve children, adults and
seniors. He emphasizes that these projected reductions in mental
health care services represent a complex issue with far-reaching
consequences. "A good portion [of the funding] is matched with federal
Medicaid dollars," he says. The federal government contributes two
dollars to every one that the state spends. Welch says that the
combination of the state and federal cuts will reach nearly $50
to $60 million and are slated to become effective in FY2007.
"The Department of Health and Human Services and the legislature
are trying their best to find a way to arrive at some savings,"
he says. One suggestion has been to implement Medicaid initiatives
not currently in place. However, Welch doubts that such a goal is
realistic.
Providers in the state are trying to devise a capitated system
and have presented a proposal to the administration, according to
Welch. He indicates that the plan "will implicate how and who we
will serve." Welch adds that the state "…has an obligation to serve
the mentally ill. That will continue to be the focus."
On July 1, Welch and his committee presented their proposal to
the court master for review. "We'll be at the table in a feverish
pitch during the next six months," he says. "I'm optimistic that
we can realize some efficiencies. It's unusual that a provider trade
association would report the imposition of these measures, but it's
better to do this instead of curtail services."
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