Sifting Through the LePage FY 2016/2017 Proposed Budget: DHHS Meets With AFA, HHS

Posted on February 1, 2015. Filed under: Uncategorized | Tags: , , , , , , , , , |

DSC_0121Maine Department of Health and Human Services (DHHS) Commissioner Mary Mayhew along with Alec Porteous and Stephanie Nadeau met with the 127th Legislature’s Appropriations and HHS Committees for three hours on January 22 to discuss the administration’s FY 2016/17 biennial budget as it pertains to the state’s largest agency (Governor Paul LePage’s 2016-2017 Biennial General Fund Budget Proposal can be found here). The entire meeting is below, recorded in five clips.

From a DHHS press release:

    “For years, DHHS has come to the budget committee with news of massive shortfalls that send lawmakers scrambling,” said Commissioner Mayhew. “This time, it’s different. Under Governor LePage’s leadership, we have stabilized spending in the Medicaid program and are no longer managing to a crisis. Instead, the budget proposal tackles some of the Governor’s biggest priorities: nursing home funding, waitlists, primary care, and much more.”

    The DHHS budget proposal identifies significant savings to help fund important new initiatives, with a net request of just over $6 million for the FY 2016-2017 biennium-this out of a total Department General Fund budget of more than $2 billion.

    DSC_0123Among those initiatives are $24 million in additional Medicaid reimbursement funding for nursing homes; $46 million to move elderly, disabled, and mentally ill patients off of waitlists for services; $28 million to improve access to primary care providers; and $14 million to fulfill Maine’s obligation to mental health under the Consent Decree.

    Roughly $11 million in savings from a proposed reform to General Assistance reimbursement to municipalities will be directed specifically to fund services under Section 21 for disabled Mainers on waitlists.

    A total of $20 million from the Fund for a Healthy Maine (FHM) will be repurposed away from third-party advocacy organizations and directed to fund increased access to primary care providers for Medicaid recipients.

    After doubling in size, enrollment, and cost in the decade prior to Governor LePage’s first inauguration, Maine’s Medicaid program has since seen enrollment drop from a high of 354,000 in 2011 to 291,000 today. In 2011, 26 percent of Mainers were enrolled in Medicaid, compared to 18 percent of the national population. In 2014, Maine’s Medicaid enrollment matched the national average of 22 percent. “After years spent bailing out the sinking ship of Medicaid, we have finally charted a new course where spending on able-bodied adults is controlled and services for the elderly and disabled are prioritized,” added Commissioner Mayhew. “I am proud to be presenting this balanced budget to the Appropriations Committee on behalf of Governor LePage, whose tenacity and responsible priorities have gotten us where we are today.”

Part 1

Part 2

Part 3

Part 4

Part 5

After the conclusion of the meeting, Daniel E. Wathen, Consent Decree Coordinator, met with the two committees to discuss multiple ongoing issues at Riverview Psychiatric Center and answer questions from legislators. The two clips of that meeting are below.

Part 1

Part 2

Read Full Post | Make a Comment ( None so far )

Weekly Legislative Update by Rep. Justin Chenette (D-Saco): Overview of Kennebec County Jail, Riverview Pyschiatric Center

Posted on January 24, 2015. Filed under: Uncategorized | Tags: , , , , , , , |

This week, Representative Justin Chenette, now serving in his second term, recorded his first video legislative update and kindly gave permission to share:

As he remarked within the clip, some of the members of the Legislature’s Criminal Justice and Public Safety committee has started to tour some of the state’s correctional facilities. His observations of the Kennebec County Jail and Riverview Psychiatric Center are below.

    “What an eye-opening experience. Sometimes you just don’t realize the negative sides of society until you see it firsthand (and this was just a narrow focus). Alongside Sen. Linda Valentino and York County Sheriff Bill King, we toured the Kennebec County Correctional Facility and Riverview Psychiatric Center to ask questions and actually witness some of the issues plaguing our criminal justice system and mental health facilities. Just a few quick takeaways based on my initial observations:

    Sen. Linda Valentino, York County Sheriff Bill King and Rep. Justin Chenette at the Kennebec County Correctional Facility in Augusta

    Sen. Linda Valentino, York County Sheriff Bill King and Rep. Justin Chenette at the Kennebec County Correctional Facility in Augusta

    At the jail, we met a group of women in an innovative program to help actually rehabilitate their lives while in the system. Focusing on support and getting individuals to change their lives for when they get out is better than just sitting in jail awaiting a return to a life that is not only a determent to themselves but the safety of those around them. Gave me hope that we could use it as a model in other facilities, but much like anything else has been reduced and limited due to a lack of funding. Learned the state has over 21 well-organized gangs. Jail officials have to put special care in where they place certain inmates from rival gangs or violence is extremely heightened. The overcrowding problem was apparent, but partly the issue is so many mentally-ill individuals end up being housed there after ping ponging within the system that the jails have become ill-equipped to handle the influx; not to mention the increased need for proper treatment and care that the jails really can’t provide effectively.

    We visited the high risk part of Riverview that tends to have the most attention about patients attacking staff. I have to admit I was a little nervous about being there especially after we were briefed on the protocols in case patients went on a rampage in our presence who were only an arms length away. The staff have a high level of frustration with CMS and the lack of legal willingness or adaptiveness to policies that could enable the facility to be more hands on in restraining ‘patients’ that cause significant physical harm to nurses and others while at the same time not wanting to become something other than a hospital. It seems like the lines between corrections and high risk mental health treatment though are blurring and clashing at the same time.

    As you may have seen in the media, issues surrounding our county jails and corrections system will be hot button topics as we navigate challenges of overcrowding, control, and funding. Not to mention a huge monkey wrench from the Governor in not appointing members to the Board of Corrections out of protest. Without a quorum for the board, it’s almost impossible to tackle the $2.5 million shortfall until a resolution is settled from the Governor’s Office or we find a way around him. More tours are being planned with my Criminal Justice Committee over the course of the next few weeks to continue collecting needed information from boots on the ground rather than just those at the very top.”

Link here to Chenette’s website for signing up for future updates.

Read Full Post | Make a Comment ( None so far )

AFA, HHS Joint Committee Meet w/ DHHS Officials to Discuss CTS, Riverview Psychiatric Center Woes

Posted on August 20, 2014. Filed under: Uncategorized | Tags: , , , , , , , , |

HHS Committee member Rep. Henry Bear (Maliseet) speaks with HHS Senate Chair and new AFA committee member Margaret Craven (D-Androscoggin) before meeting begins. Also pictured is AFA Senate Chair Dawn Hill (D-York)

HHS Committee member Rep. Henry Bear (Maliseet) speaks with HHS Senate Chair and new AFA committee member Margaret Craven (D-Androscoggin) before meeting begins. Also pictured is AFA Senate Chair Dawn Hill (D-York)

Joint meeting by the Appropriations & Financial Affairs, Health & Human Services standing legislative committees held to discuss a number of topics with officials from DHHS and Riverview Psychiatric Center including CTS (transportation), safety concerns, training issues, re-certification efforts and more.

The committees submitted two pages of detailed questions to Commissioner Mayhew, who responded with a 27 page document and sent Stephanie Nadeau, Ricker Hamilton and Riverview superintendent Jay Harper in her stead.

Maine Legislative AFA, HHS Joint Cmte Meeting 8 19 14 (Pt 1)
http://youtu.be/EJLhEDmND0M

Maine Legislative AFA, HHS Joint Cmte Meeting 8 19 14 (Pt 2)
http://youtu.be/jLbETF0ueVg

Maine Legislative AFA, HHS Joint Cmte Meeting 8 19 14 (Pt 3)
http://youtu.be/EZr0wWC6Xko

Maine Legislative AFA, HHS Joint Cmte Meeting 8 19 14 (Pt 4)
http://youtu.be/uvSq6_H08UU

Maine Legislative AFA, HHS Joint Cmte Meeting 8 19 14 (Pt 5)
http://youtu.be/VKeiXLa_R1k

Maine Legislative AFA, HHS Joint Cmte Meeting 8 19 14 (Pt 6)
http://youtu.be/AOP8eDHN09I

Read Full Post | Make a Comment ( None so far )

Weekly Address of Governor Paul LePage: The NFL has an Opportunity to Push Back Against Domestic Violence

Posted on August 13, 2014. Filed under: Uncategorized | Tags: , , , , , , , , , |

5pm UPDATE: Here is the letter.

nfl boycottNOTE: Last week, Governor Paul LePage went onto WVOM’s George Hale and Ric Tyler Show and during his interview, said that he was “boycotting the NFL”. He also referred himself in the third person when discussing his chances for re-election:

    “The governor does not agree [that it’s a tight race]. … The governor says that he’s either going to be blown out by a landslide or he’s going to win by a landslide. … The Maine people are either going to throw me out or take me in wholeheartedly, but I don’t think this is going to be close.”

He has still not spoken publicly about his meeting with Democratic leadership, despite new reports that the situation with Augusta’s Riverview Psychiatric Center is more dire and will be even more expensive than thought even last week.

This week, he chose to use his weekly address to double down on his condemnation of the NFL. A reminder: The only professional football team in all of New England is still located in Massachusetts, not Maine.

No word from RGA Chair Chris Christie (the New Jersey governor who favors the Dallas Cowboys over his own local teams) who was in Maine supporting LePage on Tuesday, on his views of the LePage “NFL boycott”.

———

Audio link here.

The NFL has an Opportunity to Push Back Against Domestic Violence

Domestic Violence does not discriminate. This crime affects thousands of people, no matter their age, race or economic background.

DSC_0112Hello. This is Governor Paul LePage.

Most domestic violence victims are women, but this is not just a women’s issue. Men must be part of the solution to end the pattern of abuse.

Recently, the National Football League has taken heat for how it sanctions players who commit a domestic violence crime.

NFL Commissioner Roger Goodell gave a mere two-week suspension to Baltimore Ravens running back Ray Rice. This man knocked his fiancée unconscious, then dragged her out of an elevator. Rice pled not guilty, but the video doesn’t lie. Sadly, his fiancée is now his wife.

If a two-week suspension is the “punishment” for knocking a woman unconscious, then there is something very wrong with the NFL culture.

This week in a letter to Goodell, I told him I’m appalled that he promotes permissive disciplinary procedures that could ultimately result in the death of innocent people.

NFL quarterback Michael Vick served 2 years in prison for running a dog-fighting ring, but an NFL player who commits a violent crime against a woman gets a two-week suspension. The NFL mandates harsher penalties for players who violate the league’s personal-conduct policy or abuse drugs than those who commit domestic violence. This defies common sense.

Taking thugs and wife beaters off the field may be bad for business, but the NFL is playing games with people’s lives.

I don’t know if Commissioner Goodell is familiar with domestic violence or if it has affected his family personally. However, I can tell you firsthand that domestic violence is about a perpetrator having power and control over another individual. Too many times, it leads to murder.

I have a zero-tolerance position on domestic violence. There is no excuse for this type of behavior in our society. Until all of us make an effort to end this abuse, the cycle will continue.

NFL players are role models for young men, and many of them excel at that. But if some players are allowed to act violently toward women, then young men will think that behavior is acceptable. It tarnishes all players and gives the NFL a bad name.

This is not about winning or losing. This is about life or death. The NFL has an opportunity to change the rules. We urge Goodell to do the right thing.

Thank you for listening.

Read Full Post | Make a Comment ( None so far )

LePage, Democratic Leaders Finally Meet To Discuss Riverview Woes, Alexander Report Payments

Posted on August 8, 2014. Filed under: Uncategorized | Tags: , , , , , , , , , |

Democratic leaders had waited for more than two months for an opportunity to speak with Governor Paul LePage on a number of concerns, not the least of which were the troubling news of Riverview once again failing to qualify for federal re-certification and final resolution of the monies owed back to the state from the Alexander Group for their now widely discredited and plagiarized report.

DSC_0032A reminder: It was reported back on May 23 that Maine had finally suspended payments to Alexander and at that time, Paul LePage indicated that the option was on the table.

    On Tuesday, the governor released a statement to the Portland Press Herald, saying, I will take every action we can. I am not happy about this.”

    He added that the state may attempt to reclaim the $500,000 it has already paid The Alexander Group.

    “It’s all a matter of the extent of what the damage is,” he said.

Apparently “the damage” ultimately wasn’t that bad in Paul LePage’s eyes.

Yesterday Democratic leadership finally got their chance to question the governor and others, albeit in a closed door meeting. The news for Maine was pretty bleak, as LePage now has no intention of recouping the $475,000 already paid to the Alexander Group.

While the Governor’s office has had very little to say about the meeting, Senate President Justin Alfond and Speaker of the House Mark Eves quickly issued a joint statement about the first meeting between the three since January:

    “Our top priority for the meeting was to press the Governor for answers on the Alexander Group refund and on the latest developments at Riverview,” said House Speaker Mark Eves of North Berwick. “It’s clear that he has abandoned the effort to recoup a full refund for the discredited and plagiarized report from the Alexander Group. Of the nearly $500,000 in taxpayer funds paid to the Alexander Group, the state has recouped only $27,000.

    During the meeting, the Governor reiterated the administration’s position that it was confident the state would correct problems at the Riverview Psychiatric Center despite a recent failed bid to qualify for federal re-certification. The state psychiatric hospital lost its certification last September due to mismanagement and dangerous conditions at the hospital. As a result, the federal government said it could [hold back] approximately $20 million in funding for the hospital.

    Senate President Justin Alfond (r)answers questions at weekly media availability meeting as Speaker of the House Mark Eves (l) looks on.

    Senate President Justin Alfond (r)answers questions at weekly media availability meeting as Speaker of the House Mark Eves (l) looks on.

    “We hope the Governor is right, but we remain concerned,” said Senate President Justin Alfond of Portland. “We expect the Governor to take seriously the deficiencies in safety conditions for patients and workers that led to the loss of $20 million.

    During the meeting, Governor LePage complained that lawmakers did not pass his 11th hour proposal to increase funding for the Maine Drug Enforcement Agency. The bipartisan Appropriations Committee passed an amended bill to include funding for substance abuse treatment. At the time, the Governor said he would veto anything but his original proposal so no further votes on the bill were taken.

    “The Governor sat on the sidelines when lawmakers were doing work, whether it was the budget or other important bills. He continues to blame others for his unwillingness and inability to work constructively with the legislature,” said Senate President Alfond.

Mike Michaud at June 2014 press conference discusses plans as governor to create inspector general office, charged with investigating DHHS issues. Also pictured: State Senator Colleen Lachowicz (D-Kennebec)

Mike Michaud at June 2014 press conference discusses plans as governor to create inspector general office, charged with investigating DHHS issues. Also pictured: State Senator Colleen Lachowicz (D-Kennebec)

Today Democratic gubernatorial candidate Rep. Mike Michaud issued a statement of his own:

    “The Alexander Report has been a case study in government waste and poor judgment from the very beginning,” Michaud said.

    “This deeply flawed and controversial report has never been anything more than a political document meant to further Gov. LePage’s re-election. And now, despite public outrage and evidence that parts of the report were plagiarized, the LePage administration is still refusing to seek a full refund of hard-earned taxpayer dollars that could have been used to help working families, improve education and meet other important priorities. This is pure mismanagement and fiscal irresponsibility on the part of Gov. LePage. Mainers deserve better.”

    Michaud released a plan earlier this year to appoint an Inspector General for the Department of Health and Human Services and cited the ongoing scandal revolving around the Alexander Report as an example of one of the many issues of waste and mismanagement the office would be tasked with preventing.

    “Gov. LePage has made a big issues about waste, fraud and abuse as governor, but it’s clear that the biggest culprit of wasting taxpayer dollars is the governor himself,” Michaud said. “Mainers deserve a governor who will work with Democrats, Republicans and independents to address the issues facing Maine and who will use tax dollars wisely.”

In July it was reported that LePage thought Maine should give up on the Riverview Psychiatric Center re-certification efforts, throwing away more than $14 million in federal funding. Michaud’s response at that time:

    “Since taking office, Gov. Paul LePage’s Department of Health and Human Services has been a case study in government waste and mismanagement,” said Michaud. “His mismanagement of Riverview Psychiatric Center is the pinnacle of this and it needs to be addressed immediately. The list of issues at Riverview is exhaustive, troubling and a black eye on this administration and state. Rather than pledging to Mainers that he will address these issues, Gov. LePage is choosing to give up and throw away millions of dollars in funding. His inaction makes Maine vulnerable to lawsuits, puts Riverview on the brink of crisis and leaves Maine taxpayers to foot the bill for his failed leadership.”

Maine Republican Party spokesman David Sorensen took to Twitter, as the thus far sole GOP reaction on the meeting:

Not quite accurate, as the federal government is demanding Maine pay back monies dating back almost a year and will be still on the hook for a hefty sum, even were the hospital to become re-certified.

    We will be seeking the return of that money because the facility has been decertified,” Richard McGreal, associate regional administrator for the Centers for Medicare and Medicaid Services, told the Press Herald this week.

    If Riverview becomes certified, federal money will flow back to the center. But even then the center would not be funded retroactively, and Riverview will still owe the federal money it has used in the months it was ineligible, McGreal said.

    State officials said they have not been told of the pending “disallowance” action and have been drawing from the federal account the entire time. Maine is entitled to $20 million per year in federal money to operate Riverview, representing more than half of the hospital’s $36 million budget.

(To be updated as needed.)

*RELATED: Paul LePage And Gary Alexander: A Timeline

*RELATED: Emergency Hearing On Riverview Psychiatric Center Held; Dems Voice Concerns

Read Full Post | Make a Comment ( None so far )

Emergency Hearing on Riverview Psychiatric Center Held; Dems Voice Concerns

Posted on October 15, 2013. Filed under: Uncategorized | Tags: , , , , , |

DHHS Commissioner Mary Mayhew talks with Rep Dennis Keschl (R-Belgrade) prior to emergency meeting with AFA and HHS committees.

DHHS Commissioner Mary Mayhew talks with Rep Dennis Keschl (R-Belgrade) prior to emergency meeting with AFA and HHS committees.

Last Wednesday, Department of Health and Human Services Commissioner Mary Mayhew met with a joint session of the members of the 125th Legislature’s Appropriations and Financial Affairs (AFA) and Health and Human Services (HHS) Committees to discuss what lead to the federal government’s $20 million defunding of Maine’s Riverview Psychiatric Center. According to the feds, the decision to pull funding was based upon the center’s failure to comply with safety standards. The LePage administration received notification on October 2nd (letter dated September 27) of the decision by Centers for Medicaid and Medicare Services (CMS) in a 17 page document which detailed concerns going back to March of this year.

In late August, legislators passed emergency measure LD 1515, “An Act To Increase the Availability of Mental Health Services” designed to correct the safety and understaffing issued raised by CMS. In early September, the administration repeatedly assured lawmakers that this measure to expand the Maine State Prison’s mental health unitwould address the federal government’s concerns by reducing the patient load at Riverview. But that was not the case, as CMS terminated its $20 million funding to the psychiatric hospital following an unannounced site visit to the facility in mid-September. It cited ongoing operational, governance, and management deficiencies leading to safety concerns and human rights violations.

Here are links to some of the discussions between DHHS Commissioner Mayhew, legal counsel Ken Albert, and various members of the joint committees in their 3 1/2 hour long meeting.

Pt 1

Pt 2, Pt 3, Pt 4, Pt 5.

Afterwards, some lawmakers continued to voice concerns:

“Today’s meeting was about fulfilling the Legislature’s responsibility to work together with the Department in solving critical problems at Riverview. We expected to hear answers about how Riverview got here, why the Legislature was not kept in the loop, and what we must do going forward,” said Senator Dawn Hill of York, the Senate Chair of the Appropriations and Financial Affairs Committee.

House Chair Peggy Rotundo of Lewiston expressed frustration with the lack of answers provided: “Today was a beginning but we still don’t have clear answers from the administration about how they’re going to fix this problem and how we’re going to pay for patient care in the interim.”

She continued: “Since March, I believe, the administration has known that funding for Riverview could be in jeopardy, but the Legislature was not informed until August,” Rotundo said. She said lawmakers were then told the bill to expand mental health services at the prison would correct those problems.

“And that we would be kept in the loop in terms of what was happening at Riverview,” Rotundo said. “But since then the Legislature was not informed that CMS had been to Riverview to do the survey.”

Representative Mike Carey of Lewiston: “This comes down to staffing and money. This is what it will take to ensure the safety of the workers and to help the patients who go to Riverview to get better. But if we are going to get this done, we need direct answers and more timely information from the administration.”

AFA Committee member Senator Emily Cain of Orono: “We are all pulling for the same positive outcome. We have a responsibility for, and care deeply about the patients and staff and Riverview, and the budget implications of this crisis. And it is in the spirit of resolution that we are here today seeking answers that are long overdue.”

Mayhew responded to all: “It is unfortunate that we must continue to spend additional financial and staff resources to appeal the decision and reapply for certification. I remain confident, however, that Riverview Psychiatric Center will be recertified by CMS and will receive necessary funding for critical psychiatric services for the people of the state of Maine.”

It is still unclear what the next steps beyond the state applying for recertification will be, if there will be more discussion within the Legislature at this point and how the ongoing federal government shutdown will affect this situation and the funding woes at Riverview.

Read Full Post | Make a Comment ( None so far )

Liked it here?
Why not try sites on the blogroll...