AUGUSTA — She’ll try.
Commissioner Brenda Harvey of the Maine Department of Health and Human Services told 80 social workers caught up in Possibilities Counseling’s downward spiral Thursday night that she’ll try to find out which claims are still outstanding, whether it’s possible to reach back and cover old, unpaid bills, and if exceptions could be made because of the bind they’ve found themselves in.
What she said she couldn’t address: the matter of what could be unbilled millions.
Licensed by the state as a mental health agency in 2006, Possibilities Counseling in Auburn started to unravel in August when a surprise inspection found among a host of deficiencies that most staff had quit and shortly after that, therapists had stopped being paid.
Possibilities, headquartered on Center Street, had worked with 500-plus social workers who served 10,000 patients around Maine. The therapists and case managers worked as independent contractors, with Possibilities acting as billing agent on their behalf. MaineCare was its largest client.
Harvey spoke Thursday at a forum at the University of Maine at Augusta organized by the Maine Chapter of the National Association of Social Workers. She said that last September, the state paid Possibilities and President Wendy Bergeron $1.3 million in claims. Last October: $1.37 million.
This September, that figure dropped to $358,000. This October: $309,000.
Harvey said there’s no indication that DHHS has claims languishing in its system.
“Staff is working with (Bergeron) to get claims submitted accurately,” Harvey said, adding later: “Wendy arrived at our door, so I was told, with a box of claims to be processed.”
Possibilities and Bergeron are the subjects of three lawsuits, one by a business that used to loan the agency money for payroll and two that want to serve as class-action suits on behalf of the social workers to recoup what one attorney estimated is more than $3 million in back pay.
Several people took Harvey to task for, as they saw it, not stepping into the situation sooner.
“We as affiliates trust that you are going to oversee her and make sure she’s doing her job,” said Jill Hymers of Topsham. “Now I feel like I have to hire an attorney to get to the bottom of this. The state should have been stepping forward as our advocates.”
Mitch Markowitz of Lincolnville said he was frustrated that if he chose to go it alone as an independent provider in the future versus using an agency like Possibilities he’d earn $10 to $15 less an hour.
“That’s not viable; that’s a lot of revenue lost,” he said. “Independents should bill MaineCare at the same rate as an agency. Who’s going to work harder for less money? It seems like a negatively rigged deal.”
Harvey said the affiliate structure, “an agency without walls,” is something bound to face scrutiny in the Legislature this winter. She asked everyone in the room what they thought could happen when they signed their independent contractor agreements with Possibilities.
“I think that’s one of the struggles with this whole model,” she said. “Did you understand the risks?”
She said she’d assign someone at DHHS on Friday morning to act as a customer service rep to social workers to help answer the question of outstanding claims.