AUGUSTA — Lawmakers on the Health and Human Services Committee on Tuesday voted mostly along partly lines to approve Gov. Paul LePage’s restructuring plan at the Department of the Health and Human Services.

The panel approved an amended version of LD 1887, a recently submitted bill designed to streamline the operations of the state’s largest agency. All eight Republicans supported the plan. Rep. Matthew Peterson, D-Rumford, voted with the majority.

Republicans have advocated overhauling operations at an agency that employs about 3,600 people and comprises about 45 percent of all state spending.

Several Democrats said they shared that goal, but predicated their dissenting votes on their mistrust of an agency that they believe purposefully withheld information about a DHHS computer error that allowed 19,000 ineligible Mainers to receive Medicaid benefits.

The mishap was the subject of dueling partisan press events during which Democrats accused the LePage administration of covering up the computer error during DHHS budget deliberations earlier this year.

Republicans fired back, saying billing errors at the agency well predated their 14-month control of state government. In addition, the computer mishap has pushed back GOP efforts to pass another — and potentially politically unpopular — DHHS budget into the election season. 

The dynamic served as a backdrop to the governor’s restructuring plan that contained several controversial provisions. The most contentious proposal was a plan to privatize a program that connects people afflicted with serious and often life-threatening mental illnesses with state advocates.

Opponents said privatization of the program, known as intensive case management services, could invite the kind of incident that became the impetus for its implementation: the 1996 murder of two Waterville nuns by a mentally ill man.

The attack prompted the state to evaluate how it handles and monitors people with mental illnesses. Shortly thereafter, the state deployed a specially trained team of DHHS employees to embed with county jails and coordinate with police, corrections officials and homeless shelters to monitor and counsel high-risk individuals who might be predisposed to violent and dangerous behavior.

The 37-member unit works in the Office of Substance Abuse and Mental Health Services. LePage has proposed eliminating the agency and the $1.5 million intensive case management budget. The administration wants to then shift $925,000 to the Department of Corrections, which would contract a private agency to conduct the same services.

Law enforcement, jail administrators and advocates for the mentally ill were highly critical of the governor’s plan. They worry that their clients could fall through the cracks if a private agency takes over.

Such concerns prompted the administration to amend the proposal to gradually phase in privatization. The change won over GOP panelists, but several Democrats were still concerned about a private agency’s ability and willingness to take on clients who might not qualify for Medicaid.

Mental health advocates added that the clients served by the ICM program are often homeless, violent or mentally ill and often refuse assistance. Others questioned why the administration wanted to privatize the service given that it doesn’t appear to generate any savings.

Nonetheless, the vote moves forward a bill that eliminates and reassigns the duties of several agencies into consolidated departments. Ninety-one positions will be eliminated in the plan; however, another 44 will be created, for a net loss of 47 positions.

Thirty-seven of the 47 positions are in the intensive case management program.

The administration has said savings isn’t the impetus for the bill. It’s designed to make the agency more effective. 

Republicans on the HHS committee said the proposal was long overdue. 

“Doing nothing is not an alternative,” Rep. Les Fossel, R-Alna, said. “To vote to do nothing is to continue what I consider to be the insanity that’s been going on at (DHHS) for a very long time.”

Democratic Reps. Mark Eves of North Berwick and Linda Sanborn of Gorham said they didn’t have the necessary trust in DHHS to endorse the plan. 

Sanborn added that claims by agency officials that the restructuring would refocus benefit delivery on preventive care didn’t jive with the administration’s cuts to programs such as the Fund for a Healthy Maine.

The rhetorical jousting over the DHHS computer error continued throughout the day Tuesday. 

Democrats used the press conference to assert that the LePage administration participated in a “cover-up” and pressed for an investigation. The event came on the heels of a bill request by Sen. Joseph Brannigan, D-Portland, asking the Legislature’s watchdog agency to investigate the matter. 

Brannigan’s request was tabled by the Republican majority on the Legislative Council. However, Sen. Roger Katz, R-Augusta, who chairs the committee that oversees the watchdog agency, said last week that the panel would initiate the review during its Tuesday meeting. 

Katz repeated those comments during an unscheduled press conference. 

Sen. Justin Alfond, D-Portland, said the announcement was “a good first step.”

“It’s imperative that we know all the facts and whether information was deliberately withheld to create a false sense of crisis,” he said in a statement.

Republicans derided the press conference as “pure political showmanship.”

“It is nothing more than another episode of political theater . . . it distracts from the work of trying to solve, once and for all, the persistent problems in a department that has grown uncontrollably over the years,” said Rep. Andre Cushing, R-Hampden

Issues with payments going to ineligible Medicaid recipients had been identified by state auditors beginning last summer. 

State Auditor Neria Douglass said auditors informed the appropriate program directors at DHHS. Douglass told the Sun Journal that she first began hearing from her staff about potential wrongful Medicaid payments last summer.

DHHS Commissioner Mary Mayhew acknowledged that state auditors had expressed concerns about the “lack of action” on some of the identified problems. However, she said, inter-department communication wasn’t what it should have been. 

The affected program directors were also new on the job. The directors are political appointees of the governor. LePage, in an effort to implement his new policy initiatives, last year jettisoned a host of program directors from DHHS, including all three directors who would have been notified of the computer problem.

Two of the replacement directors were new to the agency. A third was promoted from within DHHS. 

smistler@sunjournal.com

This story has been updated to note the meeting time for the Government Oversight Committee. 

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