It’s time for Gov. Janet Mills to get “personally involved” in finding solutions to long-running deficiencies with state services for disabled children, a key Democratic lawmaker said Tuesday, one day after the U.S. Department of Justice announced it was suing Maine for violating the Americans with Disabilities Act.

The DOJ, in its lawsuit, said that Maine’s failure to provide community-based care has resulted in children staying in hospital emergency departments for months waiting for a placement. The Long Creek Youth Development Center, Maine’s only youth prison, has been used as a “de facto psychiatric facility” according to the lawsuit.

State Sen. Joe Baldacci, a Bangor Democrat and co-chair of the Legislature’s Health and Human Services Committee, said in an interview with the Press Herald on Tuesday that the lawsuit sends a “serious message” that the issue is not going away, and that the system needs to be overhauled.

“The governor needs to be personally engaged,” Baldacci said. “She needs to be personally involved in fixing the problem, and needs to have a hands-on approach to (the Department of Health and Human Services).”

But Ben Goodman, a spokesperson for Mills, said the governor, also a Democrat, “has been actively engaged.”

“She has been briefed throughout the state’s negotiations with the U.S. Department of Justice, and she will remain involved in any ongoing discussions with the litigation,” Goodman said in an email response to questions.

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Nancy Cronin, executive director of the Maine Developmental Disabilities Council, a quasi-government agency funded by federal and state dollars, said a blue ribbon commission that has been examining the state’s behavioral health system will meet next week to discuss reforms.

But Cronin said meaningful changes need to happen soon to settle the lawsuit or it could result in a trial, a potential loss of federal dollars or a consent decree.

A consent decree would result in the court’s taking control of services and reforms, similar to how Maine operated under a consent decree for former patients of the defunct Augusta Mental Health Institute. That consent decree was originally signed in 1990 and an agreement to end it was signed in 2021.

A similar consent decree stemming from a 1970s lawsuit was in effect until 2010 requiring the state to improve care for people formerly served by the Pineland Center, a former state-run institution for those with intellectual disabilities.

“The state needs to do something substantive, make changes very quickly, and then you could have a settlement,” Cronin said.

Federal authorities warned Maine in a June 2022 letter that it was violating the civil rights of disabled children by not providing needed care.

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Advocates for nonprofit agencies that provide community-based services for children with behavioral health needs have long said that Medicaid reimbursement rates paid to care providers have not kept up with increases in what private employers are paying workers, despite recent improvements. That’s resulted in a drastic workforce shortage and long wait lists for patients.

On average, children with behavioral disabilities are waiting six months to a year to receive services, according to the lawsuit, filed Monday in U.S. District Court in Portland.

“Higher wages have to be part of the solution,” said Baldacci, the state senator. “It’s the only way we are going to attract the necessary workforce.”

Lindsay Hammes, spokesperson for the Maine Department of Health and Human Services, said state officials had “felt optimistic that we were making progress” during “years-worth of good-faith negotiations” with the Justice Department, but “unfortunately” the DOJ filed suit.

“The state of Maine agrees that these services are critical, and, as we defend ourselves vigorously during the lawsuit, we expect to remain in discussions with the U.S. DOJ,” she said. “Fundamentally, the state wants to continue to address this problem and strengthen the delivery of services for children with behavioral health disabilities.”

NOT THE ONLY STATE UNDER PRESSURE

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Hammes pointed to a number of initiatives that have improved accessibility for behavioral health services. But the lawsuit said recent monthly wait lists showed more than 400 children were waiting for needed mental health and developmental services.

While it’s unusual for the U.S. Department of Justice to file lawsuits to compel states to provide services, recent actions in Utah, Nebraska and Rhode Island show that Maine is not the only state facing legal pressure.

The Rhode Island case is not currently a lawsuit, but the Justice Department released the results of an investigation that showed children were “languishing” at a psychiatric hospital rather than receiving community care.

“It is nothing short of appalling that (Rhode Island) has chosen to warehouse children in a psychiatric institution, rather than stepping up to provide the community care, support, and services that these kids need, and that the law requires,” U.S. Attorney Zachary A. Cunha said in a statement in May.

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