LePage unveils plan to restructure DHHS

AUGUSTA, Maine — The LePage administration laid out a plan Wednesday to restructure the Department of Health and Human Services into a leaner organization that better serves Maine’s needy.

LePage’s proposed bill would consolidate four DHHS offices into two and reorganize another. It eliminates 91 positions across various levels and creates 44 jobs for a net loss of 47 positions.

Several of the jobs under the ax are vacant.

DHHS employees were notified of the planned cuts earlier Wednesday.

In the works for several months, the restructuring bill is not designed to address the department’s current budget gap, according to DHHS Commissioner Mary Mayhew. The legislation also predates a computer error that came to light last week which led the state’s Medicaid program to continue paying medical bills for up to 19,000 beneficiaries after they became ineligible for the program, she said.

“We have been focused on evaluating this department since last summer in terms of our vision for this level of integration,” Mayhew said.

The bill, expected to be submitted this week, will require approval by the Legislature.

The proposal seeks to merge the Offices of Substance Abuse and Adult Mental Health Services and combine the Offices of Elder Services and Cognitive and Physical Disabilities Services.

The Office of Child and Family Services will reorganize and link together its four major service areas, including child welfare and behavioral health.

The Office of MaineCare Services and the Office of Family Independence, which oversees food stamp and child support programs, are not targeted under the restructuring.

Officials still are nailing down the reorganization’s financial effect, but early predictions are for modest savings of around $500,000, Mayhew said.

The savings might be used to draw down a wait list for services for adults with developmental disabilities, she said.

Lawmakers continue to grapple with a roughly $85 million shortfall at DHHS looming in the next fiscal year. Late last month, Gov. Paul LePage signed into law a measure that closed a $120 million budget gap this year, allowing DHHS to keep paying its bills through June 30.

Meanwhile, the legislative session is quickly approaching its April wrap-up.

The restructuring legislation is expected to be printed “any day now,” followed by a public hearing within several more days, Mayhew said.

The goals of the shakeup are to shift resources from middle management to front line services, and to make DHHS’ web of various services easier to navigate, according to Bonnie Smith, deputy commissioner of programs.

DHHS administers a range of health and social services including mental health programs, foster care and oversight of public drinking water. It has offices from Sanford to Fort Kent and employs roughly 3,600 people.

Under the restructuring, contracts will be consolidated to cut down on administrative costs. The overhaul also would help DHHS better serve children in the system who fall through the cracks after reaching adulthood, Smith said.

Hospitals, clinics and other health care providers should benefit from better communications within the department, according to Mayhew.

“We would clearly hope that the administrative burden, at a minimum, on providers and agencies could be reduced as a result of this,” she said.

If approved by the Legislature, the restructuring would mark the first substantial overhaul of DHHS since it formed in 2004 through a merger of the Department of Human Services and the Department of Behavioral and Developmental Services. That consolidation, too, was designed to improve efficiency.

“Back in 2004 when the departments merged to create the Department of Health and Human Services, the result was that while much of the work merged, some of the things still didn’t come together and much of our services and our programs were designed in silos,” Smith said.

While DHHS officials said the restructuring bill was unrelated to last week’s Medicaid computer problems, Mayhew has cited poor communications within the department as a factor in the bad payments.

Rep. Mark Eves of North Berwick, the lead House Democrat on the Legislature’s Health and Human Services Committee, said he sees a direct link between the computer problems and the loss of jobs outlined in the restructuring proposal.

LePage has swept a host of high-ranking DHHS managers from their positions since taking office, leading to a “brain drain” within the department that contributed to the erroneous payments and a budget proposal based more on ideology than sound information, Eves said.

“We will keep an open mind” about the proposed reorganization, he said. “We do have a lot of questions.”

The Health and Human Services Committee was briefed Wednesday on the planned restructuring.

Republican committee co-chair Rep. Meredith Strang Burgess of Cumberland said she’s optimistic the bill will reduce duplication and finally tie up loose ends from the 2004 merger.

She credited the proposal for shifting the focus from management to people who use DHHS services.

“Anything that helps the people of Maine, I’m all ears,” she said.