AUGUSTA, Maine — Gov. Paul LePage’s plan to privatize a program that connects people afflicted with serious and often life-threatening mental illnesses with a state advocate could have disastrous consequences, according to opponents of the proposal.
Privatization of the program, known as intensive case management services, is but one of several changes included in the governor’s recently submitted bill to restructure and streamline the Department of Health and Human Services.
However, the measure is drawing sharp opposition from opponents who warn the plan could invite the kind of incident that became the impetus for the program: The 1996 murder of two Waterville nuns by a manic depressive man.
The bloody attack made national news and prompted the state to evaluate how it handles and monitors the mentally ill. 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 may 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 manager budget. The administration wants to then shift $925,000 to the Department of Corrections, which would then contract a private agency to conduct the same services.
Law enforcement, jail administrators and advocates for the mentally ill are highly critical of the governor’s plan.
Glenn Ross, the Penobscot County sheriff and head of the Maine Sheriffs Association, said county sheriffs were universally opposed to the provision.
Col. Mark Westrum, administrator of the Two Bridges Regional Jail in Wiscasset, told the Sun Journal that the proposal would have a significant effect on jail populations and recidivism rates.
Several current intensive case managers agree. They worry that their clients could fall through the cracks if a private agency takes over.
“I am not here to save my job. I’m here out of concern for the clients I work with,” said Peggy Paine, an intensive case manager from Falmouth.
Paine and Audrey Bonner, a case manager who works at the Androscoggin County Jail, argued that they had established relationships with clients and were available after normal work hours. They told the Health and Human Services Committee several anecdotes in which their familiarity with mentally ill clients had saved them and others from doing harm to others or themselves.
Bonner said she and her colleagues were often the last resort for individuals who are uninsured and refuse treatment.
Paine said community agencies are often unable to work with the uninsured or may not have the funds for charity care. She said engaging with some clients is time consuming. She told a story of how it took her four months to convince a young, pregnant homeless woman to accept her assistance.
Guy Cousins, the DHHS director of substance abuse, said the proposal strikes the right balance between streamlining without eliminating services. Cousins also rejected claims that a private agency would not be equipped to handle the intensive case managers’ caseload.
Sen. Margaret Craven, D-Lewiston, and others questioned the administration’s proposal to privatize the service given that it doesn’t appear to generate any savings.
“Why are we replacing people who have experience with people who don’t?” Craven asked.
The intensive case management program may be the most controversial of LePage’s restructuring proposal.
Most of the testimony on Wednesday opposed the bill. However, several private care agencies that stand to benefit from the reorganization supported the bill.
The governor announced the bill last week.
The 48-page bill 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.
DHHS Commissioner Mary Mayhew has said that cost savings isn’t the impetus for the bill.
“The goals of restructuring are to focus more resources on the consumer, to improve frontline resources and better integrate services over the age span and across many levels of care,” Mayhew said last week.
Critics, however, are questioning the late arrival of the bill. The Legislature is scheduled to adjourn in mid-April. Barring an extension, all legislation is supposed to be reported out of committee by Friday.
The Health and Human Services Committee will hold a work session on the restructuring bill on Thursday.
To see more from the Sun Journal, visit sunjournal.com.
I’ll be glad when LePage’s Reign of Terror ends!
When his eights year are up
Sounds like testimony is reflecting the overused [union] talking points: safety and experience. Of course people tend to forget that there’s just as much experience available in the private sector when cases are managed by private sector long term employees. If [public] safety had been foremost in the minds of those responsible for managing the case of the man who murdered the two Waterville nuns, their murders might not have occurred. I can’t say that the murders wouldn’t have occurred, but I couldn’t have reasonably said that if his case management had been overseen by a private sector contract either.
It is against the law to force severely mentally ill people to take medication or get treatment against their will. Intensive case management is essentially used for the chronic and severely mentally ill people within the community. It would be absolutely ignorant AND dangerous to shift the case management of these individuals to the private sector. The whole reason this population receives PUBLIC case management is because it allows for better, more consistent and SAFER outcomes for not only those served but also the public. But hey…if you want to hope that a for profit organization that ONLY cares about making a profit provides the level of monitoring necessary to keep people with paranoid schizophrenia from becoming psychotic and homicidal due to forgetting to take their medication then start praying that none of your loved ones are living, working, attending school or out in the community when people stop taking their meds and start thinking the harmless 10 year old riding their bike is with the CIA and are trying to kill them. Good lord some people are SO DUMB…and LePage is right at the top of the list.
Drugs are bad, and many can kill without a known reason, especially phycitropic drugs and sudden unexplained death. Some doctors do not take the patients warnings about how detrimental a mediation can be. They are psychotic why should they? I guess is the mentality. I do not think we should be allowed to force people to take medications that may kill them.
If it’s CIA or some other government agency, are you sure they are schizophrenic? I ‘ve been told no two schizophrenics hear the same things and people who are considered normal think things about the government. Look at how many people believe in or talk about big brother. What have we learned or still do not know about electromagnetic waves in the air and all around us, and the government has them allocated, some only for government agencies, especially lower one’s right near our brainwaves. Who needs telescreens?
Sure that voice in your head, or thought in the back of your mind isn’t a microwave, that cooks food from the inside out? Data, like cell phone technology is carried on microwave frequencies. How do they effect our brains? Hoping not enough to cook the brain, but what happens when the cells are stimulated by microwaves?
Besides is it about someone hearing higher and lower frequency voices? Lower frequencies do not travel through things like trees and the skull like higher frequencies, but travel further without obstruction. Or is it about how one reacts, and there harmful actions?
There are stints that can stop electricity, imagine a frequency that could stop computers or change a gate on a board and change the outcome, or shut down our own bodies for a moment as we are affected by electrical current, and conduct electro chemical reactions. A 21st century concern for homeland security, wireless technology.
Most of the stories with people on bath salts and hearing voices were not the same government conspiracies, necessarily. I remember hearing of people walking around naked, breaking into people’s homes to watch TV. That is different.
Don’t listen to me. Apparently my thought is abstract and out of line with the norm, so I must be crazy?
Nokola Tesla was an INTP where Edison was an ENTP, Tesla On a MBTI Tesla was much smarter than Edison but much more introverted a bit of a nut. Edison go got the credit for much or Teslas work being more extroverted . I also do not seem to think the same way the majority of people do. If just makes me different. Seems to me a lot of peoples thinking is with emotions not logic. Why do they not make cellphones work 5 miles from a tower . When Ham operators could talk around the world 100 years ago? The government must be so far ahead of things by now that they do not want the average person to know. I do not think we made 911 . But knew right from the start the war was not about WMDs . It did not make me popular then. Politics is more about popularity than than the truth. Maybe that is why I am fascinated By Tesla and Kaczynski hint. I may see the world a but differently than most people but I am really OK with that.It dose not mean I am mentally ill .
Almost all of the agencies capable of being contracted to provide the same services that DHHS-ICM’s provide are NON-PROFIT organizations. The model/idea of the DHHS/ICM program is a novel and helpful one. The oversight of the program so far however, has proven wasteful and poorly managed. There are definitely some great DHHS/ICM workers who do an incredible job, however there are also many who should have and would have been relieved of their jobs long ago had they been employed by a non-state agency. Many of those who work directly with ICM’s know exactly what I’m saying. Perhaps if the program is going to continue to run with agencies other than the state providing the services, preference in interviewing for the new positions should be given to those state workers with experience doing the job. There are certainly some ICM’s who would fear this prospect however, as their personal reputations are soiled by years of poor service to the consumers of mental health services. Others could face this prospect with confidence as their performance and work history would give them many references who could attest to their great job performance.
Over her history The United States of America has produced some of the finest warriors the planet has ever known. From the very beginning of our history at The Lexington Green where ordinary people took up arms against a highly trained and well equipped British Army, to the trenches in Europe in World War One, to the beaches of Normandy and the Islands in the Pacific in World War Two and even in the invasion of Iraq the American Warrior has proven over and over to be the best the world has ever seen. They have been extremely good at destroying things and killing the enemy. They have, when given the chance, defended liberty and our way of life. What they have not done so well at is being social workers. Maine’s Sheriff’s have shown an ability to run jails and with a few exceptions have done an excellent job of keeping criminals incarcerated. Like the American Warrior they have proven themselves to be good at what they are trained to do, keep the bad guys in jail. However they , like the military, are not social workers either. Mental illness is not a crime in our country. Why then put the care of those who suffer from mental illness in the hands of jailers? The Sheriffs admit it isn’t something they want to do or are trained to do. Jails are for criminals, not sick people.
What about the parents of the children with mental illness should they be taking care of there children instead of Maine Care. Why is it the state problem all the time. I am sorry for whats happens to the parents and children but someone needs to draw the line. So if you have a mental illness its the states problem???
LePage, the leader of people strikes again.
With a nickname like Penguin he should be more supportive of the original cause of having ICMs. Nuns were killed, then the ICM program as it is now was created.
LePage loves nuns. He loves to make jokes at the Heritage Foundation Annual Meeting about pregnant ones.