Maine violated the Americans with Disabilities Act by not making community-based services accessible enough to children with mental health and developmental disabilities, the U.S. Justice Department said Wednesday.
Following a complaint filed by Disability Rights Maine, an investigation determined that the state violated the law as well as a Supreme Court decision holding that people with disabilities have a right to receive services in a setting appropriate to their needs, such as homes and communities.
“Absent these services, Maine children with disabilities enter emergency rooms, come into contact with law enforcement, and remain in institutions when many of them could be at home if Maine put in place sufficient community-based services,” the department said.
An investigation found that there were a number of barriers in Maine that prevented such services such as lengthy waitlists, an insufficient provider network, inadequate crisis services and a lack of support for foster care parents which lead to children entering in- and out-of state facilities or Long Creek Youth Development Center to receive behavioral health services, according to the department.
The pandemic made it difficult for providers to hire and maintain staff to provide needed services, saying it “set back” the progress the state hoped to make in providing care, Department of Health and Human Services spokesperson Jackie Farwell said in a response to the finding.
She noted the problems Maine faces in providing care for children go back decades and the state is dedicating $230 million in the next two years to behavioral health services. The state also put $12 million toward trying to keep people out of inpatient settings by boosting community treatments and case management services.
“We share the strong sense of urgency in ensuring that Maine children with disabilities have timely access to an array of high-quality, evidence-based services that prevent institutionalization whenever possible – and will continue to work diligently towards that end,” she said.
The finding shows Maine has not yet come to terms with its service issues and the harm it has caused families and children, said Atlee Reilly, the legal director for Disability Rights Maine.
“Hopefully today is the day that Maine begins to turn away from expensive and ineffective institutional solutions and toward a system that supports youth in their homes and communities,” he said.
Due to the pandemic, hospitals across Maine reached capacity and caused staff shortages, which resulted in people with mental and behavioral crises being put on waiting lists and kept in emergency rooms because there was no room for them elsewhere.
A Bangor mother told the BDN in November how her 8-year-old son with severe ADHD, impulse control issues and intermittent explosive disorder had been institutionalized for six months already because he was at risk of losing a residential bed if he left the hospital.
The department made five main recommendations to the state to fix its violations and avoid a lawsuit. Chief among them was reducing its waitlists for access to care, improving its community-based programs and supporting a policy requiring providers to serve children.
It noted Maine has set aside $10 million in American Rescue Plan Act funds to improve wrap-around services for children with complex needs. But the eligibility criteria, when those services start or how they will interact with MaineCare services has not been detailed.
“I hope that the violations identified by the Justice Department can be remedied so that these children and their families are able to obtain quality services in their own communities,” said Darcie N. McElwee, Maine’s U.S. attorney.
BDN writer Caitlin Andrews contributed to this report.