The LePage administration has failed to provide group-home care and other services to more than 100 intellectually and developmentally impaired adults as required under Medicaid, according to a class-action lawsuit filed in Kennebec County Superior Court.
The lawsuit names as defendants Gov. Paul LePage, Health and Human Services Commissioner Mary Mayhew, and Ricker Hamilton, acting director of the Office of Adults with Cognitive and Physical Disabilities Services.
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It was filed Monday by parents, family members and guardians of 18 men and women who are representing 176 Mainers on a priority waiting list for group-home placement and other services, according to court records.
A federally approved Medicaid plan directs the state to provide services to 2,935 eligible Mainers, but the program now serves only 2,820, said Gerald Petruccelli, a lawyer for the group.
“You cannot have approved slots and then not fund them and fill them,” Petruccelli said Tuesday. “I’m assuming the court will do what it’s supposed to do and the state will comply.”
The LePage administration declined to comment on the lawsuit. In recent interviews about rising Medicaid costs, Mayhew has referred to 779 people — the priority list plus others — who are waiting for placement in group homes, financial assistance for supportive home environments and other services.
If the court orders the state to comply, Petruccelli said, it’s unclear how the DHHS will decide who among the 176 people on the priority waiting list will be chosen for the 115 available slots.
The services are provided through MaineCare, the state’s Medicaid program.
LePage and the Legislature are facing a $90 million shortfall in the current DHHS budget, which ends June 30. LePage’s proposed budget for the next two fiscal years calls for $52 million in cuts to health care and human services programs.
The state began restricting access to group homes and other services for mentally impaired adults in 2008, three years before LePage became governor.
The program was closed then to new participants, and only a few have been enrolled since, said Mary Lou Dyer, managing director of the Maine Association for Community Service Providers, which represents 70 group-home operators and other providers across the state.
The program’s current budget sustained a 5 percent cut, eliminating $3.6 million in state funding and about $7.2 million in matching federal reimbursements, Dyer said. It may lose an additional $850,000 in the supplemental budget for January through June that’s now before the Legislature.
The restricted funding has put dozens of mentally impaired adults at risk of abuse, neglect and exploitation because they cannot live on their own or need assistance to do so, Dyer said. It also has put their parents, family members and guardians in untenable situations.
“They have cared for, protected and advocated for their children for years,” Dyer said Tuesday. “Now, when they are unable to continue, it’s a parent’s worst fear that no one will take care of their adult children.”
The plaintiffs include Ruth Andersson, 56, who has been on the waiting list since 2009, according to the lawsuit.
She has Down syndrome and needs full assistance with daily living activities. She lived with her mother, who died in March, and now lives with a couple who provide limited support without being reimbursed.
Another plaintiff is Edward Nielsen, 45, who has been on the waiting list since 2011. He has cerebral palsy, is nonverbal and requires constant supervision and assistance with daily activities.
His mother cared for him until she died in early 2012. Now his sister is trying to care for him in the family home, which requires her to be away from her husband and family.
Monica LaRose, 43, has been on the waiting list since 2009. She has a combination of developmental and mental health challenges that require daily supervision and monitoring of medications. She lives with her elderly father, who has health problems that limit his ability to care for her.
Given their tough budget choices, Maine legislators may be forced to fund services that are required by law rather than those that are considered optional, said lawyers at Petruccelli, Martin and Haddow in Portland.
“These are people who have been on the sidelines, waiting to get into the program for a long time,” said Bruce McGlauflin, another lawyer for the plaintiffs. “They shouldn’t have to wait anymore.”
CORRECTION: This story was updated at 10:50 a.m. on Jan. 30, 2013, to reflect that the program may lose an additional $850,000 in the supplemental budget for January through June that’s now before the Legislature.
Staff Writer Kelley Bouchard can be contacted at 791-6328 or at:
kbouchard@pressherald.com
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