AFA Update: Thursday, March 5, 2015- Cuts to mental health and substance abuse treatment

Public hearing day 4 of 5 with AFA and the Health and Human Services committees addressed the Governor’s proposed cuts mental health and substance abuse services including:

  • Riverview Psychiatric Center (RPC)
  • 10% reduction in Sec. 28 and Sec. 65 outpatient community mental health services
  • a drastic reduction in reimbursement for what are now considered medication management services
  • the elimination of coverage for methadone treatment in favor of exclusive use of Suboxone

Audio of today’s hearing is here.

Commissioner Mayhew presented her testimony in defense of the cuts. (Note: the first page of each instance of the Commissioner’s testimony this week is the same. As an example here is previously unpresented testimony from the Commissioner on the initiatives discussed yesterday impacting drug coverage for seniors and reimbursements to providers.)

Dr. Vijay Amarendran of Acadia Health refuted 4 different data points from the Commissioner’s testimony regarding the efficacy of Suboxone and methadone as treatments. In each case he pointed out that the source documents say precisely the opposite of what the Department claims.

Providers testified that the twin cuts in Secs. 28 & 65 and the medication management cuts will result in closing their doors.

Tom McAdam of Kennebec Behavioral Health shared the following rate changes:

Now: $211/hour               Proposed:$96/hour

a cut of 55%

Now $267/hour                                Proposed: $96/hour

a cut of 64%

This provider estimates that they will have to eliminate service to 4,000 patients statewide. They also believe that the medication management cut alone will cost the provider $2.6M annually.

Other providers testified that there is no medical basis to support the elimination of methadone treatment. Many noted that Suboxone is not an appropriate for those with severe addictions.

The point was repeatedly made that diverted methadone does not primarily  come from addiction clinics, instead from prescriptions for pain management. Finally it was noted that it is illegal for the state to not offer methadone maintenance treatment. The case at issue is Banks v. Concannon (see page 2).

Providers noted again and again that community treatment is cost effective. A year of community treatment costs roughly the same as one day of institutional care.

Providers of outpatient mental health services reminded the committees of incidents that led to the creation of our current system and support of community mental health services. Some referred to the tragic events in Waterville in 1996.

Another provider told the committees that these cuts directly undermine efforts to reform RPC. In order to be discharged from RPC one needs an appointment with a psychiatric provider. That very network is threatened by these cuts.

Public testimony 1

Public testimony 2

Public testimony 3

Public testimony 4

Public testimony 5

Public testimony 6


Tomorrow the Health and Human Services public hearings on the biennial budget comes to a close starting at 10:00 AM.

Next week looks like this:

Monday Education committee
Tuesday IF&W committee and Marine Resources
Wednesday State and Local Government
Thursday Environment and Natural Resources and Energy, Utilities and Technology
Friday Labor, Commerce, Research and Economic Development


The full schedule can be found here.

You can always attend hearings and work sessions in Room 228 or listen live here.


One thought on “AFA Update: Thursday, March 5, 2015- Cuts to mental health and substance abuse treatment

  1. Pingback: AFA Update: Thursday November 5, 2015- Drug Summit, Blind and Visually impaired Services, etc… | Maine Budget Blog

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