MaineCare cuts could 'virtually eliminate' Portland programs

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PORTLAND — City officials are warning that proposed cuts to the state’s MaineCare program would virtually eliminate health and case management services to low-income residents.

Gov. Paul LePage has proposed cutting $120 million from MaineCare to close a budget deficit in the state Department of Health and Human Services. The proposal would affect about 65,000 Mainers.

Mayor Michael Brennan said he will go to Augusta on Wednesday to testify before the Appropriations Committee about the proposed cuts.

Brennan, a former state senator and majority leader, told the City Council on Monday he would ” try and talk to my former colleagues about the impact this type of proposal would have on the city of Portland.”

Brennan will join other Democrats in opposing the plan. The Maine Council of Churches is also planning a prayer vigil at the Statehouse on Wednesday.

Assistant Senate Minority Leader Justin Alfond, D-Portland, said in a statement the cuts could also cause the state to lose federal funds at a 2-to-1 ratio.

“Those 65,000 Mainers won’t all of sudden stop needing health care and, as we all know, they won’t be able to afford to purchase health insurance,” Alfond said. “The problem won’t go away, it just shifts the burden, and the cost.”

City Hall spokeswoman Nicole Clegg said the city is still crunching the numbers about how many Portland residents, and how the city budget, would be affected by the proposed cuts.

“That stuff is going to have clear impacts on the community – on the city,” Clegg said. “We just haven’t had a chance to wrap our arms around what that really means. We know it’s going to have an impact.”

Clegg said staffers were quantifying those impacts in preparation for Brennan’s testimony.

According to a Dec. 8 analysis by city Health and Human Services Director Doug Gardner that was provided to city councilors, many of the city’s social service programs – particularly those that focus on childless homeless individuals between the ages of 21 and 61, and refugees – would be “virtually eliminated” under LePage’s plan.

The cuts could also impact the city’s budget, since more people would be expected to seek assistance through the city’s general assistance program.

LePage’s proposal to eliminate the Mainecare Childless Adult Waiver would affect the Portland Community Health Center’s two sites: the Healthcare for Homeless Clinic and 180 Park Ave.

Those clinics provide health care to those who can’t otherwise afford it. The programs are funded by federal reimbursements.

The impact to the Healthcare for Homeless Clinic is of particular concern to city officials, since there has been what Gardner’s analysis called a “significant” (60 to 40 percent) decrease in the number of MaineCare eligible patients in recent years. 

A similar cut was proposed earlier this year. Dr. Shuli Bonham, a physician at the clinic, testified against the changes in May before the Appropriations Committee.

According to a transcript of Bonham’s testimony, the clinic annually provides physical health, mental health, substance abuse and oral health services to 2,200 homeless people.

“This clinic is the only option available to the city’s most vulnerable population to access to primary care,” Bonham said at the time. “Were it not for Health Care for the Homeless, these men would either forgo treatment or show up at the emergency room for charitable care.”

The elimination of Targeted Case Management, meanwhile, would virtually eliminate all case management services offered by the city at the Family Shelter, Oxford Street Shelter and within its Refugee Services.

Clegg said case management services allow the city to work with landlords to keep vulnerable residents in a stable home environment, rather than on the streets.

Portland’s community-based residential facilities, such as the Serenity House, Milestone, Opportunity Alliance and Shalom House, would also take a “devastating” hit, Gardner’s analysis said. 

This is the second time this year funding for Milestone has been threatened.

Milestone, which provides a refuge for homeless people struggling with substance abuse, closed its emergency shelter temporarily last month due to changes in the federal Medicaid program.

The city later worked about a deal to keep the center open without losing funding. 

City officials also fear that cuts to the Fund for Healthy Maine will affect their Healthy Maine Partnership programs. Gardner said those programs focus tobacco cessation, nutrition, substance abuse and increasing physical activity.

Councilor John Anton encouraged the mayor and city manager to make the potential impacts of LePage’s plan better know to the public.

“The information I saw was pretty stunning,” Anton said. “The more we can articulate staff analysis of the proposal as a direct impact to the city – both on a human level and a budget level – the wider that information is disseminated, the stronger it will be.”

Randy Billings can be reached at 781-3661 ext. 100 or Follow him on Twitter: @randybillings