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Maine has reached a settlement with the U.S. Department of Justice after the agency took legal action against the state over its children’s behavioral health services.
Gov. Janet Mills announced Tuesday that her administration reached an agreement with the federal agency after years of negotiations. Though Mills said the concerns preceded her time as chief executive, she has worked with the state Legislature to invest $260 million in increasing accessibility, availability, quality and consistency of children’s behavioral health services.
Mills said she is confident the state could have successfully defended itself in the lawsuit, but asked herself: “‘At what cost?’ Protracted, expensive litigation would only have detracted from what’s most important — continuing to improve our children’s behavioral health system.” She added that the settlement recognizes the improvements the state has already made while outlining a path to continue that progress to ensure the state is in compliance with Title II of the Americans with Disabilities Act.
“We all strongly agree that in-community behavioral health services are critical, and we are committed to continuing to strengthen the delivery of those services for Maine children who need them,” Mills said in the news release.
The settlement comes after the DOJ filed a complaint in September alleging that Maine unnecessarily segregated hundreds of children with mental health and/or developmental disability, often sending them out of state, without giving their families much of a choice in the matter.
As part of the agreement the state will increase the availability of community-based behavioral health services for children, while allowing families to make informed choices about accessing services outside of their homes. It also includes commitments to provide timely assessments, reduce wait lists and lessen the need for short term stays in hospitals and other institutional settings.
Improvements to children’s behavioral health services
The Maine Department of Health and Human Services is also making improvements such as spending $15.4 million annually to expand accessibility of the Maine Crisis Line, as well as the Mobile Crisis and the Cumberland County Crisis Receiving Center. This includes doubling the staff at the Maine Crisis Line. There are also investments in home treatment options and wraparound services.
“The State of Maine agrees that it has an obligation to protect and care for children with disabilities and behavioral health needs, and that’s why we’ve dedicated years of time and investments to rebuild Maine’s children’s behavioral health services,” said Sara Gagné-Holmes, commissioner of the Maine Department of Health and Human Services.
The department is also piloting a children’s behavioral health walk up center in Bangor to provide immediate mental health support. This pilot has already served 150 youth experiencing anxiety, depression, suicidality and other behavioral health needs by providing them with follow up support and helping coordinate higher levels of care within their community.
The department has also allocated $237 million to revise the reimbursement rate for behavioral health services with MaineCare providers.
As a result of the state’s efforts to improve services, the total number of Maine children in in-state residential treatment has decreased by about 100, while the number of children in out-of-state care has dropped from 250 to 69. Waitlists for home and community-based services have also decreased since June 2022.
The Mills administration has budgeted another $2.2 million to streamline the assessment for medium and high intensity services, implement in-home family therapy, expand the children’s behavioral health workforce and add news positions that will conduct quality assurance reviews and provide other support to deliver high quality care.
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