Blue Ribbon Commission delivers 25 recommendations to reorganize Maine DHHS; committee to consider changes

The Blue Ribbon Commission studying the organization and service delivery of the Maine Department of Health and Human Services presented a report to the Joint Standing Committee on Health and Human Services, urging 25 recommendations across eight topic areas and asking the committee to consider legislative and rulemaking responses.

Senator Henry Ingorson, chairing the meeting, introduced the report and the commission chairs before the commission summarized its findings. "First and foremost, we worked in a bipartisan manner," said Senator Jill Dusan, Senate Assistant Majority Leader, describing the commission's approach and the range of issues it examined.

The commission said its 25 recommendations — developed over eight meetings — fall into eight topic areas: child welfare and child protective services; children and youth with special health care needs; behavioral health and developmental disabilities; elder services; complex cases; service delivery improvements; and legislative oversight. The report recommends actions ranging from improving internal and external communications and oversight to strengthening department leadership and adjusting use of federal block grant funding.

The commission urged the Legislature to "support the 30 recommendations" of a separate government oversight committee investigation into the experience of persons who report suspected child abuse, a recommendation intended to increase reporting follow-up and public feedback about reports. The commission also recommended that the Department of Health and Human Services implement security standards for licensed childcare facilities through rulemaking while "taking into consideration the cost providers will incur," a change commissioners said is currently absent.

Nancy Cronin, executive director of the Maine Developmental Disabilities Council and a parent of a child with special health care needs, emphasized gaps for medically complex children that she said are not captured by the state’s behavioral health model. "We really do need a continuum of care for children that doesn't just look at things from a behavioral health model," Cronin said, citing Title 5 and the original Social Security Act as foundations for coordinated services.

The commission flagged several implementation and oversight items: tracking and consolidating multiple wait lists for nursing or other intensive services; examining how Title 5 block grant funds are used (including noting the federal law expectation that 30% of Title 5 funds support certain activities); and continuing to monitor progress related to a Department of Justice settlement tied to the state's behavioral health system.

Representative Margaret Craven, who chaired the Blue Ribbon Commission, said the panel tried to identify both problems and areas where the department already performs well. Representative Dan Shigure was noted as the sponsor of the legislation that created the commission; according to the record, a bill title to implement the commission's recommendations was filed after the report but then withdrawn to allow this committee to determine what it may wish to include.

Commission staff thanked policy and fiscal analysts — Anna Broom and Lynn Westfall from the Office of Policy and Legal Analysis and Luke Leshore from the Office of Fiscal and Program Review — for supporting the commission’s review.

What happens next is for the Joint Standing Committee on Health and Human Services to review the report and decide whether to advance legislation, rulemaking, or other oversight actions. The commission’s summary materials were provided to the committee clerk at the meeting.