PARIS
— Community Concepts, Inc. (CCI), the nonprofit social-services agency serving
Oxford, Androscoggin and Franklin counties, has announced that it will shut
down the last of its adult day services programs, effective January 31.
But
while Community Concepts lays the blame for the program’s demise on the state,
officials with the Department of Health and Human Services say it is the local
agency that dropped the ball.
The
closing will affect approximately 50 clients and nine staff members in
locations at High Street in Paris and Congress Street in Rumford.
According
to Community Concepts spokesman Mary Ellen Therriault, the agency will continue
leasing the High Street building, with “no immediate change,” because that site
also houses staff from its property management arm.
The
final nail in the adult day services program follows earlier restructuring by
Community Concepts in November 2005, that shuttered a second Rumford location
offering the program, as well as one in Farmington. Eight employees were said to have lost their
jobs in that realignment, designed to try and keep some offerings up and
running.
Launched
in December, 2001, as a service designed to provide daytime care for senior
citizens — especially those with Alzheimer's or other forms of dementia — the
program soon expanded to other adults with mental health challenges. The service allowed families to place their loved
ones in a safe, monitored environment while they went to work, or ran the
necessary errands of life.
“Basically,
it was for someone who can’t or shouldn’t be left alone,” said Therriault. “We provided health monitoring — making sure
they take their medicine, personal care as necessary — showers and that kind of
thing, nutrition based on their specific medical needs and socialization
activities.
“We
would have trips into the community as well as have folks come in and do
activities with them,” said Therriault.
At
its high point, Community Concept’s adult day services program served 128
people in the tri-county area.
With
the help of those services, clients were able to continue living in their communities,
forestalling the need for institutional care, said Community Concept’s
executive director, Matthew Smith, in a recent press release.
Smith
said he worries about the demise of locally based support for mental health,
fearing it will lead to greater stress on other public services.
“Our
clients will be faced with worsening conditions and may be forces to seek help
at hospital emergency rooms, or find themselves involved with the police [and]
our courts,” he said.
“Folks
won’t have this service anymore, so what are they going to do when they end up
having a crisis?” asked Therriault, rhetorically. “They are going to end up in the emergency
room. They are going to end up at the
police station.”
“The
long-term effects on our elderly, our poor, and those among us that suffer from
mental illness will be devastating,” said Smith.
“It’s
going to end up costing us all more in the long run,” added Therriault.
Already,
Community Concepts has fielded calls from both clients and family members
expressing concern over the loss of services and questions about where they can
turn.
“Unfortunately,
there isn’t much to refer them to,” said Therriault. “There is no other place to take people for
day services. There is no other program
like this anywhere [in the area].”
To
explain why Community Concepts will no longer provide adult day services, Smith
pointed the finger at the state.
"In
February of 2005, the Department of Health and Human Services changed its
MaineCare practices, reducing client time for mental health services, which
translated directly to the loss of essential revenues to support the
program," he said.
Therriault
said these changes resulted in the number of hours MaineCare would pay for
being slashed in half, across the board.
Fees structures also were reduced and “made more complicated”, she said,
resulting in the adult day services program running at a monthly deficit of
"thousands and thousands of dollars" since DHHS enacted its new
rules.
But
Geoffrey W. Green, deputy commissioner of operations and support for DHHS says
the fault lies with Community Concepts.
Under
MaineCare regulations, day services — which consist of activities — are
reimbursable at approximately $15.00 per hour, per person. Skills development — described as a “specific
and specialized service” — is billable at a higher rate of approximately $50.00
per hour.
“CCI
was billing for day services at the higher rate for skills development,” said
Green, “but the service being provided did not meet the requirements for skills
development specified in the rule.
“DHHS
staff attempted to work with CCI to modify its program so that billings would
be consistent with the service being provided,” said Green. “We thought that the agency had made the
necessary adjustments. In fact, CCI opened
two additional sites this past summer.”
But
at Community Concepts, the story seems to be one of the little guy being
bullied by the behemoth of the state, with little or no assistance, and no
recourse but to eventually throw in the towel.
“We
tried really hard. We tried since
February,” said Therriault, referring to the various consolidations, service
changes and recruitment efforts reportedly undertaken to keep the program
running.
“We
just couldn’t sustain it,” she said. “We
were running at a deficit since February, trying to make it work. But at some point we knew we had to accept
that we are a nonprofit and we had to be able to at least make it a go of it
[financially].”
“We
are aware that other day services providers have had to modify their programs
to come into compliance,” said Green.
“The Department [DHHS] has worked cooperatively and successfully with
them to do so. CCI is the only provider
we are aware of that has opted to close its program.”
That
closure now leaves as many as 50 local families hanging, and the people Smith
laments as “vulnerable citizens” without a safe harbor, possibly exposing them
to increases risks.
“I
think that what we would like people to know is that this change that happened
at the DHHS level is really just one small piece of what is becoming a trend to
reduce community-based care,” said Therriault.
“It is actually going to result in higher costs. It is something that we are concerned about
and we think that the community should be aware and concerned, as well.”
“DHHS
will focus its efforts on making sure that the clients affected will continue
to receive needed support services,” said Green.
