DHHS backtracks
on outsourcing Meals on Wheels
In a talk last week with business leaders in Presque Isle, Department of Health and Human Services Commissioner Mary Mayhew said the agency is not necessarily going ahead with plans to issue a request for proposals seeking competitive bids to run the federally funded Meals on Wheels program.
The meals are currently provided by area agencies and volunteers, but DHHS announced it would put out a request for proposals, citing state law on managing public contracts.
“We’ve been re-evaluating whether or not at this point it makes sense to move forward,” Mayhew said, responding to a question at a breakfast gathering with the Central Aroostook Chamber of Commerce.
Beyond the Meals on Wheels program, Mayhew told the small crowd at Cafe Sopresso in Presque Isle that her work in Republican Gov. Paul LePage’s administration has been focused on trying to bring more Mainers into the workforce, while preserving funding for those with the most severe limitations and diseases.
“We have for too long looked at people through the lens of either their poverty or their disability, and have lost sight of their potential,” Mayhew said. “These programs should be helping people back on a pathway to self-sufficiency and independence.”
The governor and agency have been criticized for cutting low-income Mainers from cash assistance, health care and food assistance programs and for opposing the expansion of MaineCare eligibility under the Affordable Care Act, which health advocates say could help people with drug addictions gain access to treatment.
Since 2011, enrollment in the Supplemental Nutrition Assistance Program has decreased by 20 percent and Temporary Assistance for Needy Families enrollment has dropped by more than 50 percent, according to DHHS. Last year, about 15 percent of Mainers received SNAP food benefits, and there were 6,570 TANF cash assistance cases, which includes family households.
Maine and other states, Mayhew argued, have not been meeting the aims of the 1996 federal welfare law, which established time limits and work requirements for a number of programs.
“These programs need to have employment as their core focus,” Mayhew said.
The law set lifetime limits and work requirements for TANF, but in 2008, the federal government allowed Maine and other states to waive limits in the wake of job losses during the Great Recession.
In 2011, DHHS began enforcing a five-year lifetime limit on TANF eligibility and in 2014 started to require non-disabled, childless adults between the ages of 18 and 49 who were receiving SNAP benefits to work 20 hours per week, volunteer or enter vocational training. People who were cut off from the programs were offered job-search and training resources with the Maine Department of Labor and regional career centers, and could qualify for transportation and child care support as they started new jobs, Mayhew said.
Some 6,900 Mainers ultimately were removed from the SNAP program after the changes, but Mayhew said a subset of them have found employment and increased their income since losing the food benefits, citing a preliminary study by the governor’s policy office.
State Economist Amanda Rector, a co-author of the report, has emphasized that it’s a preliminary analysis, looking specifically at reported wages from three affected groups.
“Since this was just a preliminary analysis, we didn’t attempt to make any conclusions about causality,” Rector wrote. “A more detailed analysis would be needed for that, bringing in additional data sets that would give us a larger picture of the outcomes.”
Mayhew said the administration is trying to attract and retain employers.
“But if we don’t have a motivated workforce that’s ready, willing and able to work, we’re going to be hard pressed to keep employers here.”
Mayhew said she recently met with Maine construction industry executives who told her they have a lot of open jobs, but receive few applicants. “I met with one construction owner who said, ‘We’re not going to be able to bid on job, and the work’s going to go to out-of-state companies,’” she said.
While in Aroostook County, Mayhew, whose father is from Madawaska, also visited with a group of foster parents, and said she is “scared and concerned” about the impact of drug abuse on the some of the state’s next generation. More than 60 percent of Maine children under DHHS protective care come from parents with families with substance abuse.
On that and other issues, Mayhew said that she is trying to encourage DHHS staff to learn from information gathered by the agency, such as MaineCare medical claims.
The agency is studying children covered by MaineCare who have been diagnosed with attention deficit hyperactivity disorder.
ADHD treatment often includes stimulant-based medications, but there is not much research on the drugs’ long-term safety in children. For children younger than 6, the U.S. Centers for Disease Control recommends behavioral therapy as the first line of treatment, before medication.
Mayhew said the agency is asking questions aimed at understanding trends for ADHD among youth on MaineCare, such as: “What percentage of those children are taking medications? How many used and benefited from therapy that would have perhaps reduced their need for medication?”
