28 Tierney Drive

Delmar, NY mow-5729
Phone (515)527-1913
Fax 351?1+5+
E?mail: 

Final Report

Kiwi/756k v. Concannon

United States District Court
Distfict 01C Maine

159

Clarence J. Sundraml Esq

lndependent(:onsuhant

Juig 2.005

 

 

 

[ntz-nrlm?titm

Pursuant to an Agreed-Upon Order of the United States District Court, District of
Maine, I was retained by the Department of Behavior and Developmental Services as an
independent expert consultant to advise the Defendants on how to achieve full
compliance with the Settlement Agreement in this matter expeditiously and effectively.
As described below, the primary role of the consultant is to make recommendation
regarding the timely access to the services covered in a Settlement Agreement in this
matter, rather than to evaluate or address issues pertaining to the quality of services

provided.

Speci?cally, the Order requires a written report setting forth recommendations,
after considering whether adequate resources have been allocated to achieve expeditious
and effective compliance, and whether institutions and systems in place charged with
achieving compliance are able to do so. The report is to identify barriers or impediments
to compliance and, if such exist, to make recommendations for removing those barriers
expeditiously and effectively. An interim report was submitted on March 31, 2003
addressing some of the issues with the data collection and tracking system and

supplemented by a progress report on May 19, 2003.

The underlying Settlement Agreement of May 3, 2002 establishes timeliness
standards for the provision of in-home behavioral health services and case management
services, and for the development of Individual Treatment Plans and Individual Support
or Service plans. It also requires that the Department "will develop and implement a
system that allows DBDS to identify and track each individual child under the age of 21
for whom a request has been made to an approved agency . . . in order to disclose
whether, for that child, the timeliness standards . . . have been complied with and in
order to be able to generate data disclosing the nature and extent of compliance with the
timeliness standards set forth in this Agreement. (Settlement Agreement, May 3, 2002,

paragraph 7)

In preparing this report, I have reviewed the following documents:

 

 

Settlement Agreement, May 3, 2002 
Agreed-Upon Order of February 12, 2003

:Iti'tdai'tts aims-a Burgess February 23. April I May I. Print 3t't_ 1003'

and July 1, 2003

Af?davits of Lori Jones, February 28, April 1, May 1, May 30, 2003 and

July 1, 2003 I
Children's Enrollment Form (CEF)

Entering A CEF

Instructions for Status Update Form for In?home Support

Services

Instructions for Status Update Form for Case Management I
Sen-?res

In Home Support Data lititry

Enrollment and Closure Data Entry

Smtlement Agreement Report ?dust-miter, l; IMP-1
.?'itluit'n?tm'll. Report ii?hmun' H.
2003

on the 1 It?lfallittgl isl For Fair: management and Iolt?ue
Services, dated May 13, 2003

EIS reports of children on the waiting list February ?July, 2003
Flow Chart for Children?s Services Central Enrollment for Habilitation
and Behavioral Health Services, dated May 11 2003, and related
descriptions of the process

Procedures For Centralized Enrollment And T: tags

Documents pertaining to the rate-setting process for case management
services

Technical Speci?cations document for EIS, dated May 27, 2003

Maine Care Children?s Cabinet, Annual Report 2002 and Annual Report
Update 2003.

 

In addition, I have met with various staff of DBDS who are involved in developing
and maintaining the information system utilized for tracking children who have applied
for services, and in interacting with providers of in home services and case management
services; with representatives of the Governor?s Of?ce and the Legislative Children?s
Oversight Committee; with Family and Parent Organizations; and with representatives of
provider agencies. I also visited several provider agencies where I met with their
management and direct support staff, and with parents of children served by the agencies.

A complete list of the persons with whom I met is attached as Appendix A.

Many of the persons with whom I met traveled signi?cant distances for the meetings
and put aside other obligations to make themselves available. Their candid discussion of
the issues and their opinions were enormously helpful in assisting me to understand and
appreciate the importance of the services at issue, the of the existing service
system and the barriers which have prevented the timely delivery of needed services to

children and families. I acknowledge their assistance with gratitude.

Background

The services at issue in this matter are supplied by private providers who contract
with the Department of Behavioral and Developmental Services for the provision of case
management services (29 Provider agencies) and in-home supports to children who are
eligible for such services (47 Provider agencies). These services must be provided to
Medicaid-eligible children within 180 days of their ?start date,? as that term is de?ned in
the Settlement Agreement. Figure 1 displays the overall waiting list for in home services
(IHS) since February 2003, as well as the children waiting for services for more than 180
days.1 These data indicate that while 80% of the 1084 persons on the waiting list in
February 2003 were waiting for more than 180 days for in home services, by July 2003
that percentage had dropped to 23.5% and the total number of people on the waiting list
had also declined to 637.

Waiting List for IHS

 

 

Children
on
c:
C)

  

 

 

 

 

Feb-03 I Mar?03 Apr-03 May-03 Jun-03 Jul-03
IHS 180 Days a IHS ~~Tota  Waiting

Figure I

There are two different programs of in-home support services. Children?s
Habilitation Services are provided pursuant to section 24 of the Maine Medical
Assistance Manual to children who have a diagnosis of mental retardation or autism and
meet the level of care criteria. Providers are paid according to rates negotiated

with DBDS, which are based on their costs. Approximately 1000 children received

 

Table 1 in Appendix contains all of the data submitted by DBDS.

 

 

 

services pursuant to this section in FY 2002. There are 152 children on the waiting list for
section 24 services and, of these, 27 have been waiting for more than 180 days as of July
1, 2003, according to data supplied by the Department. (See Figure 2) For this service,
the overall numbers of persons waiting did not decline signi?cantly between February
and July 2003, but the proportion of those waiting more than 180 days declined from
77% in February to 17.8% in July.

 

IHS-?Section 24

 

 

 

 

 

 

 

 

 

 

     

 

 

 

 

as, IHS Section 24>180
'5 Days
IHS Section 24Tota 
0 Waiting
0 . . . . .
Feb- Mar? Apr? May? Jun- JulFigure 2

In-home treatment services are provided pursuant to section 65H of the Maine
Medical Assistance Manual to children who have a DSM IV Axis I or Axis II diagnosis
and have behaviors that cannot be managed by parent/guardians, or which puts them at
risk for out of home placement. Providers are paid according to rates ?xed by the
Department of Human Services, the State Medicaid Agency, which are currently $25/hr.
for staff (direct support sta?) and $75/hr. for BS-2 clinical supervisors. These rates
are not cost based. Approximately 1450 children received services under this section in
FY 2002. There are 485 children on the waiting list for section 65 services and, of these,
123 have been waiting for more than 180 days as of July 1, 2003, according to data
supplied by the Department. (See Figure 3) The data demonstrate that there were
signi?cant declines in the numbers of children waiting for service and in the proportion

of those waiting for more than 180 days. In February 2003, 80.6% of the 922 children on

 

 

 

 

the waiting list had been waiting for more than 180 days. By July, that percentage had
dropped to 25.4% and the total number of children had fallen to 485.

 

Waiting List-Section 65

 
 
  

 

 

 

 

 

 

 

 

 

 

IHS Sec 65 >180 Days
600 
400 i??e 65 Total
0 200 Wanting
Feb- Mar- Apr? May- Jun- JulFigure3

Case management services assist children and families develop Individualized
Support Plans (ISPs) and assist in arranging for the services identi?ed in the plans and in
assessing the effectiveness of such services. Providers are paid according to rates
individually determined based on their costs for each of two levels of case management,
subject to maximum caps on reimbursement. Level 1 case management addresses
moderate to minimal needs, speci?cally for those families needing information or help
accessing resources or guidance in doing their own case management and advocacy. The
Level 1 case management rate is based on a caseload of 25 clients per case manager and
is reimbursed at an average rate of $227 per client. Level 2 case management
addresses moderate to extensive needs and is for families with complicated clinical
situations and resource needs or family dif?culties that need more help that Level 1 case
management can provide. The Level 2 case management rate is based on a caseload of 15

clients and is reimbursed at an average rate of $420.

Case management services were provided to 5,857 children in ?scal year 2002.

There are 463 children on the waiting list for case management services and, of these,

 

 

nine have been waiting for more than 180 days as of July 1, 2003, according to data

supplied by the Department.

The Settlement Agreement also requires that Individualized Treatment Plans be
developed for in-home behavioral services for children who have a medical need for such
services covered under section 24 or section 65, within 120 days of the start date. As of
July 1, 2003, there were 521 children on the waiting list for the development of a
treatment plan, of whom 189 children were waiting for more than 120 days without a
treatment plan. (See Figure 4) While the overall waiting list has declined moderately
from 625 to 521 between February and July 2003, more than a third of those on the

waiting list have been waiting for more than 120 days.

 

 

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ITP Waiting List
800 ma 748
I: 600
DJTP 120 Days
400
a ITP - Tolai Walling
200
Feb-03 Mar-03 Apr-03 May-03 Jun?03
Figure 4

 

[mam-m in 

The services covered by the Settlement Agreement are of vital importance to
families and children who are eligible for the services. In the many meetings with parents
and representatives of parent groups, it was evident that these services are essential not
only for family preservation, but also to provide some semblance of normal family life
despite the signi?cant demands on the families? physical, ?nancial and emotional
resources created by the mental health needs of their children. In the absenceof these
services, there are limited options available to families. They can either seek out of home
placements for their children, or neglect their needs, with the probable eventual outcome
of requiring crisis services or an emergency hospitalization. These options are
inevitably substantially more expensive for the State and usually undesirable for the child

and family as well.

Families offered many opinions about the ways in which the service system could
be improved, but there was a broad and general approval of the services provided. As

one parent put it, "it's a good system once you?ve got it, but getting it is the problem."

The data submitted by the Department of Behavioral and Developmental Services
show a reduction in the number of children who have not received the covered services
within the timelines established by the Settlement Agreement, but there are still a
substantial number of children who are unserved within the required timelines. The
largest waiting lists are for in home services under section 65H (most of which is in
Regions 2 3) and for the development of individualized treatment plans. (See Figures

Timid I3. and Appendix H. able 1)

 

 

Ch i Id nan

Children

ChiIdren waiting >180 Days for Section 65H --By Region

 

 

 

 

 

Ei Regina"



Children waiting >180 Days for Section 24 ?By Region

 

 

 

 

 

 

 

 

Figure 6

 

Feb-03

 

Mar-03

Apr-03

 

May-03

Jun-03

 



a 180 Dave
2 3' 'Eln Days

I Dare:

UF?Eglnn 1 7E4: 
HHEQIDH 2 Eli-'15-
EI Region 3 ?33 Ila-32

 

 

S?m??it??lif Harriers to Tinlt'h Senicrs

There are three principle barriers to services provided in accordance with the

timelines contained in the Settlement Agreement.

a. For in?home behavioral services, the primary problem is insuf?cient availability
due to the difficulty in recruiting, training and retaining staff for these positions.
These problems are especially acute in remote areas, which are far from sites

where providers are located.

b. For the development of an Individualized Treatment Plan (ITP) within 120 days,
the problem is that there is often no one to develop the plan, as provider agencies
will not start this process unless they will be delivering the service. There is no
method of reimbursing their costs otherwise. Thus, the delays in linking the child
with an in home service provider, for which the maximum timeliness standard is

180 days, can also affect the development of an ITP within 120 days.

c. Access to timely services of case managers is affected by the manner in which
funding is provided to case management agencies, which requires that, if they do
not have current vacancies, they must have enough children waiting to make up a

caseload in order to cover the cost.

There are also reports that access to professional evaluations required to establish
eligibility, which is part of the intake process, and to re?ceitify eligibility, is dif?cult in
some parts of the state and for some types of disabilities autism, Asperger?s
evaluations). It is not clear to what extent this problem affects

the timeliness standards at issue, as the reports received are anecdotal.

Each of these issues is addressed in the recommendations in this report.

10

 

 

With respect to the tracking system, it remains a work in progress although
improvements have been made in the reliability and accuracy of the data provided. The
Department's decision to rely upon the EIS to track children's timely access to the
covered services placed this program into a large and complex computer system that is
intended to manage virtually all of the data needs of the Department. That system itself
is under development and has been undergoing testing, revision and debugging. The
system is intended to meet not only the managerial needs of the Department, but also to
permit it to respond to information demands arising out of other litigation involving
constituent groups of the Department class action lawsuits involving adult mental
retardation services, the AMHI Consent Decree and other Medicaid waiting list litigation,

etc).

This tracking system is one of the priorities in implementing the l-?l system. From
what I have observed, as resources have been needed to address the particular needs of
this part of the data system, the Department has been able to allocate the manpower and
secure additional consultation as needed. But the complexity of the EIS has caused some
design changes and improvements, that were intended to address initial problems, not to
work as intended process wizards), requiring more time and effort to implement. In
this process, the speci?c needs of this part of the data system have to be prioritized with
other pressing needs, which the EIS must also ?il?ll. The necessary resources appear to
be available but the policy decision to utilize the EIS for this purpose has brought a level
of complexity to the task that has caused inherent delays in making the revisions to
procedures as the need has arisen. Some of the bene?ts of the EIS, such as its capacity to
produce an almost in?nite variety of reports from the data, to provide a scheduling and
tickler function, have not been realized as yet, as they have been assigned a lower

priority. (See recommendations)

As I previously reported, the system design issues are not the only problem in
producing timely and accurate reports of the status of the waiting list for services. Since
the entire system is highly dependent upon the quality and timeliness of inputs from

provider agencies, and the extent to which they comply with expectations placed upon

11

them for producing accurate and updated information, the Department has been
continually addressing this need with provider agencies. I have been informed that there
are 5-6 provider agencies that are responsible for most of the late reports. The
Department has addressed this issue by shortening the time frames for providing reports
and updates to the Department from to within 5 working days, and has increased
the responsibility placed upon the provider for submitting complete and accurate reports.
It is now sending back incomplete Children?s Enrollment Forms to providers and has
determined to withhold payment from providers that do not submit timely reports.
Regional team leaders have been instructed to make auditing of data a priority. The new
procedure for Centralized Enrollment and management of the waiting list should reduce
the likelihood of inaccurate information in the EIS, especially duplicate counts of the

same child who is on the waiting list for multiple providers.

The effectiveness of these measures in producing timely and accurate reports can only
be judged by examining the end product. The Department staff have developed internal
procedures to continually examine the quality and accuracy of the data being entered into
the EIS and it is my opinion that these procedures are reasonable and are resulting in
increasingly reliable reports. As noted in my progress report, due to the time needed to
enter and audit the data, the EIS is not able to provide ?real time? information. Even as
these processes are being implemented to verify the accuracy of the information, the
status and numbers of the children on the waiting list might be changing. For these
reasons, the reports may not be precisely accurate; however, they provide a reasonable

accounting of the status of children on the waiting list.
While have met with the 1n 1hr.- of lists 

entrt. and auditing. and have {hauls-sent! system design issues I'm? Fl?t stall

and hilt-t: personally. produced

12

 

 

 

Recommendations

I. Reducing or eliminating the waiting list for in-home supports services and case
management services requires expanding the availability of such services. There are two
broad strategies that can be utilized to increase service capacity. The ?rst is to facilitate
the expansion of existing provider agencies or the development of new services,
especially in areas which are unserved or underserved. The second is to examine the
utilization of existing resources to determine whether there are opportunities for more

ef?cient utilization/deployment of resources.

.1. l-Itnandina Honin- Cannritv

l. The ability to expand service capacity is highly dependent upon the ability to
recruit, train and retain additional workers who are quali?ed to provide the
services needed, especially in areas that are unserved or underserved. There are
several barriers at present inhibiting recruitment and retention. Chief among them
is the manner in which these positions are structured and compensated. Most
families receive a few hours of in?home service before and/or after the normal
school day. For a worker to get suf?cient hours to equal a ?ll] workweek, it is
often necessary to work six or seven days. These front-line jobs are typically
structured as hourly positions, with no bene?ts, sick leave, or vacation time. If the
child is hospitalized or out of the home, if the family goes on vacation or does not
require service on a particular day, the employee's paycheck is affected. Providers
report that worker?s schedules are changed ?'equently based on the child?s and/or
family?s changing needs. Employees are required to travel from their homes to
work sites that may be at a great distance and involve substantial travel time.
Most employers do not reimburse travel time and expenses, ?uther reducing the
real wages of these direct support staff. Not surprisingly, turnover in these
positions is high and places children and families in the position of continually

adjusting to changes in staff in their homes and enduring service interruptions.

l3

One provider agency that has full-time employees, provides bene?ts, and
reimburses travel expenses reports a more stable and committed work force, but
also reports running a substantial annual de?cit for this service. Other providers

have simply ceased providing the service.

The Department needs to reexamine the reimbursement rate structure and adjust it
to cover the reasonable and necessary costs of providers to support a stable
workforce. While there is a role for part-time, hourly workers, this cannot be the
mainstay of the service system. The front-line positions should pay a living wage,
and provide a reasonable bene?t package.2 The state should establish a policy on
reimbursing, through its rate structure, the cost of travel and transportation for
front-line workers who must travel beyond a normal commuting distance 15

to 20 miles, 20 to 30 minutes).

In re-examining the rate structure, the Department should also ensure that the
rates cover reasonable administrative costs for supervision, training, staff
attendance at training, meetings among multiple direct care workers supporting
the same family, meetings with case managers, and, for case managers, time spent
in discharge planning for children who are in hospitals or residential facilities.
One provider agency has estimated that its true costs in providing section 65H
services are $33/hr. (the same as is currently reimbursed for adult in-home

services) rather than the $25/hr. currently paid.

2. While the Katie Beckett waiver program offers some options for people who do
not qualify for traditional Medicaid, this program is not well-known and,
reportedly, even some staff in the Medicaid agency do not ?illy understand how it
works. This program has great potential to enhance services to families in need. I

recommend that the Department support the creation of a position in each region

 

2 The State may want to explore the option of asking for federal approval for employers to buy into
Medicaid for low wage workers, and determine if this is a cost-effective strategy for meeting employees?
bene?t needs.

14

 

 

of a Katie Beckett coordinator to provide education and information to families
and service providers, and to provide training and assist families in the application

process for the Katie Beckett waiver.

3. For families eligible for in?home services, who have gone unserved beyond the
180 day timeline, and for whom there is no clear prospect of service in the
reasonably near ?iture due to the unavailability of providers in the geographic
area, the state should develop a mechanism vouchers) authorizing the family
to secure services by quali?ed independent contractors for an interim period, and
provide oversight of such services through BDS regional office staff or through a
contract with a quali?ed clinician. Once this system is in place, BDS should
consider the appropriate use of vouchers in unserved and underserved areas well

in advance of the maximum timelines for service.

4. For children who do not have an Individualized Treatment Plan within 90 days
from the Start Date, the Department should ensure that they are assigned to Level
1 case management to develop a preliminary treatment plan, recognizing that this

plan will undergo revision once the child is assigned to a provider agency.

5. With respect to case management services, providers report that if their
caseloads are they must wait until they have 15 new children assigned before
they hire a case manager as the reimbursement rates are predicated on this
caseload (Level 2). If there are fewer than 15 children, the agency will incur the
cost but will have no way of recouping its expenses through the reimbursement
system. The Department should provide start-up ?nding to provider agencies to

hire case managers to serve children who are nearing the 180-day deadline.
6. To expand the recruitment pool, the Department should institute a procedure to

waive the training requirement if there is reliable information about equivalent

quali?cations potential part-time workers with 4-year college degrees may

15

 

 

 

 

1.

be able to demonstrate equivalent training against the 50-hour training

requirement for BS-ls.)
H. uf Existing Fir-saunas.

The Department needs to develop a Quality Assurance program to regularly evaluate
the quality, responsiveness and effectiveness of the in home services and supports
provided to families. In this process, it will be important to examine provider
discharge planning practices, and whether service planning clearly identi?es goals to
be achieved by the services, and criteria for discharge. Part of this program should
include utilization review to identify capacity that may be available through a review

of:

high users of services and the effectiveness of the services provided to them;

b. families whose needs may have changed or diminished;

c. families who will require a level of maintenance over the long-term to
preserve gains that have been achieved;

d. families who can be discharged from service. (At present, very few
discharges occur due to the achievement of service goals. Families are
understandably reluctant to terminate services that are so hard to obtain. This
reluctance is even greater if there is no assurance of priority if the family?s
needs change and services are once again required. Appropriate discharges
may be possible if they are accompanied by an individualized crisis plan that
assures prompt and priority access to services should they be needed in the

future. 

2. The ?ll] implementation of the Centralized Enrollment system for in-home
services should also help improve the ef?cient use of existing resources. When
multiple provider agencies receive direct referrals, and do not know when the
family enters into service with another agency, each agency may be performing

their own assessment and own eligibility determination. Eventually only one of

16

 

 

them will become the provider agency, which is eligible to bill for its services.

The time spent by the other agencies is essentially wasted and non-reimbursable.

(One agency estimated that 20% of their time is spent on inappropriate referrals

and people whom they do not serve.)

.-?tdminislrmiir rermmneudnliims

1. Recognizing that the timelines in the Settlement Agreement are outer limits for

the provision of services, the Department should develop a tickler system,

independent of the EIS until this function is operational, to:

a.

Identify cases that are 30 days from the maximum waiting period, and
assign them for special review to determine what steps might be taken to
provide timely services (For example, cases described in

recommendations I (4) and and

keep track of dates when re-evaluations are due, or the Katie Beckett
renewal is due, to alert providers and families in suf?cient time to ensure

that deadlines are not missed.

2. The Department should develop a practice of sending providers a report

generated by the EIS for all children assigned to the agency, with a request to

verify the accuracy and current status of all information with respect to each of

the children. These EIS reports may prove useful to provider agencies in their

own management of their caseloads, while also reinforcing the importance of

timely and accurate information in the EIS system.

3. While the Department has expressed an intention to withhold payment as a tool to

ensure the timely completion by provider agencies of the reports required to track

children on the waiting list, no written procedures exist either to make all staff

17

 

 

aware of this process or give provider agencies adequate notice of their potential

?nancial jeopardy' This policy should be appropriately adopted and formalized.





Clarence J. Sundram, Esq.
Independent Consultant

 

18

 

 

 

 

Appendix A

List of Persons Attending Meetings with Independent Expert Consultant

The following persons were interviewed or attended meetings to discuss
children?s mental health services. Peter Rice 0f the Disability Rights Center, and Patrick
Ende, of Maine Equal Justice Partners attended portions of these meetings. Joan 
Assistant to the Deputy Commissioner, assisted in arranging the meetings and attended
most of them.

In-horne Support Providers:

Lee Jellison, Care Comfort

Teresa Barbieri, Woodfords Family Services
MJ Dougherty, Woodfords Family Services
John Carroll, Richardson Hollow MH Services
Chris Davis, Richardson Hollow MI-I Services
Charity Webster, Support Solutions

Sara Camolli, Support Solutions

Ann Rossignol, Waban

Tammy Smith, Gentiva

Tricia Kail, UCP

Sally Larrabee, Charlotte White Center

Governor's Of?ce:

Ainsworth, Senior Policy Advisor
Kurt Adams, Legal Counsel to the Governor
Todd Lowell, Assistant Attorney General

Central Office Management Staff:

Sabra Burdick, Acting Commissioner, DBDS

Ron Taglienti, Children?s Systems Manager

Lisa Burgess, Director of Children?s Services, BDS

Lori Jones, Children?s Services Information Systems Manager
Richard Hayward, System Team Leader

Michael Biddle, System Analyst

Dennis Tan, Consultant

Other BDS Staff

Jeanne Tondreau, Family Information Specialist? Region 11
Dorso, Family Information Specialist- Region II

19

 

 

 

Gary Kaszas, Enrollment Specialist, Presque Isle

Bonnie McLaughlin, Enrollment Specialist, Lewiston
Michael DiFillipo, Quality Improvement Specialist, Lewiston
Michael Austin, Quality Improvement Specialist, Lewiston
Cindy Trinward, Quality Improvement Specialist, Portland
Brenda Gagnon, Regional Supervisor, Portland

Teresa Barrows, BDS Region II

Family Parent Organizations:

Patricia Small, Children?s Oversight Committee

Carrie Horns, NAMI Maine

Carol Tiernan, Gaining Empowerment Allows Results (GEAR)
Kimberly Megrath, Southern Maine Parent Awareness

Sharon Harbin, Children?s Oversight Committee

Janice LaChance, Maine Parent Federation

Donald Brann, Autism Society of Maine

Cathy Cyr, Autism Society of Maine Parent

Rebecca Weinstein, DD Council

Case Management Providers:

I eff Janell, Youth Family Services

Donna Dwyer, Sweetser

Trish Niedorowski, WINGS

Catherine Ryder, Tri-County Mental Health Services
Blanca Gorrola, Community Counseling Center
Katie Campbell, Community Counseling Center
Lynda Flood, Catholic Charities Maine

Ed French, Sweetser

Heather Bingelis, Richardson Hollow Mental Health Services
Tricia Kail, UCP

Richard Brown, Charlotte-White Center

Susan Hancock, Catholic Charities Maine

Site Visits
Lewiston, Maine
Support Solutions Children?s In-home Supports (section 24)

Sandra Hebert, Director of Children?s Services
Heather Jacoby, Program Manager

Faryl Orlinsky, Program Manager

Sara Comolli, Program Manager

Charity Webster, Program Manager

Danielle Driski, BS 1

20

 

 

Will Liberty, BS 1
Tanya Labbee, Parent
Terri Allen, Parent

Richardson Hollow Children?s In-home Supports (section 65 I-I.)

Linda Hertel, Chief Executive Of?cer

John Carroll, Assistant Clinical Director of Children?s Services
Libia Coutinho, BS 1 and Team Leader

Lee Hewitt, BS 1

Theresa Winslow, Parent

Christine Corson, Parent

Denise Esancey. Parent

Bangor, Maine
Wings -- Case Management Services

Trish Niedorowski, Executive Director
Cindy Schroeder, Clinical Director
Wanda Anderson, Program Supervisor
Ann Hartman, Program Supervisor

Jo DeVries, Case Manager

Beth Cotrell, Case Manager

Helen Spencer, parent

Mrs. Hermanowski, parent

Charlotte White Center -- Case management and In Home Services

Pamela Jacobson, Of?ce Manager

Sally Larrabee, Coordinator, In Home Supports
Stephen W. Pratt, Sr., BS 1

Brad Bosse, BS 1

Suzanne Sovin, BS 1

Judy Lenihan, BS II

Glenn Davis, consumer

Janice Tolman, parent

21

 

 

 

 

Appendix -- Table 1

'Waiting List Data? Feb 1-July 1,
20033

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1-Feb 1-Mar 1-Apr 1-May 1-Jun 1-JulI
Case Mgmt. >1 80 Days 4 4 9 
Case Mgmt. ?Total Waiting 259 398 4a
IITP 120 Days 625 619 535 470 401 189i
ITP ?Tota  Waiting 625 619 644 708 748 521
IIHS 180 Days 869 658 482 398 313 150I
IHS --Tota  Waiting 1084 1011 996 1016 1028 637
Sec 65 >180 Days 744 567 413 339 266 123i
IIHS Sec 65 Total Waiting 922 867 844 859 827 485
Region 1 180 Days 59 37 27 25 14 4
Region 1 Total Waiting 68 55 59 68 69 31
@gion 2 >180 Days 454 361 279 240 199 76
Region 2 Total Waiting 565 568 574 605 579 275
Eton 3 >180 Days 231 169 107 74 53 43 
@ion 3 Total Waiting 288 244 211 186 179 179'
IHS Section 24>180 Days 125 91 69 59 47 27
IHS Section 24 Total Waiting 162 144 152 157 201 152
Region 1 180 Days 44 23 16 13 7 5
_R_egion 1 Total Waiting 64 47 58 64 96 60
Region 2 >180 Days 59 50 41 34 30 12
Elan 2 Total Waiting 69 68 71 66 64 41
Region 3 >180 Days 22 18 12 12 10 10 
Region 3 Total Waiting Data submitted by DBDS from EIS reports. Note that the report periods do not necessarily coincide with
the report periods for data submitted in the affidavits submitted by Lori Jones pursuant to Judge
Singal?s February 12, 2003 order. DBDS staff also report that the information relative to ITPs and case
management was not entered into the EIS until late March or early April. The data from the more recent
months is believed to be more accurate than the earlier numbers for many of the reasons described in the

report.

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