Feds reach agreement with Maine to fix crisis in children’s behavioral health services

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Gov. Janet Mills and the U.S. Department of Justice announced Tuesday that the state and the federal government had reached an agreement to resolve widespread problems within the children’s behavioral health system, ending a federal lawsuit asserting the state has forced scores of children into institutions due to its longstanding failure to sustain a robust network of mental health services. 

The announcement marked a prompt conclusion to litigation that began less than three months ago but grew out of a yearslong effort to force officials to come up with a plan to solve a crisis that has had dire consequences for children and families. 

The federal government’s lawsuit, filed Sept. 9, came more than two years after it notified the state that it was systematically violating the rights of children with disabilities due to a statewide lack of community-based mental health services, causing many to unnecessarily end up in hospitals, residential programs and the state’s youth prison. 

In that time, the federal government and state officials had tried to reach an agreement to resolve the problems but failed, prompting the Justice Department to take the state to court. 

On Tuesday, Mills, a Democrat and the state’s former attorney general, said she believed the state would have prevailed if it had continued in its defense, but “[p]rotracted, expensive litigation would only have detracted from what’s most important — continuing to improve our children’s behavioral health system.”

“I prefer to solve problems through conversation and negotiation, rather than litigation. I welcome this agreement because it recognizes the work we have done while outlining a path to continue our progress. 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,” the governor said in an announcement.

Mills said her administration has invested millions of dollars in children’s mental health services over the past few years, but it has not been enough to overcome a statewide shortage that has forced children to wait hundreds of days for programs designed to prevent their behavioral health challenges from worsening. 

State officials have blamed a behavioral health workforce crisis that caused many programs to close or run a limited capacity for hindering those efforts, but the federal government’s complaint in September also accused the state of missing opportunities to boost services. 

“This agreement reflects the Civil Rights Division’s commitment to ensuring that children with disabilities can live at home surrounded by the love and support of their families rather than isolated away in facilities,” Kristen Clarke, assistant attorney general with the Justice Department’s Civil Rights Division, said in a statement. 

“We know that too many children with behavioral health disabilities end up in juvenile justice settings or in out-of-home placements, often in different states far from their families, disrupting their lives in ways that can cause permanent harm. Under this agreement, more children will have access to community-based services and in-home behavioral health services so that they can grow up surrounded by family and loved ones.”

The governor said the agreement with the federal government will result in greater access to services offered in and outside of a child’s home. Her office’s announcement detailed a list of multimillion dollar investments her administration is making to realize that goal, including money for programs that provide intensive support for children and families at home and increasing staffing levels for teams that respond to kids when they are in the midst of a mental health crisis. She said her administration will also sink an “unprecedented” $237 million into increased reimbursement rates for programs under MaineCare, the state’s Medicaid program.

An independent reviewer will be appointed to evaluate the state’s compliance with the agreement, and the federal district court will have the power to enforce it, the Justice Department said.

​Correction: This story has been updated to clarify the requirements of the agreement between Maine and the Department of Justice.