December 30, 2013

A Look Back at 2013: MaineCare cutoff left hundreds seeking new mental health providers

Hearings are set for January for two Augusta-based providers that were no longer eligible to receive federal money after credible allegations of fraud were found.

By Betty Adams badams@centralmaine.com
Staff Writer

AUGUSTA — Lisa M. Dailey was one of hundreds of people in central Maine receiving services from AngleZ Behavioral Health Services and Umbrella Mental Health Services who saw her care disrupted three months ago when the federal government suspended Medicare and Medicaid payments to those agencies. Those payments came through the state’s MaineCare Services.

Those suspensions, which are being appealed, meant Dailey and others had to scramble for new providers when they realized any decision on the appeals would take a while. It appears neither provider is currently operating and hearings are set for next month.

Today, Dailey, 48, still lives at Emmaus Homeless Shelter in Ellsworth, but she’s on her way toward returning to the Rockland area, where she has friends who can help her.

“I finally received my Section 8 voucher,” she said. That means the federal housing program will pay a rent subsidy directly to her landlord.

Dailey had complained to the media in September about losing services from AngleZ, an agency for which she had high praise, and said her advocacy on behalf of the displaced clients earned her an invitation to join the housing board of Rockland-based New Hope for Women to aid others with housing issues.

“A whole lot of things are opening up,” she said. Dailey has signed on with a new provider, Assistance Plus, and has been assigned a case manager, but this agency operates a little differently than AngleZ.

“They want me to look for natural supports,” Dailey said.

Among other services AngleZ had helped Dailey arrange rides to medical appointments. Now she is expected to set those up herself.

Dailey said she also heard from people who were former clients of AngleZ and Umbrella.

“They’re having a hard time getting services,” she said.

Earlier, she had raised similar concerns.

“There is a reason that daily living skills workers are provided to folks with disabilities and challenges of all kinds. This is why there are case managers because people need this support system to recover, to thrive, to gain self-confidence, to have a voice to reintegrate from whatever trauma or challenge they have faced,” she said.

In the meantime, Marjorie Averill, owner of Umbrella Mental Health Services, which had offices in Augusta, Damariscotta and Wiscasset, has appealed the suspension of payments to her agency and a hearing is set for Jan. 23.

“I doubt very much we’d be back in (business) even if I can clear myself at the hearing,” she said last week. “It’s a tough situation the way it’s orchestrated.”

Annalee Morris, owner of AngleZ Behavioral Health, which had offices in Augusta and Winthrop, also filed an appeal of that agency’s suspension, and that hearing is set for Jan. 7.

The two women formerly operated Umbrella Mental Health Services prior to Morris splitting off to form AngleZ Behavioral Health.

Sarah Grant, director of communications for MaineCare, said all the people who had been receiving services from Umbrella and AngleZ agencies received letters that included lists of other agencies that could provide similar services.

In late September, the state Department of Health and Human Services found “a credible allegation of fraud,” and so was legally obligated to suspend payments, John Martins, department spokesman said at that time.

Once a fraud allegation is deemed credible, an investigation is conducted by a state or federal law enforcement agency.

Betty Adams — 621-5631badams@centralmaine.comTwitter: @betadams
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