Federal Report: Maine DHHS Failed To Report Critical Incidents

A federal report from the federal Department of Health and Human Services said Maine failed to comply with federal and state reporting and monitoring requirements for Medicaid beneficiaries with developmental disabilities.

The report, which was conducted by the Office of Inspector General, said the Maine Department of Health and Human Services did not ensure that community-based providers reported all critical incidents to the state.

DHHS did not make sure community-based providers conducted reviews within 30 days of all critical incidents, according to the report. Those incidents involved serious injuries, dangerous situations and suicidal acts.

The report said that the state did not appropriately report all restraint usage and rights violations to Disability Rights Maine.

The report also found that the state did not investigate and report immediately to the appropriate district attorney's office or to law enforcement agencies all critical incidents involving suspected abuse, neglect or exploitation.

DHHS did not ensure that community-based providers reported all beneficiary deaths to the department and made sure the deaths were investigated and reported to law enforcement agencies and the medical examiner's office.

The report stated that "Maine failed to demonstrate that it has a system to ensure the health, welfare, and safety of the 2,640 Medicaid beneficiaries with developmental disabilities covered by the Medicaid waiver."

The report recommends that DHHS implement regulations for reporting critical incidents involving Medicaid beneficiaries with developmental disabilities.

The state disagreed with the report's findings that DHHS did not ensure that community-based providers reported all critical incidents and that it did not investigate or report critical incidents to the appropriate authorities.

The Office of Inspector General said the evidence supports all of its findings.