News Article Details

Wilmington mother worried for son over disability program cuts

Star-News - 4/18/2017

April 18--WILMINGTON -- Marcus Green, 29, wants to live as independently as he can.

Diagnosed with autism and attention deficit hyperactivity disorder (ADHD), Green holds a part-time job he loves at The Home Depot. He can write checks to pay bills and is able to have a conversation.

It's a stark change from nine years ago when Marcus, before being helped by a basic skills-assistance program funded by Trillium Health Resources, would stay in his room, talking to himself, said his mother, Susan.

But during the last nine years, Marcus regularly interacted with people who taught him how to do simple things like tie his shoes and got him out of his shell through trips to a bowling alley and to see movies -- he saw "Power Rangers" last week.

"I liked it," Marcus said of the movie.

But now, Susan Green said, the provider of the program, Maxim Healthcare Services, a Maryland-based service provider with an office in Wilmington, told her the services would be cut off beginning May 1.

"I'm afraid my son will regress back to his old ways," she said. "The program was very good for him."

Green has found herself in the middle of a complicated change of delivery for developmental disabilities services involving state politics, funding sources, intermediaries and health care providers. She said the result is her son is at risk of losing the care he needs to live outside of a group home.

She's called Matrix. They've told her the blame lies with Trillium, which distributes federal and state public money for a host of services for mental health patients, people recovering from substance abuse, and people with developmental disabilities.

Green has called Trillium. The company's answer, she said: call your provider.

"It makes me feel helpless," Green said.

Funding source

Cindy Ehlers, vice president of clinical operations for Trillium, bristled at the suggestion that Trillium cut off funding to service providers.

"We have not cut a thing," she said. "We don't want to pull the rug out from anybody."

Ehlers said the organization has tried to steer providers of certain services -- including those for people with developmental disabilities -- toward contracts with Medicaid in the wake of state budget cuts to managed-care organizations like Trillium, which covers a 24-county region in Eastern North Carolina.

"We were really trying to be proactive ... in a way that would guarantee services would continue," she said.

The emphasis came following state funding cuts, amounting to more than $150 million statewide last year, after lawmakers told such organizations to spend down their savings -- about $63 million in Trillium's case.

Trillium has used much of that savings continuing to fund services, Ehlers said. Gov. Roy Cooper has proposed restoring state funding to managed-care organizations, but the budget is ultimately up to the General Assembly.

"If the General Assembly doesn't put money back in the budget, then these folks would have no funding," Ehlers said.

Affected patients

Ehlers said Trillium reached out to each of the 22 providers of services for the developmentally disabled under contract with Trillium. Maxim, she said, was the only one to decline the new funding stream through Medicaid, which she said would have paid more than the state funding stream.

"It was the provider's decision not to offer the service," Ehlers said. "All of the other 21 providers did accept the new service line."

Travis Quinn, an administrator at Maxim's Wilmington office, said only that Maxim had received word from Trillium "that services are changing."

"At this time Maxim has no comment on your matter in question. Thank you for reaching out," he said in a follow-up email.

Ehlers said Trillium tried to get new services through Medicaid coverage for roughly 300 people affected by the shift from state funding. All but two, she said, were able to continue receiving services through providers switching to Medicaid -- because of federal health privacy laws, she could not identify the patients.

"It really should be about moving from one insurance to another," Ehlers said. "There should be no impact to the consumer."

Green said Maxim officials asked her not to speak with other people about the ending of her son's care. She disregarded it.

"I've been fighting for Marcus since we found out he had special needs when he was (a child)," Green said. "I'm fighting for my son."

Reporter Tim Buckland can be reached at 910-343-2217 or Tim.Buckland@StarNewsOnline.com.

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(c)2017 the Star-News (Wilmington, N.C.)

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