Key Democrats vote against DHHS nominee
Democrats ask tough questions on experience, reform and political memo
February 1, 2011
AUGUSTA – Key Democratic lawmakers on the Health and Human Services Committee today voted against the confirmation of Gov. Paul LePage’s nominee to lead the Department of Health and Human Services, Mary Mayhew, after asking tough questions about her background and experience as a lobbyist for the hospital industry. Senator Margaret Craven of Lewiston and Representatives Mark Eves of North Berwick and Peter Stuckey of Portland voted against the nomination.
“I firmly believe the leader of this department must have a strong understanding of our human service sector, which helps abused children in need of foster care or adoption; the mentally ill whose daily lives are a painful struggle; the elderly and the many families in our state who are victims of the economy and need a safety net,” said Senator Margaret Craven of Lewiston. “While Mrs. Mayhew has demonstrated extensive experience as a lobbyist for hospitals in our state, she lacks the critical experience necessary to run the agency that primarily handles human service issues.”
The Department of Health and Human Services manages a budget of more than $3 billion (state and federal) and 3,000 employees.
Democrats also raised questions about how Mayhew would prevent the politicization of state workers in her department in light of a leaked memo from the governor’s office laying out a plan to use the executive branch to support Republican legislative campaigns.
“The Department of Health and Human Services is charged with helping all Maine people not one political party,” said Rep. Mark Eves of South Berwick, the lead House Democrat on the committee. “The recent memo from the LePage transition team expressed plans to use state workers and particularly this department in an overtly political light and we want to make sure that Mrs. Mayhew has a plan to prevent this and ensure that all Maine people and providers have a fair shake and an equal seat at the table.”
Rep. Peter Stuckey of Portland also asked the nominee to provide more details regarding her public statements on reform of Maine’s safety net.
“We all know once we get beyond campaign rhetoric and look at the facts of the programs within the Department we often find that the sound bites don’t match the reality of the facts,” said Rep. Stuckey. “We must ensure that our commissioner is governing based on data not rhetoric.”
Enclosed below is a list questions asked by Democrats on the Health and Human Services Committee.
Questions for the Confirmation Hearing of Mary Mayhew for the position of Commissioner of Health and Human Services.
Tuesday, February 1, 2010
- Why do you want the job?
- As we have worked through the supplemental budget last week, particularly as it relates to making payments to providers, most notably hospital payments, I have tried to raise the awareness that there are many providers beyond hospitals that are owed money. The enhanced federal Medicaid match is relevant to all providers that are paid through Medicaid. My concern is making sure all providers have an equal seat at the table.
A recent memo from the LePage transition team in December characterized state workers in an overtly political light. How will you in the job of the Commissioner of the largest department in State government make sure that policy decisions are not dictated by political favors? In other words how will everyone have an equal seat at the table and a fair shake?
- Can you assure us, that you are going to represent Maine’s most vulnerable people as vigorously as you represented the hospitals?
- There have been ongoing efforts to get the hospitals to disclose billing rates, and measures to ensure transparency, regarding cost effective solutions, do you have a plan to continue that work?
Definition of ‘truly needy’
- During the press conference announcing your appointment you stated ‘For the truly needy, those who need a temporary hand up because of life's circumstances, I will make sure our health and human services programs are solvent and effective,’ ‘The question we must ask and be held accountable to, are we helping those in need and moving them to a better life? Welfare was never meant to be a lifestyle, yet that is exactly what it has become for too many families who are trapped in a failing system.’
You’ve been in this building a lot over the years, and I’m not aware of you ever saying things of this nature before. In fact, I believe the record would reflect that in the instance of “non-categoricals” on Maine Care, you lobbied to keep them covered. Are these childless adults grouped in with your definition of ‘truly needed’? Who are the “truly needy” you refer to?
Administrative experience and effective leadership
- With the many vacant positions within the Commissioner’s office how will you recruit train, and retain the brightest we can afford?
- "Equally important as reducing costs and expanding accountability is the real need to change the mission of the Department of Health and Human Services.” – Mary Mayhew
What is your current understanding of the mission of DHHS and what are your plans on changing the mission of the Department?
- “We need someone who understands health care and she is clearly an expert in the field of health care.” – LePage
My expectation of a qualified candidate would also be an expert in the other half of the title of Health and Human Services- How would you rate your working knowledge of Human and Social Services and all that the Department encompasses outside of the healthcare sector?
- You stated that you plan to complete a top-down review of the department. How long do you think this will take and how long do you think it will take to begin implementing substantive changes?
- How do you plan to build a skilled team, who are qualified to run such a diverse department? I was dismayed to read in the Portland Press Herald of the loss of experience in the department’s leadership team when the Medicaid Director was escorted out of the building and dismissed, before a replacement was found to replace him. Were you aware this was happening, you were part of the cabinet at the time.
- DHHS was in the process of rolling out a Managed Care for the state of Maine, do you intend to continue implementing Managed Care? What about the Advisory Council on Health Systems Developments efforts on payment reform?
- How will the work on quality, cost effective health care delivery such as the Maine Quality Forum and the Advisory Council on Health Systems Development continue under this administration?
- “I haven’t seen anything about Dirigo Health Program that I want to preserve.” – LePage
Are you aware that there has been a 76% increase in Dirigo’s small business market since last August and their individual market received no rate increase? What is your current assessment of the Dirigo Health Agency, not the political differences that have led to its current form?
- Do you believe the state should honor its contracts? Including their contract with Harvard Pilgrim? If not how do you envision healthcare coverage for the 15,000 people who are covered under Dirigo Choice now?
- Some have commented on the mental health and behavioral health service delivery system being fragmented and uncoordinated. Do you share this opinion and if so could you share some ideas on improving the system?
- Your remarks during the press conference announcing your nomination, you mentioned that you hoped to help Mainers move from, “…addiction to self-control.” Addiction is widely recognized as a disease and referring to the cure as “self-control” fundamentally misunderstands the nature of treatment and recovery. In light of that, I would like to hear more about your philosophy for substance abuse treatment.
- Can you comment on your opinion about our child welfare system as it relates to permanency planning and what your plans would be related to children in State custody?
- As we all know once we get beyond campaign rhetoric and look at the facts of the programs within the Department we often find that the sound bites don’t match the reality of the facts. For example our TANF benefit is the lowest in New England which has not changed since its inception 15 years ago and the average length of time a recipient is receiving TANF is 18 months, not a lifetime. The profile of an average recipient is a single mom in her mid thirties with the average age of the child being 2-3 years old. What do you mean by welfare reform?
- Another example of the complexities of our public assistance programs is that 23% of people on Maine Care represent 65% of our cost in Maine Care. The 23% represent our elderly and disabled. When we include children the percentage grows even larger. Given this spending profile and given the fact that our Medicaid spending over the past 5 years out of our general fund has been steady and even declining, and given the makeup of our Maine Care population and the needs of a State that is disproportionately poor and elderly, where do you think we can find savings in our budget that doesn’t harm these populations?
Jodi Quintero [Eves, Peterson, Stuckey], 287-1488, c. 841-6279
Ericka Wainberg [Craven], 287-1515, c. 232-5892