SANFORD — Maine’s commissioner of the Department of Health and Human Services says the $2.5 billion Medicaid program called MaineCare has been in financial crisis for more than a decade. DHHS Commissioner Mary Mayhew told the Rotary Club of Sanford-Springvale Thursday morning that during the first year of the Paul LePage administration, DHHS had to request $200 million to sustain the program.

“That led to a lot of difficult decisions,” Mayhew said.

From the last fiscal year to this one, the commissioner said, there’s been zero growth in overall spending, and she said she’s no longer “staring at a sea of red ink for the next biennium.”

And while people on MaineCare are receiving health benefits, she said the most vulnerable ”“ those with intellectual and developmental disabilities and the elderly ”“ are on waiting list for services and support.

Mayhew, who along with Gov. LePage has been criticized for their approach to expending aid, spoke of a 75-year-old couple who have a 50-year-old developmentally challenged son, who she said is increasingly difficult for them to care for. Their health is failing and so is his. But he’s on a waiting list for a group home or other support.

Mayhew said she intends to ask for $45 million to fund the waiting list in the next budget.

She described the federal Medicaid program as antiquated, focused on facilities, and not keeping pace with programs to help keep older folks in their homes. The state funds a homemaker program to help the elderly stay at home, but, she said, there’s a waiting list there, too.

“We believe this program really deserves increased support,” Mayhew told the audience of business leaders.

Mayhew went on to talk about what’s been accomplished. She pointed out LePage paid the hospitals that hadn’t been paid in years, and is now paying on time. She said the agency has to look at reimbursements to primary care physicians, whom she said are closing their practices to MaineCare patients because of low reimbursements. She also said the department is looking at performance measures for medical providers.

Following the meeting, she spoke with reporters about the welfare-to-work program and another that, pending adoption of rules in October, would require welfare recipients convicted of felony drug crimes to undergo drug testing. The American Civil Liberties Union of Maine says the latter may be unconstitutional.

According to an Aug. 25 Associated Press story, Oamshri Amarasingham, the ACLU’s public policy counsel, said at a public hearing on the issue that the government must have a warrant based on probable cause to get a drug test except in limited circumstances.

“In addition to violating the Constitution, the proposed rule represents unsound fiscal policy, leaves many critical questions unanswered, and gives credence to harmful and false stereotypes,” Amarasingham said.

Mayhew on Thursday said she beleives the drug testing policy will pass constitutional muster, and said she found the ALCU’s stance troubling.

The ACLU has taken legal action against several states that have sought to implement drug testing requirements. Last year, a federal judge struck down a Florida law requiring all applicants for welfare benefits to undergo mandatory drug testing.

Mayhew said those who test positive for drug use won’t lose benefits if they agree to substance abuse treatment. And, she said, the welfare-to-work program is designed to move families from welfare to education, training and the workforce.

She said there’s a misconception that LePage is waging war on the poor.

“He refuses to accept the status quo of programs that have created dependency and trapped people in poverty,” she said.

— Senior Staff Writer Tammy Wells can be contacted at 324-4444 (local call in Sanford) or 282-1535, ext. 327 or twells@journaltribune.com.