Staff Writer

Caleb Hanmer, 4, spent Wednesday morning playing outside Shooting Stars in Scarborough as parents dropped off children for a day of play and learning.

Caleb, like about half the 48 children at the preschool, will receive a combination of speech, physical and occupational therapy at the preschool

But Shooting Stars owner and operator Ruth Hughes wasn’t there to greet the students, half of whom need special services. Instead, she was in Augusta to fight a change in MaineCare policies she believes could force her to close the preschool she has operated since 2005.

A proposed repeal of MaineCare manual Section 27 would affect eligibility standards for children who need special developmental services, lead to reductions in state reimbursements to service providers and additional training requirements for staff. The proposed policy changes would take effect Sept. 1.

Charlene Kinnelly, a spokesman for the Maine Association of Community Service Providers, said eligibility revisions could affect 75 percent of children receiving services under MaineCare and drive preschool providers out of business throughout the state.

However, Maine Department of Health and Human Services Commissioner Brenda Harvey has a countering view. Harvey oversees the MaineCare program within the department and has assured parents that funding for speech, physical and occupational therapy services for children once paid by MaineCare will now be paid through the Department of Education’s Child Development Services, known as CDS.

Harvey said it has not been determined how many children could lose eligibility for state-provided services because of revised standards, but estimated it will affect one-third, not three-quarters of children who now receive those services through MaineCare.

Jaci Holmes, a legislative liaison with the Department of Education, said federal standards also require that DOE ensure all students who need special education services receive them, whether they are in preschool or above. She said the department will continue to reimburse providers at current rates despite the revision to MaineCare reimbursements.

Although current standards will remain in place for CDS provider reimbursements, Kinnelly, Hughes and Stacy Maguire, a pediatric occupational therapist who works with children at Shooting Stars, said they worry the revised eligibility standards will prevent children who need early intervention services from getting help because the DOE focus is on school readiness.

Maguire said occupational therapy efforts to teach children how to play and lead normal lives may not fall under the umbrella of educational services the DOE is required to provide.

The proposed 10 percent reduction in MaineCare reimbursements for her services mean she would earn less than she did when she entered the field 15 years ago, Maguire said.

Maguire is one of about 15 staff members at the preschool Hughes said she would have to lay off if the proposed changes take effect.

With about 24 of the 48 children in the program who need combinations of speech, occupational and physical therapy, Hughes said the program could also lose about 50 percent of its revenue.

“My passion is for inclusion,” Hughes said.

Maguire said she has seen elementary school-age children who received early intervention therapy no longer need services when enrolled in school. Cutting now will lead to larger expenses later, she said.

As Caleb greeted friends on the playground, his father, Jared Hanmer said the preschool has helped his son immensely through occupational and speech therapy.

“He has made enormous leaps and bounds,” he said.

Kinnelly said she did not believe “whole agencies will close” because of the proposed rule changes, “but a number of early intervention services would be in jeopardy.”

Kinnelly said doctors are reluctant to place labels on younger children and the evaluations could mean only the most severe cases will be eligible for services.

“The kids who are likely to see the most dramatic improvement are the most likely not to be eligible,” Kinnelly said

Harvey said the DHHS will continue to accept written comments about the proposed rule changes through Aug. 14.

Online comments may be sent to www.maine.gov/dhhs/oms/rules/provider_rules_policies.html

Staff writer David Harry can be reached at 282-4337.