June 23, 2018
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Bill seeks in-home services for elders

By Meg Haskell, BDN Staff

Public policies designed to help elderly Mainers live safely in their own homes were last overhauled in 1980, during the administration of Gov. Joseph Brennan. On Tuesday, advocates packed the Legislature’s Health and Human Services Committee room in Augusta to tell lawmakers it is time to renew the state’s commitment to providing health care, homemaking, transportation and other home- and community-based services for Maine’s aging population.

“Maine has been on the leading edge of home-based services, but we’ve dropped the ball,” said Sen. Margaret Craven, D-Lewiston. Especially given the current economic crisis and Maine’s standing as having one of the most rapidly aging populations in the country, she said the state should invest in “helping people stay where they want to be — in their homes.”

Craven is the primary sponsor of LD 400, a bill that would implement many of the recommendations of a blue-ribbon commission charged with improving noninstitutional, long-term care in Maine. Many spoke in support of the bill at Tuesday’s public hearing.

The measure is opposed by the nursing home industry, and said its approximately $2 million price tag over the next two years could sink it in these lean economic times.

“Money is the terrible object right now, and it’s going downhill all the time,” remarked the committee’s co-chairman, Sen. Joseph Brannigan, D-Portland.

In addition to ramping up funding for home-based services, the bill calls for the Department of Health and Human Services and the Department of Administrative and Financial Services to develop a “unified” budget for the delivery of long-term care for the elderly and adults with disabilities. It would require the elimination by 2011 of waiting lists for home-based services, improve discharge planning from hospitals, and promote the use of computer and other technology in improving the health and safety of the elderly and disabled.

According to Brenda Gallant, the state’s long-term care ombudsman, Maine spends 75 percent of its long-term care budget on nursing homes and only 25 percent on helping people stay in their own homes or in supported-living facilities that promote independence.

Budget cuts in recent years, she said, have led to the erosion of a program that pays qualified family members to care for aging relatives, another that helps fund home improvements such as wheelchair lifts and bathroom renovations, and financial support for regional resource centers for the aging and disabled.

While such programs have a price tag, they ultimately save money by avoiding or delaying the need for nursing home care, a far more expensive option, Gallant said.

There are 975 Mainers on a waiting list for homemaker services, she said. In most cases, elderly individuals qualify for about six homemaker hours a month, she said, which can include picking up medications, preparing meals in advance and performing routine cleaning and organization. The cost to the state is about $18 an hour.

Other programs provide home health aides, nursing visits, transportation and other assistance that can keep people safe and healthy in their homes.

“But last month, 119 people who wanted home-based care went into nursing homes from the wait list,” Gallant said.

Also speaking in favor of the bill were representatives of the state’s nonprofit Agencies on Aging, the Maine chapter of AARP, direct care workers, Legal Services for the Elderly and several elected officials. Several Maine families sent letters to the committee urging passage of the measure.

Diana Scully, director of the DHHS Office of Elder services, said she could not support LD 400 because its $2 million fiscal note is not included in Gov. John Baldacci’s biennial budget now under review by lawmakers. But she weighed in in favor of “updating” Maine’s 28-year-old policies, adding that qualified direct care workers such as homemakers and aides already are in short supply.

“They are the face and the backbone of home- and community-based care services, and we must find ways to support them,” Scully said.

The Maine Health Care Association represents nursing homes in Maine. President Richard Erb told committee members the unified budget proposed in the bill would unnecessarily pit institutional providers against other long-term care providers, to the detriment of Maine’s elderly population. The provision could undermine the quality and availability of nursing home care, Erb said.

The bill also was opposed by Aging Services for Maine and New Hampshire, a nonprofit professional group representing nursing homes as well as home- and community-based providers.

The HHS Committee will hold a workshop on LD 400 at 1 p.m. today.



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