Lawmakers to revise elder services bill

Posted March 05, 2009, at 10:07 p.m.

AUGUSTA, Maine — Lawmakers this week sidelined a proposal that would restructure state spending in order to provide more health care and other home-based support services to Maine’s frail elderly residents.

The bill, LD 400, received broad endorsement at a public hearing on Tuesday, despite its $2 million price tag — at a time when many programs are going begging — and objections that it would pit nursing homes against agencies that provide home-based services such as personal assistance, nursing and housekeeping.

Rep. Anne Perry, D-Calais, House chairman of the Legislature’s Health and Human Services Committee, said the measure merits close consideration, especially given Maine’s rapidly aging population.

“There is no doubt that we are going to have a push upwards in terms of aging,” Perry said Thursday. “We are going to have to take care of people in a more cost-effective way.” For many elderly Mainers, she said, a relatively small investment in home-based support services can make the difference between continuing to live safely in the community and being forced into more expensive nursing home care.

But that doesn’t mean there won’t be a need for nursing homes and the more intensive care and supervision they provide, Perry said. The bill has been set aside for necessary changes and is expected to be aired before the committee again in coming weeks.

The language and some provisions of the bill, which was authored by a committee of senior advocates and sponsored by Sen. Margaret Craven, D-Lewiston, drew some criticism during the public hearing. Rick Erb, president of the Maine Health Care Association, rejected its implication that some people are prematurely admitted to nursing homes when they can’t get home-based services.

“Maine has some of the most stringent assessment criteria in the nation,” Erb said. Others at the hearing rejected outdated terminology that casts nursing homes and other long-term care facilities as “institutions” rather than providers of compassionate, appropriate care for those in need. Testimony also criticized a proposed “unified” budget that would shift the majority of spending from nursing home to home- and community-based care.

Changes to the bill could include provisions to support the development of a direct-care work force for home-based services and protections for current residents of nursing homes who might be found ineligible if admission criteria are changed.

The Office of Elder Services within the Department of Health and Human Services testified in support of the measure but could not endorse the $2 million fiscal note, which is not included in Gov. John Baldacci’s proposed biennial budget.

“There is no money,” acknowledged Perry. “No matter what we do now, the problem will still be there.” But, she added, implementing even the beginning of a change in spending policy is the first step in establishing a long-term solution that can meet the needs of Maine’s elderly and their families. Perry said the HHS Committee hopes to include funding for the measure when it releases its own budget recommendations in the next few weeks.

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