July 22, 2019
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Why Maine’s political leaders are fighting again about nursing home funding

WGME | CBS 13
WGME | CBS 13
An employee enters a room at Ledgeview Living Center, a nursing home in West Paris in this Aug. 9, 2018, file photo.

AUGUSTA, Maine — Gov. Janet Mills has delayed action on a legislative proposal to guarantee increased funding to embattled nursing homes as the state reviews a federal payment cap that a top advocate says the Mills administration has misinterpreted in its explanation of the move.

The measure would put just more than $1 million in state money toward wage increases at nursing homes scheduled as part of a $33.2 million increase in a spending proposal that passed in 2018 in a divided Legislature over the veto of former Republican Gov. Paul LePage.

Nursing homes have long been underfunded in Maine, the oldest state in the nation by median age. Six nursing homes closed in 2018, with advocates blaming low Medicaid reimbursements, a tight labor market and minimum wage increases approved by voters in 2016.

The Kaiser Family Foundation found that Maine nursing home residents required the fourth-highest average number of staff hours nationally in 2017. At the same time, nursing and residential care workers made a weekly average wage of $554 last year, putting them roughly on par with workers in the larger retail sector, according to state data.

All of that has turned nursing home funding into a political football in Augusta. There is often bipartisan agreement on funding them, but while conservatives often invoke them as top budget priorities, LePage vetoed last year’s increase after saying it was “ fiscally irresponsible” and blaming minimum wage increases for the larger problem.

Democrats took over the Legislature and the Blaine House after the 2018 election and the two-year budget passed in June included a $25 million cost-of-living adjustment for nursing home facilities. But Mills held onto 39 bills after the Legislature adjourned last month, which means she will have three days to act on them when lawmakers return in January.

One of them was the bill from Senate President Troy Jackson, D-Allagash, that would provide the $1 million for wage increases at nursing homes. Senate Republicans championed that funding in last-minute budget negotiations, and Sen. Marianne Moore, R-Calais, released a statement saying she was “very disappointed” in the governor’s move.

On Monday, Mills spokeswoman Lindsay Crete said the governor delayed action on the bill because of concern that the funding would exceed a federal cap on services that would, in turn, stop federal match funding. She said Republicans were “playing politics” by wrongly implying that Mills “does not care about nursing homes or elderly Mainers.”

However, Rick Erb, executive director of the Maine Health Care Association, said on Monday that his group, which represents nursing homes, sees no cap problem and was “surprised and a little disappointed” that Mills held onto the bill.

He provided a letter from a consultant who said the administration’s stance was based on misclassifications that would lead to higher caps once corrected, though he also said that it’s possible that the increase could come without the bill and with existing funds.

“This part is actually fairly straightforward, and I’m quite confident that we will stay under the limit,” Erb said.

Erb said his group has provided information to the governor’s office. Jackie Farwell, a spokeswoman for the Maine Department of Health and Human Services, said Tuesday the Mills administration is working with a consultant to assess the current cap calculations, and “it is not clear” that the state can adjust reimbursements past what the Legislature has directed.

In an interview with WVOM on Tuesday, Rep. Beth O’Connor, R-Berwick, said Mills’ explanation “doesn’t hold water,” and House Republicans released a statement later in the day saying they believe Mills made an “honest mistake.” Jackson said in a statement that Democrats would work with the governor’s office to maximize federal funding to “struggling” nursing homes by January.

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