Maine is among the oldest states in the nation — and it’s getting older. This is something to embrace: Older Mainers bring wisdom, experience and richness to our lives.
But as a recent Washington Post article highlighted, we have work to do to ensure that older residents can live with dignity in the place that best suits them, whether in their own homes, group homes, assisted living or nursing homes.
This is a central goal of the Maine Department of Health and Human Services, and we have a plan to address it.
Our Office of Aging and Disability Services has convened an Aging and Long-Term Services and Supports Advisory Group. Its 16 members bring a variety of perspectives to the table on expanding access to services in residents’ homes and communities. The group will also identify ways to improve coordination of care for people who are eligible for both Medicaid (MaineCare) and Medicare.
The group will produce a report by the end of this year, aligning with a separate report from the recently created Commission to Study Long-Term Care Workforce Issues. I will join others from throughout the state in identifying opportunities, barriers and solutions to the shortage of workers to meet the needs of our aging population.
However, we are not waiting to act. We have started work on expanding the workforce for long-term services and supports.
To that end, we are renewing collaboration and participation in activities with the Department of Labor under the Workforce Innovation and Opportunity Act. This enables better coordination between DHHS programs that increase work participation and the Maine CareerCenter system, which provides a full range of assistance to job seekers under one roof.
We are building on Maine’s Food Supplement Employment and Training Program that has received national attention for innovative programs such as Family Futures Downeast. We also partner with Goodwill of Northern New England to help SNAP recipients develop job skills.
And, in October, DHHS will launch HOPE: Higher Opportunity for Pathways to Employment to connect low-income Mainers to jobs in fields such as health care.
Directly expanding the number of workers is one part of the strategy. Ensuring that they are paid adequately for caring for older Mainers is another. Gov. Janet Mills proposed and secured $8.5 million in state funds to increase MaineCare payment rates to nursing facilities in the biennial budget. The governor also directed DHHS to use $11 million in available funds to implement a new cost-of-living adjustment for nursing facilities, which took effect last month. These investments — which total an estimated $55 million with federal matching funds — aim to improve the continuity and quality of care provided to Mainers who reside in these facilities.
DHHS is looking at an alternative way to fund nursing homes without exceeding a federal limit that would put millions of federal matching dollars at risk. This “upper payment limit,” as currently calculated, precludes spending an additional $1.04 million in state funds for nursing home rate increases in a bill considered in the final hours of the legislative session. The department is analyzing the upper payment limit to determine whether a higher limit could be allowed by the Centers for Medicare and Medicaid Services. Regardless of the outcome, we are committed to working with legislative leaders on a new bill in January to invest this amount in the nursing home workforce.
More importantly, we are exploring changes in how we pay for long-term services and supports — in nursing facilities as well as home and community settings — to reward quality, compassionate care. This includes providing opportunities for advancement of this valuable workforce through skills development and strategies focused on retention. Band-Aids and patches are not enough for the demographic shift that is shaping not only Maine’s future, but also the nation’s.
While addressing this shift is urgent, it also requires careful thought and planning. But rather than seeing this situation as potentially “catastrophic,” as one expert in the Post story predicted, we view it as yet another challenge that Mainers will roll up our sleeves to address.
The state and Maine DHHS stand ready to prove the naysayers wrong.
Jeanne M. Lambrew is commissioner of the Maine Department of Health and Human Services.