Thursday, December 5, 2013
AUGUSTA — A legislative commission grappled Friday with the complicated details of funding, staffing and judging the quality of Maine’s long-term care facilities as it met for the first time.
The Legislature agreed in the spring to form the Long-Term Care Facilities Study Commission after receiving several bills related to long-term care issues.
Much of Friday’s discussion focused on underfunding by MaineCare, the state’s Medicaid program, which paid nursing homes $29.4 million less than it cost them to provide care in 2011, according to commission member Rick Erb, CEO of the Maine Health Care Association.
“There is a gross underfunding of the long-term care system,” said state Rep. Peter Stuckey, D-Portland, a co-chair of the commission.
Stuckey said the system is “on the brink” in the face of rapid growth in Maine’s senior population, which is the subject of an ongoing Portland Press Herald/Maine Sunday Telegram series, “The Challenge of our Age.” The investigation has shown that the state isn’t taking good care of its seniors now and isn’t prepared for what’s coming.
The median age of Maine’s population – 43.5 years – is the highest in the United States, in part because the state has a dwindling younger population, according to the U.S. Census. The state’s proportion of people 65 and older – 17 percent – is second only to Florida’s 18.2 percent.
Maine has the nation’s highest proportion of baby boomers – 29 percent of its 1.3 million residents were born in the period from 1946 to 1964 – and they’re turning 65 at a rate of 18,250 a year, according to AARP Maine.
By 2030, more than 25 percent of Mainers will be 65 or older, magnifying the already serious challenges facing seniors and their communities. That will put Maine on the crest of a worldwide aging trend that’s already contributing to economic, social and political instability across the globe.
In Maine, the increase is exposing shortages in transportation, housing, health care, long-term care, family caregiver support and legal protections against elder abuse that promise to cripple the state economically and socially if not addressed soon.
Sen. David Burns, R-Whiting, proposed the formation of the Long-Term Care Facilities Study Commission after the Atlantic Rehabilitation and Nursing Center closed in 2012, leaving Calais without a long-term care facility.
Burns said rural communities have fewer long-term care options, more MaineCare recipients and fewer private-pay residents, which drives down revenue and makes it difficult for many nursing homes to survive.
Erb, whose organization represents Maine nursing homes and assisted-living facilities, called the MaineCare pay model “archaic” and said it comes about $20 a day short of covering the cost of each nursing home resident.
The funding gap is particularly tough on nursing homes in rural areas, leading to closures that require some Mainers to drive two hours to visit loved ones in long-term care, said Calais Town Manager Diane Barnes, a study commission member.
Erb said long-term care facilities compensate for MaineCare underfunding by shifting costs to private-pay residents.
As a result, Maine nursing homes have the ninth-highest private-pay rates in the nation, according to the AARP. By pushing up those rates, underfunding drives private-pay residents onto MaineCare sooner, he said.
“The private sector is compensating for (lack of) public-sector funding,” said Sen. Margaret Craven, D-Lewiston, the other co-chair of the commission.
Commission members discussed the impact of rehabilitation “swing beds” in rural hospitals, pay-for-performance incentives and higher reimbursement rates for long-term care facilities that have more MaineCare residents.
Several experts are scheduled to speak at the commission’s next meeting, at 10 a.m. Oct. 25 in Room 209 of the Cross State Office Building in Augusta.
Kelley Bouchard can be contacted at 791-6328 or at: