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Sen. Marianne Moore: We can prevent an impending Maine nursing home crisis

Senator Marianne Moore represents Washington County in the Maine State Senate.

As we begin a new year and a new legislative session, it is time to bring about a New Year’s resolution to the issues of caring for our most vulnerable friends, family and neighbors.

Hello, I am Marianne Moore, State Senator for District 6.

Though we were able to provide a small increase in funding for our nursing homes on the last day of the last legislative session in June, the need is still great and it just got much greater. A large part of the need has to do with the increased cost of paying employees to work in these facilities. As of this week the minimum wage in Maine has increased again for the third straight year.

Despite these government mandated increases in labor costs, the state has not increased the Medicaid reimbursement rates to these facilities so that they can keep up.

Commissioner Lambrew of the Department of Health and Human Services tells us her staff has placed the need for nursing homes at an additional $7 million for this fiscal year alone.

At the same time, she says that DHHS has $31 million in unspent Medicaid funds and we are very hopeful that Governor Mills will authorize the Commissioner to use some of those funds to head off a further crisis. If this required new legislation, I have little doubt there would be unanimous support for a Governor’s bill that makes this happen.

As nursing homes have closed, or in order to avoid closing, some of them have shifted to MaineCare-funded assisted living facilities, also known as “Private Non-Medical Institutions” or PNMIs. Adult Family Care Homes are also small assisted living facilities.

Often, nursing homes cannot survive in rural areas because of their high operational costs.  When that happens, smaller assisted living facilities may be part of the solution and allow seniors to stay close to their community. Often these residents are able to “age in place” and avoid the need to transfer to a nursing home. 

Assisted living is an important part of Maine’s continuum of care. With Maine’s expanding elder population and the limited number of nursing home beds, their value in the community will only increase.

The average PNMI resident is 83-years old. 70% of these residents are wom­en. 88% have no spouse. Over half have Alzheimer’s disease or some other form of dementia, and 77% are MaineCare beneficiaries.

Most have given up their homes to live in a PNMI and many are eligible for nursing home level of care.

Maine has achieved a more balanced, cost effective, long-term care system because of PNMIs. Converting 40% of our nursing home beds to create PNMI assisted living has saved the state millions of Medicaid dollars over the last 20 years.

Despite these savings, however, MaineCare rates have not kept pace with increasing costs of care.

This leaves today’s PNMIs in a precarious financial position, and at risk of closure. While Maine uses the term PNMI, 48 states provide some form of Medicaid assisted living for their elderly and disabled populations. Maine can preserve it by providing a reasonable Maine­Care rate increase in the biennial budget.

To this end, LD 935 was carried over from the last session to this upcoming one as part of the Special Appropriations Table. It includes a modest but necessary increase to the MaineCare reimbursement rate for PNMIs and I sincerely hope the legislature can act in a positive way on this bill.

I have one constituent in Calais in my district who has shifted his nursing home facility to assisted living in order to continue to provide care. He believes that without passage of this bill and its funding, he will have to close his facility, leaving his clients without the care they need.

As we look to stabilizing our nursing home facilities in Maine, we must also look at the growing and critical needs of these assisted living centers to be sure they, too, are able to continue to play a critical role in the overall care of our seasoned citizens.

Again, I am Marianne Moore, State Senator for District 6, wishing you and yours a Happy and Prosperous New Year!

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