Future of care

The state’s Department of Human Services set out six years ago to reduce the number of nursing home beds and increase home-care options, and it has been successful in this. So successful, in fact, that half of the remaining nursing homes have operating losses and 40 percent are insolvent. The Legislature’s Health and Human Services Committee this session has produced a reasonable solution to this problem that deserves the full support of lawmakers.

Given Maine’s demographics — the nation’s fourth-oldest population and a rising number of people over age 65 — the state will need more, not fewer, nursing facilities in the near future. It will also need to encourage a full range of care models and facilities and develop ways to staff them. A comprehensive look at caring for the elderly so that Maine is prepared when the baby boomers start to retire is the minimum that should be done in the next couple of years. Short term, however, the goal might be to simply keep open the number of nursing facilities Maine currently has.

To do that, and to pay personal care attendants something better than $6.50 an hour, will require more money from the state and federal governments. This is especially true for facilities that have few private-pay residents – and no facility has a lot of them; approximately 82 percent of the funding from nursing homes is public money. The federal money is easier to come by – many of the costs for long-term care facilities are paid for by matching two federal dollars for every state dollar spent — although increases in Medicaid reimbursements fall well short of inflation.

Congressional help with Medicaid levels is crucial, but Maine can also act. The legislative committee would increase state spending by a total of $15 million. Critics will say that the industry is not nearly as bad off as its lobbyists say, and, in any event, still has more beds than Maine needs. But the trend in nursing homes is clear: Less money going in, fewer profits, more losses and a large number of Maine residents, now in their 50s, who will increasingly need services starting in the next decade.

At the least, Maine needs to shore up its current system of care for the elderly while it figures out how it will deal with the challenges that are not far in the future.