Last year we supported a “no” vote on Question 1, an ambitious referendum that would have created a new entitlement program for long-term care.
We came to our position not because we think that helping elderly and disabled people afford care is a bad idea. And it was not because we oppose improving pay and working conditions for caregivers as a way to make sure that the workforce will be big enough to meet the growing needs of Maine families.
We took issue with the details of the program, which would have been funded by a dedicated payroll tax and run by an unaccountable board. But we thought that the referendum’s backers had identified the right problem on which to focus, even though they had come up with the wrong solution. When the referendum was defeated, we encouraged the Legislature to keep working on the issue in the next session.
And that is what they did.
As a result of a law passed this year, a 15-member commission, which began work last week, will meet throughout the fall and propose recommendations for the full Legislature to consider next year. They are attacking the same issues that drove the referendum’s authors. We hope that they will come up with solutions that are more consistent with good government practices.
The problem has not changed. As more Mainers age, there are fewer people who can help take care of them.
Nearly a quarter of our population is age 65 or older, and that number gets bigger every year. Meanwhile, the share of the population ages 18 to 24 is shrinking rapidly, dropping 8 percent between 2010 and 2018.
“We need to go no further than these numbers to understand that our workforce is shrinking, but our population is not,” said Rep. Jessica Fay, D-Raymond. “This means we need to shift the way we think about work and our community.”
Fay will be co-chair of the commission. So will Democratic Belfast Sen. Erin Herbig, who promises an inclusive process.
“Our hope is a lot of great things can happen when you have experts in their field who are working either as a direct-care worker providing that service, you work in health insurance or the Maine Legislature,” Herbig said. “We are hoping to get all those folks at the table to really see what the true barriers are.”
Building the workforce will require cooperation between the public sector, which pays for much of the care, and private agencies and individuals, who deliver the care. It will also require better coordination within the government on both the state and federal levels: They pay for different services through different programs in ways that are impenetrable to most families.
It will also require better recruitment and training of caregivers, including family members who deliver care. And of course, it will also require better pay for the people who do this important work.
Virtually every family in Maine has had to struggle with finding affordable care for an elderly or disabled family member, or can anticipate have to face the issue in the future. Because of Maine’s demographics, solving the long-term care crisis won’t be solved without making fundamental changes.
It’s encouraging that the Legislature didn’t give up when the referendum votes were counted last November. Long-term care is still the right problem on which to focus.
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