In less than a week, Maine citizens will determine the fate of Question 1, a divisive home care initiative that over-promises and under-delivers.
The Maine Health Care Association (MHCA) is a private, not-for-profit trade association representing Maine nursing homes and assisted living communities.
MHCA opposes Question 1 for several reasons:
• The initiative uses tax dollars to provide benefits to all, even the wealthiest people in the state. It also includes individuals who are not full time residents of Maine.
• The initiative is being touted as an alternative to nursing home care, but it only requires recipients to need help with one Activity of Daily Living, like dressing or bathing. The average Maine nursing home resident needs helps with 4.4 ADLs and may have complex medical and/or cognitive needs.
• The universal homecare program would be overseen by an elected board made up of interested parties who would have access to private health and contact information and would operate independently from the legislative and executive branches of state government.
• It would duplicate the bureaucracy that currently oversees home based care in Maine, at a cost of up to $6.5 million, and most likely create a new waiting list as staffing shortages persist.
• It requires every independent homecare worker, even family caregivers, to be represented by the state employees union.
• Multiple state agencies have rendered their interpretation of who will be impacted by the tax hike. Experts agree it is on Maine individuals, families and businesses.
Question 1 undermines years of public policy that has led to the development of a solid, long term care continuum.
By design, Maine increased its nursing home admission criteria nearly 25 years ago to pave the way for the development of more home- and community-based options. Simply put, only the most frail and sick Mainers qualify for nursing home level of care today.
Consequently, our state has the lowest nursing home utilization in the country. MHCA continues to support this continuum that successfully cares for people at the right place at the right time with the right service.
In addition to the concerns highlighted above, our state has a severe and persistent staffing shortage. It is impossible to see how Question 1 could make good on its promise of universal home care without a significant increase in qualified caregivers. We do not have an adequate supply of caregivers to meet the current demand. The last thing we need is another waiting list.
It is ironic that proponents of Question 1 accuse MHCA of using scare tactics to defeat this initiative while they promise that Question 1 will keep people out of nursing homes. Again, an individual needing help with one ADL is very unlikely to be admitted to a nursing home. They won’t qualify.
Proponents also claim that the “nursing home lobby” is paying for the Stop the Scam, No on 1 Campaign, when in fact, there has been a single contribution from a single individual affiliated with MHCA in the amount of $50. The public campaign financing report speaks for itself.
We do, however, join 40-plus organizations, including the Maine Home Care and Hospice Alliance, Maine Hospital Association, and Maine Community Service Providers, who oppose the creation of a duplicative and unregulated home care program.
MHCA recognizes that all levels of long term care require additional resources, but believes that Question 1 is the wrong approach. It creates an inefficient system that over promises what can be delivered, while instituting the largest income tax increase in Maine history, raising more than $300 million per year.
In our view, fully funding existing programs would be a far better use of the taxpayer’s money.
Richard A. Erb
President and CEO
Maine Health Care Association
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