Small elder-care facilities fear proposed MaineCare cuts

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CHEBEAGUE ISLAND — Seven senior citizens call the Island Commons home. They have lived on Chebeague or other islands, and their caregivers are island residents.

They are part of an “age in place” community that keeps the elderly in a familiar, nurturing environment where they can age gracefully.

But Island Commons, like nearly 160 other private, non-medical institutions in Maine, could be forced to close if Gov. Paul LePage’s proposed budget cuts are passed.

LePage’s proposal to cut $120 million from MaineCare to close a budget deficit in the state Department of Health and Human Services would take place by July 2012, if federal waivers are granted, and could affect about 65,000 Mainers.

Amy Rich, Island Commons administrator, said many rural and island communities are planning to join forces to make their voices heard throughout the budget process. She said the cuts would be devastating to small facilities throughout Maine.

“It has been from my research and findings that this would leave approximately 4,000 people displaced,” she said.

Rich said Island Commons’ 15 employees, like its residents, come from Chebeague, Cliff, Peaks and Great Diamond islands and the greater Portland area. The facility houses residents who predominantly utilize MaineCare, but there are a few private-pay beds, too, Rich said. 

“If these changes are put in place, our residents would be displaced and we would lose employees,” she said. “I don’t think we’d exist.”

Susan Stranahan, a Chebeague Island resident and Island Commons board member, said the facility is an institution that plays an important role in island life.

“It’s been a real lifesaver for many islanders who have been able to keep their parents close by,” she said. “But with all the proposed changes and (budget) cuts, the apple cart has been tipped for us. To change the way assisted living has been provided is devastating. We are not alone, but because we are an island, we have very few options.”

She called the proposed cuts “an assault without any common sense.”

But according to the LePage administration, the proposal would avoid more drastic, across-the-board cuts that would eliminate hundreds of state programs, affecting all Mainers. By making cuts to MaineCare services and the benefits program, instead of raising taxes, the administration hopes to avoid cuts to education funding.

The governor’s plan will redesign the benefits program by eliminating some optional services that are not federally required, including chiropractic, dental, occupational and physical therapy, podiatry, adult family care and vision services. 

These proposed cuts may bring Maine more in line with the national average, but they could affect facilities similar to and larger than Island Commons.

At the Pine Point Center, 67 Pine Point Road in Scarborough, administrator Leslie Currier said there are 70 beds and 12 are designated for assisted living. All 12 residents are eligible for MaineCare services, she said.

“We are keeping an eye on the budget proposals, and have shared information with residents and families,” she said. “We are encouraging family members to get involved by advocating for themselves and their loved ones.”

Barbara Walker, director of nursing at Seaside Nursing & Retirement at 850 Baxter Blvd. in Portland, said the budget cuts would “definitely affect all (private non-medical institutions).”

At Seaside, which was established in 1974, Walker said there are 154 beds and 30 are designated for assisted living; most of those are MaineCare.

“If the cuts were to pass in this form, I don’t know if we’d have (the assisted living beds),” she said.

At Cape Memory Care, 126 Scott Dyer Road in Cape Elizabeth, there are 20 MaineCare beds. Cape Memory Care is owned by Woodlands Assisted Living, a private, family operated company that has six assisted living facilities and one independent residential facility.

Matthew Walters, Woodlands chief executive officer, said the proposed cuts will not only significantly affect residents, but their families, the employees, and the state’s tax base.

“If this is actually implemented, of the 400 residents we serve throughout the state, almost 50 percent will be affected,” Walters said.

Walters said like some of the other facilities, the Woodlands sent a letter to family members when the governor’s proposal first came out.

“We had to tell these families that their loved ones would be discharged unless they are able to pay the entire private amount,” he said. “We encouraged them to contact their representatives, their legislators and the commissioner of the Department of Health and Human Services.”

Walters said of the 200 residents who are on MaineCare, 80 have Alzheimer’s disease and cannot live on their own or in the community.

He said he has written to LePage, testified at public hearings and will continue to spread the word about the proposed cuts.

“It is hard to believe that (the governor) truly understands the economic impact of these cuts,” Walters said. “There are thousands of jobs at stake, and even bigger economic repercussions if the cuts pass – higher unemployment rates, loss of income taxes and property taxes.”

He said even if more affordable housing becomes available, the people who live at assisted living facilities need the services provided and cannot live on their own.

Walters said he supports trying to find ways to shrink MaineCare to be more in line with the rest of the country, but there is a difference between cutting benefits to a 19-year-old and a person with Alzheimer’s disease.

“This proposal is a death knell for the whole industry,” he said. “The people that live with us are not welfare opportunists. Ninety percent of MaineCare residents are people who have worked their whole lives and spent their money on in-home care. And now they don’t have enough left over to cover 100 percent of the cost in their final years.”

Sen. Richard Rosen, R-Bucksport, is the chairman of the Appropriations and Financial Affairs Committee. He said the federal government is not very supportive of the private, non-medical institutions model and has expressed concerns about continuing to provide matching funds to support these facilities.

He said he is interested in understanding more about how the clients that still remain eligible for medical services can recieve those services – if not under the current system, then through an alternative.

“I think at this point, we are going to look at alternatives to a complete defunding of PNMI as of July 1,” he said. “I don’t dismiss the evaluation of the situation, and I accept what (the owners, operators and administrators of assisted living facilities) are saying.”

But Rosen said something has to be done. He said 28 percent of Maine’s general fund is slated for MaineCare, and the share is projected to grow at a rate of 7 percent per year.

“It is important to understand that from a budgeting point of view, the program places a burden on the state,” Rosen said. “If we raise taxes, or take money away from the education program, that will get us through one, $18 million problem. But we will be back at it again for the next two year budget.

“I think residents should appreciate that the members of the Legislature do understand and seriously consider the impact and magnitude of the governor’s  proposal and we will be exerting a tremendous amount of effort and energy to address it,” he said.

There will be another joint work session with the Health and Human Services Committee on Jan. 3.

Amy Anderson can be reached at 781-3661 ext. 110 or Follow her on Twitter: @amy_k_anderson.

Sidebar Elements

Island Commons on Chebeague Island is one of many small elder-care facilities throughout southern Maine that would be affected by proposed MaineCare budget cuts.