Long-Term Care - Illinois General Assembly

The nursing home industry in Maine deserves credit. They could have easily dug their heels in
and said: ”No way.” It's a sign that people agreed that you just can't raise wages in one sector
of this system and not expect it to create problems in others.
In order to contain system costs, there have been sacrifices in some of the flexibility that existed
in the past. There are very tight service authorization guidelines — down to how many minutes
a person gets if he or she needs a bath. This sounds a little obsessive/compulsive, but it is an
important method for assuring some equity in how limited resources are allocated and used.
There is a challenge of rising expectations. In a sense, the better and more accomplished, the
more the legislature expected to squeeze out additional savings. Most of the savings have
been pretty much wrung out of the system.
Another issue is managing high acuity consumers at home, people with behavior problems.
These are individuals who, without a second thought, used to go into the nursing home. Now,
there is an expectation and a system that says: “You don't go into the nursing home until you
really need that level of care.” So the people being served at home are not used to being called
the nice little “blue rinse crowd,” the nice little old lady who just wanted her knickknacks dusted.
Services are being provided to very high acuity people, and that's a challenge to do that at
home.
Because Maine is experiencing the same financial problems that many others are, it is, once
again, facing a situation where State-funded home care programs have a significant waiting list,
and it's hard to tell people that they have a choice when, in fact, one of their choices isn't
available because there isn't sufficient funding.
The charts below are basically what were used with legislators. It's just so simple. People
understand it. They can look and say: “Okay, in 1995 this is where we were serving people, and
in 2002, this is where people are getting services. It's something that most people can
understand. It has been very effective in working with legislators to get them to see and
continue to have confidence in the policy reforms. Maine is making progress.
Long-Term Care in Maine
Where are People Receiving Services?
Total Persons Served: 19,742 Total Persons Served: 25,650
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