Ask any older person if they would prefer to receive nursing care or other supports in their own homes, and the answer is likely to be “yes.” Referendum Question 1 on the November ballot plays on Maine voters’ wishes and hopes by promising free home care for everyone.
If people want real action on home care and other senior service needs — and to prevent creation of an entirely new bureaucracy — they should vote against passage of Question 1. Then, give votes to legislative and gubernatorial candidates who pledge to strengthen and modernize Maine’s existing home care services.
During the administration of then-Gov. Angus King, Maine was recognized nationally for efforts to expand alternatives to nursing homes, including home care. The initiative had the support of seniors, families and both parties in the Legislature. The Legislature has continued to recognize the needs of seniors, but the growth of Maine’s aging population calls for more investment and innovation in service delivery.
Question 1 will raise money by adding a tax on families and individuals who earn more than $128,000. Instead of directing those tax dollars to existing public programs, Question 1 sets up a separate, essentially private, home care system. A board of directors that will not be accountable to the Legislature or the public, will have $300 million of public money to spend. Up to $15 million can be diverted for spending on a new, stand-alone bureaucracy to manage the funds. Families, many already in crisis, will have the added challenge of navigating two bureaucracies.
Existing home care programs look at an individual’s income and assets to make sure that scarce public funds are spent fairly. Question 1 states that “income may not be a factor in establishing eligibility for the program.” So, people well able to pay for their own care could get services while those less able might be consigned to a waiting list.
State and federal rules value the protection of patient confidentiality. Question 1 ignores an individual’s right to privacy by requiring the DHHS to share personal contact information of anyone currently receiving home care services. The individual can “opt out” of being contacted, but they cannot opt out of having their personal information shared.
Staff shortages are the main reason many seniors now wait for care. More money would help, but cannot magically deliver workers who aren’t there. And, not just anyone is suitable to provide this critical care. Maine requires in-home workers to pass a criminal background check and participate in on-going training. If the proponents of Question 1 understood what’s involved in delivering home care, they would know it’s not as simple as paying people more money.
The referendum also gives the new board the authority to impose additional reporting regulations on home care providers, who already are strictly regulated by the state and federal governments. This will take agency staff time away from patient care and likely discourage some agencies from accepting patients whose services are funded by the new program.
Question 1 makes an end run on how tax and public program policy should happen. The Maine People’s Alliance, the sponsor of the referendum, never consulted any of the statewide groups that provide home and community services to seniors and persons with disabilities. Large public programs, like home care, succeed when they have broad input from all interested parties. Similarly, tax policy is the job of the Legislature’s Taxation Committee. The Committee takes the time to analyze the effect of proposed changes, as they did successfully during this recent legislative session when they adjusted Maine’s tax code because of the tax bill passed by Congress.
Question 1 sounds too good to be true, and it is. Don’t say yes to a proposal that delivers false hope to Maine seniors.
Christine Gianopoulos is the board chair of Home Care for Maine, Inc. a not-for-profit, statewide agency founded in 1994. She served as director of the Maine Bureau of Elder and Adult Services from 1987-2004.
Christine Gianopoulos
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