Who Can Ask for Assistance
- Any person interested in improving the quality of care for consumers
- A consumer receiving services from a home care agency
- A resident of a long-term care facility
- An employee or administrator of a home care agency or a long-term care facility
- A friend or relative of a resident or consumer
- Representatives of public agencies and community groups
Ombudsman Program staff is actively engaged in representing the interests of long-term care consumers before the Maine State Legislature. Whenever possible, we share data and information with legislators, the executive branch and state government officials concerning the first-hand experiences of consumers and their family members with the long-term care service delivery system. We work to educate legislators and policy makers regarding the needs and problems of long-term care consumers.
Our experience in resolving consumer complaints is the foundation for our testimony on long-term care legislation. We strive to provide a strong voice on behalf of consumers.
126th Legislative Overview
Section 19, Home and Community Benefits Waiver On August 12th 2014, The Long-Term Care Ombudsman Program entered comments on the proposed rule changes for Section 19: Home and Community Benefits for the Elderly and for Adults with Disabilities.
Section 19 Comments: Click here
LD 1487, An Act to Implement Managed Care in the MaineCare program. Senator Roger Katz (R-Kennebec County) introduced this bill late in the 2013 session. It sought to contract-out the administration of the Maine’s Medicaid Program to 3 to 4 private managed care plans. It proposed a phase-in period for all Medicaid services, including long term care. The bill was carried-over to the 2014 session and became the vehicle for a bi-partisan compromise, pairing Medicaid managed care with the federally funded expansion of Medicaid. The LTCOP testified on the bill expressing concerns about continued access to care, patient choice of provider, and maintenance of quality standards (including staffing ratios.) These concerns were largely addressed in the committee amendment. The bill passed the House and Senate but was vetoed by Governor LePage. The veto override failed in the Senate by two votes.
LD 1596, Resolve, Directing the Department of Health and Human Services To Amend MaineCare Rules as They Pertain to the Delivery of Covered Services via Telecommunications Technology. Sponsored by Representative Carol McElwee (R-Caribou), this bill proposed to direct DHHS “to amend MaineCare rules to allow registered nurses and behavioral health specialists to be reimbursed for providing covered services via telecommunications technology” in the same way that medical doctors, physician assistants and family nurse practitioners do. The LTCOP testified in support of the bill and recommended that Medicare certified home health care agencies be included. The HHS Committee amended the bill to direct DHHS to convene a working group to review the definition of “telehealth” in MaineCare rules and when telephonic over video communication may suffice; it also directs DHHS to amend its rules after the review. The Home Care and Hospice Alliance of Maine is included in the working group. The bill became law without the Governor’s signature.
LD 1745, An Act To Preserve Maine's Long-term Care Facilities.
Sponsored by Representative Katherine Cassidy (D-Lubec), this bill proposed to “give MaineCare Appendix C private nonmedical institutions a 2% cost-of-living rate increase,” the General Fund cost of which was $987,000 in fiscal year 2015. The LTCOP testified in support of the bill, pointing out the growing acuity needs of patients in these facilities, and saying, “We know that providing adequate funding for long-term services and supports across the continuum of care is essential in providing access and quality of care.” The HHS Committee unanimously reported the bill out, amending the FY15 appropriation to $1.08 million. Unfortunately, the bill died on the Special Appropriations Table.
LD 1749, An Act To Create Greater Cost Efficiency and Improve Health Outcomes by Incorporating Increased Access to Dental Services for Adults through MaineCare's Care Management and Coordination Initiatives. Sponsored by Representative Drew Gattine (D-Westbrook), this bill sought “to better coordinate care and to reduce health care costs by allowing MaineCare coverage of preventive or restorative dental services to persons 21 years of age.” The LTCOP testified in support of the bill, pointing to evidence that lack of timely access to dental care can lead to more serious and more costly health problems. HHS Committee unanimously rejected the bill, opting instead to send a letter to DHHS requesting that it explore options to accomplish the bill’s intent.
LD 1757, Resolve, To Establish the Blue Ribbon Commission on Independent Living and Disability. Sponsored by Representative Matthew Peterson (D-Rumford), this bill proposed to establish the commission “to evaluate the needs of Maine citizens with a disability, review existing available resources and services and recommend priorities for cost-effective changes designed to promote independent living and community inclusion” including “access to housing, transportation, public accommodation, education and employment.” The LTCOP testified in support of the bill. The HHS Committee reported the bill out (with slight revisions to the Commission membership) in a party-line vote. Enacted in both chambers, Governor LePage vetoed the bill. His veto was overridden in the House but sustained in the Senate.
LD 1776, An Act To Implement the Recommendations of the Commission To Study Long-term Care Facilities. As originally drafted by the Commission (on which the LTCOP had a seat), the bill required the following:
- That DHHS “amend its rules governing reimbursement for nursing facilities under the MaineCare program with regard to facility base year, peer group upper limits, administrative and management cost ceiling, personnel health insurance costs, cost-of-living adjustments, supplemental payments for nursing facilities whose MaineCare residents constitute more than 70% of their residents and increased acuity for dementia.
- Requires DHHS “to collect amounts overpaid to nursing facilities and private nonmedical institutions under the category of cost of care and to correct the computer problems that are leading to the overpayments.”
- Requires “the first $10,000,000 of collected overpayments to be used to fund nursing facility reimbursement under the amended rules.”
- It “establishes 2 study commissions: the Commission To Continue the Study of Long-term Care Facilities and the Blue Ribbon Commission on Long-term Care.”
The unanimous HHS Committee amendment made only technical changes to the bill. However, Appropriations removed “the provisions that require [DHHS] to amend rules governing principles of reimbursement for nursing facilities as they relate to the inclusion of the costs of health insurance for nursing facility personnel.” Appropriations also provided one time funding of $4.7 million for the increased rates, and eliminated the Blue Ribbon Commission on Long-term Care. The bill became law without the Governor’s signature.
LD 1779, An Act Relating to Nursing Facility and Inpatient Hospice Patients and Medical Marijuana Use. Sponsored by Senator Colleen Lachowicz (D-Kennebec), this bill proposed to allow hospice and nursing home patients who qualify for Maine’s Medical Use of Marijuana Program to keep and use non-smokeable medical marijuana in their rooms. The LTCOP testified in support of the bill, recommending that provisions other than in-room storage of this medicine. The HHS Committee unanimously amended the bill to allow facilities to adopt policies restricting the use and storage of this medicine within the facility. The bill became law without the Governor’s signature.
LD 1843, the supplemental budget. Budget negotiations were unusual this year in that the Governor did not submit a proposal. Instead, the Appropriation Committee was left to do so on its own. Among the ideas they considered were across the board cuts of 1% in FY 2014 and 3% in FY 2015. The LTCOP testified in opposition to these cuts, citing the damaging impacts on services to the patients and families it serves. Fortunately, these cuts were not included in the enacted budget. Governor LePage vetoed the budget, but his veto was overridden by large margins in both chambers.
LD 1858, An Act To Achieve the Savings Required under Part F of the Biennial Budget and To Change Certain Provisions of the Law for Fiscal Years Ending June 30, 2014 and June 30, 2015. This bill was a follow-up to the supplemental budget, resolving several areas of contention between the parties that could not be resolved in the earlier budget bill. It is notable for a last minute deal that resulted in two positive developments. It earmarks $5 million in the next biennium to address DHHS waiting lists for home care services for people with disabilities. It also earmarks another $5 million in the next biennium to increase Medicaid rates for nursing homes. Governor LePage vetoed this bill, but his veto was overridden by large margins in both chambers.
"All long-term care consumers have the right to be treated with dignity and respect."