When the Department of Health and Human Services convened stakeholders from across the state on May 7, 2019, to engage with the new Mills administration on how best to serve older Mainers, the mood of the participants was hopeful and upbeat. After years of being ignored, older adults, advocates, home care providers, gerontologists, Area Agencies on Aging and others affirmed the new administration’s top priorities: expanding access to in-home services and improving coordination of care.

Audra Keenan, Russ Phillips and Cindy DiBiase, left to right, put meals into bags before distributing them to seniors in Scarborough last July 21. The meal distribution is a collaboration between Scarborough Community Services and the Southern Maine Agency on Aging and is an effort to get meals to seniors because the pandemic keeps the weekly in-person meal from being held. Gregory Rec/Staff Photographer

ABOUT THE AUTHOR

Paul Saucier is director of the Maine Department of Health and Human Services’ Office of Aging and Disability Services.

No one imagined that 10 months later, we would be responding to a historic pandemic with a disproportionate impact on older adults in Maine and nationally. Neither did we understand then just how important in-home services would become to thousands of older Mainers sheltering in their homes. Fueled by supportive state and federal policy and funding, a small army of in-home support workers, volunteers, municipalities, nonprofit support agencies and health care providers rose to the occasion:

• Expanding meal delivery services provided by Area Agencies on Aging and community partners, providing older Mainers with over 100,000 meals every month, and ensuring funding is in place to sustain this level of service for the rest of the year.

• Growing MaineCare’s Home and Community Based Services waiver program for older adults, which provides flexible supports to help with daily needs and prevent admissions to nursing homes, by 40 percent from 2019 to 2021.

• Increasing participation in the Homemaker program, which provides help with light housekeeping, laundry, and grocery shopping to support independent living, by 18 percent from 2019 to 2021. The program now reaches 2,300 households statewide through Catholic Charities of Maine.

• Adapting state rules to allow Homemaker assistants to do grocery shopping for older adults (rather than with them) in response to the pandemic.

• Supporting frontline home care workers, on whom this service expansion depends, by accelerating a 23 to 30 percent rate increase for personal support specialists in MaineCare and state-funded programs.

• Implementing MaineCare expansion on Gov. Mills’ first day in office, covering an additional 72,000 Mainers, including nearly 18,000 who are 50 to 64 years of age and do not yet qualify for Medicare.

For now, our immediate priority is getting older adults vaccinated. We have leveraged Maine’s unique network of home and community-based service providers to assist older Mainers and overcome barriers to vaccine access. Area Agencies on Aging have been taking calls from older adults and assisting them with making appointments, referring them for transportation and other supports, and partnering with home health agencies, emergency management service agencies and pharmacies to arrange for vaccine delivery to those who are homebound. The majority of Mainers 70 and older have now received a first dose, and Maine is on track to begin vaccinating those who are 60 and older this week.

Going forward, home-based supports will be even more important as growing numbers of older adults prefer to age in their homes and communities. This reality is reflected in the governor’s biennial budget proposal, which includes two important initiatives that will support continued access to in-home assistance as we navigate uncertain economic conditions: Ensuring that Home and Community Based Services are classified as a regular MaineCare service and therefore covered by federal matching funds, and easing estate-recovery provisions for MaineCare to lessen the financial burden for older Mainers and encourage them to pursue MaineCare coverage.

We also recently published the first Age Friendly Plan, developed with assistance from more than 50 organizations across the state. The plan takes a wholistic approach to aging in the community, addressing issues outside of health and social services, including access to outdoor spaces, broadband internet service, transportation and financial security.

With the support of Gov. Mills, we look forward to continuing this vital collaboration with community stakeholders, Area Agencies on Aging and providers as we work together to ensure that all Mainers have the support and access to services they need to thrive in their later years.