AUGUSTA — Vermont saved $13 million on long-term care over the last two years, largely by spending more on home-care services and group homes that help keep seniors in their communities and out of nursing homes.
More than half of the money saved is on track to be “reinvested” in expanding independent-living options for a growing senior population, said Dr. Susan Wehry, Vermont’s commissioner of disabilities, aging and independent living.
It’s a model that Maine and other states could follow to help improve elder care, reduce costs and create more livable communities for people of all ages, Wehry said Tuesday as the featured speaker at the second in a series of round-table talks on aging challenges facing Maine.
Vermont’s innovative efforts in rural communities serve as viable examples at an opportune time, she said, when the federal government and many states are looking for better, less- expensive ways to provide long-term care.
“I have never seen the stars more aligned than they are now,” Wehry told about 30 panelists and 40 audience members at the Augusta Civic Center.
The round-table series is hosted by House Speaker Mark Eves, D-North Berwick, and sponsored by the Maine Council on Aging. Talks on Oct. 15 and 29 will focus on creating livable communities and addressing workforce and economic issues, respectively.
Eves launched the round-table series this fall to help tackle the challenges facing Maine with its rapidly aging population. Legislation may result and be introduced early next year, Eves said.
The Portland Press Herald/Maine Sunday Telegram is examining the impacts of Maine’s aging population in an ongoing special series, “The Challenge of Our Age,” which has found that the state isn’t taking good care of its seniors now and isn’t prepared for what’s ahead.
Maine’s median age – 43.5 years – is the highest in the nation, in part because the state has a dwindling younger population, according to the U.S. Census. New Hampshire and Vermont rank second and third.
Maine’s proportion of people age 65 and older – 17 percent – is second only to Florida’s 18.2 percent. Vermont has a similar proportion of seniors: 15 percent of its 622,000 residents were age 65 or older in 2010 and the proportion was expected to hit 17 percent by 2015, according to the AARP. More recent data were unavailable Tuesday on the Census Bureau website because of the federal government shutdown.
Maine also has the nation’s highest proportion of baby boomers – 29 percent of its 1.3 million residents were born between 1946 and 1964 – and they are turning 65 at a rate of 18,250 a year, according to AARP Maine.
By 2030, more than 25 percent of Mainers will be 65 or older, magnifying the already serious challenges facing seniors and their communities. That will put Maine on the crest of an aging trend that’s already contributing to economic, social and political instability across the globe.
In Maine, the trend is exposing shortages in transportation, housing, health care, long-term care, family caregiver support and legal protections against elder abuse that threaten to cripple the state economically and socially if not addressed soon, experts say.
When it comes to long-term care, Maine has yet to follow Vermont’s lead in shifting costs to cheaper and preferred in-home and group-home care. As a result, the inflation-adjusted cost of MaineCare-funded long-term care services increased 33 percent in the last decade, from $266 million in 2000 to $354 million in 2010, according to the Muskie School of Public Service at the University of Southern Maine.
During that period, nursing home expenditures increased 27 percent, from $186 million to $236 million, and state-funded assisted-living costs increased 116 percent, from $32 million to $69 million. Meanwhile, spending on more home-care services decreased 4 percent, from $49 million to $47 million.
Vermont’s approach may not suit Maine exactly, Eves said Tuesday, but provides a positive example as state leaders rethink the delivery of long-term care and public policy challenges.
Wehry acknowledged the “strong intersection” of many aging issues, especially among low-income seniors. She is a board-certified geriatric psychiatrist who has advised policymakers, caregivers, physicians and other professionals on aging issues across the nation.
Vermont began shifting its spending priorities in 2005, when lawmakers recognized that long-term care costs were growing at an unsustainable rate and the state wasn’t meeting the needs of 90 percent of seniors who wanted to stay in their homes, Wehry said.
Vermont adopted a federally approved waiver program that offers Medicaid funding for a spectrum of long-term care, including in-home care, group homes with varied levels of assistance, assisted-living facilities and nursing homes, according to the state’s website.
As a result, the number of seniors and disabled adults in Vermont nursing homes dropped from 2,286 to 1,862 from 2006 to 2013, and the number of seniors receiving home and community-based services, including those living in group homes, increased from 1,161 to 1,912 during the same period.
Because in-home care, group homes and assisted-living facilities cost less than nursing home care, Vermont saved $7 million during the 2011-12 budget year, Wehry said.
Vermont spent $4 million of that savings last year to increase rates paid for home-health, adult-day, residential and direct-care services and increase spending on mental-health care programs, she said. And it likely will “reinvest” about half of $6 million saved in the 2012-13 budget in a similar way this year.
After Wehry’s presentation, participants in a round-table discussion raised a variety of concerns and ideas about the best way to service Maine’s senior population.
Jessica Maurer, executive director of the Maine Association of Area Agencies on Aging, said community leaders must form innovative partnerships to find solutions to long-standing problems with available resources, “because we don’t have more.”
Sen. Anne Haskell, D-Portland, pointed out the increasing difficulty that some seniors have making ends meet and the growing burden that’s being placed on family caregivers who are taking care of seniors at home.
“It’s the gaps that I think about,” Haskell said. “We need to find ways to fill those gaps.”
Kelley Bouchard can be contacted at 791-6328 or at: