Common sense home healthcare reform provides relief for vulnerable Maine families


Governor Janet Mills on Friday, June 28 signed into law LD 84, a bill sponsored by Rep. Patrick Corey of Windham, “Resolve, Directing the Department of Health and Human Services To Allow Spouses To Provide Home and Community-based Services to Eligible MaineCare Members.” The bill received bipartisan support in both chambers of the legislature and was passed to be funded from the Special Appropriations Table on the last day of the first regular session. 

LD 84 requires the state to submit a waiver to the federal government allowing reimbursement to individuals who provide care for their spouse under Section 19 of the MaineCare Benefits Manual, a service called Home and Community Benefits for the Elderly and Adults with Disabilities. In doing so, the state will help alleviate the financial hardships of families with elderley or disabled loved ones who seek to stay in their homes. 

LD 84 will have a significant impact on the lives of those who require the aid of a personal support specialist. Under current law, spouses of those who require home healthcare services under Section 19 cannot be reimbursed by Medicaid for the care they provide. Instead, families must hire a personal support specialist from an agency that is reimbursed by the state for the services provided through MaineCare, and often have hours of unmet need due to workforce shortages within the home healthcare industry.

Current law neglects to acknowledge the regular care provided by spouses when a personal support specialist is not on the clock inside a home. Unlike the Universal Home Care initiative Maine voters rejected at the ballot box in 2018, LD 84 is a practical solution that poses minimal fiscal costs to the state while offering tens of thousands in potential savings. 

When an individual is in poor health or has hours of unmet home care needs, spouses of elderly and disabled Mainers are often unable to work or forced to cut back hours at their job to provide care for their loved one. This inability to work, coupled with lack of reimbursement for the care they provide, often leads to financial hardship. Given that the other half of the household is unable to work and eligible for Medicaid, it’s hard to imagine how these families could make ends meet under the current rules. However, once in effect, LD 84 will immediately begin to provide relief for these families. 

Under LD 84, spouses can be hired as their loved one’s personal support specialist after a federal waiver has been approved allowing the state to reimburse spouses for these services. In addition to spouses being paid, families will no longer be required to hire someone from an outside agency to provide care. Families looking for continuity of care have struggled grappling with new providers in their home on a regular basis, if one shows up all. LD 84 will improve the financial security of these families, and by receiving the services they require, elderly and disabled Mainers will be able stay in their homes longer.

Allowing people to remain in their homes for as long as possible is fundamentally the right thing to do, and it also provides fiscal benefit to the state.

The average annual cost of a private room in an assisted living facility or nursing home is $59,892 and $108,405, respectively, in Maine. Under the current reimbursement rate for services under Section 19, if an individual required 40 hours of care per week, the state would spend less than $38,500 to reimburse for these services. Allowing spouses to be paid through MaineCare fills a significant need in the home care workforce while providing financial benefit to the state. In fact, keeping someone out of a nursing home for one year could pay for the services of a personal support specialist for nearly three years.

LD 84 is a common sense solution that will improve the lives of Maine families. As someone who has a chronic neurodegenerative disease— and may one day benefit from this legislation—kudos to Rep. Corey, the Maine House and Senate, and Governor Mills for coming together in a bipartisan manner to enact this bill.


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