Gratwick bill would ensure clarity for nursing home applicants

Posted: May 02, 2017 | Senator Gratwick

AUGUSTA — A bill by Sen. Geoff Gratwick, D-Bangor, would ensure that applicants for nursing homes, and the nursing homes themselves, are updated by the Department of Health and Human Services on the status of their applications in a timely manner.

The bill — LD 1424 “An Act to Amend the Laws Governing MaineCare Eligibility Determination For Applicants to Nursing Homes” — received a public hearing before the Health and Human Services Committee on Monday.

Eligibility rules and standards for MaineCare can be highly complex for those applying to nursing home facilities. Conflicting and confusing information about eligibility makes application for placement in a nursing home difficult, with some seniors ending up having to apply twice or even more times before the application is complete.

Sen. Gratwick’s bill directs the department to provide adequate notice to the applicant and the facility they are applying to if the department is unable to make an eligibility determination for a lack of information or errors on the application. The bill also provides applicants with enough time to respond to questions about their application, rather than forcing them to apply from scratch again.

“As a physician, I’ve seen firsthand the kind of stress that moving into a nursing home causes for seniors and their families,” said Sen. Gratwick. “These families are dealing with an enormous change in their lives and a complex bureaucracy the likes of which they’ve most likely never experienced. This bill tries to ease that burden by ensuring clearer communication between the nursing home, the department and the families who are trying their best to deal with a new situation.”

Gratwick brought the bill after meeting with officials from The Westgate Center for Rehabilitation and Alzheimer’s Care in Bangor, who shared frustrations with the current system.

President and CEO of Maine Health Care Association (MHCA) Richard A. Erb spoke in favor of the bill at the public hearing.

“Delays in MaineCare eligibility determination are one of the biggest concerns of MHCA members. When Decisions on eligibility take weeks and even months, the facility is caught in the middle,” said Erb. “They are uncertain on whether to admit the resident, not knowing if there will be a source of payment.”

The bill also received the support of Robert Hemenway of The Westgate Center for Rehabilitation and Alzheimer’s Care, and the Maine Long-Term Care Ombudsman Program.

LD 1424 faces further action in the Health and Human Services Committee and votes in the House and Senate.