Libby bill would ensure memory care facilities are appropriately staffed

Posted: March 29, 2017 | Senator Libby

A bill by Sen. Nate Libby, D-Lewiston, would seek improvements to long-term memory care by ensuring staffing levels at healthcare facilities are adequate to meet patients’ needs.

The bill — LD 804, “An Act to Establish Long-term Memory Care Facilities and To Provide Adequate Staffing and Reimbursement — was the subject of a public hearing in the Legislature’s Health and Human Services Committee on Wednesday.

Sen. Libby submitted LD 804 after hearing concerns about memory care facilities raised by a Lewiston family. The bill would establish a definition of long-term memory care facilities in state law, and convene a working group to recommend appropriate staffing levels. The bill also calls for additional funds to offset the increased staffing costs that facilities would have to bear from lower staff to resident ratios.

“Constituents came to me concerned about care for their mother,” said Sen. Libby. “The issues they raised, particularly inadequate staffing levels overnight, were a real concern to me. I also have a family member with an acute cognitive impairment. We should all be able to know our loved ones are receiving the care and supervision they need — and not just during the day when relatives and guests may be around to observe them.”

In Maine, Private Nonmedical Institutions (PNMIs) are residential care facilities that are reimbursed by MaineCare, the state’s health insurance program for low-income families. They serve primarily elderly residents and provide personal care, medication administration, supervision, dietary services, and they coordinate with other medical services.

Some of these PNMIs also have memory care units to serve patients with a complex set of medical issues, including memory loss, disorientation, reduced ability to perform daily tasks and psychiatric and behavioral symptoms such as agitation, depression, psychosis and social withdrawal. These medical needs necessitate higher ratios of residents-to-caregivers than are needed in non-memory care PNMIs.

“Most memory care homes across the state recognize the needs of the residents they serve, providing staffing sufficient to provide quality care,” said Brenda Gallant, the state’s Long-Term Care Ombudsman, who spoke in favor of the bill. However, “while the acuity of residents served in residential care has increased, staffing requirements have not been adjusted to reflect this change.”

According to a study done by the Muskie School of Public Service at the University of Southern Maine, the assistance people in residential care facilities require has risen in recent years. Between 2000 and 2010, “the overall case mix index grew by 20 percent.”

The Committee on Health and Human Services will make its recommendation to the full Legislature on LD 804 in the coming weeks, after which the bill will be subject to votes in the House and Senate.