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Panel: More Beds Needed for Elderly Mainers with Mental Health Conditions

AUGUSTA, Maine — A legislative study commission is recommending that the state create more nursing home beds for patients with psychiatric needs.

The panel, which was set up to study long-term care obstacles for patients with complex medical conditions, issued other recommendations as well.

There is no single answer to the problem of finding long-term care for Mainers coping with unique medical conditions, but Democratic state Rep. Drew Gattine says the legislative commission that he co-chairs has zeroed in on partial solution.

"There are circumstances where putting in some additional resources, beefing up some additional resources that are already there could actually help somewhat with this problem," Gattine says.

Gattine and other members of the Commission to Study Difficult-to-Place Patients have been trying to address the problems of patients who can no longer be cared for by family members or by the nursing home or extended care facilities in which they live.

More often than not, these are geropsych patients — elderly Mainers in need of mental health treatment.

"It's generally a behavioral or psychiatric condition that makes it difficult to place them in a regular nursing home or residential care setting because their behaviors are such that they're very difficult to manage," says commission member Jeff Austin of the Maine Hospital Association. He says that's not good for the hospitals, or the patients.

"So these patients just stay in hospitals for days weeks, months, some can stay a year and there's no reimbursement to the hospital," Austin says. "It's not a home; it's not where these people belong. They deserve a home and we're trying to figure out a way to find them one."

The commission would like to see up to 25 new geropsych beds located in areas north and east of Waterville, where options for those patients are currently limited. The panel is also recommending about $150,000 in funding to cover the cost for two additional staffers at the Long-Term Care Ombudsman program that assists those with complex medical conditions.

Brenda Gallant, a member of the panel representing the ombudsman program, says the extensive requirements of some patients takes significant time and effort when it comes to placement.

"People with complex medical needs, people on ventilators, people with tracheotomies, people with more complex medical needs have real difficulty in finding placement in Maine nursing facilities, and we have not yet developed the capacity statewide to provide those services for individuals," Gallant says. "There's just a couple of nursing homes that have admitted residents on ventilators, so there is a need for the expansion of these services."

Commission member Ricker Hamilton, deputy commissioner of programs for the state Department of Health and Human Services, cast the lone dissenting vote on the 9-1 commission recommendation. While he agrees with some of the recommendations in the report, Hamilton says the request for more geropsych beds should wait until a better assessment of existing resources is carried out.

"A lot of money is being spent in there," Hamilton says. "I looked at the rates over the weekend. If each facility receives a different rate, I think there's a lot of work that we could do in there. I'm not doubting that there's probably a need for more beds, but I'd like to have the current system be more responsive, effective and efficient."

Among the other recommendations issued by the panel are further exploration of expanding home-based services and the prosecution of family members who have gained access to a patient's financial assets. The committee's recommendations will be taken up the by the Legislature's Health and Human Services Committee when lawmakers return to Augusta next month.