Home Care for All Stirs Up Conflict in Maine

A sweeping universal home care initiative, Question One, will be on ballots this November in Maine. However, its opposition is calling it the “Universal Wait List.”

Many groups have already chosen sides. Some consumer advocacy groups, such as The Alliance for Retired Americans and Caring Across Generations, have come out in support of Question One. Other organizations in the business and health care communities are leading the charge against it. The Home Care and Hospice Alliance of Maine is in unanimous opposition, and other provider and business groups are also fighting the initiative, including The Maine State Chamber of Commerce, Maine Hospital Association and Spectrum Health Care Partners.

Representatives from Stop The Scam, a non-partisan effort focused on convincing residents to vote no on Question One (officially called An Act To Establish Universal Home Care For Seniors and Persons With Disabilities), believes that while there is room for improvement in home care services in Maine, there are a lot of services already available for those in need and the initiative won’t be workable.


“There is no means test, so any millionaire or billionaire would be able to access the program,” Newell Augur, Stop the Scam campaign chair and lawyer and registered lobbyist for the Home Care and Hospice Alliance of Maine, told Home Health Care News. “Martha Stewart, who [spends part of her] summer [in] Maine, would be allowed to get services through this program as they’ve written it.”

The tax that would pay for the home care initiative could keep some individuals, companies and their employees from moving to Maine, Augur said, adding that the state would suffer economically if Question One were to pass.

“Our business community would be eviscerated,” he said.


The Home Care and Hospice Alliance also has sharp concerns over potential violations of the Health Insurance Portability and Accountability Act (HIPAA), related to patient information being shared with third-party organizations should the measure be enacted.

NO on Question One/Stop the Scam
NO on Question One/Stop the Scam Dana Connors, president of the Maine State Chamber of Commerce spoke at the launch of the NO on Question One/Stop the Scam campaign in South Portland, Maine.

Home care ballots similar to Question One have been popping up across the country. Hawaii financed a program last year that sought to fund home care services.

It’s not a stretch for states with large aging populations to look for possible solutions like a universal home care benefit.

Maine’s median age is 44, and only a few other states in the nation have a median age over 40, according to 2016 Census data from the American Community Survey. The data also shows that 19% of the population of Maine is over 65, a number that is expected to grow.

“This is an issue that affects all of us,” Mike Tipping, the communications director of Maine People’s Alliance (MPA), told HHCN. “The state we are in is not a good one, something has to be done here, and we think this is the best way of approaching it.”

MPA is a grassroots organization that focuses on a variety of issues such as caregiving, health and economic justice. MPA created and is working to pass Question One. The organization has 32,000 members statewide and is 36 years old.

MPA used Maine’s citizen initiative process to get Question One on the ballot.

Stop The Scam believes that MPA is simply using it to push its “agenda” on the state.

“We say this is a scam because [the proposal] has nothing to do with home-based care,” Augur said.

The question will appear on ballots reading:

“Do you want to create the Universal Home Care Program to provide home-based assistance to people with disabilities and senior citizens, regardless of income, funded by a new 3.8% tax on individuals and families with Maine wage and adjusted gross income above the amount subject to Social Security taxes, which is $128,400 in 2018?”

The fund would be managed by a democratically elected board of home care workers, families and individuals receiving services and home care providers, according to Tipping.

Opponents take issue with the notion that the board will be “democratically” elected, noting that only stakeholders in the provider, patient, and home care worker communities—not the general populace—will be able to vote on board members.

MPA sees the proposal as a necessary initiative in order to help the aging population in the state.

“At its core, it’s a guarantee,” Tipping said. “So, it’s meant to say if you need this care you can get it to stay in your home. Even if you’re a part of the wealthy [population] … that is paying for it, you will have access to this.”*

MPA also looks at Question One as a possible help to home care workers.

“Like the rest of the country, we have a real problem right now with the caregiving workforce,” Tipping said.

The idea is that by passing Question One, home care workers will look at caregiving as a more viable profession with more training and a possible wage increase. In turn, the state could then see a reduction in turnover, according to Tipping.

The median turnover rate in the United States was 66.7% in 2017, according to the 9th Annual Edition of the Home Care Benchmarking Study by Home Care Pulse.

But because there is already a home care aide shortage, the state wouldn’t likely be able to keep up with the demand if this initiative were to pass, Augur noted. So, while this initiative could solve problems for the state, it may also cause them.

“We are probably going to be outspent,” Augur said. “But if we are able to get the word out to folks of just how pernicious this thing is, [Mainers] will vote it into the gutter where it belongs.”

But Tipping is just as optimistic that Mainers will see the good that Question One can do for people.

“We have an opposition that is trying to sow doubt about this and they’re throwing things at the wall—I don’t think any of them are sticking,” said Tipping. “I think people understand that this is a very simple, basic issue—that people deserve the support they need to stay in their homes, that it makes financial sense and that we can do it as a state.”

Only time and votes will tell.

*Editor’s Note: A previous version of this story referenced specific numbers as to how many people in Maine would be affected by the tax. Because the two sides of the issue dispute the numbers, HHCN has removed them from the story. Further information about the tax structure can be found in the public comment letter below, sent by the state’s Department of Administrative & Financial Services to Maine Secretary of State Matthew Dunlap.

DAFS Public Comment – Home Care – Letter and Technical Memo 

Written by Kaitlyn Mattson

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