National expert: Question 1 can address Maine’s ‘home care crisis’

Stephen Campbell, data and policy analyst for PHI, the nation’s leading authority on the direct care workforce, spoke in Portland on Tuesday about the demographic changes and policy decisions that have led Maine to the brink of a “home care crisis,” and how Question 1 on November’s ballot can help.

“In the next couple of decades, the population of people age 65 and over is going to grow by half. While the population of working age people with dwindle,” said Campbell at a press conference in Portland. “And in the broad swaths of rural areas here in Maine, that’s especially a challenge, because the population of older adults is growing even faster, and the population of working age people is leaving for educational and economic opportunities in cities and other states. So we have a crisis looming, but Question 1 could take real steps to address this crisis.”

Campbell added, “What people end up doing is paying for home care out of pocket, which here in Maine costs $50,000 a year. So for many folks, they are spending down their bank accounts and all of their assets until they reach poverty, at which point they qualify for Medicaid. But Medicaid is a program that competes with all these other budget items in the state legislature. Home care reimbursements are very low and that challenges employers to invest in this workforce to provide them with a decent wage, benefits, quality training. And as a result, two-thirds of this workforce leave every year. One in six home care positions is vacant. And for people who need care, they are missing 6,000 hours every week of care.”


Campbell will also speak at the Maine Wisdom Summit Wednesday in Augusta.

Rhiannon L’Heureux, a former home care worker who now works at a nursing facility, described why she left the home care field, as well as the difficulty her family faced caring for her twin sister, left with a severe disability after an accident, in rural Maine.

“In the end, I just couldn’t afford to keep working for such low wages and I had to quit, like so many of our best home care workers do every year,” said L’Heureux. “It’s because I love my sister and because I loved my clients that I support Question 1.”

Abdullahi Ali, CEO of a home care agency with offices in Portland, Lewiston and Augusta, agreed with Campbell’s assessment.

“The most difficult aspect of home care right now is how poorly we are able to compensate those who do this vital work for some of the most vulnerable people in our society,” said Ali. “At the current rate, there’s no room to pay for training or advancement. Home care workers don’t get the respect and the career opportunities they deserve.”

Question 1 will guarantee that all seniors and Mainers with disabilities can access needed home care, paid for through a tax on the wealthiest 1.6% of individual income earners.

“Here’s another layer of this crisis,” Campbell said. “Nursing homes also have a staffing shortage. One in six nursing home positions is vacant. And one third of nursing homes have recently turned away new residents because they don’t have the beds for them.”

He explained, “With Question 1 we can chart a new path forward for a long-term care system for the 21st Century. That’s not just something we can do here in Maine. It could be the start of something much bigger, across the country.”

“We need to think creatively about how we can solve these problems so we can ensure that people are getting the care they need and that we’re well prepared for the future,” Campbell said.

(Photo: Stephen Campbell of PHI speaking at a press conference in Portland about Maine’s universal home care referendum.)

About Dan Neumann

Avatar photoDan studied journalism at Colorado State University before beginning his career as a community newspaper reporter in Denver. He reported on the Global North's interventions in Africa, including documentaries on climate change, international asylum policy and U.S. militarization on the continent before returning to his home state of Illinois to teach community journalism on Chicago's West Side. He now lives in Portland. Dan can be reached at dan(at)

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