Plans to close veterans' home spark outrage

An emergency bill to require legislative approval before any Maine veterans' home could be closed is one of the many efforts to keep the homes in Machias and Caribou open. Posts on social media by the public had spurred the Maine Veterans' Homes (MVH) board of trustees to issue a public statement on February 24 confirming that two of their six facilities would close by May 1, sparking outrage by residents in Washington and Aroostook counties. The board had made the decision in October, but according to MVH officials they had not made it public so that a closure plan could be put in place and staff and families could be informed. Also, for more than three months Down East Community Hospital (DECH) has been working on a transition plan with MVH if the Machias home closes.
Citing significant financial losses, a declining veteran population and the growing scarcity of a qualified workforce, MVH submitted the closure plans on February 11 to the Department of Health and Human Services (DHHS). In their statement, the MVH board noted that the timeline might seem drastic, but that it was a multi year deliberation of known factors in Maine, including several years of exploration for opportunities to address the growing deficit.
"The mounting operational losses are unsustainable and threaten the financial viability of the entire system," said MVH Chief Executive Officer Kelley Kash, in his testimony before the legislature's Veterans and Legal Affairs Committee during the hearing on the emergency legislation on March 2. "This was a difficult but necessary decision by the all veteran board. By facing the economic realities and addressing the increasing operational challenges, we protect our ability to offer high quality, award winning care that our veterans deserve for years to come." MVH has said it will keep the two facilities open until all residents have been relocated and commit to securing their next care settings, including transfer to another MVH facility if desired.
LD 2001, submitted by Senate President Troy Jackson of Allagash, would provide one-time funding to cover shortfalls and keep the homes open while a long-term solution is developed and would not allow the closure of any veterans' home without legislative approval. However, during the hearing on the bill, Kash stated, "We can weather a fiscal storm, but we can't weather the workforce crisis. Closure is the only option we see available to preserve the system as a whole."
However, in his testimony to introduce the bill, Jackson stated, "When I asked the CEO of MVH what the legislature could do to keep these facilities open I was met with silence. It seems to me that the powers to be were intent on closing these facilities despite outcry from the congressional delegation, legislative leaders and more importantly the community. If that is the case, we need to ask ourselves: Is this how we're going to treat our service men and women?" He said he was "in shock" at how quickly the closures were happening. "We cannot turn our backs on the brave men and women who have served our country or military spouses who now find themselves in need of quality, compassionate long-term care."
MVH is an independent, nonprofit organization providing care to veterans, their spouses and Gold Star parents at homes throughout Maine. The other locations are Augusta, Bangor, Scarborough and South Paris.
Opened in September 2005, the Machias veterans' home became a reality after a nearly 30 year battle by local veterans and politicians to have a home established in Washington County. The 30 bed facility currently serves 23 veterans and employs 49 caregivers. The 70 bed Caribou facility currently serves 57 veterans and employs 76 caregivers. MVH total capacity statewide is 640 beds, with 384 veterans currently being served.
DECH leases both the building and grounds to the Machias home. In his testimony in opposition to Jackson's bill, DECH CEO Steve Lail said if the home is closed then the vacated space would allow DECH to expand clinical services, bringing additional clinical specialties to Washington County that would strengthen its service to the community.
Lail felt that the bill would "set a very bad precedent for state government interference in the affairs of a private company." He informed the committee that DECH had been working with MVH for "the last three months to develop a transition plan."
Employees of the Machias veterans' home, according to Julie Hixson, DECH communications director, have received job and benefits packets for positions available at DECH.

Voices of elected officials ring loud
Governor Janet Mills issued a statement on February 25 expressing her concern over the situation. She advised that she sent a letter earlier in February asking the MVH board to consider a two year hold on their decision so alternative options could be discussed to prevent the closures. She wrote that the "drastic move, done on an aggressive timeline, will displace more than 70 veterans and spouses and result in the loss of jobs for the people who care for them."
Rep. Will Tuell of East Machias and Senator Marianne Moore of Calais say they are saddened by the decision, offering that the entire Washington County delegation has maintained a long relationship with the Machias facility.
"The Machias veteran home is an amazing facility," says Tuell. "The staff and administration cares for the vets. They go above and beyond to make it like home for them and their families. That's what makes this whole thing so difficult. Yes, there are legitimate reasons why the facility is closing, but the families are reeling."
"While I understand the board has the fiduciary responsibility to the system, these closures are still troubling since it affects veterans who have provided their service to our country and deserve to be provided the care we promised them," says Moore. "The Washington County delegation has celebrated numerous milestones with these folks. They have become like family."
In their joint statement, U.S. Senators Susan Collins and Angus King along with Representatives Chellie Pingree and Jared Golden voiced opposition to the decision. "The closure of these homes will have a devastating impact on the veterans and spouses of veterans who reside in these facilities. Their families, the staff members who currently provide care to these veterans, as well as the surrounding communities and local hospitals will also be adversely affected by these unexpected closures."
Citing strong support among the governor, the Maine legislature and the congressional delegation, the lawmakers requested that the MVH board of trustees meet with all involved to discuss options to maintain both homes.

Reasons to close homes outlined
Responding to the governor's letter, MVH board Chairman James Settele said the primary reason for the decision was the continued financial drain the two facilities were having on the four remaining facilities. The two homes had combined deficits over $2 million in each of the last two years and are on track to lose $3 million this year. Settele said the losses threaten the economic viability of the entire system. "Notification of the decision and closure timeline may have seemed drastic, but, in earnest, it was a multi year deliberation of known factors in Maine, which included several years of exploration for opportunities to address the growing deficit," he said.
He added that financial support would not change the circumstances of declining veteran populations and healthcare workforce supply. "The number of veterans will decrease by as much as two thirds in Aroostook and Washington counties, according to VA projections -- 2010-2040. Similarly, the workforce crisis makes it impossible to staff operations in the near future, which puts MVH at risk for not meeting regulatory staffing requirements."
The statements concerning staffing shortages, though, were questioned by an employee of the Caribou veterans' home, Nashali Parks, who said in her testimony to the legislative committee that staffing is not an issue there.
During the public hearing on Jackson's bill, Settele did agree to update the MVH board about the concerns expressed. "I don't know how we will proceed," he added.

Efforts in play to stop closures
In addition to LD 2001, Rep. Will Tuell submitted in February 2021 a bill, LD 614, which provides nearly $2.3 million in additional funding to DHHS to amend its rules governing MaineCare reimbursement in order to provide cost based reimbursement to MVH facilities through June 2023. This bill unanimously passed in the legislature but has been on the appropriations table since the summer. "Perhaps this will now get some additional attention due to the current situation," says Tuell.
At the March 2 hearing on Jackson's bill, MVH CEO Kash testified that he believed the bill to be political posturing in an election year and that "the last minute amendments and emergency bill status make it clear to me that this is an attempt at hostile takeover." He believes this action would usurp the MVH board's fiduciary authority and that there are already mechanisms for state oversight. Matthew Warner, an attorney for MVH, argued that the bill is unconstitutional because it would force the nonprofit to continue operating the homes at a substantial loss.
Both Rep. Tuell and Senator Moore spoke neither for nor against the bill, since they agreed with Kash that the requirement for legislative approval to close a home would be a hostile takeover. "We don't own the homes," Tuell noted. "Mandating facilities to stay open without addressing staffing shortages is a recipe for disaster." Both Tuell and Moore agreed that the best course of action is for the public to now reach out to the federal delegation and voice their concern.
In her testimony to the committee, Brenda Gallant, ombudsman for Maine Long Term Care Program, pointed to studies showing the extreme stress that results when residents are forced to move and that both homes are memory care units. "If these homes close, residents would need to have access to the same specialized care they have been receiving. The memory care homes closest to Machias are located in Brewer and Bangor." She noted that other homes are closer but not suited for the care these veterans require, and few openings are available in these homes.
Washington County Manager Betsy Fitzgerald, speaking for the county commissioners, agreed that costs are higher and staffing is an issue, but this is the reality everywhere right now. She also pointed out that Washington County's population contains more veterans per capita than any other county in Maine. "Maine is a rural state. Instead of collecting the services in Augusta, upgrading the services in the more rural facilities would better serve the veterans."
How to enlarge the number of people who would qualify to be admitted to the veterans' homes in order to increase revenue and keep the homes open was explored by some who testified at the March 2 hearing. Army veteran Bettyann Sheats of Auburn, who now works with American Legion Maine and Maine Military Community Network, expressed her shock about the MVH board decision. Noting the dire urgency of this moment she stated, "There are current rules in place that limit who can reside in the veterans' homes. Changing the rules could increase the demand for those spaces. I understand that Maine homes require a veteran to be 70% disabled to qualify. Other states allow a veteran to qualify at 50% or lower. MVH does not allow reservists or members of the National Guard to qualify. Expanding eligibility could significantly increase the demand while better serving our veteran community."
The Veterans and Legal Affairs Committee was scheduled to hold a work session on the bill on Friday, March 11.

Another blow to rural Maine
Washington County is experiencing a number of challenges just a couple of months into 2022. According to Washington County Commissioner Chris Gardner, the closure of veteran homes comes to the immediate forefront.
"Though this is not directly in our purview, we do have a voice for the 35,000 people we serve in this county," says Gardner. "Bottom line: These are veterans. We made a promise and veterans' care is at the core of the promises we make, and the federal and state government need to do better."
"In a system that has open beds, I find it interesting that a new MVH facility in Augusta will open soon at a cost of $90 million," says Gardner. "The closure of these two rural facilities at the same time speaks once again to the rural areas of Maine taking it on the chin."
Gardner believes this decision speaks to the state's identity issue. "The state of Maine is a rural state," says Gardner. "More people live in rural Maine than in urban Maine like Portland, Augusta and Lewiston. Are we going to be a state with a rural and urban mix, or are we going to continue to be the I 95 corridor and the outlands?"
Tuell believes the emotional element of this proposed closure is here to stay no matter the outcome. "I think the biggest impact will be uncertainty. Uncertainty where the vets go, uncertainty over what impact this closure will have on DECH, uncertainty over where future veterans needing services will be able to access those services."
Submitting testimony on behalf of her 85-year old mother, Columbia Falls resident Jolene Farnsworth reminded everyone what her family is now going through. "My mom has been living at MVH Machias since May 2021. The change that we have seen in her since her move to this facility has been amazing. She has gone from a frail, weak and depressed lady to one that has gained weight, strength and a vibrant outgoing personality. I attribute that to the wonderful care she has received." Farnsworth added, "'This is one big family here and when I lay my head down at night I don't have a care in the world!' my mom recently told me. Closing this home would mean she would leave the community she has lived in all her life, not to mention giving up her doctors, family and church family by moving over an hour's drive away. Please keep these rural homes open."