Inadequate oversight. Poor management. Galloping costs.
Maine’s home health care industry is vulnerable to fraud and abuse because no one seems to be accounting for the tens of millions of dollars spent for nonmedical services for an unknown percentage of Maine’s elderly and disabled.
Decent Home Care Inc., a Lewiston-based home health care agency, received $1 million from MaineCare last year to provide services — like laundry and light housekeeping — to 45 clients. That’s $22,222.22 per client that year. For that cost, those clients could have had full-time housekeepers.
Global Home Health Care, another Lewiston-based home health care agency, has received $68,000 in MaineCare funds so far this year to provide services to 14 clients. If we extrapolate that cost to the end of the year, the company will bill MaineCare $163,200, or $11,657 per client this year. Although better than Decent, it’s an outrageous sum for such services.
The costs may not seem excessive if the service included nursing or medical aid care, but that’s not the case. We’re talking about changing light bulbs and sweeping floors. Services that non-MaineCare clients are able to hire at much less cost.
Decent and Global were both raided by federal investigators earlier this month as part of a fraud investigation, but no one — the feds and the company owners — will talk about the details of that investigation.
That they remain under investigation is not the point just now.
The point is that MaineCare’s bill for nonmedical services climbed from $13.6 million in 2002 to more than $21 million in fiscal 2009, a 58 percent jump. During the same period, medical health care services increase at a slower pace of 36.4 percent. Maine’s elderly and disabled population grew by just 1 percent.
The incongruity of these numbers should have raised red flags all around Maine’s Capitol building and caused lawmakers to squint at MaineCare’s financials. But, no.
According to Beth Ashcroft, the director of Maine’s Office of Program Evaluation and Government Accountability, “We aren’t looking at it and nobody has asked us to look at it.”
Why not?
Is there some indication from economists that general housekeeping services have rocketed well beyond accepted inflation figures and lawmakers have just accepted that? Hardly. They’re just not paying attention.
Mainers spent $22 million for housekeeping services in the past year and no one was watching the money or regulating the agencies providing those services.
Sen. Margaret Craven acknowledges that the system needs better oversight.
“We need to do a better job of checking back on the people that are being trusted enough to be let into people’s homes,” she said.
But background checks are already being performed on all home care workers. The problem is there’s no oversight on the money spent for the services. It’s like home health care agencies have been given a blank check by the state to bill whatever springs to mind.
While lawmakers think we may need better regulation of the workers, we definitely need to do a much better job of checking on the money, too.
Every penny.
Every expenditure.
Kind of makes us wonder what other programs are running unchecked, and how much more money disappears without accountability.
editorialboard@sunjournal.com