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From a financial perspective, it is not surprising that veterans’ homes in Caribou and Machias, facing declining populations and rising costs, can’t balance their books. But that, in some ways, is beside the point. The mission of a veterans home, no matter how it is structured and funded, should be to ensure that those who have served in America’s military, many of them in wars, receive the care that they need and deserve.
Making that simple mission a reality, of course, is not so simple.
Maine’s six veterans homes, which provide long-term and skilled nursing care to veterans and qualified family members, are run by a nonprofit and funded through a mix of federal funds, from the Veterans Administration, Medicare and Medicaid, and private money through insurance and donations. They are not run by the Veterans Administration or state government.
Maine Veterans’ Homes confirmed last week that it plans to abruptly close two of those facilities – in Caribou and Machias – because they are losing money and only about half full. The company’s board of trustees, all of whom are military veterans themselves, also cited the difficulty of finding enough workers to staff the two homes, a problem exacerbated by the COVID pandemic.
We don’t doubt these challenges, but this situation highlights the pitfalls of leaving some essential services, like veterans care, to an independent organization.
Maine Veterans’ Homes operates six facilities with 640 beds, but only 384 veterans are receiving treatment there, according to the company’s CEO Kelley Cash. Although Maine has a large percentage of residents who are veterans, it is unusual for a small state to have so many veterans homes. New Hampshire, Vermont, Connecticut and Rhode Island each have one. Massachusetts has two.
“We have many more beds than we do have veterans,” Cash told Maine Public. “We’re looking at where can we best put our limited resources to do the most good for the most people.”
The Machias and Caribou homes have lost a combined total of $2 million annually for the last several years, according to the nonprofit’s spokesperson Christine Henson. The facilities are on track to lose a combined $3 million this year and their operations are subsidized by the other homes in the system. Maine Veterans Home revenue in total exceeds its expenses, according to recent tax returns.
The Machias home, which has 23 residents and 49 employees, is scheduled to close on April 15. The Caribou home, with 57 people in residential and nursing care and 76 employees is slated for a May 1 closure. Maine Veterans Homes said it would not close either facility until every current resident has a place to live.
This news has prompted a flurry of activity from Maine lawmakers, the governor and the state’s congressional delegation. They, as the veterans homes board of trustees did, face the difficult task of looking for ways to balance financial realities with the commitment to provide care to our military veterans.
Gov. Mills urged the board of trustees to delay the closure for two years to allow further examination of alternatives. She also directed several state departments, including the Department of Defense, Veterans and Emergency Management and the Department of Health and Human Services to provide assistance while the Maine Veterans’ Homes organization looks for alternatives.
Maine Senate President Sen. Troy Jackson has introduced legislation that would provide some emergency funding for two years. The bill would require legislative approval to close, or open, a veterans home. There is precedent for legislative involvement. In 1985, lawmakers passed a bill to authorize construction of veterans homes in southern and northern Maine, in addition to the then-existing home in Augusta. In 2016, lawmakers passed a bill that deleted from state law language that stipulated where each of the six veterans homes were located and how many people they would serve.
“Although we acknowledge that operating these homes in the long-term may pose challenges given expected demographic changes and the current nationwide shortage of trained, available health care workers, we urge the Board to reconsider its decision and consider all potential options short of closure so that veterans at these facilities have access to the care they have earned in their service to our Nation,” Reps. Jared Golden and Chellie Pingree and Sens. Susan Collins and Angus King wrote in a Feb. 24 letter to the board of trustees of Maine Veterans’ Homes.
They suggested that the board consider expanding the eligibility for admission to the homes to a broader pool of veterans, including members of the Maine National Guard. “We also note that MVH’s public 2019 tax return appears to show a gross operating profit of nearly $25 million, which calls into question the urgent need to shutter these homes and warrants a fuller explanation of MVH’s current financial position,” the delegation members said in their letter.
All of these efforts are important but lawmakers should keep in mind that fundamental changes in financing and structure may be necessary to best serve all of Maine’s veterans. In the meantime, these closures should be delayed to allow for more consideration of alternatives.