Maine to open two public defender offices in rural counties

The state will establish two new public defender offices covering Aroostook, Piscataquis and Penobscot counties, and change the name of the Maine Commission on Indigent Legal Services to the Maine Commission on Public Defense Services. 

Gov. Janet Mills signed the emergency bill, L.D. 653, into law Thursday after it passed unanimously in both houses. The legislation creates positions for 10 new public defenders and 12 other staff members, bringing the total number of public defenders in Maine to 25. 

“This legislation creates new public defender positions across communities in rural Maine and advances my commitment to improving the delivery of legal services to low-income people to ensure their constitutional right to counsel,” Mills said in a statement

The state’s first public defender office opened in Augusta late last year; it covers Kennebec County and will expand to include Somerset County when staffing levels increase. It followed the establishment of a Rural Defender Unit that has five trial attorneys who travel around the state.

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The commission hopes to open four more offices in the next two years. One would cover Hancock and Washington counties; one covering Androscoggin, Franklin and Oxford counties; one covering Sagadahoc, Lincoln, Knox and Waldo counties; and one covering Cumberland and York counties. 

The public defender offices have been designed to handle about 30 percent of adult criminal cases in a given region, employing somewhere between three and eight attorneys with support staff. Their work will be supplemented by private lawyers in a hybrid system. 

Until recently, Maine was the only state with no public defenders, instead appointing private lawyers overseen by the Maine Commission on Indigent Legal Services to represent poor defendants. 

A nine-month investigation by The Maine Monitor and ProPublica published in October 2020 found that the commission repeatedly hired attorneys with criminal backgrounds, including a registered sex offender who was convicted of possessing child pornography, and a lawyer who exposed himself to a client.

The investigation found that the commission did not have enough money or staff to supervise these lawyers, many of whom had been disciplined for professional misconduct.

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The ACLU of Maine sued the state in 2022 on behalf of poor defendants, claiming that the commission was failing to provide them with adequate counsel and thus violating their constitutional rights. 

The case is ongoing, and two attempts by the parties to resolve the matter have been dismissed by a judge. Last month, Superior Court Justice Michaela Murphy rejected the second proposed settlement agreement, saying it failed to address the constitutional crisis of individuals going without legal representation. 

Maine is facing a critical shortage of defense lawyers who will accept new indigent cases, and there are hundreds of people awaiting court-appointed counsel across the state, many of whom are in jail

“Standards and accountability mean very little when very few attorneys, or no attorneys at all, have been made available by (the commission) for judges and justices to appoint,” Murphy said when she denied the settlement.

She scheduled a trial to begin in late June.

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In a State of the Judiciary address to lawmakers last month, Maine Supreme Judicial Court Chief Justice Valerie Stanfill said the courts have made progress in shrinking the pandemic-induced backlog of cases, but not enough, pointing to the lack of available lawyers on the commission’s roster. 

“We have people sitting in jail every day — frequently a dozen or more in Aroostook County alone — without an attorney because there is no one to take their cases,” she said. “I hope that adding some public defenders will help, but it will be a while before we really see results. And in the meantime, I fear the system will indeed collapse.”

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A tenth of Maine’s pharmacies have closed in the past decade

A typical day for Doug Edinger begins at 8:30 a.m., when he opens the doors to Seaside Pharmacy in Stonington, on the southern tip of Deer Isle.

The Ohio native moved to the Hancock County town with his family nearly 20 years ago. For the last decade he has owned and operated Seaside Pharmacy as its sole pharmacist, with his wife, Lydia, and daughter, Allison, assisting as pharmacy technicians.

Edinger, 69, regularly puts in 12-hour days, working well past his pharmacy’s retail hours. With the next-closest pharmacy 23 miles away in Blue Hill — a trip that requires crossing the length of Deer Isle and two bridges to get to the mainland — Edinger said he serves most of the island’s year-round population of nearly 900.

In the summer months, when the population swells, he often works even longer days.

“It’s quite a challenge on the old body,” Edinger said, “but we make it, and you know, we’re doing OK.”

As a significant number of Maine pharmacies have shuttered in the past decade, businesses like Seaside Pharmacy have had to carry a larger load.

In 2013, there were 314 pharmacies in the state. A tenth of those have closed.

In rural areas, the decline has been even steeper, with some counties losing more than a fifth of their pharmacies in the past decade.

Growing gaps in pharmacy access

There are currently 283 pharmacies in the state, according to the Maine Department of Professional and Financial Regulation.

Of those, just 20 percent are independently owned, like Edinger’s; 79 percent are owned by chains such as CVS, Walgreens or Hannaford. The rest are specialty retail pharmacies, such as those serving long-term care facilities or veterinary pharmacies.

A Maine Monitor analysis of pharmacy licensing data found that since 2013 the number of pharmacies has decreased in 11 of the state’s 16 counties.

The greatest declines were in Washington and Somerset counties, where the total number dropped by 31 and 22 percent, respectively. Per capita, Waldo, Somerset, Oxford, Sagadahoc and York counties have the fewest pharmacies — ranging from 1.3 to 1.6 per 10,000 people.

Two maps of Maine pharmacy locations, side by side. On the left are the locations of pharmacies in Maine in 2013. The locations in 2024 are on the right.
A comparison of Maine pharmacy locations in 2013 and 2024. A 2022 study in the Journal of the American Pharmacists Association found that in large urban areas nationwide, 63 percent of pharmacies were chains, whereas in rural areas, 77 percent were franchises or independent pharmacies. Chains are indicated in red. View the interactive maps: 2013 and 2024.
Source data from the Maine Department of Professional and Financial Regulation, Maine Board of Pharmacy. Maps and analysis by Emily Bader

A 2021 analysis by researchers at GoodRx found that in every Maine county except Cumberland, York and Sagadahoc, at least a third of residents live more than a 15-minute drive from the closest pharmacy.

Access was the worst in Washington County, where 84 percent of the county’s 31,000 residents lived more than 15 minutes from the nearest pharmacy.

The Monitor’s analysis found the number of pharmacies in Washington County has decreased from 13 to 9 in the past decade. Two of the remaining locations are within tribal health clinics, and the rest are in Calais, Machias, Milbridge and Eastport.

Today there are 28 fewer independent pharmacies statewide than in 2013, the Monitor found.

Most counties saw a significant drop in independents over the past decade. In York County, for example, the total dropped from seven independent pharmacies to just one.

Feeling the squeeze

Lee Ohmart, a retired Brewer pharmacist, got his start working for his father, who owned three independent pharmacies, Ohmart and Hinckley Pharmacies, in the Bangor area. One night, Ohmart recounted, while “struggling to pay bills, my father looked at me and said, ‘You better really like owning a business. With the way chains and the insurance companies are squeezing us, you will work more hours than your chief pharmacist and you will end up being paid less.’”

Independent pharmacies are getting squeezed by pharmacy benefit managers, middlemen that negotiate pharmacies’ reimbursement rates with insurance companies and manufacturers, said Emily Dornblaser, an associate professor at the University of New England School of Pharmacy, in an interview with The Maine Monitor last fall.

Some pharmacy benefit managers are owned by insurance companies that also own the retail pharmacies. For example, the health insurance company Aetna, pharmacy benefit manager CVS Caremark and CVS Pharmacy are all subsidiaries of CVS Health Corporation. Aetna will often give customers preferential drug pricing at CVS pharmacies, or only cover prescriptions filled at a CVS.

The system leaves independent pharmacies without access to drug discounts the big chains get and with worse reimbursement rates, Dornblaser said.

“That has really been one of the reasons that independent pharmacies have been gutted, because they cannot actively compete with such large, organized health-care system entities that span insurance to distribution,” she said.

But the large chains have had their own problems, and have closed a number of stores across the state in recent years.

Rite Aid, which filed for bankruptcy last fall, closed three Maine locations in 2018 and sold the remaining 76 to Walgreens. Since then, Walgreens has closed 21 stores, including some still operating under the Rite Aid name.

Just last week, Walgreens shut down a store on Main Street in Lewiston. CVS closed two stores in 2020. Both chains announced hundreds of closures nationwide last year.

“The mantra was like: a pharmacy on every corner. And you used to see corners where there was a Walgreens and the Rite Aid or CVS like directly across from each other. And now that’s definitely not the case,” Dornblaser said. “I think the companies are recognizing that there’s not a lot of volume at those stores, and the cost to staff them is not worth it and that’s why they’re closing.” 

A sign listing the pharmacy's operating hours.
A sign inside the Walgreens at 713 Congress St. in Portland displays the pharmacy’s new hours. Respondents to a Maine Monitor survey reported many frustrations with chain pharmacies, including reduced hours, long wait times and automated messages that incorrectly told them prescriptions were ready when they weren’t. Photo by Stephanie McFeeters.

Many chain locations across Maine appear to have had staffing trouble.

One Washington County resident said they drive 24 miles one way from their home in Addison to the Walgreens in Machias to pick up prescriptions, and often find that even when submitting refill requests days in advance, one or more of their prescriptions aren’t ready when they arrive.

“What ends up happening is after I’ve started to go home, halfway home I get a notification on my phone that the other prescription is ready and I can’t turn around and go back,” the resident said in response to a Maine Monitor survey conducted last week.

“They don’t have enough people to cover the pharmacy. I waited one day for a half an hour, and I never got waited on and so I walked out.”

Maine law says a pharmacy must have a pharmacist in charge working and must be open at least 40 hours a week, or it must notify the Maine Board of Pharmacy, which licenses and regulates pharmacies, pharmacists and technicians.

In 2022, Walgreens — the state’s largest pharmacy chain — paid more than $68,000 in fines after the Board of Pharmacy found that 10 locations, including the one in Machias, failed to have a pharmacist in charge or reduced its hours without notice.

“We continue to meet, and in most locations exceed, the Maine Board of Pharmacy’s requirement for retail pharmacies to be open 40 hours per week,” a Walgreens spokesperson said in an email, noting there is “a shortage of pharmacists across the country, which has led to some adjusted pharmacy operating hours or temporary closures, including those in Maine.”

As the Monitor reported in the fall, this nationwide shortage of pharmacists has led to sudden closures and irregular hours at chain locations across the state.

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In the mid-2000s, a wave of new pharmacy schools opened to meet the shortage of pharmacists. But then the 2008 recession hit, and as more people were entering the profession, fewer were retiring, Dornblaser said. By the late 2010s, jobs had become more competitive and wages had stagnated or dropped, leading pharmacy school enrollment to drop. 

Then came the pandemic and the COVID-19 vaccination rollout, which added a new dimension to pharmacists’ jobs. Last fall pharmacy staff at some CVS and Walgreens locations across the country walked off the job to protest what organizers said were untenable working conditions.

Independent pharmacies a beacon in rural communities

When Audrey Parks opened Western Maine Pharmacy in Kingfield in 2011, she said there hadn’t been another pharmacy in the town for at least 50 years.

According to licensing records, Mt. Abram Regional Health Center is the only other pharmacy Kingfield has had. But newspaper clippings reveal the pharmacy did not fill its own prescriptions and instead outsourced that work to now-shuttered pharmacies in Farmington and Madison. The health center withdrew the pharmacy license in 2011.

Parks’ pharmacy serves a huge swath of northwestern Franklin County that runs west past Rangeley to the New Hampshire border, and north on Route 27, past Carrabassett Valley and Eustis all the way to the Canadian border.

Betty Ann Listowich, who lives in Freeman Township in Franklin County, said before Western Maine Pharmacy opened, she had to travel 20 miles to Farmington to get her medications. Now her drive is only four miles.

“They know who we are and are extremely helpful,” she said.

the exterior of the western maine pharmacy as seen from the parking lot
Western Maine Pharmacy, in Kingfield, opened in 2011. Owner and pharmacist, Audrey Parks, said there hadn’t been another pharmacy in the town for at least 50 years. Photo by Audrey Parks.

A 2022 study in the Journal of the American Pharmacists Association found that in large urban areas nationwide, 63 percent of pharmacies were chains; in rural areas, 77 percent were franchises or independent pharmacies. 

Among the 79 people who responded to The Maine Monitor’s survey last week, many said they have had only positive experiences at local independent pharmacies, including Carroll Drug Store in Southwest Harbor, Harris Drug Store in Greenville, Wilson’s Drug Store in Bath, Belfast Drug Company in Belfast, and Mt. Blue Drug in Farmington.

Several also praised the locally owned chain Community Pharmacies, which has locations in Bucksport, Corinth, Cornish, Gorham, Hermon, Randolph, Saco and Waldoboro. 

A Camden resident who uses Jensen’s Pharmacy in Rockland said they prefer independent pharmacies “because of their ability to hear you.”

“There’s nothing we can do”

Those who rely on CVS and Walgreens reported a number of frustrations, including long waits, reduced hours — many are not open on weekends — and automated messages that told them prescriptions were ready when they weren’t.

Asked if they ever had trouble filling a prescription, a South Bristol resident said, “Yes. If it’s Friday, Saturday, Sunday or Monday.” 

They noted there are only two pharmacies in Damariscotta — a Walgreens and a Hannaford — and said one is closed on weekends and can take four to five days to fill prescriptions, while the other often has a line out the door. 

“Very hard for a single person to get prescriptions when sick,” they said.

Another respondent, from Islesboro, said, “Just Saturday I went to pick up a prescription and discovered that the pharmacy is now closed on Saturdays.”

In an email, a CVS Pharmacy spokesperson said, “We strive to ensure we have appropriate levels of staffing and resources in place at each of our pharmacies through a combination of staffing, labor hours, workflow process and technology.”

Several respondents mentioned they get some prescriptions by mail, but that’s not possible for drugs that need to be refrigerated.

One woman, whom the Monitor is identifying by her first name, Betsy, to protect her privacy, said she noticed her usual pharmacy, the Hannaford in Gardiner, falling more and more behind over the past 18 months.

It came to a head in December when she went to pick up her daughter’s prescription for mood stabilizers to treat bipolar disorder.

Betsy said she made the 21-mile drive from her home in Richmond, in Sagadahoc County, to Gardiner to pick up the prescription, as she has done for years. When she got to the pharmacy, she was told she could wait 40 minutes or come back the next day.

When she returned the next day she was told the same thing: wait 40 minutes or come back tomorrow. This continued for days. On the fifth day, she said she was getting agitated because her daughter had run out of medication.

“Now I’m getting angry,” she said. “But they’re just like, ‘You know, there’s nothing we can do.’ ”

She made the trip seven times in 10 days. After her daughter went two days without medication, Betsy borrowed a few days’ worth of pills from her son, who also has bipolar disorder and takes the same medication. It was Christmastime, stress levels were high and her daughter was going through withdrawal. Had her son not been able to help, Betsy said the situation would have been dire.

“I would have stood in the middle of the pharmacy and started screaming,” she said. “Honestly, I think I would have lost it.”

A Hannaford Supermarkets spokesperson said the company apologizes for any inconvenience customers may have faced. “When a prescribed medication is unavailable, we may require more time to fill a prescription while we work with the provider to identify a comparable alternative,” she said.

Despite the frustrations, several respondents said the pharmacists seem to be doing the best they can given staff shortages, and noted that having to provide vaccinations alongside filling prescriptions is a lot to manage. 

“The staff is doing their best but they are constantly overwhelmed,” said a Bath resident.

Edinger, the Stonington pharmacist, said even with the long days, he loves what he does.

“I wouldn’t be doing this if I didn’t,” he said. “It’s nice to be working with your family. And the customers are more like our neighbors and friends than they are customers.”

Edinger ended up in Stonington in the early 2000s because a local pharmacy had closed.

“It was a real hardship to the community. That’s how I got called to the island. One of the local businesses wanted to bring a pharmacy onboard inside their business and they asked me to come and start it for him. So that’s how I got here,” he said.

Asked what would happen if Seaside Pharmacy closed, Edinger said that’s not a possibility.

“The island needs a pharmacy,” he said. “There’s no option to close.”

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California’s “Lithium Valley” may power millions of electric vehicles. Does Maine still need a lithium mine?

It would be hard to find two landscapes in the continental United States more different than the flat, arid desert of California’s Imperial Valley and the forested, stream-laced mountains of western Maine.

In late winter, while Maine’s ground is blanketed in snow, a patchwork quilt of irrigated fields covered with salad crops and hay stretch to the horizon in the Imperial Valley and to the Salton Sea, a 35-mile long, landlocked lake near the Mexican border.

But beneath the surface, western Maine and the Imperial Valley share something in common — nationally significant deposits of lithium.

It’s a strategic metal considered essential for batteries that power electric vehicles and the storage systems needed to support a global, renewable energy revolution.

News reports have highlighted the Maine discovery said to be one of the world’s largest deposits of lithium, locked in rock crystals on the side of Plumbago Mountain in Newry.

Meanwhile, lithium found thousands of feet underground in the superheated, salty water called geothermal brines is making global headlines.

There’s enough lithium contained in the brines around the Salton Sea for 375 million batteries for electric vehicles, according to a recent federal analysis. It’s enough to help the U.S. meet global demand for decades, the analysis says. 

Only 2% of the world’s lithium supply now comes from the United States. Most comes from Chile, Argentina, Australia and China, with much of the processing taking place in China. So there’s a huge effort to ramp up domestic production for national security and economic reasons. 

As America scrambles to develop a resource sometimes called the “new oil” or “white gold,” contrasts are emerging between what’s happening in western Maine and southern California. In a nutshell, Maine is moving cautiously to consider a single mine while California is well on the way to hosting a multi-billion dollar industry.

Maine has not been friendly to mining. The state’s metal mining laws, revised in 2017, are among the strictest in the country. No modern mines have been developed in decades, and no company has applied for a metallic mining permit from the Department of Environmental Protection since the law was passed. 

Wolfden Resources Corp., a Canadian company aiming to mine for zinc and copper near Pickett Mountain, was recently turned down by the Maine Land Use Planning Commission in its request for a rezoning, the first step before the company could apply for a mining permit. That is the closest any company has come to testing the state’s regulations.

But Maine may be more receptive to a lithium mine. On Wednesday, the citizen board that oversees the Maine DEP voted unanimously to adopt changes to the mining law that would exempt some metals from the state’s strict metallic mining regulations, provided developers can prove they won’t pollute nearby watersheds or cause other environmental harms.

Chemical processing would still be regulated under the metallic mineral mining law. The changes are expected to go back to the legislature for approval in the coming weeks.

While Maine cautiously considers a way to permit a lithium mine, pilot projects aimed at extracting lithium on a large scale are well underway by California’s Salton Sea.

Global investors and major automakers are spending billions on what they say will be the world’s cleanest, major source of lithium extraction. Some boosters have dubbed the area, “Lithium Valley.”

An orange star marks the approximate location near the Salton Sea being discussed.
The orange star marks the approximate location of the area dubbed Lithium Valley, where global investors and major automakers are spending billions on what they say will be the world’s cleanest, major source of lithium extraction.

What’s happening in California could ultimately impact the future of lithium mining in Maine and other places by raising a critical question: If new, lower-impact technology can tease out global supplies of lithium from geothermal brine, is it better to leave rockbound deposits in the ground?

This question came to the fore because of activity at geothermal power plants at the southern edge of the Salton Sea. For more than 40 years, geothermal plants near the lake have pumped the 500-degree brine, using the steam to spin turbines and injecting what’s left back underground.

Today there are 11 power plants with a total generating capacity of 400 megawatts, enough to power 300,000 California homes, with more plants planned. 

But until recently, the millions of tons of dissolved lithium in the brine were pumped back into the earth, unused.

Now three operators are at various stages of extracting lithium from the salty water using technology known as Direct Lithium Extraction, or DLE, which they say could bring their pilot projects to commercial scale.

If they succeed and the methods are financially viable, proponents say the process could capture lithium with lower environmental impacts than hardrock mining, while generating clean, renewable energy. 

White smoke rises from a production well.
As part of the first phase of the proposed Hell’s Kitchen campus, Controlled Thermal Resources has drilled two geothermal production wells and is optimizing its process for recovering lithium from the hot brine. Source: Controlled Thermal Resources.

The projects, however, are not without controversy, in part because large volumes of water are used in extraction processes. An investigation by the Howard Center for Investigative Journalism, reported in February in USA Today, reviewed 72 proposed mine sites and found most would take billions of gallons of water from already stressed resources such as the Colorado River. That’s the largest source for Salton Sea projects.

There’s also pushback from residents in the impoverished Imperial Valley, who already struggle with elevated health problems. In January, the nonprofit Comite Civico del Valle announced its intent to sue to overturn permits for a proposed lithium production campus, citing concerns over water use and air pollution from construction and operations. 

Meanwhile, developers and investors are in a race toward commercial viability. Three major players are taking the lead.

Berkshire Hathaway Energy Renewables: This Warren Buffett-led company’s subsidiary runs 10 geothermal plants. It has worked since 2022 on a process to recover lithium at a demonstration plant and produce battery-grade lithium carbonate.

EnergySource Minerals: This company is developing Project ATLiS at the 55-megawatt John L. Featherstone power plant. It’s using a patented extraction process and is aiming to be in full operation in 2025. Last year it signed a supply contract with Ford Motor Co.

Controlled Thermal Resources: This company held a groundbreaking ceremony in January to launch its $1.8 billion Lithium Valley campus, billed as the world’s first fully integrated facility to extract and process lithium, possibly with on-site battery manufacturing and recycling plants.

Aerial image of the Featherstone power plant.
EnergySource Minerals is developing a lithium extraction process using geothermal brine at the 55-megawatt John L. Featherstone power plant, near the Salton Sea in southern California. It’s aiming for full operation in 2025, and has a supply contract with Ford Motor Co. Photo courtesy Daniel Alexander, Cyrq Energy.

The project is called Hell’s Kitchen and the company says fully realized, it could represent a $28 billion capital investment and support nearly 8,000 jobs. The company has entered into investment and supply agreements with General Motors, and has received $100 million from Stellantis, the parent company of Jeep and Chrysler, to advance development.

In late January, Biden administration officials were among those at a groundbreaking for the first phase of the planned Lithium Valley production campus.

“This administration supports the vision of Lithium Valley,” said John Podesta, Biden’s climate czar, during remarks at the event, “and it’s not just winning the (lithium) race, it’s about providing good-paying jobs.”

A game-changing technology

Direct Lithium Extraction isn’t a new process. But the latest techniques to filter lithium from the salty, mineral rich brine and create a sustainable industry in tandem with geothermal power plants, is a game-changer, according to Michael McKibben, a research professor at the Department of Earth and Planetary Sciences at University of California, Riverside. 

“We should never mine lithium from hard rock again,” he said.

McKibben, who contributed to the federal analysis, said the key issue is the economics of bringing the extraction processes at the Salton Sea to commercial scale.

“I think ultimately, if DLE can be scaled up successfully in many places, it will put hard rock mining out of business. It may take a decade, but I think the writing is on the wall.”

A flowchart demonstrates the geothermal power and lithium extraction process. After the sale of renewable energy, step one is to produce clean power and stream. Very hot brine is produced from deep below the earth's surface. Step two is to recover lithium from the brine. Brine is injected back into the geothermal reservoir. Step three is to produce lithium carbonate or hydroxide. Battery manufacturing by others yields electric vehicle batteries and production.
This flowchart shows how lithium can be extracted from hot underground brine, already used by geothermal power plants near the Salton Sea in California. After use, the brine is injected back underground, and the lithium can be used to produce batteries. Graphic courtesy Controlled Thermal Resources.

Not everyone agrees that the Salton Sea projects represent a disruptive technology.

“Do I think what’s going on at the Salton Sea will replace any or all lithium mining in this country?” said Corby Anderson, a professor and associate director at the Colorado School of Mines. “No, I don’t. It’s not a panacea. It’s an opportunity.”

Anderson said supporters downplay the technical challenges and costs of recovering lithium from a thick brine loaded with compounds and minerals. And he said public opposition to mining often is based on perceptions that linger from polluting practices no longer used. 

“Modern mining,” Anderson said, “it’s not like all the dirty pictures of the past.”

Is Maine’s lithium still worth mining?

Mining is cleaner than it used to be. But with so much potential and investment already taking place at the Salton Sea, is mining in Maine needed for the U.S. to develop sustainable supplies of lithium?

Yes, said Mary Freeman, the co-developer of the Plumbago North project.

“If mining can be handled in an environmentally responsible manner,” she told The Maine Monitor, “what is the value of excluding Maine from participating in a viable sector of the economy?” 

Freeman and her husband, Gary, are gemstone miners who split their time between Maine and Florida. They want to expand the pit they developed near Newry to mine lithium-bearing spodumene minerals from a deposit some experts estimated could be worth $1.5 billion.

They plan to ship it out of state for processing, which would avoid the waste products that could threaten Maine water supplies.

Mary and Gary Freeman pose for a photo in their test pit.
Mary and Gary Freeman stand in their test pit in the woods of Newry, surrounded by spodumene crystals. Photo by Garrick Hoffman.

Freeman said their project is on hold, awaiting legislative acceptance of the proposed amendments to Maine’s mining regulations.

But she said development of additional domestic resources such as the Salton Sea doesn’t diminish the value of mining the spodumene at Plumbago North, which contains large crystals with both high lithium oxide and low iron content. These materials can be used for products such as scientific glass, used in computer and cell phone screens.

This sentiment reflects the notion that market competition will lead the U.S. to develop a range of domestic lithium sources. That’s likely, according to Patrick Dobson, a lead geological scientist at Lawrence Berkeley National Laboratory and chief author of the federal analysis done for the U.S. Department of Energy that characterized the geothermal resource and lithium potential at the Salton Sea. 

Dobson is aware of the Plumbago deposit and monitors efforts to extract lithium and other critical minerals from geothermal, hard rock and clay deposits. They include:

Silver Peak, Nevada: Albemarle Corp. has produced lithium from brine deposits for decades at what is, for the moment, the country’s only active lithium mine. Lithium is concentrated through evaporation in a series of ponds. The company plans to double production, even as opponents say it’s depleting the area’s aquifer.

Clayton Valley, Nevada: Canadian-based Century Lithium Corp. is working to advance a lithium brine project near the Silver Peak site. The Clayton Valley project is conducting pilot plant operations and has a processing operation elsewhere in Nevada.

Thacker Pass, Nevada: This mine, on the Oregon border, is at one of the country’s largest lithium deposits. Native tribes and environmental groups fought it but pre-construction has begun. General Motors is investing $650 million for rights to the lithium supply and now is the largest shareholder. It previously was owned largely by Ganfeng Lithium Group of China.

Lithium potential isn’t limited to the arid west. Piedmont Lithium is seeking to develop a project in North Carolina, in a forested area west of Charlotte that is more like Maine. The company describes the area as the “Carolina Tin Spodumene Belt.”

The company has asked state regulators for more time to conduct feasibility studies. The proposed open-pit mine faces opposition from Gaston County residents concerned with water pollution, groundwater levels and other concerns.

These and other projects illustrate the soaring demand for battery storage and political pressure to develop domestic supplies. But Dobson said it remains to be seen which ones come to fruition.

Whether Maine stays in the mix may be decided in the weeks ahead.

“Which lithium projects turn into actual commercial developments,” he said, “will depend on a variety of factors, such as local acceptance, environmental approvals and the commercial viability of each project.”

An explanation of how lithium is extracted. The amount of water needed to obtain lithium carbonate for use in batteries depends on the method used to concentrate and extract the material, which is now commonly obtained by hard rock mining or brine evaporation. In hard rock mining, spodumene ore is physically extracted, heated, pulverized, mixed with acid, reheated, refiltered and concentrated to lithium carbonate. It is an expensive and energy-intensive process. Lithium mining from spodumene occurs internationally, but currently not in the U.S. For evaporative processes, lithium-rich, highly saline brines are pumped from wells up to 200 feet deep. The liquid is passed through a series of ponds for months to concentrate the lithium as the brine evaporates. Once the brine has been concentrated, it typically goes through a filtration step to remove impurities, a precipitation step to isolate the lithium, and a carbonation step to produce lithium carbonate. Brine mining is a slow, land-intensive process. The Silver Lake mine in Nevada is the only operation in the U.S.
This is an edited summary of how lithium is extracted and processed, as detailed in the Lawrence Berkeley National Lab report to the Department of Energy.

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Funds sought for more rural patrol officers

With two legislative proposals now dead or unlikely to pass, Washington County leaders are eyeing one remaining plan to provide more funding for rural law enforcement patrols following the pullback of the Maine State Police from patrol coverage in the county last summer.

During a work session on January 8, the legislature’s Criminal Justice and Public Safety Committee decided not to recommend a bill, LD 630, that sought to fund more law enforcement officers in rural parts of state, including Washington County, although two committee members voted for an amended version of the bill.

Senator Marianne Moore of Calais, a co-sponsor of the bill, understands that the committee opposed the measure because of the proposed funding source.

With the reduction in state police patrol coverage beginning last July, Washington County Sheriff Barry Curtis says of his call for deputies, “We have quite a need for more people. The state police forced our hand to get more people to handle all of the complaints.”

Curtis estimates the sheriff’s office now will be handling about 3,000 additional calls a year that were previously covered by the state police.

In 2022, the sheriff’s office handled between 7,000 and 8,000 complaints; in 2023 the number increased to 9,557, with the state police helping to cover the calls until early July. This year Curtis expects the number will be well over 10,000.

“We have to pick up more people to cover the complaints,” said Curtis. The cutback in rural patrol coverage is “doing a great injustice to the people of Washington County if we don’t.”

Curtis said additional deputies would help the sheriff’s office provide more coverage and allow changes in the current scheduling to give more time off for the deputies.

Of the need for more law enforcement officers in the county, Chris Gardner, chair of the Washington County commissioners, noted in his testimony for the bill, “The rural drug issue remains our biggest fight. Criminals know we lack resources and have set up shop in rural Maine. So much so that recently the facility with the most people incarcerated for homicide-related offenses in Maine other than the Maine State Prison was the Washington County Jail.”

Gardner says the county has “consistently invested in our side of the equation.” While the proposed county budget in October would have increased the county tax by almost 20% to fund additional sheriff’s deputies and dispatchers, that amount was cut down in the budget that was approved to an 11.3% increase for county taxpayers, with funding for one additional deputy and two dispatchers.

“We invested, but where’s the state?” he asks.

In his testimony he noted that in the 1990s there was a 50/50 call sharing agreement between the state police and the sheriff’s office. That was reduced to one-third coverage by the state police a decade ago.

This past year state police rural patrols were diminished even more, although the agency does provide assistance with its specialized teams. LD 630 was meant to be a mechanism for “how the state could step up and help carry their side of the equation,” Gardner said.

However, after the bill was carried over during the last session, the Maine Sheriffs’ Association worked with the Maine Municipal Association to introduce a bill amendment to provide funding for the measure through a reallocation of the real estate transfer tax. Under the proposal, the amount the counties retain from that tax would increase from 10% to 20%.

“It was not a great idea,” said Gardner, as it would mean taking money from MaineHousing, a state agency that seeks to make homeownership affordable, which was a concern brought up by members of the legislative committee.

Taking money from affordable housing initiatives to fund rural law enforcement was not viewed favorably by the committee during the work session.

Gardner pointed out that increasing the amount retained by the counties from the real estate transfer tax would have meant an additional $84,000 for Washington County, while an additional sheriff’s deputy, including a patrol vehicle, can cost $150,000 to $175,000.

“The state police pulled out of Washington County, and we lost three bodies,” said Gardner. The proposal brought forth during the work session would have provided only $84,000 to the county “to replace three” state police rural patrol troopers, he notes.

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Gardner also pointed out that under the proposal Cumberland County would have received over $1.4 million.

“How the hell is this a rural patrol bill then?” he asked rhetorically. “They turned a rural patrol bill into a taxation and housing issue.”

Gardner says the county commissioners did not want to raise taxes and promised to “take the fight to the state” for more funding for rural patrol. The plan, though, “went completely off the rails.”

Along with concerns about the source of the funding, others who opposed the bill saw it as an unnecessary expense. Michael Kebede, policy counsel at the ACLU of Maine, stated in his testimony that the measure would “expand a fundamentally flawed arm of state government.”

He stated, “Over the past few years, it has become increasingly clear that we have relied on the policing institutions in our state to solve challenges better suited to our healthcare, housing and educational systems.”

Kebede added that “by neglecting human services and instead investing in policing, Maine and other states have turned law enforcement into de-facto social workers, healthcare workers and investigators of minor traffic problems.”

Other funding efforts

A previous effort to provide more funding for Washington County law enforcement was also turned down.

Senator Marianne Moore had proposed bills to provide $200,000 a year for two county sheriff’s deputies and $400,000 a year for four dispatchers, but the proposals were rejected by the Legislative Council in 5-5 votes in November as it considered bills to be allowed for introduction during the second session of the legislature.

The additional positions were initially included in the 2024 budget proposal for the county, but the county budget committee had scaled back that proposal to fund only one additional sheriff’s deputy and two additional dispatchers.

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An additional measure, LD 2109, has been proposed by Senator Jeff Timberlake of Turner that would direct the Maine State Police to maintain their rural patrol services in all counties of the state at no less than the 2020 staffing levels.

“I totally support this bill in hopes that Washington County could again have shared shift coverage by the state police,” said Senator Moore. Gardner says the county commissioners also will be supporting the bill, which has not yet been scheduled for a public hearing.

“The state has failed to fund the state police. Our problem is not with the state police, but it is with those who fund them,” Gardner said. “The road troopers are just as overworked as anyone else. There’s just not enough of them.”

He observed, “The state has a responsibility to fund rural patrol, and the only mechanism is the state police.”

However, the state has underfunded state police rural patrol for 40 years, with no increase in funding for patrol troopers since 1977.

Gardner said that, if the Maine State Police do receive more money from the state, those funds should go to rural patrol.

“We need a better funded Maine State Police,” he commented, but if funding is provided, he says the state should contract with the counties until the state police can hire more troopers to provide the additional rural coverage.

“The commissioners are going to continue to fight, because we have to,” the county commission chair said. “We have to address this. We can’t just keep putting this on the property taxpayer.”

This story was originally published by the Quoddy Tides, and is republished here with permission.

The story Funds sought for more rural patrol officers appeared first on The Maine Monitor.

Long term care leaders urge more funding to prevent more closures of nursing homes

Within the last decade, 23 nursing homes in Maine have closed, prompting long term care advocates, providers and industry leaders Wednesday to urge lawmakers to provide additional funding to prevent more closures.

“This is a call to action to address what has become a crisis in our long term services and support system resulting in the closure of nursing homes and residential care facilities across the state,” Brenda Gallant, the state long term care ombudsman, told a group of lawmakers Wednesday.

Since 1995, Maine’s number of nursing homes have decreased from 132 to 81, according to data presented to lawmakers.

There are currently no nursing homes at all in Hancock County and only one in northern Penobscot County. Half of the homes in Washington County have closed since 2014.

Gallant, whose ombudsman program advocates for long term care residents and their families, said nursing home closures force residents to relocate to other facilities, sometimes much further away.

She told a story about one resident in Aroostook County who could only find a placement in York County, 267 miles away, after her facility closed. The ombudsman program eventually found her a placement in Aroostook County, but only “after great difficulty,” Gallant said.

Nursing homes were the hardest-hit health care sector during the pandemic, said Anglea Cole Westhoff, president and CEO of the Maine Health Care Association, which represents about 200 nursing homes and assisted living facilities across the state. Maine lost 10 to 15% of its long term care workforce, and the primary reason they gave for leaving is stress and burnout.

To keep up with staffing minimums, nursing homes have turned to temporary agency staffing, but the “cost of temporary staff has just exploded and reimbursement doesn’t keep pace with that,” Westhoff said.

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Mary Jane Richards, CEO of North Country Associates, which operates 23 nursing homes across Maine and Massachusetts, said their costs related to agency staff increased from about $7 million in 2019 to $39 million in 2022.

“We simply can’t sustain that,” she said.

North Country Associates had eight closures since 2018, including in Bar Harbor, Saco, Belfast, Ellsworth and Houlton, Richards said. 

The Department of Health and Human Services is currently looking at reimbursement rate overhaul to adjust how nursing homes are paid for the care they provide, but Westhoff said there has not been any updates on a new model or reimbursement methodology.

Current MaineCare reimbursement rates fall about $40 short of the cost of care per resident per day, Westhoff said. Since 2012, this annual shortfall in Maine has grown from $28 million to $43 million.

DHHS last month issued $19 million in one-time MaineCare payments to nursing homes for pandemic recovery. 

Without these supplemental support payments during the pandemic, the shortfall in 2022 would have been $96.5 million, Westhoff said. Without new investments or continued one-time payments, nursing homes will continue to close, she said.

“The status quo is really unacceptable. More facilities will be left with no alternative but to look at this path of closure or converting to a lower level of care,” Westhoff said. “This is harmful to the resident, to their families and to the communities where they live.”

Two nurses walk down a hallway. One is pushing a patient that is sitting in a wheelchair while the other pushes a computer monitor.
The urgency in needing to find solutions is highlighted by the suffering of patients that has been compounded by the health care crisis. Photo by Garrick Hoffman.

Sen. Marianne Moore, who sits on the Health and Human Services committee, told The Maine Monitor before the press briefing the best approach to address these challenges is to address workforce shortages by preventing burnout and overtime.

“Throwing money at it is not the answer,”  said Moore, R-Washington.

Other solutions the advocates and providers discussed included expanding training programs, supporting family caregivers, expanding adult day centers and providing onsite daycare for direct care workers. 

Rep. Anne Perry told the Monitor another key solution is providing a pathway for immigrants to join the workforce earlier. 

“This is a long-term problem that’s going to require a long-term solution,” said Perry, D-Calais.

Nursing home beds in Maine have decreased from 10,000 in the mid-1990s to less than 6,400. The disappearance of nursing home beds pushed more Mainers with higher medical needs into less intensive residential care facilities, the Monitor found in a year-long investigation.

“As the state that has the oldest median age, and we are aging, this is a trend that if left unchecked could really spell disaster,” Westhoff said. “As Baby Boomers age, we will not have the capacity to adequately care for older adults who require long term care supports and services.”

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Our best clean energy stories of 2023

Falling Short

Maine nursing homes lead nation in meeting the Biden administration’s proposed staffing standards, but challenges loom

Rural nursing homes across the country, already understaffed, face significant new federal staffing requirements. With on-the-ground reporting from the Institute for Nonprofit News’ Rural News Network and data analysis assistance from USA TODAY and Big Local News at Stanford University, eight newsrooms, including The Maine Monitor, explore what the rule change would look like for patients in communities across America. Support from The National Institute for Health Care Management (NIHCM) Foundation made this project possible.

Maine nursing homes are closer to meeting the Biden administration’s proposed minimum staffing standards than their counterparts in most other states, but recent payroll data show that still fewer than one in 10 are meeting these proposed standards every day.

And while some long-term care advocates said the national standards should go further, nursing home industry leaders said it would be difficult for a rural state like Maine to find the workers to meet the required minimums, which could lead to more closures.

The Biden administration in September proposed federal standards that would require nursing homes to have a registered nurse on duty at all times, and establish minimum care hours per resident from registered nurses and nurse aides.

During the second quarter of 2023 — from April to June — Maine nursing homes met the proposed minimum care hours from both registered nurses and nurse aides an average of 59 out of 91 days in the quarter, according to analysis from The Maine Monitor, USA TODAY and Big Local News at Stanford University, the latest federal staffing data. The data is collected by the Payroll-Based Journal from the U.S. Centers for Medicare and Medicaid. 

Only Alaska was higher with an average of 88 days. The national average was 18 days.

However, only 8% of Maine nursing homes met both standards on all 91 days of the quarter. This still places Maine third in the country behind Alaska and Hawaii. (The national average was 1%.)

Part of the reason Maine nursing homes are more prepared to meet the standard could be because the state already has its own nursing home staffing requirements, including minimum staff ratios.

However, long-term care resident advocates and industry leaders said the biggest challenge for Maine homes would be meeting the proposed requirement for registered nurses on duty at all times.

Two nurses walk down a hallway. One is pushing a patient that is sitting in a wheelchair while the other pushes a computer monitor.
On average, Maine nursing homes met the nurse and nurse aide minimums recommended by CMS in 2001 on 14.5 days of the quarter, according to an analysis of payroll data. Photo by Garrick Hoffman.

Brenda Gallant, Maine’s long-term care ombudsman who advocates for nursing home residents and their families, praised the effort to establish national minimum standards. She viewed staffing as the most important aspect of quality of care in a nursing home. However, Gallant said, she would have liked to see the proposal go even further.

“Honestly, why is it taking the country so long to do the right thing, both by residents and staff?” she said. “We can’t expect people to want to do this work without sufficient resources and when there isn’t sufficient staffing.”

Studies have tied staffing to quality of care and called for the establishment of a federal minimum staffing standard.

The Maine Health Care Association, which represents 200 nursing homes and assisted living facilities across the state, has called the proposed minimum an unfunded mandate that could lead to more nursing home closures

In less than three years, the number of nursing homes in Maine has dropped from 93 to 83, some of which have cited staffing challenges as part of the reason. The federal payroll data included staffing information from 85 nursing homes for the second quarter of this year, but two more have since closed. 

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Angela Cole Westhoff, the organization’s president & CEO, said Maine nursing homes are among the closest to meeting Biden’s proposal because the state already has some of the highest standards in the country and because Maine homes serve residents who often have higher care needs, which requires them to provide more staffing per resident.

But workforce shortages are already stressing the industry, she said, adding that there needs to be significantly more investment from policymakers to better train and pay direct care workers.

“Essentially, every single nursing home in Maine has multiple jobs posted,” Westhoff said. “We already want more staff. The issue is that Maine simply does not have the workers available to meet our needs.”

While Maine is comparatively better than most other states, the fact that other states are so low demonstrates there is a significant challenge to meeting this proposal, said Jess Maurer, executive director of the Maine Council on Aging.

The proposed rules for nurses and nurse aides would be phased in over three years for most homes, but rural areas would have five years to meet the new standards. The proposal also includes $75 million for staff recruitment and training.

Maurer said the proposal should include additional support and funding for rural communities where it will be hard to find the workers to meet these standards, especially in Maine because it is the oldest state and has among the lowest working-age population in the country.

“We’re the first in the country to deal with this, but we will not be the last,” she said. “We should be the canary in the coal mine. The Feds should be looking at how many nursing homes have closed in Maine and why and who is going to follow because they can’t meet these staffing ratios in small, rural areas.”

Best and worst performers

Even some of the nursing homes doing the best at meeting the proposed requirements were critical of the proposal.

Seven of Maine’s 85 nursing homes met both Biden requirements on all 91 days of the quarter. Among those were two Maine Veterans Homes, in Augusta and Bangor. Both locations have a five-star rating from the federal government based on staffing, health inspections and quality measures.

Rebecca Gagnon, Chief Operating Officer of Maine Veterans Homes, said the homes might have met the proposed minimum staffing requirements because they are “consistent with the unique VA regulations” they already are required to meet, such as round-the-clock presence of a registered nurse.

These existing requirements make operations more costly due to workforce scarcity, Gagnon said.

“Although Maine Veterans’ Homes assumes that the recent change proposed by CMS concerning minimum staffing requirements is prompted by a priority of ensuring care for nursing care residents, we are concerned that the mandate will have the opposite, unintended effect of complicating the availability of services for Maine’s seniors as the industry continues to struggle to meet staffing levels,” Gagnon said.

Aerial photo of the Maine Veterans Home in Augusta.
The Augusta location of Maine Veterans Homes is among seven nursing homes in Maine to meet the two Biden administration requirements on all 91 days of the second quarter. Courtesy photo.

Cove’s Edge in Damariscotta also met both the proposed registered nurse and nurse aide hours on all 91 days of the quarter and has a five-star rating from the federal government. But MaineHealth, which owns and operates Cove’s Edge, said it had “serious concerns” about a national ratio.

MaineHealth is able to invest and subsidize staffing across all its facilities because it is the state’s largest health system, but it comes at a cost and stand-alone nursing homes may not be able to do the same, said Katie Fullam Harris, chief government affairs officer for MaineHealth.

The existing labor shortage, especially for nurses, is creating pressure across the entire healthcare system.

On any given day, MaineHealth hospitals have 60 to 70 people waiting to be discharged to a nursing home or rehab but there’s nothing available, she said. Cove’s Edge has an additional unit that is currently empty because reimbursements are too low to staff it, Harris said.

“If you mandate a staffing ratio for which there’s no justification, all you will do is put further pressure on a system that is already in crisis,” she said.

Four of the five nursing homes least prepared to meet the proposed standards are owned by Genesis Healthcare, which is one the largest long-term care providers in the country with nearly 250 skilled nursing homes and assisted living facilities in 22 states, according to the company’s website.

Cedar Ridge Center in Skowhegan met both of Biden’s requirements on one day of the quarter and has a two-star rating from CMS. Pine Point Center in Scarborough met both requirements on two days and has a four-star rating. Sandy River Center in Farmington met both on four days and has a one-star rating. Sedgewood Commons in Falmouth met the requirements on five days and has a three-star rating.

A representative for Genesis did not respond to requests for comment.

The proposal on the table

If Biden’s proposed minimum standards are implemented, nursing homes that accept Medicare and Medicaid would be required to provide residents with a minimum of 0.55 hours of care from a registered nurse per day and 2.45 hours of care from a nurse aide per resident per day. And a registered nurse would need to be on duty at all times.

Current standards require a registered nurse or licensed practical nurse to be on duty at all times.

Public comments on the proposal were accepted through early November.

Minimum staffing standards would improve safety and quality care in nursing homes, Xavier Becerra, secretary of the U.S. Department of Health and Human Services, said in a press release at the time.

“When facilities are understaffed, residents suffer,” Becerra said. “They might be unable to use the bathroom, shower, maintain hygiene, change clothes, get out of bed, or have someone respond to their call for assistance. Comprehensive staffing reforms can improve working conditions, leading to higher wages and better retention for this dedicated workforce.”

The interior of a room within a nursing home
The Maine Health Care Association, which represents 200 nursing homes and assisted living facilities, has called the proposed minimum an unfunded mandate that could lead to more nursing home closures. Photo by Garrick Hoffman.

The Centers for Medicare and Medicaid has estimated that about three-quarters of nursing homes nationally would need to increase staffing to meet the proposal.

Maine nursing homes are already required by state law to have one direct-care staff member for every five residents during the day; one for every 10 residents in the evenings; and one for every 15 residents overnight.

These standards are very close to the three hours of care per resident from a registered nurse and nurse aides that would be required under the national standards, said Gallant, with the ombudsman program.

Gallant said she’d like to see national standards go even further and require 4.1 hours of direct care for each resident. This number comes from a 2001 study by CMS into quality of care, which recommended that registered nurses, licensed practical nurses and certified nurse aides provide a total of 4.1 hours per resident per day. (This recommendation included a standard for LPNs, but Biden’s proposal does not.)

On average, Maine nursing homes met the nurse and nurse aide minimums recommended by CMS in 2001 on 14.5 days of the quarter, according to the analysis of payroll data.

The ombudsman program has conducted focus groups with direct care workers across the state to hear about concerns. In these discussions, Gallant said she’d heard from workers who felt like they couldn’t call in sick because there was no one else to come in.

“There’s not a choice about providing sufficient staffing. Period. There’s just not. That’s what facilities exist to do: take care of people,” she said. “People want to do a good job. If you don’t have sufficient staff, it becomes impossible.”

The primary challenge in a rural state like Maine would be meeting the requirement to have a registered nurse on duty at all times, according to both Gallant and Westhoff, with the industry group representing Maine nursing homes.

“The Feds should be looking at how many nursing homes have closed in Maine and why and who is going to follow because they can’t meet these staffing ratios in small, rural areas.”

Jess Maurer, executive director, Maine Council on Aging

Nearly a quarter of Maine’s nursing homes — 20 out of 85 — met the proposed minimum registered nurse hours on every single day of the 91-day second quarter, according to the analysis of payroll data. This ratio is higher than all other New England states. Nationally, only 6% of nursing homes met this proposed minimum on every day of the quarter.

According to an analysis from the American Health Care Association, about a third — 28 out of 85 — Maine homes would currently meet a 24/7 registered nurse requirement, Westhoff said.

Low MaineCare reimbursement and workforce shortages are driving nursing home closures, Westhoff said, which causes a ripple effect across healthcare as hospitals and other facilities absorb the backlog of patients.

Rather than regulations and obligations, there should be a focus on innovation and solutions, said Maurer with the Maine Council on Aging. For example, it might be a better use of time to regulate staffing agencies, which are expensive for nursing homes and are intended as a stopgap during an unforeseen staff shortage but are increasingly becoming the norm.

And it’s long overdue to increase reimbursement rates for this work, she said. 

“We should be talking about, as humans, what do we value and how do we want to receive care? And we should pay for it.”

This article was written with additional support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and The Silver Century Foundation.

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Aroostook power corridor faces opposition from rural landowners

ALBION — Over 50 years, Eric and Rebecca Rolfson have created a rural oasis in this central Maine farming community. On 123 acres, they have hand-built a log cabin and renovated a 200- year-old family farmhouse.

They have created a maple syrup business, cultivated hayfields that serve local dairy farmers and cut a community trail system through their woods. This is where they plan to grow old, on land where Eric Rolfson’s parents are buried.

So they were shocked last July when they received a letter from LS Power, a New York City-based power and transmission system developer.

The Rolfsons learned they were among 3,500 or so landowners with property on the potential route of the Aroostook Renewable Gateway, a roughly 140-mile overhead transmission line that would connect the largest wind farm east of the Mississippi River with New England’s electric grid.

A map of the proposed LS power route.
The latest proposed route of the Aroostook Renewable Gateway. Dotted lines are route options. Source: LS Power. View a larger version.

A map shows a potential 150-foot wide corridor slicing north-south through the Rolfson’s property.

Standing in the farmhouse’s yard in mid-November, looking up at the wooded ridge that could someday trace the path of transmission lines strung from 110-foot towers, Eric Rolfson expressed his frustration and fear after a lifetime of pouring his heart into the land.

“We love it here,” he said. “We can’t imagine looking up at those towers.”

When it was approved last June by lawmakers and signed by Gov. Janet Mills, the bipartisan legislation enabling the Aroostook Renewable Gateway was hailed as an achievement that would finally unlock northern Maine’s green energy potential while lowering electric rates. 

But already the Aroostook line is beginning to feel reminiscent of another controversial corridor — the troubled New England Clean Energy Connect project, the six-year effort by Central Maine Power’s parent company to build an overhead transmission line from Quebec to Lewiston.

After years of court battles, a citizens referendum was overturned in April and work was allowed to resume. Crews are being reassembled to finish the now-estimated $1.5 billion project, the company said, with plans to energize the line in 2025.

Meanwhile the Rolfsons, and neighbors in Albion, Palermo, Freedom, Thorndike and Unity, are organizing in opposition to the Aroostook line.

They have held protest rallies. They set up a Facebook page with 1,000 members and created a citizen group, Preserve Rural Maine. They’ve hired a Portland attorney with experience fighting transmission lines, including NECEC.

Nearly a dozen towns have enacted temporary moratoriums.

This wasn’t supposed to happen.

The 2021 citizens’ initiative aimed at killing NECEC also contained unprecedented language that requires the legislature to approve any new “high-impact electric transmission lines.”

The idea was to provide a check on developers seeking to push projects through communities that opposed them. The Aroostook line was the first test of the new law and, based on the fight brewing here, it’s not working as planned.

Two problems are becoming obvious. First, rank-and-file lawmakers were asked by key legislative leaders to endorse the project before even knowing where the transmission corridor would run. Second, language in an initial 2021 transmission line bill encouraged new lines to be located in existing rights-of-way or corridors “whenever feasible.” But feasible is a broad term, leaving it to developers to assess what’s technically and financially doable.

The prospect of new transmission corridors going through resistive communities has led some lawmakers to take a step back.

Eleven relevant bills were proposed for the upcoming legislative session, ranging from study alternatives to preventing eminent domain takeovers to rescinding approval altogether. None got the initial go-ahead this month from the Legislative Council, the 10-member leadership body that controls the flow of legislation, although one was granted on appeal. The council includes two Aroostook County lawmakers who are key champions of the project: Senate President Troy Jackson, a Democrat, and Senate Minority Leader Trey Stewart, a Republican.

There’s wide agreement that Maine and the region will need more transmission lines to carry clean energy and phase out the fossil fuel generation linked to climate change. But the highly organized opposition against the Aroostook venture is raising a critical question about how Maine is pursuing its interconnection goals. 

Eric Rolfson and Rebecca Rolfson pose for a photo with their dog.
Eric and Becky Rolfson stand in one of their farm fields in Albion, below a proposed route for a transmission line from northern Maine. Photo by Tux Turkel.

What lessons have politicians and policy makers learned from the NECEC debacle, or from Northern Pass in New Hampshire, the failed attempt to construct a 192-mile overhead line from Quebec that was killed in 2018 after stiff community opposition?

Northern Pass, NECEC and Aroostook Renewable Gateway have something in common. They were designed to carry high-voltage power over lines strung on tall towers running through wide swaths.

By contrast, a similar-size project now being built from Quebec to New York City, the Champlain Hudson Power Express, plans to run cables underground and underwater in narrow corridors. Another cross-border proposal, Twin States Clean Energy Link, would put some of the line under state roadways.

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The Aroostook Gateway is the product of decades-long ambitions to connect Maine’s northernmost county with New England’s electric grid, and boost the local economy by building wind, solar and biomass power plants.

It remains in its early stages, planned to come on line in 2029. LS Power has yet to seek key permits from utility and environmental regulators.

As the process unfurls, two additional questions loom: Will Maine push ahead with an unpopular overhead transmission design that has snarled two similar high-profile projects? With an eye on lessons from Northern Pass and NECEC, is it still possible to bury cables underground?

For its part, LS Power stresses that no routes have been finalized.

The company met in July with residents along proposed route options to hear their concerns. It plans a second round of meetings in early 2024 and expects to adjust the route based on feedback.

The route is subject to change until all permits are in hand, the company said, no sooner than 2026.

The company even explored placing towers along sections of Interstate 95, but that idea was rejected by the Maine Department of Transportation. 

One thing not likely to change, according to Doug Mulvey, the company’s vice president for project development, is the alternating current, overhead wires design. LS Power is familiar with underground projects, working on one in San Jose, Calif., Mulvey said.

But burying a high-voltage line that carries the required direct current from Aroostook County to central Maine would cost roughly five times more than the overhead option, he said. That would be a non-starter because a top reason the $2.9 billion project won a competitive bid process at the Public Utilities Commission is it promised to save electric customers money.

“Everyone in the state, everyone we talked to, is extremely concerned about rates,” Mulvey said.

Adding to the complexity, LS Power and the PUC are bogged down in negotiations over details of the power purchase and transmission service agreements. Mulvey told the Portland Press Herald that the impasse was putting the project at risk.

Renewable energy versus ratepayers

The Aroostook Renewable Gateway checks a lot of boxes on the wish list for Maine’s clean energy aspirations.

The line would connect to a 170-turbine wind farm in southern Aroostook County called King Pine, to be built by Boston-based Longroad Energy. The $2 billion project would have a capacity of 1,000 megawatts, producing enough electricity to power 450,000 homes. Other generators, such as solar or biomass, might someday also be able to use the line.

In approving King Pine and the power line last January, the PUC estimated that most Maine residential electricity customers would pay an extra $1 a month — or $1 billion in total — for a 60% share of the project. The rest would be paid by Massachusetts customers as part of that state’s clean energy acquisitions. The actual megawatt-hour cost of electricity hasn’t been made public.

When it was approved by the PUC, the project was hailed by Mills’ energy office as a way to combat the impact of volatile natural gas costs on electricity supply, while creating economic opportunities in northern Maine. Jackson said it would unlock affordable, homegrown renewable energy and create good jobs.

“With today’s vote,” Jackson said at the time, “we are the closest the state has ever been to making the northern Maine transmission line a reality, and unleashing the untapped economic potential and power of Aroostook County.”

All this seemed far away in Albion, roughly 130 miles south of the planned wind project. This is dairy farm country in a state where the industry has been shrinking for decades. But here, 10 dairy farms hang on, evident by the hayfields and pastureland spread across rolling hills.

Driving the country roads, what sticks out most isn’t the cows. It’s the signs. Election season is over but what looks like roadside campaign signs are everywhere. Black-and-white signs read: “Keep LS Power off our land.” Yellow signs with an outline of a transmission tower say, “Stop Gateway Grid,” with the weblink,

A roadside sign that reads: Keep LS Power off our land
Roadside protest signs against LS Power and its proposed power line project are common along central Maine roadways near Albion, Freedom and Palermo. Photo by Tux Turkel.

The signs are on the Noyes Family Farm, a third-generation dairy operation with 100 cows that grows corn and hay on 370 acres. Chuck Noyes and his daughter, Holly, were part of a protest at the Albion town office in late July. It was organized to call attention to concerns ranging from loss of farmland to electromagnetic radiation from overhead wires.

In mid-November, Holly Noyes came to the Rolfson farmhouse, with several residents who formed action committees in their communities, to talk about next steps. Over pancakes and the farm’s maple syrup, they discussed a path forward.

“What are our next steps if the legislature isn’t going to listen?” asked Josh Kercsmar of Unity, vice president of the Preserve Rural Maine group. “Where can we turn?”

‘No real input’

This is not what lawmakers had in mind in 2021 when they considered LD 1710. The bill created the Northern Maine Renewable Energy Development Program and directed the PUC to seek proposals for a transmission line that would ship power from green-energy generators in Aroostook County into the New England grid. Jackson, who represents a district in far northern Maine, was the lead sponsor.

But some interest groups that testified on the bill, such as the Maine Farmland Trust, urged lawmakers to remove the “wherever feasible” clause, to “ensure that there is a strong preference for proposals that are collocated with existing utility corridors and roads, and as such, avoid further impacts to important natural and working lands.” No changes were made.

And after the passage in June of LD 924, a follow-up, legislative resolve sponsored by Jackson, Stewart and others to signal specific approval for the Aroostook Gateway, some lawmakers felt the process was being rushed.

“My big concern,” said Rep. Steven Foster, R-Dexter, “is that we’re approving this line, it’s going through 41 communities, but there was no real input during the legislative process before the approval was made.”

Foster, who serves on the legislative committee that handles energy matters, represents towns through which the line could pass.

He proposed a bill for the upcoming session to reconsider the project’s PUC approval. It was rejected by leadership in early November, along with all but one of the proposed remedial measures — a bid from Sen. Chip Curry, D-Waldo, to prevent eminent domain from being used to build the line.

A map showing how the power line corridor will impact the town of Albion.
This map depicts the proposed route of the power line, along with their farmhouse (Home 1), a planned family house and existing dwellings. Map courtesy Eric Rolfson.

“I think (Senate) President Jackson and others are determined to get this project done,” Foster said. “And I’ll leave it at that.”

Jackson’s perspective, however, is that some lawmakers who oppose wind farms were “piling on” to create obstacles.

After meeting with the Albion-area organizers, Jackson said he’s sympathetic plight and wants LS Power to do its best to mitigate impacts. But he doesn’t see how the lines can be buried, based on the PUC’s bidding criteria.

“That’s not what the PUC asked for in its request for proposals,” Jackson told The Maine Monitor. “They would have to re-bid the whole thing. You’re going to have different costs and ratepayers are going to be impacted.” 

But by selecting a project with overhead transmission lines, Maine is ignoring a lesson from both Northern Pass and NECEC, according to Beth Boepple, a Portland attorney who represented opponents in both cases. It’s technically feasible to run high-voltage cables underground along existing corridors or roadways, she said, and that’s what Maine should require.

“It’s one of the lessons we should have learned,” she said. “We don’t need to reinvent the wheel.”

One difference, Boepple said, is opponents have organized early. There’s still time to press the PUC and permitting agencies such as the Department of Environmental Protection to require underground cables. That could avoid long and costly legal battles, she said.

“We’re a long way from going to court,” she said. “There’s a lot that can be done through the permitting process.”

But even at this early stage, the process is fraught with competing tensions, according to Bill Harwood, Maine’s public advocate. 

The developer requested and won some assurances before investing millions of dollars. But the legislature had to sign off on a major project without key information.

Customers statewide want lower-cost electricity. Local residents, though, don’t want giant towers and overhead wires on their land. 

“Going forward,” Harwood said, “we need to think carefully about whether there’s a better way.”

The story Aroostook power corridor faces opposition from landowners appeared first on The Maine Monitor.

Maine rarely sanctions residential care facilities even after severe abuse or neglect incidents

This article was produced for ProPublica’s Local Reporting Network in partnership with The Maine MonitorSign up for free newsletters from The Maine Monitor to stay informed about what’s happening in Maine. Research by Mariam Elba of ProPublica and photography by Tara Rice for ProPublica.

One lunchtime in 2021, a longtime resident at Woodlands Memory Care of Rockland started throwing up. His fingernails turned purple, and his skin became red all over. He was lethargic and fidgety, and his breathing grew shallow, according to the facility’s daily care notes.

The resident was well known at this residential care facility in Maine’s Midcoast region. Former facility employees told The Maine Monitor and ProPublica that he was a nationally renowned concert pianist who continued to play a portable keyboard in his room even as his Alzheimer’s disease advanced.

It wasn’t until a family member arrived and asked if the resident had eaten peanuts that employees realized that he was having an allergic reaction to the peanut butter sandwich that he had been served for lunch, according to the facility care notes. Staff used an EpiPen to treat his anaphylactic shock and took him to the hospital. He died days later, though no official records were made available that show the cause of his death.

The employee who gave the sandwich to the resident wrote in the facility care notes the day after the incident that they “didn’t know” that the resident “was allergic to peanuts.”

In interviews with the Monitor and ProPublica, however, four former employees said the resident’s severe peanut allergy had been documented throughout the facility: in his resident profile, in his room and posted in the kitchen.

“It said it everywhere you looked around him that he was allergic to peanut butter,” said Stacy Peterson, who served as the human resources coordinator at Woodlands of Rockland from 2018 to 2020.

So it was a mystery to the former employees how the resident had been served a peanut butter sandwich that day for lunch.

After receiving an anonymous complaint, the Maine Department of Health and Human Services investigated the incident and cited Woodlands of Rockland for two resident rights violations — first by failing to protect the resident from a severe allergic reaction and the second time by not reporting the case to the state. (The citations do not identify the resident.)

Under state regulations, the health department had the power to impose a fine of up to $10,000 or issue a conditional license that would bar Woodlands of Rockland from accepting new residents for up to 12 months. But it did neither. Instead, it simply required the facility to submit a report, called a plan of correction, stating how it intended to address the deficiencies.

In that plan, Woodlands of Rockland acknowledged that the resident’s allergy had been documented but disputed the health department’s characterization that the facility violated the resident’s rights in the incident. Still, it promised to discipline the employee who served the sandwich and to retrain others on how to handle allergies and to report incidents.

A portion of a Maine DHHS report about the allergy incident. The document notes, in part, that the resident was neglected by failure to protect a resident's health from an allergic reaction to an identified restricted food. The report also notes the resident became lethargic, fidgety and body stiffened after vomiting up lunch. The resident's  peanut allergy, the report says, was listed on the resident's service plan and included on an allergy listing posted in the facility's serving kitchen. The staff person who served the sandwich to the resident failed to refer to the allergy listing before serving the sandwich to the resident, the report reads.
The Maine Department of Health and Human Services found that Woodlands Memory Care of Rockland violated a resident’s right to be free “from abuse, neglect or exploitations” by serving him a peanut butter sandwich despite his documented peanut allergy. (Obtained by The Maine Monitor and ProPublica. Highlighted by ProPublica.)

The health department’s modest response to the peanut allergy incident exemplifies its approach to oversight, an investigation by the Monitor and ProPublica found. The health department rarely imposes fines or issues conditional licenses against the state’s roughly 190 largest residential care facilities, classified as Level IV, which provide less medical care than nursing homes but offer more homelike assisted living alternatives for older Mainers.

From 2020 to 2022, the health department issued “statements of deficiencies” against these facilities for 59 resident rights violations and about 650 additional violations — involving anything from medication and record-keeping errors to unsanitary conditions and missed mandatory trainings.

Despite these violations, however, it imposed a fine only once: a $265 penalty against a facility for failing to comply with background check rules for hiring employees. And it issued four conditional licenses: three in response to administrative or technical violations and one in response to a variety of issues, including a violation of a resident’s privacy rights.

By contrast, Massachusetts, which has 269 assisted living facilities, doesn’t shy away from imposing stiff sanctions. From 2020 to 2022, the state suspended eight facilities’ operations for regulatory violations.

The paucity of sanctions in Maine comes at a time when Level IV facilities like Woodlands of Rockland — which are similar to what are known generally as assisted living facilities in other states — are expanding their presence in the state. The share of Maine’s population that is 65 or older, 21.7%, is the highest percentage in the country.

As the Monitor and ProPublica have reported, the state’s decision in the mid-1990s to tighten the requirement to qualify for nursing home placement helped spur thousands of older Mainers, many with significant medical needs, to move to these nonmedical facilities — which are subject only to state regulations that hold them to much lower minimum staffing, nursing and physician requirements than nursing homes, which face both state and federal scrutiny.

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In stark contrast to how rarely Level IV facilities face sanctions, nursing homes in Maine are often hit with considerable fines for regulatory violations.

Health department spokesperson Jackie Farwell said that plans of correction are often sufficient for improving conditions at facilities. She added that as part of an effort to improve the long-term care system in Maine, the state has been considering rules changes to “establish fines and sanctions as more meaningful deterrents.” But she declined to elaborate on the specifics.

Dan Cashman, spokesperson for Woodlands Senior Living, which runs 14 Maine facilities including the one in Rockland, said the company has “a zero-tolerance policy” and has taken disciplinary actions against any employees who were found to have violated residents’ rights.

Cashman added that the company is in favor of stronger state action against individuals found to have violated residents’ rights to prevent them from working in residential care settings again.

But long-term care advocates say the health department is not doing enough to crack down on facilities, as opposed to individuals, and is allowing poor conditions to persist for vulnerable residents.

Richard Mollot, executive director of the Long Term Care Community Coalition, a national advocacy group focused on improving nursing homes and assisted living facilities, said stiff sanctions should be imposed more, so that there’s a “meaningful ladder of sufficient penalties to ensure that facilities are properly motivated to take steps to ensure resident safety.”

Otherwise, Mollot said, facilities have no incentive to change their behavior. “To pussyfoot around resident neglect or abuse,” he said, “is essentially encouraging. It’s allowing it to happen.”

A review by the Monitor and ProPublica of state inspection records from 2020 to 2022 shows that the health department employed the lowest intervention possible, even for some of the most serious abuse and neglect incidents. 

In the summer of 2021, for instance, a resident at Crawford Commons in midcoast Maine was found to have sexually abused another resident multiple times, according to the state’s investigation. The health department cited the facility for two resident rights violations but only required it to submit a plan of correction.

A year later, a resident in Jed Prouty Residential Care Home in the Penobscot Bay region was found around 6:30 a.m., naked and asleep on the floor, “soaking wet with urine,” after falling sometime after 10 p.m. Witnesses said the resident had been crying for help and complaining of thirst until medics responded. No efforts had been made by staff to move the resident from the floor or provide clothing, according to the state’s investigation. Again, the health department cited the facility for a resident rights violation but only required it to submit a plan of correction.

Similarly, in 2021 and 2022, the health department also investigated Woodlands of Rockland for two other serious incidents. In one, a certified nursing assistant at the facility slapped a resident who had spit at and attempted to bite her, according to the state’s investigation.

In the other, a resident wandered out to the facility’s locked courtyard, but employees didn’t notice that she was missing until they went to give her medications nearly two hours later, according to the state’s investigation. When the resident was found outside in the snow at around 8:40 p.m., employees wrapped her in blankets and called for emergency medical care. The resident died in hospice days later, and the state investigation cited the cause as “complications of hypothermia.”

In the end, both incidents also led to plans of correction.

A Maine DHHS report about the incident notes the facility neglected to protect a resident's health and welfare. The resident got out into the secured courtyard undetected, according to the report.
The Maine Department of Health and Human Services cited Woodlands Memory Care of Rockland for not protecting “a resident’s health and welfare” after the resident wandered out unsupervised into the facility’s locked courtyard. (Obtained by The Maine Monitor and ProPublica. Highlighted by ProPublica.)

Woodlands of Rockland has been disputing the health department’s characterization that the facility violated the resident’s rights in the courtyard incident. But Cashman declined to elaborate on the specifics.

Edward Sedacca, CEO of Magnolia Assisted Living, which runs Jed Prouty, said his company took over the operation of the facility in August 2022, a month before the incident, and has since made it a priority to enhance its staffing and training. “The staff we inherited was lacking in overall general knowledge,“ he said. “Magnolia has built an infrastructure well beyond that required under regulation to enable us to provide a higher level of care to all of our residents.”

Crawford Commons did not respond to requests for comment.

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For Maine’s nursing homes, however, the response to similar incidents has been very different.

From 2020 to 2022, more than half of nursing homes in Maine received fines — 98 penalties in all, totaling nearly $700,000 — according to U.S. Centers for Medicare and Medicaid Services reports. These fines were imposed in response to a range of violations, including not following COVID-19 infection prevention protocol, making medication errors, not reporting unexpected deaths and failing to protect residents from harm.

In 2020, for instance, an employee at Pinnacle Health & Rehab, a nursing home in Canton in western Maine, “lost it” when a resident became combative, according to CMS investigation records. The employee punched the resident, who ended up with a black eye and bruising around the eyebrow. CMS fined the facility $41,650.

A year later, a resident at Heritage Rehab and Living Center, a nursing home in central Maine, wandered off the premises at night using a walker and was found later by police by the side of a road in the rain. No one at the facility had noticed that the resident was missing, according to CMS investigation records. CMS fined the facility $71,243.

Ken Huhn, administrator of Pinnacle, said the employee was fired, and he made it clear that “that type of behavior would not be tolerated” at his facility.

Heritage did not respond to requests for comment.

“To pussyfoot around resident neglect or abuse is essentially encouraging. It’s allowing it to happen.”

Richard Mollot, executive director of the Long Term Care Community Coalition

Even without the involvement of CMS, which does not regulate assisted living facilities around the country, the health department has the power to adopt a tougher approach toward Level IV facilities. Under state regulations, for instance, it can impose a fine when an incident poses “a substantial probability of serious mental or physical harm to a resident.”

Long-term care advocates told the Monitor and ProPublica that under this standard, some of the egregious abuse and neglect incidents in recent years at Level IV facilities should have resulted in stiff sanctions.

“Because the incidents are so egregious and show such disregard for the well-being of residents, they would have warranted some significant penalty and not just a pro forma requirement that the facility submit a plan of correction,” said Eric Carlson, director of long-term services and support advocacy at Justice in Aging, a national legal advocacy nonprofit focused on ending poverty among seniors.

Paula Banks, who has served as the executive director of another Woodlands facility in Cape Elizabeth and as an assistant administrator of a Maine nursing home, said the fear of such sanctions would be effective. If she were still helping run a residential care facility, she said, it would spur her to take immediate action to address any problems.

“What’s the impetus to change if there’s no consequence?” said Banks, who now runs a geriatric consulting and care management firm.

But Dr. Jabbar Fazeli, who has served as medical director at multiple residential care facilities and nursing homes in Maine, said that rather than imposing sanctions, the state should require more medical attention by increasing nursing hours and requiring a medical director to be on the premises.

“If they had more medical care, I would say 50% of these issues will self-resolve,” Fazeli said.

The health department metes out sanctions in only a small percent of the incidents it hears about each year. Most of the time, it hardly does anything.

To better understand the health department’s process for looking into potential issues, the Monitor and ProPublica analyzed a database of incidents reported to the state by Level IV facilities themselves. Unlike the state inspection records, the database of facility-reported incidents gives a window into what happens earlier in the health department’s enforcement process.

Level IV facilities are required to report an incident to the state when a regulatory violation may have occurred or when a resident’s safety was put at risk. We focused particularly on reports of incidents with the potential for direct harm: the cases of abuse and neglect.

From 2020 to 2022, the state received more than 550 reports of abuse and neglect incidents from Level IV facilities, according to the Monitor and ProPublica analysis. Of those, 342 cases involved residents abusing other residents, 102 cases involved “elopement,” in which residents wandered away unsupervised, and 61 cases involved a staff member abusing a resident.

The analysis shows that in nearly 85% of these incidents, state investigators took “no action” — which, according to Farwell, means that the health department decided not to investigate. She said this could have been for a range of reasons, such as when a facility has already taken corrective action, when state investigators do not expect to find a regulatory violation, or when an incident is being investigated as part of another case or is expected to be reviewed later.

The analysis also shows that the health department did not step up its enforcement even when individual facilities repeatedly reported similar issues.

From 2020 to 2022, 13 Level IV facilities, including Woodlands of Rockland, each had at least 10 abuse and neglect incidents, collectively reporting 348 cases to the state. Even after these facilities had reported multiple cases, the health department still took no action in 91% of them, the analysis shows.

Farwell said state investigators do pay attention to repeated incidents. “If patterns are observed, specific issues may be flagged for follow-up at the next scheduled survey,” she said.

But such follow-ups might not happen for many months, depending on the timing of the next inspection required for license renewal, which takes place only once every two years.

Dionne Mills, who served as the program coordinator at Woodlands of Rockland from 2019 to 2021 and also worked at two other Level IV facilities, said she became aware of the lack of state oversight during her time at the Rockland facility. She said she reported multiple incidents to the state until eventually a state investigator told her that they were too overwhelmed with complaints and that she would have more success taking her concerns to the media.

“The state is so super busy that they only have time to look into the absolute worst-case scenario,” Mills said.

Dionne Mills poses for a photo.
Dionne Mills outside her home in Northport, Maine Photo by Tara Rice for ProPublica.

Farwell disputed Mills’ account, noting that state investigators made seven visits to Woodlands of Rockland from 2020 to 2022, the time period when the facility was under investigation for the courtyard, peanut allergy and slapping incidents. Mills’ account “is inconsistent with the number of onsite visits that were conducted at this facility,” she said.

According to Farwell, the health department has 13 investigators — and is in the process of hiring two more — to inspect more than 1,100 assisted housing facilities in the state for license renewals and to investigate any incidents.

Mollot, of the Long Term Care Community Coalition, said the health department needs to do more against facilities with a history of repeated incidents, such as requiring independent monitoring and, possibly, revoking licenses.

“Faced with the fact that these facilities have reported over and over and over and over and over again incidents of abuse and neglect, why have there been a paucity of enforcement acts?” Mollot said.

Several former employees told the Monitor and ProPublica that the history of repeated incidents at Woodlands of Rockland illustrates what can happen to a facility’s standards when the health department takes little enforcement action.

Stacy Peterson poses for a photo outside the Woodlands facility.
Stacy Peterson, a former human resources coordinator at Woodlands Memory Care of Rockland, said facility managers made little effort to address recurring problems when she worked there. Photo by Tara Rice for ProPublica.

From 2020 to 2022, Woodlands of Rockland had the highest number of abuse incidents reported by a Level IV facility — 48 cases in all, including 38 in which a resident abused another resident, according to the health department database.

But the health department investigated only five of the incidents that Woodlands of Rockland reported, took no action on the rest and imposed no sanctions other than requiring the facility to submit one plan of correction.

With little pressure from the health department, efforts to address recurring problems “were nonexistent when I worked there,” Mills, the former program coordinator, said.

“What’s the impetus to change if there’s no consequence?”

Paula Banks, former executive director of a Woodlands facility in Cape Elizabeth

Joshua Benner, who served as a residential care aide at Woodlands of Rockland from 2018 to 2020, said he found it concerning that when the facility was cited by the health department, none of the managers at the facility shared with employees what problems had been found.

“Every other health care place that I’ve ever worked, you have interventions, usually after the state comes in, to go over what you’re dinged on and what can be improved,” said Benner, who has worked at a nursing home and two other residential care facilities.

Cashman, the Woodlands spokesperson, denied that Woodlands of Rockland had “an ongoing or systemic problem” with abuse incidents, noting that the bulk of the cases involved a small number of residents “whose progressively worsening dementia-related behaviors became more and more challenging.”

In response to these residents’ behaviors, Cashman said Woodlands of Rockland has been proactive and taken “multiple interventions,” including resident care plan updates, medication modifications, referrals for hospital treatment and discharge planning.

Cashman said Woodlands of Rockland and its employees have been doing “their best to manage what can be extremely difficult behaviors by individuals living with significant cognitive impairments.”

But Banks said something is amiss if any facility has repeated incidents, noting that she would have been alarmed to see more than one or two incidents of abuse in three years, let alone 30 or more as Woodlands of Rockland did.

“When you have people in your building and you took them in and you told their families you would take care of them and you took their money,” Banks said, “I don’t care what’s going on. I don’t care if you have a staff of three. You’ve got to take care of your people.”

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The story Maine rarely sanctions residential care facilities even after severe abuse or neglect incidents appeared first on The Maine Monitor.