The Strafford County Commissioners convened on August 28, 2025, to discuss critical issues surrounding long-term care and the implications of recent legislative changes. The meeting was led by Nick Compass and included discussions on the establishment of a new committee focused on long-term care funding and management.

The primary concern raised was the potential loss of approximately $60 to $70 million in federal funding for long-term care programs, which could significantly impact both county and private nursing homes. Compass emphasized that this funding is crucial, as it would be unavailable under a managed care program. The committee, which includes state representatives, is tasked with addressing these funding challenges and is expected to report back by October 1, 2025.

Another significant topic was the ongoing staffing shortages in both hospitals and nursing homes, which complicate patient discharges. Compass noted that hospitals are unable to discharge patients to nursing homes due to staffing issues, while nursing homes face similar challenges with hospital admissions. A study committee is being formed to explore solutions to this problem, and Compass expressed his intention to be involved due to his position on the state commission on aging.

The discussion also touched on the administrative burdens associated with managing long-term care services under Medicaid, which is known for its low reimbursement rates. Compass raised concerns about the feasibility of managing these services effectively while maintaining quality care.

Additionally, the meeting highlighted the complexities of managed care organizations and their financial challenges following the end of the public health emergency. Compass, who serves on an advisory board for one such organization, noted that these entities have seen a decline in their numbers and are struggling to adapt to the new landscape.

The meeting concluded with a focus on the potential for a PACE (Program of All-Inclusive Care for the Elderly) program, which aims to provide comprehensive care for the elderly. This initiative could offer a new approach to long-term care, although its implementation remains to be fully defined.

Overall, the meeting underscored the urgent need for strategic planning and collaboration among stakeholders to address the pressing issues facing long-term care in Strafford County. The next steps will involve further discussions and updates from the newly formed committee as they work towards solutions.