Questions of how best to fund long-term care and how to encourage the use of community-based health services over costlier institutions are among the issues facing a group of senators developing legislation aimed at reining in health care costs.

After studying cost containment strategies used in other states, a Senate working group is now holding a series of roundtable discussions with local stakeholders to explore recognized cost drivers in the Massachusetts health care system. The second session, held Wednesday, focused on long-term care, like the services available to senior citizens and people with disabilities.

Sen. James Welch, a West Springfield Democrat who co-chairs the Health Care Financing Committee, said the area is one that deserves attention because the state’s population is aging, the costs of long-term services make up a “substantial and growing” chunk of the MassHealth program and because people “need and deserve” access to quality long-term care.

Senate Majority Leader Harriette Chandler said the state has a “serious problem” when it comes to caring for people as they age, and it will take “a lot of small projects” rather than one single solution to improve the situation.

“We have to do a better job than we are doing,” the Worcester Democrat said. “Too many people are too frightened about their supposed golden years because, as my mother used to say, they turn out to be the rusty years. We can’t allow that to happen. … People don’t want to talk about it – ‘Something will happen, the state will take care of it.’ But the state can’t afford to take care of it, in terms of the numbers we have to deal with.”

Approximately 251,000 people, roughly 14 percent of those enrolled in MassHealth, use long-term services and supports, according to data provided to the senators by Mass. Home Care. In 2015, 30 percent of the $14.7 billion in MassHealth spending was for long-term care, the organization said.

Al Norman, Mass. Home Care’s executive director, said making community-based services the first choice has been the goal in Massachusetts for years, but many people, including both consumers and providers, remain unaware of the “whole elaborate system of home- and community-based care you can get.”

“We’ve had hospitalists, for example, tell us that, ‘I can’t figure out what’s available in the community because it’s like reading off a complex Chinese restaurant menu. I don’t know the dishes, I don’t know what to order, and I’m under pressure to move people quickly into another setting,’” Norman said. “So, ‘community first’ has been a nice phrase, but in reality, we still have been what we call putting people on a conveyer belt from ER to inpatient care to rehab to nursing facility.”

Norman said it needs to be easier for people to find and use community services that can keep them in their homes, and suggested that Massachusetts adopt a model used in other states where someone can only be placed in a nursing facility if medical practitioners determine it’s the best option or the patient opts against community care.

Norman touted what he called the “home care dividend,” pointing to $1.014 billion in avoided costs from the 2000 fiscal year through fiscal 2016 as the number of nursing home patient days paid for by MassHealth fell by 37 percent.

Maureen Banks, CEO of Spaulding Rehab Hospital and the Spaulding Rehab Network, said the existing system makes it difficult to move people to the “optimal level of care,” saying there are patients in her facility who are stable and could be home if there were ways to reimburse family members who care for them.

“But right now we have a situation where people would have to actually leave the workforce, so they stay working, this person stays living in a hospital level of care. They don’t need to be,” she said.

Several of the discussion participants, including Tyrek Lee of the health care workers union 1199SEIU and Massachusetts Senior Care Association President Tara Gregorio pointed to the high cost of housing as one factor that can make it difficult for seniors to remain in their homes as they age.

The Senate working group rounds out its discussion series with its third and final talk next Wednesday, covering chronic and acute care management.