For 30 years, Maine has been at the vanguard of caring for persons with intellectual and developmental disabilities. From the closure of Pineland hospital to the establishment of a person-centered planning and community inclusion model, Maine has demonstrated its commitment to people of all abilities. But the system of care for persons with intellectual and developmental disabilities is in a state of crisis and bordering on collapse.
Maine is facing a workforce shortage across all sectors. Most sectors are able to raise wages to compete in the marketplace, but wages in the intellectual and developmental disabilities system are dictated by MaineCare reimbursement rates, which have been cut 30 percent — when adjusted for inflation — since 2007. As a result, providers of intellectual and developmental disabilities services are unable to recruit and retain a stable supply of workers. The decade of rate cuts has effectively depleted the system of its most necessary resource — its workforce.
Persons with intellectual and developmental disabilities rely on direct support professionals to provide the services needed to live healthy and safe lives in their community. This includes helping them shop, cook, work and handle money. For those with more severe disabilities, it includes help with using the bathroom, preventing them from hurting themselves or others and assisting with medical conditions, such as feeding tubes and colostomies. Importantly, this work must be done with compassion, kindness and professional integrity.
Without the appropriate level of funding to recruit and retain these professionals, the service delivery system does not function. Yet, over the last decade, the state of Maine has cut reimbursement rates so significantly that wages are barely above the minimum wage, causing an exodus of these critical professionals. The impact of their exodus and vacancy from the lives of people who rely on their support is immeasurable.
The current rates are unsustainable, and an erosion of services is already occurring. Families with a loved one receiving services see a revolving door of direct support professionals and overworked direct support professionals struggling to fill shifts. Waitlists have ballooned as those awaiting services are unable to secure placements because of staffing shortages.
This staffing shortage has led service providers to leave dozens of beds vacant. At least 36 group homes have been closed over the last year, and another 12 homes are expected to close within the next six months. Collectively, the crisis has adversely affected hundreds of Mainers with intellectual and developmental disabilities who are receiving services, contributing to an unnecessary, expensive and inappropriate use of institutional and hospital-based services to meet a need that rightfully should be met in the community.
Fortunately, we have an opportunity to effectively address this problem and prevent a backslide into an archaic age from which we have so proudly emerged.
House Majority Leader Erin Herbig, D-Belfast, has submitted emergency, bipartisan legislation, LD 967, to rectify this workforce crisis. Her bill instructs the Maine Department of Health and Human Services to restore reimbursement rates to 2007 levels with adjustments for inflation, which would minimally allow providers to continue providing these crucial services.
Maine has a moral and legal obligation to care for our most vulnerable residents. Without the relief of LD 967, the crisis will grow threatening the continued viability of a system that serves more than 4,000 Mainers with disabilities, employs more than 12,000 direct support professionals, and contributes $400 million in economic activity across our state.
Maine’s integrity and economy demand support for LD 967. We ask our state legislators to provide it.
Lydia Paquette is the executive director of the Maine Association for Community Service Providers. Todd Goodwin is the CEO of Community Partners Inc. and the president of the Maine Association for Community Service Providers.