When it comes to helping people with disabilities in Maine, the state has long been leaving them behind.
More than 4,000 people with intellectual disabilities in the state of Maine require services from direct support professionals who ensure they take their medication, help them eat and use the bathroom, and run group homes to provide a safe place for them to live with 24/7 assistance.
But over the past decade, direct support providers have faced staffing shortages and vacancies as reimbursement rates for services paid for by MaineCare, Maine’s version of Medicaid, have been cut by 30 percent since 2007. The percentage accounts for inflation. Direct support providers are funded under Section 21 of MaineCare, and rates must be set by the Legislature.
In 2007, direct care workers made an average of $10.37 an hour. Ten years and numerous cuts to the program later, they now make around $9.17 an hour, barely above minimum wage, according to the Maine Association for Community Service Providers. Once the state minimum wage increases to $10 an hour beginning in 2018, providers will not be able to keep up.
LD 967, sponsored by House Majority Leader Erin Herbig, D-Belfast, would increase reimbursement rates by 10 percent over 2007 levels, in an effort to keep staff and prevent closures.
Just in the past year, 24 group homes have closed, Herbig said, leaving 69 people with disabilities displaced. In the next six months, another 12 homes are expecting to close, bringing the total number of people with disabilities displaced up to 109. If LD 967 doesn’t pass, that number is expected to increase.
“The state shouldn’t be in the business of deciding which of our loved ones receive care,” Herbig said. “If we do not get funding for this bill, it’s inevitable that this entire system of care will collapse.”
As the bill was originally written, it would have cost the state $65 million between July 1, 2016, and June 30, 2017, showing just how much money each year has been denied to professionals who serve those with disabilities. The $65 million would not only increase rates back to 2007, but would adjust for inflation and the rising costs of operations that have accumulated over the last 10 years.
The bill has since been amended, reducing funding to $26.5 million for 2017-2018 to simply revert rates back to levels seen in 2007 and increase them 10 percent for inflation. Further discussion has reduced this funding even more, to just $15 million, which restores 2007 rates without inflation, but this decrease has not been officially enacted yet.
When Maine closed its psychiatric institutions decades ago, it never fully created the safety net that people who need consistent care need. Not fully funding the providers who are struggling to make ends meet — and causing them to shut down — is yet another example of how Maine has let down some of its most vulnerable residents.
The bill, as it currently stands, would provide the absolute bare minimum needed to maintain the system at 2007 funding levels. This is as good as the state can, apparently, do. Providers will take the slight raise because they need it, but then what will they do next year? State government has an obligation to help people with disabilities live in their community, but the plan to make it happen has never fully materialized.
While Maine’s House and Senate passed LD 967, it currently sits with the Appropriations Committee, awaiting action on a state budget to see if the money is there to fund it. This is where many bills, approved by the full Legislature, go to die.
The state cannot choose to do nothing.
Maine has no Plan B. Without the provider community, nobody delivers these needed services. If providers are forced to close, people with disabilities who are in need of help will be left on their own. There is no way the state can ethically leave them waiting for a white knight who they need but will never come.
“If there’s no relief, this could spell the end of the home- and community-based service system in the state of Maine,” said Todd Goodwin, board president of the Maine Association for Community Service Providers and CEO of Community Partners, Inc., a nonprofit that provides direct care services to individuals with disabilities. “Without it, we’re looking at devastation.”
That’s why lawmakers must fund LD 967.