Katie Pulk receives congratulations from co-workers and family in a drive-by celebration on Wednesday, May 6, 2020, for winning the Maine DSP award for 2020 for her work at John F. Murphy Homes in Auburn. The provider is one of many being challenged by workforce shortages and the state's vaccine mandate. Credit: Andree Kehn / Sun Journal via AP

Maine is expected to lose 10 percent of the workers providing care to people with intellectual disabilities when Gov. Janet Mills’ COVID-19 vaccine mandate takes effect later this month, coming on the heels of a large exodus from the industry.

The issues at these providers have not gained as much public attention as those at hospitals that saw crunched intensive care units during a summer peak of virus cases or at nursing homes that announced closure plans after the mandate was announced in August, but they have been among the most affected by economic upheaval during the pandemic, according to industry representatives.

Providers serving people with intellectual disabilities and autism in Maine have already lost 20 percent of their workforce since the pandemic began, said Laura Cordes, the executive director of the Maine Association for Community Service Providers, who predicted that another 1 in 10 workers will leave the workforce due to the mandate that will take effect on Oct. 29.

The problems cannot be divorced from a larger worker shortage during the pandemic and long-term issues facing an industry in which workers must provide intensive levels of care. The vaccine mandate looks to have sharply driven up vaccination rates at all types of providers, but it is clear that it will push some to the brink, including many serving people with disabilities.

Along with other aging and behavioral health advocates, Cordes’ group asked Mills in August to consider a testing option or more time to get people vaccinated. The staffing reductions have led to consolidated and closed homes across the state, disrupting residents’ lives.

“As we feared … the loss of frontline essential care workers due to the mandate is impacting our ability to serve the people who rely on us for 24/7 care and support,” Cordes said.

At the end of September, 84.6 percent of workers at these providers were vaccinated, according to Maine Center for Disease Control and Prevention data, which was the lowest share among the health care sectors tracked by the state, just behind nursing homes. More have likely been vaccinated since then and it was a sharp jump from 70.8 percent a month before.

Health industry leaders, including the Maine Hospital Association and the Maine Health Care Association, a nursing home group, have remained committed to upholding the mandate, but some providers have begun to crack under pressure. In the past week, Central Maine Medical Center in Lewiston said it would shut down its neonatal intensive care unit and suspend pediatric and trauma admissions.

Mills has rejected calls from Republicans and a bipartisan group of lawmakers from the Lewiston area to provide a testing alternative, saying federal policy that will supersede hers will not allow one. The administration has maintained that requiring the vaccine is the best way to protect patients as elevated COVID-19 case levels continue to afflict the state.

Despite recent progress, John F. Murphy Homes CEO Todd Goodwin had two meetings planned on Thursday to persuade workers holding out on being vaccinated. After months of trying to educate, provide incentives and paid time off, he was at the end of his rope on how to change the situation with 80 employees across the company that will be ineligible for work.

Across the Auburn-based company, which owns a range of group homes and higher-needs nursing facilities, vaccination rates vary. Summer Street in Auburn, the nursing facility, reported a 91 percent rate last month. But at Two Teakwood Knoll in Lewiston, a group home, the vaccination rate was 51 percent, according to state data.

Teakwood had the lowest reported vaccination rate for its category, and only one facility in Maine reported a 100 percent vaccination rate. Goodwin said numbers had probably increased since then. He has not determined yet who will no longer get services, a grim calculus he will make depending on need and available staff.

“Those are numbers we cannot absorb,” Goodwin said of his 80 employees. “We cannot consolidate and move people around and still preserve care.”