2017-05-31 / Front Page

System in ‘crisis’

Bill to increase rates for adults with intellectual disabilities approved by committee
Associate Editor

BIDDEFORD — Taima Brown has been working at Community Partners, Inc. in Biddeford off and on for about six years. She loves what she does as a direct support professional, or DSP, helping to care for several of the 125 adults with intellectual or developmental disabilities that Biddeford-based Community Partners serves.

However, low wages make it hard for the single mother of two to make ends meet.

Because of low wages, rising minimum wage and a worker shortage, finding and retaining people like Brown to care for the thousands of adults with intellectual disabilities in Maine is becoming increasing difficult for the agencies like CPI.

Unless something gives, say representatives of these agencies, not only will they be unable to take on new clients, but they will have to shrink the services they are currently providing.

“Out system is absolutely in crisis,” said CPI Executive Director Todd Goodwin. “(It’s) tittering on the verge of collapse.”

Because of this “crisis” situation, a bill is making its way to through the legislative process that could improve conditions.

An amended version of LD 967, “An Act to Ensure Access to Community Services for Persons with Intellectual Disabilities or Autism,” sponsored by House majority leader Erin Herbig, D-Belfast, passed the Legislature’s Health and Human Services Committee unanimously on May 25. To become law, the bill must be approved by the Legislature as well as the Appropriations and Financial Affairs Committee and then go before the governor.

Several decades ago, adults with intellectual or developmental disabilities were housed in Pineland, an institution run by the state. As deinstitutionalization took place over a number of years, the state partnered with the private sector to provide care for those leaving Pineland, said Goodwin. Private organizations like CPI based in Biddeford and Waban based in Sanford were created to provide care for these individuals in group home settings in communities around the state.

In 2007, that state set a reimbursement rate to pay organizations providing care. This rate was intended to not only cover staff wages but also pay for administrative and many other costs.

Over the last decade, that rate has declined.

According to Luke Lazure, an analyst with the Legislature’s Health and Human Services Committee, the current rate is 12.5 percent less than the 2007 rate. Taking inflation into account, the rate for 2016, the most current year for which figures are available, is about 32 percent less than the 2007 rate.

“We’re getting 70 cents on the dollar of what it cost us to do business in 2007,” said Waban Executive Director Neal Meltzer.

Herbig’s bill would reset the reimbursement rate to the 2007 rate plus add an additional 10 percent. Meltzer and Goodwin support the bill and are hopeful it will pass.

“It’s not about the money it’s about the service,” said Meltzer.

Currently, because of rate cuts, rising minimum wage and low unemployment, Waban has 40 full-time equivalent staff openings, he said.

Goodwin said his agency also has a large number of unfilled positions.

The two agencies are not the only ones facing a worker shortage.

Providers across Maine are facing a workforce vacancy of over 30 percent, according to the Maine Association For Community Service Providers. In southern Maine, the worker vacancy rate is as high as 50 percent.

Such a vast number of openings makes it increasing difficult to meet the health and safety needs of clients, said Goodwin.

If nothing is done, when the state minimum wage increases in January — as a result of a citizens referendum passed in November — the starting wage for many DSPs will be below that.

“While we were several dollars above minimum wage (in 2007),” Meltzer said,  we will soon be below.

The 2007 average wage rate for a DSP assumed by a DHHS study was $10.37, because of rate cuts today’s hourly wage is it’s $9.17, Goodwin said.

If LD 967 doesn’t pass, filling vacancies will be even more challenging. The work provided by DSPs is more demanding then say working for a food service company, a retailer, or other places that pay the minimum, said Goodwin.

On a typical day, Brown said, she may take clients on an outing or bring them to a doctor’s appointment, administer medication, help with personal care such as showering and brushing teeth, prepare meals and more.

DSPs are also required to go through many hours of training before they are qualified to do their job.

Funding the bill will be a challenge.

If LD 967 is passed, the cost to the state would be an additional $26.5 million from the general fund, the federal government would chip in an additional $57.6 million and an agency provider tax would be $5.4 million, said Lazure.

In part because of the cost, the Department of Health and Human Services opposes the bill, according to department spokeswoman Samantha Edwards.

However, she said in a May 15 email, “During the (May 11) work session the Department said we would be open to talking about the rate increases under the condition that the providers fund it through achieved savings based on their recommendations.”

Reductions by community provides would be extremely difficult said Meltzer. “We have made cuts and leveraged technology as much as we can,” he said.

Goodwin agreed, and added “Cutting staff is not an option,” he said, the services provided by agencies like CPI are “staff intensive,” he said. “We can’t automate.”

He said he and his peers would like to sit down with DHHS officials to discuss how unfunded mandates and redundancies required by the state could be eliminated or reduced to decrease costs, while still ensuring the safety of those in their care.

Despite the high cost, the cost of not passing the bill could be greater. Since the state doesn’t have the capacity to care for adults with intellectual or development disabilities, these people could become homeless and/or end up in hospital emergency rooms or jail, said Goodwin.

“If the bill doesn’t pass,” said Meltzer. “I think instead of agencies just not taking referrals we will have little choice but to shrink.”

— Associate Editor Dina Mendros may be reached at 282-1535, ext. 324, or dmendros@journaltribune.com.

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