DHHS seeks to boost pay for workers who care for disabled Mainers - Press Herald

The Mills administration is asking federal regulators for authorization to boost pay rates for thousands of workers who provide home- and community-based services to Mainers with autism or intellectual disabilities.

These “direct care” workers were not included in an emergency funding package the Legislature passed in March that increased MaineCare reimbursement rates for other workers who help care for home-bound senior citizens. As a result, agencies that care for individuals with intellectual disabilities have been struggling to support or retain the often lower-paid workers whose services have become even more critical — and challenging —during the coronavirus pandemic.

The Maine Department of Health and Human Services is requesting a waiver from the federal government that would allow the agency to increase reimbursement rates for direct care workers by 10 percent. The reimbursement rate request, which would cost $13 million in state and federal funds, would be retroactive to March 1 and extend through May.

“Adults with disabilities and older Mainers continue to rely on these vital services and the direct support professionals who provide them in the face of this pandemic,” DHHS Commissioner Jeanne Lambrew said in a written statement. “We join the majority of states in seeking this flexibility and support from the federal government to ensure that more than 5,600 Maine people continue to be supported in their homes and communities throughout the state during this public health emergency.”

Some service providers have been critical of DHHS for not doing more to support the agencies and staff that help care for individuals with intellectual disabilities, brain injuries, autism or other disabilities. Many direct care workers earn minimum wage or slightly more, despite the emotional and physical demands of the jobs.

Those challenges have only increased during the COVID-19 crisis as staff continue to care for clients, whether in their homes or in group homes. Agencies also report shortages of the personal protective equipment, such as masks and gloves, needed to reduce the risks of transmission of the COVID-19 disease.

The agencies that provide home-based care to thousands older Mainers or residents with intellectual disabilities have been facing a workforce crisis for years. The financial crunch has been exacerbated by the fact that MaineCare reimbursement rates have not kept pace with the 60 percent increase in Maine’s minimum wage in four years and other mandates that drove up provider costs.

The Legislature approved a reimbursement rate for other home-care and personal support specialists in the spring as part of an emergency package of coronavirus bills. Mills then bumped up the timeline for the pay increases by three months in order to help workers and their employers during the pandemic.

But DHHS has said that federal guidelines require a comprehensive rate analysis before the department could enact a similar reimbursement rate increase for direct-care workers who serve individuals with intellectual disabilities.

The waiver request filed this week with the U.S. Centers for Medicare and Medicaid Services will provide DHHS with the flexibility to provide the temporary rate increase, which could be used to provide hazard pay to workers.

This story will be updated.

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