SANFORD — Parents and others say a proposed change in assessment that determines levels of service for those with developmental disabilities could result in fewer hours of service for severely disabled clients.

And although there is a mechanism under the new rule proposed by the Maine Department of Health and Human Services that could provide supplemental services to those clients, providers say staff qualifications just can’t be met because of turnover in direct support workers.

For one Maine couple, whose daughter has lived in residential care in Sanford provided by Waban Projects for 16 years, the proposed rule change would reduce their daughter’s care by 41 percent.

Robert and Luann Lawler’s 37-year-old daughter Lindsay requires, and currently receives, 24-hour care. Under the assessment tool Supporting Individual Success proposed by DHHS, Robert Lawler said she would receive only 99 hours a week of residential staff support. The proposal folds five levels of assessment into three levels of funding, a scenario Lawler questions.

DHHS has proposed the rule change based on a process that began in 2011, said department spokeswoman Samantha Edwards. She said DHHS met with families, providers and others to come up with a comprehensive plan.

“This rule change is a way to increase choice and enhance our person-centered planning process,” said Edwards. “No one is losing services. This is not a cost-savings measure.”

Waban executive director Neal Meltzer said there are some positive aspects to the proposed rule change, but there are problems too.

“The premise of the initiative is that the individual who has services would have a pool of services they could draw on, a very positive thing,” Meltzer said. “For many individuals, that is indeed what can happen.”

Meltzer said the proposal put forth by DHHS aligns with the direction Center for Medicaid Services wants services to be delivered. He added, however, that the mechanism that DHHS has built into the proposed rules for those with more significant needs is problematic.

“The staff qualifications being required to provide those services can’t realistically be achieved by providers,” said Meltzer. “The core threshold for those extra services is that the direct support professional has a minimum of three years’ experience.

“Having more experience is good, but it is not aligned with the workforce we have. The average turnover nationally, state and locally is 50 percent.”

Meltzer said Waban copes with high staff turnover by using intensive training, and has a team of behavioral consultants and board-certified clinicians to provide that training, as well as oversight and monitoring.

The second issue, he said, is that reimbursement for the staffer with three years’ service is 18 percent less than the regular rate.

A petition asking the Legislature to intervene has recently been circulated.

DHHS is reviewing comments from a January public hearing on the proposed rule change. The Joint Standing Committee on Health and Human Services, of which Sanford Rep. Patricia Hymanson is a member, heard from parents and others about their concerns with the proposed rule on Jan. 21.

“We have a long list of questions we’re asking the Department of Health and Human Services to answer, and with that comes a dialogue,” said Hymanson. “So we’re hoping they pay attention to our questions and dialogue with us, and that they will comment on every opinion and testimony brought forward to them in the public hearing they had.”

“I am hopeful they answer our (questions) and constituents’ questions, and we’ll move forward into a process that works better and people are more comfortable with, and is better for the client – this vulnerable population who can’t speak for themselves,” Hymanson said.

— Senior Staff Writer Tammy Wells can be contacted at 324-4444 (local call in Sanford) or 282-1535, ext. 327 or [email protected].