The Legislature averted a crisis for about 4,000 Maine adults with intellectual disabilities who are living in group homes or receiving other Medicaid services with unanimous votes Thursday to increase reimbursement rates for direct care workers, officials with nonprofits said.

“We are very, very happy. We’re ecstatic,” said Ray Nagel, executive director of the Independence Association, a Brunswick nonprofit that operates about 15 group homes.

Maine’s workforce shortage, combined with low wages for direct care workers, was making it increasingly difficult to find employees, threatening the survival of the group homes, advocates said. The low reimbursement rates also imperiled other programs for adults with ID, such as day activities and work programs or in-home services that help people with daily living tasks.

Gov. Paul LePage hasn’t indicated whether he will sign or veto the bill, but because lawmakers voted for it unanimously, the bill was approved with veto-proof majorities.

Nagel said if the bill hadn’t passed, the Independence Association would have had to immediately close six of its 15 group homes, and there would have been a similar crisis statewide.

Lawmakers adjourned May 2 without funding the reimbursement rate increase that they had agreed to earlier in the session. The issue was caught up in a partisan fight over funding Medicaid expansion, when House Republicans refused to provide the votes to extend the session. But a special session was called last week to take care of unfinished business.


Before the special session was called, social service agencies were left in limbo as a June 30 cutback in reimbursement rates that would have cut wages for direct care workers loomed.

Rates were set to revert to 2017 levels on July 1, which meant nonprofit agencies that operate the group homes would have been reimbursed the equivalent of an employee earning $9.17 an hour, less than the $10 minimum wage. In order to keep employees working, the nonprofit agencies would have had to use other funding sources just to pay their workers minimum wage.

Agencies were competing with other minimum wage employers where often the work is much easier, compared to the challenging and stressful job conditions that direct care workers face, advocates have said.

Lawmakers approved a temporary measure last year that increased the reimbursement rate to $10 per hour, but that was intended as stopgap funding while looking for a permanent solution, and those rates were due to expire on June 30.

Instead, if the bill, L.D. 924, is signed into law, rates will be raised to the equivalent of $11 per hour, allowing agencies to pay slightly more than minimum wage.


Maine voters approved a minimum wage increase in November 2016, and the minimum wage will increase to $12 per hour by 2020.

The bill also builds in a rate review every two years to see if rates need to be increased to keep the group homes operating.

The group homes serve adults with intellectual disabilities with the most acute conditions, and there are about 1,800 living in the group homes, with a waiting list of 1,700.

A decade ago, there were only about 100 people on the waiting list, but back then, direct care workers were earning about $3 more per hour than minimum wage, and agencies didn’t have problems staffing the group homes.

Group homes and other services for adults with intellectual disabilities are funded through Medicaid, which is a blended federal and state program. The states operate Medicaid and set reimbursement rates for services.

The bill would cost taxpayers $26 million in state funds plus an additional $55 million in federal funds to increase the reimbursement rates.


Lydia Dawson, executive director of the Maine Association for Community Service Providers, which represents the nonprofit agencies, said the votes were a big relief.

“This will help us stabilize the system,” Dawson said. “We are extremely thankful that the Legislature came back and passed this legislation. We avoided a huge crisis.”

Joe Lawlor can be contacted at 791-6376 or at:

Twitter: joelawlorph

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