BRUNSWICK

Those who care for some of Maine’s most vulnerable people have reason to be happy Monday, after the Legislature overrode the governor’s veto for increased reimbursement rates for direct care workers.

The Independence Association, a Brunswick based agency that helps children and adults with intellectual disabilities and autism, said they will be reimbursed enough money through MaineCare to pay its support staff minimum wage.

“There’s a good portion of the people that we serve that rely on total care by our staff,” said Independence Association Executive Director Ray Nagel.

That includes clients who may be incontinent, require medication three or four times a day and rely on direct care providers for all their nutrition, toileting and hygiene needs, as well as for mobility.

Nagel noted that those who need the services most cannot advocate for them.

Many have significant behavioral issues, and that means direct care workers sometimes find themselves in harm’s way.

“I just had a woman two weeks ago out of nowhere — a staff member — she got punched in the face and hit with such magnitude, it slammed her head into the wall and she ended up with a concussion,” Nagel said. “This is not uncommon in our field and the public doesn’t see those people.”

Independence Association needs 104 full-time people, and is short by about 20. Nagel attributes this to both a lack of funding and a tight work force. He recently saw Cumberland Farms was offering a wage of $13.50 an hour, “so how can I compete with that?”

What the laws do

LD 924 provides funding for people with intellectual disabilities, while LD 925 funds case management, medication management and other services that support people with intellectual disabilities and mental health issues.

With passage of LD 924, the state will provide enough reimbursement through MaineCare that Independence Association can pay its direct support personnel the $11 per hour minimum wage. The increase was part of a minimum wage law approved by Maine voters in 2016 that will see it climb to $12 by 2020.

The emergency measure had passed with the needed two-thirds majority in the Legislature June 21, before Gov. Paul LePage vetoed it last week. Without the measure, the reimbursement rate would have reverted back to 2017 levels on July 1.

The Portland Press Herald reported last week this would mean an immediate pay cut of 12 percent for workers who care for the 4,000 Maine adults with intellectual and development disabilities, according to Lydia Dawson, executive director of the Maine Association for Community Service Providers.

Nagel said Independence Association has a $10 million annual budget to run 14 group homes, employ approximately 240 staff members and serve more than 400 children and adults with disabilities.

The battle for enough funding to provide competitive wages for employees is not new for Independence Association or the industry. If the veto had carried, Nagel said the reimbursement rate would have dropped from $25.04 to $22.64, equating to an hourly wage of only $9.17. The agency uses the MaineCare reimbursement to cover its employee costs, including health insurance and workers compensation along with an hourly wage. Six percent comes off the top and goes back to the state in the form of a service provider tax.

The first reimbursement rate was set in 2007 and centered on an average direct support professional hourly wage of $10.37. There haven’t been adjustments for inflation.

Last year, Nagel said, “we were $2.73 less an hour than we were 10 years ago, and in reimbursement rates to us for the services we provide.”

Blame wage law

LePage blamed a new minimum wage law for his veto of the bills in his July 2 letter to the Legislature explaining his vetoes.

“Rate change are necessary to attract and keep quality workers to provide care,” LePage wrote. “However, although some of the need for higher reimbursement rates is being driven by the tight labor market — especially in southern Maine, much of the demand is caused by the mandated statewide increase in the minimum wage.”

LePage argued employers need the flexibility to pay market rates to attract workers. While the state could absorb the minimum wage increase to $10, the economy is not starting to overheat now, he said, “and the increase to $11 and $12 push our labor market into new territory.”

LePage had called the proposal a short-term fix. An email to LePage’s press secretary Monday asking what the long-term fix should be, was answered with a link to LePage’s veto letter.

Unlike retailers who can just raise prices to provide competitive pay for workers, agencies like Independence Association are at the whim of the state, and with reimbursement rates dropping for a decade with no adjustment for consumer price index, Monday’s veto override was a small victory.

“I can genuinely and sincerely say that we, as an agency and we as an industry, are very very thankful to all the legislators who understood our plight,” Nagel said. “I’m very fortunate to live in a state where our legislators actually listen to people and if it had not been for all of our family members and providers and the people we serve educating the legislators, this would not have been able to be possible, so I’m really happy.”

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