On Jan. 29, Home Care for Maine announced it was closing its doors. That means nearly 600 older Mainers could lose their access to care at home, and 360 people will need to find new employment. This is not simply one organization shutting down. This is a symptom of a much larger problem. This is a crisis, and we must respond.
The crisis is one of reimbursement rates and a workforce shortage. This fall we worked together as part of the Commission to Study Long-Term Care Workforce Issues to come up with recommendations to address the shortage in the caregiving workforce. This shortage affects older Mainers and people with physical and intellectual disabilities who receive services in order to allow them to live as independently as possible.
While there are issues across policy areas that can affect all of us as we age, we are often concerned about how we will maintain our independence and who will help us care for ourselves. That concern is not baseless – 52 percent to 70 percent of individuals turning 65 today will eventually need some form of assistance with the activities of daily living. Unfortunately, the size of the workforce that can provide those services is dwindling.
This is an issue across the long-term care continuum from home- and community-based services for older adults to adults with physical and intellectual disabilities and includes our residential care facilities and nursing homes.
The top line is this: There is a significant shortage of long-term care workers, and that gap is expected to grow.
There are a set of actions we recommend to address this problem. In fact, our commission issued a report that outlines 29 recommendations that we hope the Department of Health and Human Services and the Department of Labor will consider, including improving recruitment methods and better training workers. But there are two important recommendations we are proposing for immediate legislative action.
Our first recommendation addresses the largest driver of the shrinking workforce: unsustainably low wages. Caring for an aging or disabled person is hard work, and it takes a special kind of person to do that work well. It is crucial that we value the work of our caregivers and increase job quality and compensation. We are proposing a starting wage for direct care workers that is no less than 125 percent of the minimum wage.
We are encouraged to hear that DHHS has started the work needed to set rates in a sustainable way. The piecemeal way that the Legislature and the department have set rates in the past has led to a patchwork of rates that don’t keep up with rising costs, including the increase in the minimum wage and mandates like electronic visit verification. When the review is complete, we feel confident it will be obvious that rates need to change.
Our second immediate recommendation is to institute an ongoing, independent oversight committee to review progress in implementing the recommendations of this commission. That committee will address barriers to implementation and make new recommendations as needed.
Many of the recommendations from our commission are similar to those of the Direct Care Worker Task Force, which met in 2010. Many of the 2010 findings have not been fully implemented. We must ensure that this time around, our crucial recommendations won’t sit on a shelf.
If Bath Iron Works were to lay off 400 workers, or if a hospital with 600 beds closed its doors, it would trigger immediate action. The closure of Home Care for Maine should be treated the same way. Maine’s older adults and people with physical and intellectual disabilities are counting on us. Any delay in expanding the long-term care workforce in our state will put Mainers at risk. We must act now.
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