BRUNSWICK

There is a critical shortage of support professionals, DSPs, in Maine. In the first part of our series, we focused on the lack of funding from the state and its direct correlation to that personnel shortage. In part two of the series, we look at the way the state is looking to cut funding further from those who support individuals with disabilities.

Independence Association Executive Director Ray Nagel explained that agencies currently get paid on a per diem basis — a daily rate.

The way the system currently works is agencies have to staff an individual for 92.5 percent of whatever hours they are authorized by the state to receive. Being in residential care doesn’t automatically imply an individual is authorized 24 hours of care.

If an agency hits 92.5 percent, they receive 100 percent of the daily rate.

“Most agencies like mine, we try to hit like 95 percent. Sometimes we’ll hit more. Quite often with the DSP shortage — we don’t hit the 92.5 percent so they just pay us by the hour as opposed to a per diem rate,” Nagel said.

This doesn’t mean the person being served is unattended for that percentage of time. It just means that there may have been a moment in the day when there should have been three staff in a particular house but were only able to maintain two for a time — akin to a student to teacher ratio at school.

Nagel says the state noticed there’s that 7.5 percent gap between 92.5 and 100 percent and they’re implementing a rule that says that because of health and safety, they are only going to pay agencies for the amount of hours worked as opposed to a per diem basis.

Nagel said the rationale is because they’re concerned about the health and safety of the individuals that are served.

The result, according to Nagel, will be the further erosion of supports they can place in a home for the very reason of health and safety.

Given the annual operational budgets of the 45 agencies statewide are just under $500 million, that cuts $37.5 million from already strained organizations paying their support staff — in the case of Independence Association, an average of $11.16 an hour.

Nagel said he recently spoke with Neil Meltzer of Waban, who has 28 group homes. Meltzer told Nagel these cuts would bankrupt them.

“The system is in absolute chaos,” Nagel said.

Nagel said the state plans to implement the changes via an emergency rules procedures and there are no plans of having this come up for public comment.

Department of Health and Human Services spokeswoman Samantha Edwards claims the department has no intention of changing their funding model and calls claims of an upcoming emergency ruling “false.”

Further, Edwards said the hourly rate of $23.32 provides agencies such as Independence Association and Waban ample funds to pay their DSPs more. DHHS did little to expand on their position, but added it’s up to the agencies to act on hiring and retention on their own.

Despite claims from DHHS that policies will not be changing any time soon, agencies are banding together to head off what they see as an imminent crisis.

“The way we’re proceeding now — DSPs if we can’t get higher rates, literally, agencies are going to be shutting down all over the state,” Nagle said. “It’s reached a crisis point and the state is now trying to operate — they’re trying to do an emergency rule procedure to slash our funding even more from a different perspective.”

Speaking for his own agency, Nagel said DSPs need a minimum of $12 an hour starting wage to do the job they are charged with.

That lack of help also means many DSPs are working overtime, practically living in their programs. Nagel said he had a $12 per hour DSP make $67,000 because of overtime.

Had the base pay been higher, he would have been able to hire more help and not dip into time-and-a-half. Instead, the extra pay came out of the agency’s operational budget.

Another rising issue with agencies is the changing minimum wage. Mainers on Nov. 8 approved a referendum that will gradually increase the state’s minimum hourly wage from $7.50 to $12 by 2020. However, there’s no plan to increase state funding to cover the amount.

Nagel said he has rallied the advocates he partnered with to beat the SIS last year and will be taking on a three-prong approach to attack this round of cuts.

“We’re attacking it from a legal position, a PR position and legislative position. Unfortunately, any type of legislation that goes through — it’ll be vetoed by the governor,” Nagel said.

Nagel said the irony of the situation is that Maine used to be thought of as a leader in the provision of services to people with intellectual disabilities.

“For the last 20 years, they’ve been thought of as that and we’re just regressing quicker than you can possibly imagine. I have no idea why,” Nagel said.