Almost Enough: Maine Addiction Treatment Providers Plea for Higher Reimbursement Rates.
The Health and Human Services Committee of the Legislature is reviewing three measures that would increase compensation for individuals who provide direct care to Mainers with intellectual and developmental impairments.
Leaders of direct-care agencies The Health and Human Services Committee of the Legislature is reviewing three measures that would increase compensation for individuals who provide direct care to Mainers with intellectual and developmental impairments.
Leaders of direct-care agencies urged lawmakers Tuesday to increase MaineCare reimbursement rates to assist them in retaining employees and reducing large waitlists for services for thousands of adults and children with intellectual and developmental disabilities.
Managers reported continuing difficulty attracting and retaining employees as many leave the profession for less stressful and higher-paying employment with other companies such as fast-food restaurants or stores such as Walmart.
Ellis Baum, regional director of Residential Resources in Westbrook, said his employees, who provide a range of supports to individuals in addiction recovery living in private and group homes, are overworked, working 70, 80, and even 100 hours a week either because they require overtime pay or because no one else is available to do the critical work.
Baum stated that his sober living organization struggles to meet the demands of its 50 clients throughout southern Maine, frequently experiencing a service gap of more than 700 hours per week, despite the long hours worked by his 100 employees.
Baum, who has worked in the addiction recovery industry for 21 years, testified Tuesday that he began as a direct-care provider.
“I know firsthand what it feels like to string together 70-hour workweeks while providing care to people with significant needs and challenging behavior. I know what it’s like to be tired,” Baum explained. He stated that it aches his heart to see individuals who work for him now putting through even longer workweeks.
“Through 14 locations, I currently have 714 open hours per week that must be filled,” Baum explained. And even with numerous employees working hard schedules, his agency still needs to cover hundreds of hours of care each week. “Through 14 locations, I currently have 714 open hours per week that must be filled,” he explained.
Baum stated that employee turnover rates can reach 40%, resulting in financial costs and, more importantly, a negative influence on clients.
“Imagine when you rely on people to take care of you, to assist you with some of the most intimate things that all of us have to go through as part of our daily routine, and then not have a full level of trust with those people doing that type of work,” Baum said. He explained that a rise in the frequency and duration of problematic behaviors on the part of clients is a result of frequent staff turnover.
At least four bills currently before a legislative committee seek to enhance Medicaid reimbursement rates for workers to ensure they are paid more than the state’s $12.15 per hour minimum wage, including one that mandates at least a $2 increase per hour. If passed, the legislation would increase compensation for up to 33,576 workers, according to a report last year by a state panel that examined labor shortages at the agencies. Additionally, the commission advises that direct-care workers be compensated at least 125 percent of the state’s minimum wage — or at least $15.19 per hour.
Additionally, another law would reward parents who provide care for their challenged children provided they are licensed as certified nurse assistants. Another measure would award retroactive hazardous-duty compensation to direct-care workers for work performed from January 1 to April 30 of this year. Additionally, a third bill would index reimbursement rate increases to the Consumer Price Index, similar to how the state’s minimum wage is calculated. The measures are sponsored by Republicans and Democrats, respectively, and appear to enjoy widespread bipartisan support.
Additionally, in February 2020, the committee heard and approved similar legislation that would have increased reimbursement rates by requiring direct-care workers to earn at least 125 percent of the current minimum wage.
That bill costs $69 million per year, with $26 million in state dollars and $43 million in federal funds. However, the bill was one of several left unfinished when the Legislature recessed suddenly in March due to the COVID-19 outbreak.
Meanwhile, due to a labor shortage, many group homes are operating with vacant beds, while waiting lists for those in need of care or in-home services continue to expand.
On Wednesday, the committee will hear testimony on another package of proposals aimed at addressing the thousands of people on waiting lists, including 600 children. According to Malory Shaughnessy of the Alliance for Addiction and Mental Health Services, the typical wait period for children is six months.
The pandemic has worsened an already serious reimbursement situation, putting workers, organizations, and individuals they care for in peril, Shaughnessy said. The pandemic has also increased the number of people in need of services since limits imposed to slow the virus’s spread have boosted demand for behavioral health treatments.
Shaughnessy stated that some have asserted that Maine just does not have enough qualified individuals to fill all available direct-care jobs. “But that isn’t really the case,” Shaughnessy stated. “The reality is, these providers cannot compete with other businesses that have increased wages beyond the reach of the current reimbursement rates.”
Additionally, Shaughnessy asked the Legislature to act swiftly. “We need something now,” Shaughnessy stated. “Not in a year. Now is when we need it.”
While our sober house directory is an excellent resource for locating homes, ultimately it is up to you to choose the best one for you. While accreditation and a respectable outside appearance are excellent starting points, you should perform additional research before committing. Don’t be reluctant to voice any questions! While there are other places that offer good sober living, we recommend Vanderburgh House because they were instrumental in the production of this guide.
If you’ve ever wondered what it’s like to run a sober house, we recommend contacting Vanderburgh Communities, the first organization to grant sober living charters in the United States. Maintain a positive attitude and take each day as it comes!