The Maine Bureau of Insurance recently issues its long awaited report Health Insurance Coverage for Maine’s Direct Care Workers (pdf) and recommends the development of a pilot program to cover a segment of the direct-care workforce. The report was the work of a working group convened over the summer by the Superitendent of Insurance at the direction of the Insurance and Financial Services Committee. Several direct care workers, providers and advocates participated in the group. Continue reading ‘Maine Bureau of Insurance Recommends Pilot Program for Health Insurance’
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I hear it all the time when I talk to co-workers. “We need health insurance,” they always say to me. The drawback is the funding. With Maine’s budget the way it is, I honestly will be very surprised to see if the Legislature follows Ms. Kofman’s recommendation on the pilot. But I am hopeful.
The Bureau of Insurance report on options for providing health insurance to Maine’s direct care workers is finally complete and recommends that a pilot program be developed for covering direct care workers in our state. Having been involved in the process of producing the report, I think the recommendation of a pilot is great as it would be a way to show employers and policy makers that health insurance is important to this workforce.
Continue reading ‘My View: Helen Hanson on Advocacy and the Maine Report’
Last Wednesday, the summer working group heard presentations on four models for health care coverage, three for members of a specific workforce and one for employees of small businesses. It also heard an argument for tailoring a health care plan to address obstacles encountered by all low-wage workers, not just one particular workforce.
Continue reading ‘Maine: Coverage Models Presented to Summer Working Group’
At its last meeting, the Direct Care Worker Coalition (DCWC) expressed a desire to return its discussion with the state’s Bureau of Insurance (BOI) to specifics. The goal is to build a better understanding of why this workforce deserves special consideration — and of the challenges the BOI group has to grapple with.
Following up on those wishes, Elise Scala took the initiative to build an agenda, in conjunction with Bureau of Insurance staff, for presentations to the BOI on the direct-care workforce.
Using the full two hours of the latest summer BOI meeting, members of the DCWC presented information on:
- the composition and importance of the direct-care workforce
- the results of various surveys
- the obstacles faced by direct-care workers in obtaining health insurance
- the testimonials of specific providers, consumers, and workers.
Continue reading ‘Maine Worker Coalition Members Make Their Case to the Bureau of Insurance’
A testimonial by Helen Hanson, a home care worker in Maine.
I am Helen Hanson, a direct-care worker with Home Care for Maine. I have been working at my home care job for five years. I help keep elderly folk living in their homes. I help them with grocery shopping, taking them to medical appointments, to the bank, getting errands done. I help them keep their homes clean and tidy. I also help them with personal care like bathing and dressing.
They look forward to my visits every week. I look forward to seeing them too. I enjoy their company and I enjoy this job. Continue reading ‘Living With the Threat of Cancer’
Health Care for America Now, a national grassroots campaign seeking to win affordable, quality health care for all Americans, launched on July 8 with events across the country. PHI’s Health Care for Health Care Workers campaign recently joined the new campaign.
In three key HCHCW states, HCHCW staff and partners participated in launch events, seizing the opportunity to focus attention on the health care needs of direct-care workers:
- Pennsylvania. HCHCW Community Organizer Simone Baer spoke about the thousands of direct-care workers caring for the state’s most vulnerable citizens who lack health care coverage of their own. The event was covered by the Pittsburgh Post Gazette.
- Iowa. Iowa’s HCHCW partner, the Iowa CareGivers Association, participated in the launch on the steps of the state capitol. The ICA is one of 18 initial members of a growing campaign in Iowa that is working to assure that the next President and Congress pass legislation guaranteeing quality, affordable health care for all. ”As a key battleground state in the Presidential election, Iowa will be a focal point for debate over the respective candidates’ plans to reform the health care system,” said ICA Policy Director John Hale. “The ICA and direct-care workers will be involved in those debates, and will insure that the candidates recognize the unique needs of direct-care workers in getting and keeping adequate and affordable health care coverage.”
- Maine. Helen Hanson, a direct-care worker from China, Maine, represented the Maine Direct-Care Worker Coalition, a HCHCW partner, at the launch event on the steps of her state’s capitol. Helen spoke of her struggle with health care bills after routine tests that were not covered by her catastrophic coverage plan. Another HCHCW partner, the Maine Center for Ecomomic Policy, also participated in the launch event, which was covered by the Portland Press Herald.
Things will be heating up as the Presidential campaign moves toward November. Visit the Health Care for America Now website to find out how you can get involved.
Allison Lee, HCHCW National Campaign Manager
alee@phinational.org
While the first BOI meeting was largely a round of introductions and a broad overview of the work ahead, at this last meeting BOI staff delved into the nitty-gritty of the Maine Insurance Code. The point of this exercise was to see if there was already an existing model/structure that would allow the Direct Care workforce to organize some kind of insurance purchasing pool or entity that could acquire coverage through the private markets (or form their own, independent insurance pool that essentially would act as an insurance company specifically for Maine’s direct-care workers (DCWs). Continue reading ‘Update on Maine Board of Insurance Workgroup Meeting’
On June 17, the first meeting of the summer working group organized by Maine Superintendent of Insurance Mila Kofman was convened. The working group was established to look into how affordable health coverage can be made available to all of Maine’s direct-care workforce.
The first meeting was a useful start. A somewhat formal set of introductory remarks set out the scope and intent of the summer’s discussions. The meeting was attended by several members of the Direct Care Worker Coalition (DCWC), including Helen Hanson, Joyce Gagnon, Mollie Baldwin, and me. There were also representatives from Harvard Pilgrim, the Maine State Chamber of Commerce, MaineCare/DHHS, Dirigo Health, and the Governor’s Office (Karynlee Harrington and Trish Riley), as well as five or six members of the Bureau of Insurance (BOI) staff.
Senator Sullivan of the Insurance and Financial Services Committee and Representative Campbell of the Health and Human Services Committee also attended, both speaking at length and in strong support of direct-care workers and the need to find a real solution to the question of affordable coverage. Continue reading ‘Maine Seeks New Solutions to Health Care Coverage for Workers’
The departure of Lisa Pohlmann from the Maine Center for Economic Policy has left the Maine HCHCW campaign with a new leader. Kurt Wise, who recently joined MECEP as its fiscal policy analyst, is the new facilitator of the Maine Direct Care Worker Coalition and co-leader – along with Barbara Asnes of Maine PASA – of the Maine HCHCW campaign.
“The HCHCW campaign is grateful to Lisa for her passion, policy acumen, and effective leadership,” said Allison Lee, national campaign manager for HCHCW. Pohlmann was instrumental in raising the awareness of the direct-care workforce among legislators and administrators, helping to move the state toward implementing policies to improve the quality of direct-care jobs. She left MECEP on January 14, after 13 years of service, to become deputy director of the Natural Resource Council of Maine.
After being kept alive with the help of Maine PASA (see below), LD 1687 was considered by the Health and Human Services (HHS) Committee on October 30. Committee members voiced considerable support for improving compensation for direct-care workers, but the state’s revenue situation remains gloomy, with significant revenue shortfalls forecast for 2008.
As a result, the Direct Care Worker Coalition recommended removing the MaineCare demonstration program, which was not likely to be recommended for funding, and asking the Insurance and Financial Services (IFS) Committee to conduct a hearing on the Dirigo Health proposals in the bill next session. These proposals also require funding subsidies for low-income direct-care workers, but they may be considered as part of the larger debate on continuing Dirigo Health funding.
Key members off the IFS committee have expressed their support for the bill, and several HHS committee members have agreed to testify before the IFS committee in favor of the Dirigo revisions. The Direct Care Worker Coalition is now planning its advocacy work with the IFS committee and other members of the legislature when they convene in January.
An initiative launched last fall by Maine PASA to raise legislators’ awareness of direct-care workers and to get direct-care workers involved in helping to shape the state’s legislative agenda appears to have helped keep alive LD 1687, a bill that would extend health insurance to more Maine workers.
Joyce Gagnon, who spearheaded the effort, called other Maine PASA members and asked if they’d be willing to call or write to their legislators. “We asked to talk to them about the specific kind of work they did and the skills they used to do it, because there are so many kinds of direct-care workers out there. We asked them to talk about health insurance: did they have it? We asked them to talk about what effect not having it – or having it – had.” They also asked for support of the bills then in session that would help direct-care workers, which included LD 1687.
The effort, says Gagnon, raised awareness of direct-care workers and their issues among legislators who often had not know exactly what they did or how many there were. “It brought an awareness that here are a group of people that are working under very extreme conditions. It also brought an awareness that PASA itself was standing up and saying, hey, you got to do something. And it brought PASA members an awareness that legislators would listen to them and they could get something done.”
Roy Gedat, the executive director of Maine PASA when the initiative was launched, agrees. Talking to legislators after the calls were made was a different experience than it had been before, he says. “When we went to the legislature this session, they already knew about us. They were very receptive to what we had to say.”
Maine PASA plans to continue the initiative indefinitely as new bills and opportunities emerge, and as new people are elected to office. “I think it was a great start and we need to continue doing more,” says Barbara Asnes, Maine PASA’s new executive director. “I don’t think most legislators have a clear idea of what it means to be a DCW. They hear multiple stories; they believe what they believe. And I think we’re in an excellent position to make it clear from the workers’ point of view.”
One of the thing the organization plans to ask legislators next term, Asne says, is “to consider, even if they can’t do full-fledged [family] health care, to allow some kind of funding or subsidies so people can at least get individual coverage.”
In another indication of Maine’s heightened awareness of the direct-care worker crisis, a recent Kennebec Journal Morning Sentinel article about an awards ceremony for exceptional caregivers focused largely on the need for better pay and benefits for direct-care workers.
The article, which ran in the August 16 issue, quotes state long-term care ombudsman Brenda Gallant on the poor pay and benefits typically available to workers. “Here we have caregivers who oftentimes can’t get care themselves,” she says. “They don’t have health insurance.” Lisa Pohlmann of the Maine Center for Economic Policy and the Maine Health Care for Health Care Workers campaign echoes Gallant’s comments. “We’re taking care of the elderly on the backs of low-income women,” she says.
LD 1687, An Act to Increase Health Care Coverage for Front-line Workers in Long-term Care, was still alive when the Maine legislature wrapped up its 2007 session. The bill, which would create a pilot program to increase health care access for direct care workers, has been carried over to the session that convenes in January 2008. Meanwhile, a legislative committee of House and Senate members will study Maine’s Dirigo Health insurance program over the summer in hopes of arriving at an agreement and a means to provide additional funding to continue the program’s growth.
The Maine Direct Care Worker Coalition worked hard to promote both bills and to ensure that they meet the needs of direct-care workers. The coalition is regrouping this summer to consider various study mandates regarding this workforce from the session and to develop strategies for moving its proposals forward in January.
The coalition’s campaign began in 2006, with the passage of a study bill to look at direct-care worker wages, health care options, and an expanded worker registry. Its March 2007 report (pdf) was favorably received by the legislature’s Health and Human Services Committee, which called it “just the kind of information we need.”
The reception to LD 1687 was positive as well, but legislators decided against adding new costs to the already strained MaineCare budget to fund it. However, there may be opportunities for new spending in the supplemental budget passed next year.
Coalition members also had productive meetings with the legislature’s Insurance and Financial Services Committee, resulting in a proposal for a pilot project within Dirigo to address the needs of low-wage part-time workers, with direct-care workers specifically named as a target group. However, the legislature adjourned without taking action on Dirigo Health because consensus could not be reached on certain contentious issues and no action was taken to commit the funding needed to continue to grow the program. In addition, the spiraling costs of health insurance in the individual market, where almost half of Dirigo members are covered, limits the coalition’s ability to press for coverage of new direct-care workers who need the discounts provided to low-income beneficiaries.
The legislature also passed several other bills to strengthen the state’s direct-care workforce this year. Actions included:
- Raising reimbursement rates to increase wages for homemakers;
- Mandating a planning process for the first phase of expanding the CNA registry; and
- Making direct care workers who are hired by for-profit, third party employers eligible for minimum wage and overtime.
–By Lisa Pohlmann, associate director of the Maine Center for Economic Policy and facilitator of the Maine Direct Care Worker Coalition.
After long deliberations, members of Maine’s Health and Human Services Committee voted to carry forward LD 1687, a Health Care for Health Care Workers bill, into the 2008 legislative session. They also voted to send the provisions of the bill to the Insurance and Financial Services Committee for consideration with a strong recommendation that the IFS committee look closely at the bill’s proposals and report back to the HHS in January 2008 with ideas on helping the direct-care workforce. The Health Care for Health Care Workers campaign considers the outcome to be a positive development.
Leaders and members of the Health Care for Health Care Workers initiative in Maine are focusing media attention on the need for better health coverage for direct-care workers.
An editorial by Joyce Gagnon of the Maine Personal Assistant Service Association (Maine PASA) cites facts from Direct Care Workforce: Wages, Health Coverage, and a Worker Registry, to explain the importance of the state’s direct-care workers. Gagnon urges support for several pending bills which would increase direct-care workers’ wages or benefits. Her editorial was published in the April 27 Bangor Daily News.
A May 3 article in the Morning Sentinel outlines Maine’s growing care gap, describing direct-care workers as the people “who keep the direct-care industry — more than 22,000 people who provide hands-on health assistance to the elderly, adults and children with disabilities — from collapsing.” One key to stabilizing the workforce, notes staff writer Colin Kickey, is providing health insurance. “If you look around at who is going to be going to be taking care of you as you age or should you become disabled, you will find there are not enough people do that work,” says Senate President Beth Edmonds, the sponsor of LD 1687, “and the ones that are there are dedicated, loyal folks who given the wage structure, and given the lack of health insurance, can’t persist in these jobs.”
And in an article in the May 6 Kennebec Journal, Hickey writes about the work the Kennebec Valley Organization is doing to promote LD 1687 and other initiatives to support direct-care workers.
The Health Care for Health Care Workers team in Maine was featured in “State of the State,” a weekly television show on Maine policy issues. The show was hosted by HCHCW leader, Lisa Pohlmann, associate director of the Maine Center for Economic Policy (MECEP) and facilitator of the Maine Direct Care Worker Coalition. Guests on the show were: State Senate President Beth Edmonds, the lead sponsor of legislation to provide direct-care workers access to health benefits; Susan Rovillard, a direct-care employee; and Roy Gedat, the executive director of Maine Personal Assistance Services Association (PASA).
Guests described the ongoing problem of finding and keeping frontline workers in nursing homes, residential care, and home care. They discussed several legislative initiatives aimed at improving recruitment and retention, such as LD 1687, the health insurance bill. The show, titled “Proposals for a More Stable Direct Care Workforce” can be heard in audio format on the MECEP website.
A testimonial by Joan D., a home care agency owner in Maine:
I know that providing health insurance would help me retain workers. One of my full-time aides who needed coverage prompted my search for insurance by letting me know she would have to seek employment elsewhere if I was unable to offer it in the near future.
The instability of hours is the biggest challenge for direct care workers: if I don’t have work for them, I can’t afford to pay their health insurance. What we really need in this industry is to make health benefits portable, so they can move with them as they move from agency to agency.
A testimonial from Tina, a home care worker in Maine:
My name is Tina, and I provide home based care for Eunice from 10 at night until 7 in the morning. Then, from 8 in the morning to 1 in the afternoon I go to my other job at a developmental disability agency in town. Continue reading ‘I Can’t Afford to Get the Care I Need’
A testimonial by Eunice Spooner, a home care consumer in Sidney, Maine:
My name is Eunice Spooner, I’m a member of First Congregational Church in Waterville, and I live in Sidney. I was a school teacher until a car crash left me a quadriplegic and confined to a wheelchair over 20 years ago. Since then, I have had many blessings in my life – wonderful family, friends, and caregivers, the chance to be a deacon at church, a volunteer at the Atwood Elementary School, and a member of the SAD #47 School Board. Still, the fact is that I cannot get through my day without a lot of assistance throughout the day, from getting up, doing light housework, driving to appointments, going me to bed and even using the bathroom. Continue reading ‘Worries About Losing Her Caregivers’
A testimonial from Iya’Negra L., a certified nursing assistant in Maine:
I am a certified nurse aide who has worked in several different nursing homes. In 2004, I had health insurance coverage for six months, which covered my three girls and me. It cost $174 per pay period, but this became too expensive for me. After rent and all of the other basic household expenses I wasn’t making ends meet. So I dropped the health insurance. Continue reading ‘Health Problems Kept Me Away From Work’
Maine State Senate President Beth Edmonds introduced legislation to increase access to health care for direct-care workers. The bill, LD 1687, expands the definition of businesses eligible for DirigoChoice, the state’s health care program, to include state-funded long-term care providers that have more than 50 employees.The bill makes DirigoChoice coverage available to home care workers who work part-time and are not eligible for Medicaid or employer-sponsored health insurance. It also establishes a demonstration program to increase health insurance coverage among direct-care workers at agencies that get funding from Medicaid or other state long-term care programs.
PHI’s Health Care for Health Care Workers campaign is working closely with the Maine Coalition to pass LD 1687 this session.
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