Maine hearing on LD 19 32 draws broad support from direct care workers and providers; state warns of large fiscal cost

A joint standing committee on Health and Human Services heard hours of testimony on LD 19 32 on a measure that would increase the labor portion of MaineCare reimbursement for direct care and support workers to 140% of the statewide minimum wage and require those workers be paid at least 125% of minimum wage.

Speaker Brian Fekto, identified in testimony as sponsor of LD 19 32, told the committee the bill responds to a persistent staffing crisis and uses prior study findings to guide implementation. "Direct care workers care for us, and we should care for them," he said, describing the proposal as bipartisan and aimed at stabilizing a workforce that supports older Mainers and people with disabilities.

Why it matters: Multiple witnesses testified that Maine lacks enough direct support professionals (DSPs) and other essential care workers to meet approved service hours. Providers, family members and national advocates described program closures, cancelled shifts and thousands of unmet hours of care each week. Testimony included estimates that about 8,000 Mainers are out of the paid workforce because of unpaid caregiving responsibilities, a figure witnesses tied to an annual economic loss they described in the testimony as roughly $1,000,000,000.

Workers and advocates urged the Legislature to secure higher, predictable wages and to modernize training and credentialing. Jennifer Poirier, a cosponsor and community living coordinator, described how higher pay would stabilize services and preserve independence for people with disabilities. Frontline staff and providers described daily harm from turnover: missed community activities, single-staffed shifts and burnout. "This bill is a matter of life and death," testified Jessie Matheson, a family member and direct care worker, describing episodes she attributed to understaffing and low pay.

Key provisions and policy design: Testimony and the sponsor's amendment focused on three connected pillars: raising the labor reimbursement rate (to 140% of minimum wage), establishing a wage floor for direct care workers (no less than 125% of minimum wage), and improving training, credential portability and data collection so the state can budget for future care needs. Witnesses from provider networks and advocacy groups also urged the committee to include home health sections explicitly referenced in MaineCare policy so all home-based providers are covered.

Department concerns and fiscal estimate: The Department of Health and Human Services, while expressing support for workers, testified in opposition to the bill as drafted because of fiscal and implementation risks. Director Probert told the committee the estimated fiscal impact of moving the labor component from 125% to 140% would be "about $140,000,000 all funds," which the department said would be roughly "$55 to $60 million" in general funds. The department also warned the committee that implementing widescale rate changes would require substantial administrative capacity and appropriations and that the bill lacks a robust enforcement or reporting mechanism to ensure rate increases are passed through to workers.

Areas of consensus and outstanding questions: Witnesses and providers agreed on the scale of workforce shortages and the need for changes to wages, training and data. The Department and providers cautioned that rate adjustments must be paired with appropriations and a phased implementation plan; several providers said they had already used past increases to raise DSP wages and that any new increase must be funded so organizations do not operate in deficit.

Next steps: The committee closed the public hearing without taking a vote and requested additional information, including state-by-state comparisons of pay and further fiscal detail, for a work session. Representative Dan Shugori and other members asked analysts to compile comparisons of direct care pay in other states and the committee scheduled follow-up work before formal action.

Provenance: The committee opened testimony with sponsor remarks and accepted extensive in-person and Zoom testimony; the sponsor introduced the bill at the start of the hearing and the Department delivered its formal opposition near the close of testimony. The hearing was closed for work-session preparation with no formal vote recorded.