Providers and caregivers press lawmakers to restore COLAs and shore up direct‑care workforce

Across a long public‑comment record the committees heard repeated testimony urging restoration of annual cost‑of‑living adjustments (COLAs) and additional funding to stabilize the direct‑care workforce that supports long‑term services, home and community‑based services (HCBS), behavioral health and veterans’ homes.

Jess Fey of the Maine Council on Aging emphasized that prior legislative decisions to set the labor portion of MaineCare rates and to require COLAs helped grow the care workforce and reduce the care gap; she warned that not funding COLAs undermines that progress and leaves tens of thousands of hours of care unfilled each week. "Until we appropriate sufficient funds to ensure steady growth in this workforce and a reduction in the growing care gap, we will continue in a cycle that leaves older, vulnerable people without care," Fey said.

Direct support professionals and program managers from agencies statewide described the physical and emotional demands of their jobs and the difficulty of retaining staff when wages stagnate. Sarah Hunt (Woodfords Family Services) and other DSPs gave examples of high‑acuity care, emergency response and the cumulative toll of trauma and stress. Many witnesses said COLAs are required by existing rate‑setting commitments and argued that predictable adjustments are a low‑cost way to protect services and prevent more expensive crises.

Provider associations, including the Maine Healthcare Association and the Maine Association for Community Service Providers, stressed that nursing home and HCBS reimbursement rates lag the true cost of care. Angela Westhoff (Maine Healthcare Association) said the sector has lost 40% of bed capacity in the last decade and that 35 out of 77 Medicaid‑accepting nursing homes did not receive a 1% COLA previously because of guardrails in the new rate model.

Speakers urged multiple budget adjustments: one‑time state funds to offset HR 1 defunding for family planning and abortion‑related primary care (administration included a proposal on family planning), using federal match smartly for veterans homes, restoring COLAs at the scale needed to reflect minimum‑wage increases and inflation, and modest, targeted one‑time investments to shore up wages while longer‑term rate work proceeds.

Committee members listened and asked providers for concrete numbers and work‑session follow‑up; witnesses promised tables, budget impact estimates and additional documentation on how much state funding would be needed to maintain services and avoid closures. The hearing closed with the committee planning multiple work sessions to reconcile competing priorities and to quantify tradeoffs using the available surplus.