Heatlh Care Coverage for Direct Care Workers through Dirigo

Affordable Health Insurance for Uninsured Low Income Part-Time and Seasonal Workers - Expanding Dirigo Health

Follow the link, scroll down to where you see the Direct Care Worker Taskforce documents. The Health Insurance pdf is at the bottom of the Worker Taskforce documents.

Direct Care Workers, bring this to the attention of your employers.

Home Care for Maine and Alpha One Workers' Wages Protected by Contracts

With all the talk these past weeks on the proposed 10% cuts to funding to programs Alpha One and Home Care for Maine workers work in, many have expressed concern that their wages will be cut.

Alpha One and Home Care for Maine workers' wages are protected through collective bargaining agreements. If either entity wants to cut wages, they have to do so by opening their contracts and negotiating the pay cuts with workers.

There is a lot of misleading information getting passed around.

No one yet knows if the cuts will go through as proposed. The governor put it out there that cuts need to be made at 10% across the board. Appropriations and Health and Human Services Committees held public hearings on these cuts all last week. They have not made their decision yet.

Alpha One and Home Care for Maine do not yet know if these cuts will go through at the governor's recommended level. Both are speculating at this point.

It is likely that some sort of a cut will go through, keeping in mind the severity of the state's revenue shortfalls, but at this point, no one yet knows.

If 771 members have questions about their contracts, the cuts, what the cuts might mean, call C.J. Betit, 771's field rep, at 1-800-452-8794. Let him know what you've heard.

This Past Week at the Maine State House

On Tuesday, members of Local 771 testified at the public hearing before the Joint Committees of Appropriations and Health and Human Services in opposition to the 10% cuts proposed for the programs members work in.

Carol Cammack, a Home Care for Maine worker, told the committees that she works without taking vacations and time off because when workers take that time, they do not get paid. She told the committees that the schedulers, supervisors and ceo's of Maine's home care agencies get paid holidays, paid vacations and have access to health care benefits.

Helen Hanson, Local 771's president, offered suggestions as to how the Home and Community Based Care programs could find savings. She suggested consolidating all the home care agencies that rely on state funding down to five or six regional agencies, thereby saving on overhead and administration. She suggested looking into the way Goold Health Systems and Elder Indpendence of Maine do business to see if there's any cost savings there.

Senator Brannigan, co-chair of the Health and Human Services Committee asked Helen if any analysis had been done in the Lean around the idea of consolidating agencies. She responded honestly with a no.

Members of the Lean Core Team were also in attendance with many testifying against the proposed cuts.

On Wednesday, another hearing was held pertaining to the cuts to the state funded Home Based Care program.

That same morning, LD 1059 had a work session in the Insurance and Financial Services Committee. LD 1059 was the bill to set up a pilot project, using what the state of Montana did to insure its direct care workers.

Members of the Lean's Direct Care Worker Taskforce were present. Elise Scala was prepared to present to the Committee her findings on the Montana model. She did not get the chance to.

Diana Scully, the director of the Office of Elder Services, DHHS, spoke to the committee, telling them that with the current financial crisis the state budget is facing, it simply is not feasible to set up a pilot using $500,000, as the bill directed.

What Ms. Scully did say was that the Governor's Office on Health Policy has been awarded a $8.5 million grant to provide health insurance through Dirigo to direct care workers, part-time workers, and seasonal workers.

The committee members had many questions about this grant for Ms. Scully. She could not answer them. The committee also acknowledged that this is a grant, meaning that once the money is spent, it is gone.

Ms. Scully and the committee both agreed that a later meeting with Trish Riley from the Governor's Office on Health Policy and possibly someone from Dirigo is the next step. The committee will ask for specifics from Ms. Riley as to how the grant will be implemented, what groups are targeted to be covered, how the insurance will come about, etc.

The first part of this grant is being rolled out through employers. Agencies employing direct care workers need to sign on. The grant monies are to help cover the employer's share of the insurance. This is happening January 2010.

The second part of the grant is being rolled out in July with workers self-insuring. There are income guidelines that will allow for subsidies for workers to help them cover the cost of their premiums.

If you are a direct care worker, working for an agency, be it Home Care for Maine, Care and Comfort, Home Hope and Healing, any of them in Maine, and are interested in obtaining health insurance through your work, through this grant, contact your employer and ask them about it.

The committee unanimously voted LD 1059 ought not to pass, because of the state budget crisis.

The meeting that the Insurance and Financial Services Committee requested with Trish Riley is scheduled for sometime this week. The date and time is not yet known.

Thursday afternoon, LD 1364 had a work session with the Health and Human Services Committee. The bill's sponsor, Representative Matt Peterson, amended the bill. Members of the Direct Care Worker Taskforce, stemming from the Lean process, were in attendance.

The bill originally was to raise wages for Direct Care Workers. Again with the current state budget crisis, wages will not increase for Maine's direct care workers.

What Representative Matt Peterson is proposing is to keep the work of the Direct Care Worker Taskforce going. This group has come up with recommendations to strengthen the workforce through better wages, training, classification, etc. He is also proposing a definition change, removing the definition of a personal care assistant and replacing it with direct support aid.

Diana Scully was at this work session as well. She raised the issue that the language around PCA training would also be removed. The HHS Committee had many questions. One asked if the workforce is aware of these possible changes.

Representative James Campbell asked Helen Hanson if the work of the Worker Group from the summer of 2008, looking into obtaining health insurance for workers, was involved in the current Worker Taskforce. Helen responded that it is and so is much more. Helen told him that the Taskforce is looking into coming up with a classification system for the workforce because there are so many titles, she told him that the group is looking into training and the issues surrounding that, the group is looking into the Montana model.

The committee decided to hold another work session because of the changes in the definition that Representative Peterson is proposing. That session is scheduled for February 4th at 1 pm in the Health and Human Services Committee room.

Alpha One Contract goes out for ratification

January 11, 2010

Dear Alpha One Member of MSEA-SEIU Local 1989,

The Executive Board of MSEA-SEIU Local 1989 has unanimously approved your negotiated Tentative Agreement covering 850 direct care workers to be presented to you for a ratification vote at this time. Please review your copy of the Tentative Agreement (new language is underlined) and vote my marking your ballot either to accept or reject its terms. If you have any questions, contact Field Rep C.J. Betit at 1-800-452-8794, ext. 1119.

Ballots and a copy of the Tentative Agreement has been mailed out to Alpha One members the week of January 11th. Be sure to check your mail and return your vote to MSEA-SEIU Local 1989 by 5 pm on January 26, 2010.

This Agreement reaffirms the parties' commitment to work cooperatively toward mutual goals affecting our members while recognizing the challenging landscape we all face in the current economic environment. As well, this Agreement captures Alpha One's ambition to expand to a full agency model in order to remain a leader in the Direct Care field. As we continue to fend off cuts to funding in the legislature, we also seek new funding sources for improved pay and access to benefits, and this Agreement allow us to re-open sections of the contract if funding becomes available to improve those areas. Additionally, there are added protections giving MSEA the ability to negotiate if the agency changes hands or evolves to a form of employee ownership to make sure the mission of Alpha One continues.

The members of MSEA Local 1989 continue to make improvements to our contract through bargaining. We also continue to fight in the Legislature for improvements to the direct care system and improvements in wages, benefits and working conditions for all of us. I encourage all members to vote to accept this contract as we all continue to work for a better future.

Please make your selection on the enclosed ballot, either Accept or Reject,and return the ballot to MSEA using the postage paid envelope that was enclosed. All ballots must be received at MSEA-SEIU Local 1989 Headquarters, located at 65 State Street, Augusta, Maine by 5 pm on January 26, 2010, and will be counted at that time. All members are welcome to attend the ballot count.

In Solidarity,
C.J. Betit
MSEA Field Representative

Direct Care Workers and the People they Serve Again are Facing Cuts

We all know the State's revenues are down again. We all know there is a $400 million gap that lawmakers need to fill in order to balance the State's budget.

A big part of that balancing act is coming out of Health and Human Services and again, Maine's elders and those with disabilities, both living in their homes will be hurt.

One cut targets the Home Based Care (HBC) program with a $500,000 reduction, effectively cutting the program in half. DHHS is looking to achieve this by cutting the number of hours of care received. That equals a cut in pay for those direct care workers giving the care.

The second cut targets the two MaineCare self-directed programs (Section 12-CDAS and Section 22-Waiver). This cut will reduce the current hourly rate by 10%. This will NOT impact the hours of care, but will reduce the already bare-bones pay direct care workers receive. This may make it hard for those needing care to retain their caregivers because the caregivers will seek work elsewhere. It will also make it extremely hard for those in the self-directed programs to find new workers because they cannot offer a livable wage.

These cuts are poor public policy. We need to find a better way to reduce expenses without harming those needing care and without harming the workers providing the care.

We as workers, and those we care for, have a opportunity to voice our opposition, concerns, and ideas for reducing expenses. There are two public hearings on these proposed cuts coming up at the State House.

The first is on Tuesday, January 12, 2010, at 1 pm in room 228, the Appropriations Committee Room. This is on the MaineCare cuts.

The second is on Wednesday, January 13, 2010, at 9 am in room 228. This hearing is on the Home Based Care cuts.

Please join me, and the lady I care for, at these hearings. It is so important for lawmakers to hear from those that will be affected by these cuts.

Home and Community Based Care Lean Summary

as of December 30, 2009

The Home and Community Based part of Maine's Long-Term Care System has been put through a Lean process to make it more efficient, address inequality in services provided, and hopefully gain some cost savings that can be passed on to workers in the form of livable wages and benefits such as paid sick time and vacations and health care coverage.

The Lean process is the direct result of four pieces of legislation that came through this past legislative session. This legislation deals with worker issues in one form or another. The Department of Health and Human Services (DHHS) is charged with reporting back to the Legislature with the findings and recommendations coming out of the Lean process.

The actual Lean started up in early September. Five members of Maine Personal Assistance Services Association (Maine PASA); Dee Dee Strout, Ted Rippy, Cathy Bouchard, Julie Moulton and Helen Hanson, of which four are Voices Institute graduates (2008 and 2009) and three are Local 771 of MSEA-SEIU members, worked to position themselves to serve on the core team and two were successful in achieving seats on the team. The two that were successful were Julie Moulton and Helen Hanson. Cathy Bouchard became an alternate and she stepped up when Julie was not able to finish the Lean work. This is the first time workers have been involved at this level of working on system change.

The core team was charged with mapping out the system's current state in order to see where duplications and inefficiencies are happening.

The team then mapped out the system's future state with many ideals and values in mind, things that would improve service for Maine's elders and those with disabilities. From this map, we developed areas that need changing, the implementation plan.

One of the biggest changes is streamlining the system into three programs instead of seven. Along with this comes rule and policy changes, the different sections of MaineCare (Medicaid) and Office of Elder Services code getting rolled into one system that is easier to navigate, provides quality care, provides portability (a consumer can easily move from one program to another without the hassle of going through the assessment process again), and optimum choice for those needing home care or community based services.

With the mapping part of the Lean process over, the real work is now beginning. The core team has developed an implementation plan that has an aggressive timeline being driven by the legislation. There are activities in this plan around worker issues.

Where all four pieces of legislation driving the Lean process deal with worker issues, DHHS set up a Direct Care Worker Taskforce to address issues and make recommendations for change, as part of the report going back to the Legislature. This taskforce is made up of workers and providers and staff of DHHS.

Maine PASA Leadership Council members have identified seven activities surrounding the direct care workforce that we are actively involved in through the Taskforce.

1) Decide upon a single, inclusive title for caregivers – we have too many different titles

2) Encourage workers to work together as a team for the consumer, providing coverage for each other as needed, help with the fill-in problem

3) Provide higher incentives for DCWs: pay, benefits, mileage, pay differentials for nights/weekends, raise wages to $12.00/hour across all programs

4) Provide work stability for workers when a person in their care goes into the hospital or nursing home and the worker's hours are cut; make it easier for workers to pick up more work

5) Enhance opportunities for all direct care workers to receive training

6) Review training requirements and inequities, identifying how to make them more consistent and appropriate across program/modes of service and types of workers

7) Provide training for specialty equipment for clients/DCWs (equipment like mechanical lifts and oxygen apparatus)

These seven activities came out of the work of the core team, recommended changes to make to the system.

The Worker Taskforce has met three times so far. This work is ongoing through the winter and possibly into the spring. Maine PASA has five leader-members; Dee Dee Strout, Ted Rippy, Cathy Bouchard, Joyce Gagnon and Helen Hanson, as part of this taskforce. The seven activities identified as top priorities to work on are part of the work assigned to the taskforce.

We've had two meetings in December. The topic on the agenda at the first December meeting was the worker nomenclature. The second December meeting continued discussion around the nomenclature and starting discussion on what the State of Montana has done to gain health insurance coverage for its workers, with the possibility of implementing something similar here in Maine.

We've seen that worker education seems to define the title a worker has. What is not taken into account is that the core of the work performed by all the different titles in direct care work is basically the same.

We are looking into the possibility of developing three classes of workers. With this in place, it will be easier for workers have access to the training they need when they want to move up in their caregiving careers or move across programs that provide care. It will also identify core competency skills that those providing direct care should have, and help develop career pathways for when a worker wants to move up or move to a different work setting.

As a member of the Direct Care Worker Taskforce and recently completing my CNA training, I am in support of this three tier system of classification for workers. In the CNA training, the first part was training I had previously had as a Personal Support Specialist. I was able to use the same text I had in the PSS training. It would have been better if I could have proved my competency in these areas by testing out of them, or illustrating my skills somehow.

Where I've been working as a PSS for a few years, I possess those core skills, skills needed to bathe, dress, handling boundaries and abiding by them, ADLs, etc.

We workers met with DHHS, after the first December regular meeting, to talk about issues that we face in our day to day work with the people we serve. There were no providers present. This was an opportunity for workers to let the department know some of the challenges workers face and also provide feedback as to current policy and how it does or does not work. With no providers present, it meant that workers could talk freely without fear of reprimand from their employers. This was the workers' chance to shine.

At the second December meeting, DHHS had set aside time for workers to talk directly with them. No issues came up. I thought it was a good gesture on DHHS's part. Again, workers have not been involved at this level of policy making before, as far as I can tell. So, when workers get a chance to talk directly with DHHS, I encourage them to come and do so.

Now, the Department of Health and Human Services, with input from the Lean Core Team members and the Worker Taskforce, is preparing the report that is going back to the Maine Legislature in January. The report is on all this work we've been doing. Members of the Core Team let DHHS know that when the report is presented to the Legislature, we want to be there in support of Maine's Home Based and Community Care.

Maine PASA, through the work of it's Leadership Council; and Local 771, through its members that work with Maine PASA, have positioned themselves to be leaders on direct care worker issues as the Lean implementation plan gets worked through. Maine PASA and 771 leaders are working closely with DHHS in this process. This is a very exciting and encouraging time for PASA, 771, and the workers we are advocating for.

The Lean documents are available to the public online at: http://www.maine.gov/dhhs/reports/ltc-services-adults.shtml

Please check out the site and see what we've been working on. There's a lot on the site pertaining to workers.

A new CNA's hopes for her classmates

I was chosen by my classmates to give a speech at our CNA graduation.

I mentioned it to the Direct Care Alliance and they asked for a copy of it to publish on the DCA's blog.

Here is the link to the DCA's publication.

A new CNA's hopes for her classmates

Crabbit Old Woman

The following poem was among the possessions of an aged lady who died in the geriatric ward of a hospital. There is no information available as to her name, when she died, or who she was. It is so appropriate for all nursing personnel, direct care workers, families, volunteers and all who come in contact with the elderly to read. At times, we all lose patience with the elderly. This should help us to have more sympathy and understanding of all elders.

What do you see, nurses, what do you see?
   Are you thinking, when you look at me
A crabbit old woman, not very wise,
   Uncertain of habit, with far-away eyes,
Who dribbles her food and makes no reply
   When you say in a loud voice - "I do wish you'd try."
Who seems not to notice the things that you do
   and forever is losing a stocking or shoe,
Who, unresisting or not; lets you do as you will
   With bathing and feeding, the long day to fill.
Is that what you're thinking, is that what you see?
   Then open your eyes, nurse, you're looking at me.
I'll tell you who I am as I sit here so still!
   As I rise at your bidding, as I eat at your will.

I'm a small child of ten with a father and mother,
   Brothers and sisters, who love one another -
A young girl of sixteen with wings on her feet,
   Dreaming that soon now, a lover she'll meet,
A bride soon at twenty - my heart gives a leap.
   Remembering vows that I promised to keep.
At twenty-five now I have young of my own
   Who need me to build a secure happy home;
A woman of thirty, my young now grow fast,
   Bound to each other with ties that should last;
At forty, my young sons have grown and are gone,
   But my man's beside me to see I don't mourn;
At fifty once more babies play around my knee,
   Again we know children, my loved one and me.

Dark days are upon  me, my husband is dead.
   I look at the future, I shudder with dread,
For my young are all rearing young of their own,
   And I think of the years and the love that I've known;
I'm an old woman now and nature is cruel -
   'Tis her jest to make old age look like a fool.
The body is crumbled, grace and vigor depart,
   There is now a stone where I once had a heart,
But inside this old carcass a young girl still dwells,
   And now and again my battered heart swells,
I remember the joys, I remember the pain,
   And I'm loving and living life over again.
I think of the years all too few - gone too fast.
   And accept the stark fact that nothing can last -
So open your eyes, nurses, open and see,
   Not a crabbit old woman, look closer - see ME . . .

This poem was read at my CNA Graduation on December 21.
I thought it appropriate to post, as a reminder, that those in our care may be feeble, but they need to be treated with the utmost respect and dignity. They are much more than what we see as elders.
Helen Hanson

An Open Letter to the Legislatures of All Fifty States

Don't use it against us
that we become attached
to the people we serve,
that we love them
as we care for them.

Don't think you don't need to pay us
enough to have a home,
to make car payment,
to bring our children to the doctor…
don't think we'll do it
out of the goodness of our hearts –
even though our hearts are good.

Don't assume your mother
will keep her dignity today
that her colostomy bag
will be cleaned correctly,
that she'll be guided gently
through her shower,
that she'll take her medications
and eat her chicken soup.

Don't assume your Uncle John
will have a group home
where he can make choices
or there'll be someone to call
when your husband (or your wife)
comes home after their stroke.

Three million direct care workers
in our country today –
a million more needed
within a few short years.
Don't assume we'll be there
without your help.

David Moreau
2009 Voices Graduate
David724M@aol.com