MaineCare Hurdles for Workers with disabilities

The Nezinscot Guild has advocated for and employed Maine citizens with disabilities for over 30 years.  We witness daily the value and demand for meaningful work. We have been seeing a trend that is driven by MaineCare funding, which steers people with disabilities away from employment and toward other day habilitation activities such as volunteering, leisure, playing cards, going to the mall, etc. Agencies that provide these activities are paid by MaineCare.

 In a free democratic society, rules, structure and guidelines are necessary in service delivery to vulnerable citizens. Society has an obligation to provide assistance when needed. However, when these rules adversely affect those who they are meant to help, and cost taxpayers more than needed, the rules need to change.

 Specifically, I am addressing one part of MaineCare Waiver regulations concerning “cost-of-care”. Recently, an employee of The Nezinscot Guild, who has a developmental disability, learned that he has to pay for some of his MaineCare waiver services such as health insurance, day habilitation, and residential support. The MaineCare waiver does not pay for support at his job.  He will be billed for non work waiver services because his income (including Social Security of $1080. and wages of $200.) is over the allowable $1129.00 per month. He will receive a bill from MaineCare for the amount that he earns over $1129.00 per month ($151. or 76% of his earned income). This is certainly not an incentive to work.

 At this juncture, this person could decide to:

1. Continue working 3 days per week and receive “day habilitation” services for 2 days per week. (Current schedule) Ramifications of this are:

 To the individual:

*Income: $1129.  ($1080. from SS, $200. from earnings – $151. bill from MaineCare for health care premium, other MaineCare services.)

*He would pay 76% of his income from work to MaineCare.

*Fulfilling his choice to work at a job he likes.

*Individual has better quality of life, more independence, normalcy of working status, camaraderie, and all natural benefits of work.

       To taxpayer:

            *Individual makes purchases, travels, etc. and pays sales tax.

            *Individual contributes to Social Security and Medicare

            *Employer contributes to Social Security and Medicare

            *Pay cost of day services $934. per month.

            *Cost of support at The Nezinscot Guild: 0

OR

2. Stop working altogether and receive “day habilitation” services 5 days per week. Ramifications of this are:

 

To Individual:

*Income decreases from $1280. to $1080. (SS only). 16% loss of gross wages.

*Less income decreases quality of life, and all the numerous benefits of work.

      To Taxpayers:

*Less sales tax income on purchases he would have made with income,

*Less contributions to Social Security, Medicare, etc

*Employer pays less into Social Security, Medicare, etc.

*Increased MaineCare cost for day services for socializing, day trips, etc. of $2,334. per month which is a 60% increase in tax payer cost.

This person has been a dedicated, motivated, successful employee of The Nezinscot Guild for 5 years. His job contributes to his sense of well being and identity as a useful, productive member of society. He wants to work but has chosen to leave because of this newly enforced “cost of care” billing.  This person, the taxpayers, and his employer all experience a negative impact when he leaves his job.

Here is an idea for decreasing MaineCare expenses and taxes, and enriching the lives of Maine citizens with disabilities at the same time. Change MaineCare regulations so that citizens with developmental disabilities are encouraged to work and be as independent as possible instead of being encouraged financially and philosophically to receive MaineCare funded day habilitation services. There is a need for these Day Hab. services; however, they are not a good fit for all people with disabilities.

Thank you for your consideration of this issue.