Union presses Healey on PCA promises

For people with disabilities, living in their own home means "freedom," said advocate Colleen Flanagan.

But as inflation rises and home health care workers say they can no longer afford to work in the field, Flanagan said more people with disabilities and elderly residents are turning to nursing homes for their care.

Disability advocates, union representatives and personal care assistants carried signs throughout the State House on Tuesday, stopping before Gov. Maura Healey's office to demand increased rates for the personal care assistants (PCAs) who care for seniors and those with disabilities.

The PCAs' contract with the state expired on June 30, according to Rebecca Gutman, vice president of 1199SEIU United Healthcare Workers East, who represents the workers. The union has met four times with the PCA Workforce Council, made up of a designee of Secretary of Health and Human Services Kate Walsh as well as employers, Gutman said.

"Without the help of PCAs, I would not have been able to go and graduate from college. I have a four-year degree from UMass Amherst," Jerry Boyd, who uses a mobility chair, told Healey's aides outside the governor's office. "I would not be able to work ... I wouldn't be able to provide for my family without PCA help. I wouldn't have been able to be married and live independently and have a family."

Boyd said one of his PCAs recently left home health care to take a job at Walmart, where they got better wages and benefits. He added that last month one of his friends couldn't find a health assistant, who she needed to get out of bed and help her with daily tasks, so she moved into a nursing home.

PCAs make $18 an hour under their current contract with the state, but advocates on Tuesday said that Healey told the home health workers on the campaign trail that they deserved to be making at least $25 per hour.

So far, the proposed contracts the PCA Workforce Council have brought to the table have been "disrespectful," Gutman said, only offering 50-cent increases every year for the next three years, and no paid training or retirement benefits.

"Gov. Healey said $25 an hour. When she was running for office, she came to 1199SEIU and wanted support and said she was going to get us $25. Now she's in office, and now we want our money," said PCA Mikey Myles. "The governor needs to do her part and give the people what she promised."

1199SEIU Regional Communications Manager Marlishia Aho said Healey made the comment at an event in Lawrence on April 15, 2022, when the union announced their endorsement of the governor. Healey met with home health care workers during the event, Aho said.

The governor also said in January that there was a "crisis-level" workforce shortage among PCAs, MetroWest Daily News reported.

Asked about the negotiations, Healey spokesperson Karissa Hand said, "Governor Healey grew up watching her mom care for seniors in their homes, and she has a deep appreciation for the heroic work that Personal Care Attendants do. Our administration is committed to ensuring they are supported and currently negotiating a new contract with PCAs."

While 1199SEIU is fighting for a new contract, bills before the Legislature aim to reform the way the state sets these rates for home health and home care services.

"I can say with certainty that I've never experienced the workforce shortage like the one we're dealing with today. Home care workers are leaving the sector at a faster pace than they are entering," Nick LaMalfa, operations manager for Maxim Healthcare services told the Joint Committee on Health Care Financing on Tuesday.

LaMalfa and other home health care workers and employers testified in support of a Sen. Pat Jehlen and Rep. Carmine Gentile bill (S 755 / H 1195) that they say would clarify rate-setting processes to ensure the rate set by the state offers competitive wages and reflects actual operating costs.

The bill would create a rate-setting methodology that would reflect all operating costs and governmental mandates that affect the cost of providing home care and home health services, such as changes to the state's minimum wage, the Paid Family and Medical Leave Act, health insurance, employee benefits and training, and increased technology costs.

It would not set the rates or dictate the amount for future rates, but would end the need for the Legislature to fund supplemental rate add-ons each year through the state budget process, according to the Enough Pay to Stay coalition, which is made up of home care agencies.

It also requires that reports on home health rates set by MassHealth and home care purchase of service rates set by the Executive Office of Health and Human Services be filed with the Legislature.

"The workforce crisis is directly impacting access to vulnerable seniors and persons with disabilities seeking to stay in their homes in their communities," said Julie Watt Faquir, executive director of the Home Care Aide Council. "We cannot address the workforce crisis without first addressing and acknowledging the critical role of the rate setting process as in the delivery of services."

Other bills before the Joint Committee on Health Care Financing also seek to reform the rate-setting process, including a Sen. Cindy Friedman and Rep. Denise Garlick bill (S 748 / H 1192), which focuses on care for medically vulnerable children.

Angela Ortiz, a member of the state's Commission for Status of Persons with Disabilities, said the state has made progress on this issue — increased reimbursement rates, set new regulations, and created new stakeholder groups — but that it has not been enough to help families.

Ortiz testified before the committee alongside her daughter, Ayla, who requires care for her disability.

"Families who are still struggling to access essential services, parents and caregivers continue to fill a gap the state has yet to adequately address, which is having far reaching consequences," Ortiz said, choking up. "Ayla and other children and adults with disabilities have value, the nurses and other direct support professionals who are essential to provide their care have value."