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Healey vows to address shortage of PCAs

by Henry Kuczinski

Daily Hampshire Gazette, December 26, 2022

BOSTON — Governor-elect Maura Healey said she will “absolutely” work with advocates and labor representatives to strengthen Massachusetts’ Personal Care Attendant Program by addressing a “crisis-level” workforce shortage.

The MassHealth program provides funds for individuals with chronic disabilities to hire attendants for in-home care. This allows individuals to maintain their independence, stay in their community and manage their own care.

Dianna Hu, chairwoman of the Boston Center for Independent Living, has a genetic neuromuscular disease and has used a wheelchair since birth. She said the program is about “dignity” and “being able to live with freedoms.”

“PCAs get me out of bed in the morning and assist me with all activities of daily living, so that I can lead an independent life, not in an institution, but in the control of my own place to call home,” Hu said.

The program currently provides services to more than 40,000 people with disabilities, including physical and intellectual disabilities. However, the program is experiencing a workforce shortage, leaving many individuals without access to in-home care.

“There’s a workforce crisis across so many sectors right now in our state, but no sector is experiencing it more than human services and health care,” Healey said in a public forum. “And the consequence of that, where people are relying on that care, is just absolutely devastating.”

Bill Henning, BCIL’s executive director, said “high turnover” is a major reason why the program is experiencing a workforce shortage. He said compensation levels for attendants are not high enough to provide a service that can be physically and mentally challenging.

“This is important work, but it’s hard work,” Henning said. “It takes a lot of skill. It takes a lot of energy.”

Healey has made improving pay for attendants a priority, so individuals are not forced to leave “critically important jobs” to “work at places like Amazon and Target.” She also has proposed programs, like MassReconnect, that would provide job training and certification to help fill available positions.

“It’s pretty clear we need to invest in workforce, we need to go out and recruit and train up and develop a pipeline of future PCAs and other direct care workers,” Healey said.

Charles Carr, a legislative liaison for the Disability Policy Consortium, said he agrees that addressing the workforce shortage should be the top priority.

“We are relying on a workforce that’s disintegrating before our eyes,” Carr said. “Without a workforce, you don’t have a program.”

Carr said Healey’s plans to address the workforce shortage are important steps, but he added that more must be done. He said the program needs to address issues related to the number of late-night and early-morning hours attendants are allowed to work.

MassHealth currently allows attendants to work only two hours between midnight to 6 a.m. For individuals like Carr, who is paralyzed from the neck down, this is often the time they require the most assistance.

“You can’t make it through the night on one side,” Carr said. “You need to be turned, you need to take fluids, you need a bunch of things.”

According to Carr, the fact that attendant hours are constrained is one of the main reasons the program is experiencing a workforce shortage.

“Nobody is going to come into your home, or your apartment, and do ABC things in the middle of the night, for two hours of pay,” Carr said.

Carr said he hopes MassHealth will address the issue and allow attendants to work as many hours as needed. This will allow individuals with disabilities to receive vital care and allow attendants to earn a fair wage.

“If you combine this with the other enhancements that Governor-elect Healey is talking about, it will go a long way in making this a program that’s even more effective than it currently is,” Carr said.

Healey did not specifically address this issue, but affirmed her support for the program, its workers and the individuals it serves.

“As governor, I’m going to continue to stand up for the tens of thousands of home-care workers who are providing vital care, compassionate care, to ensure that people are able to live independently, safely and with dignity,” Healey said. “We deprive ourselves as a commonwealth when we fail to recognize the dignity, the worth and the capacity of each person in this state.”

Henry Kuczynski writes for the Gazette from the Boston University Statehouse Program. 

Read Healey Vows to Address Shortage of PCAs in the Daily Hampshire Gazette.