Long-Term Care Commission: Caregivers Should Be Paid At Least 125% of Minimum Wage

In order to attract caregivers into the home care workforce, one state’s labor commission is calling for something radical: a requirement to ensure they’re paid at least 125% of the state’s existing minimum wage.

Overall, state-mandated minimum wage hikes have become somewhat commonplace in recent years. At least 21 states, for example, started 2020 with higher minimum wages than the previous year.

A legally mandated home care-specific boost to a given minimum wage, however, is a relatively new concept.


Maine’s Commission to Study Long-term Care Workforce Issues, a group established in 2019 to study direct care labor shortages, shared its recommendation in a new report issued Tuesday.

The Maine legislature’s Health and Human Services Committee voted unanimously to push forward accompanying legislation that would back the proposal on the same day.

Raising caregiver wages is just one of a number of recommendations made by the commission.


The group also called for a public service campaign that promotes direct care worker jobs as a viable career option, industry-specific state-sponsored job fairs, direct care worker training and education programs, and student loan repayment eligibility. The commission also recommended the creation of a long-term care workforce oversight committee.

The commission’s recommendations have drawn support from the Home Care & Hospice Alliance of Maine, a statewide nonprofit trade association.

“We need to be competitive in order to attract and retain workers to our industry,” Laurie J. Belden, executive director of Home Care & Hospice Alliance of Maine, told Home Health Care News in an email. “It’s also time we value and appreciate the role of direct care workers and being able to offer them a living wage with benefits is the first step.”

In addition to the previously mentioned plans, the long-term care commission also called for an increase in Medicaid reimbursement rates to better reflect providers’ costs. Nationwide, the delivery of home care is becoming more expensive, propelled upward by minimum wage hikes, more paid-time-off rules, electronic visit verification (EVV) requirements and background checks.

While the Home Care & Hospice Alliance of Maine was supportive of the proposal, it did so partially under the notion that home care wages would rise in tandem with reimbursement rates. If that didn’t happen, a caregiver floor wage of 125% of Maine’s minimum wage would likely prove catastrophic for home care providers.

Just last week, the Farmingdale, Maine-based nonprofit Home Care for Maine announced it would be closing its doors in April due to financial troubles brought on by a recent minimum wage raise. The shutdown will leave almost 600 patients without home care.

In 2017, Maine’s minimum wage increased from $7.50 to $9.00; it then spiked to $10.00 in 2018 and to $11.00 the following year. Currently, the state’s minimum wage is $12.00, a result of another hike in 2020.

For context, 125% of Maine’s 2020 minimum wage would mean a caregiver baseline of at least $15 an hour.

“The MaineCare reimbursement rate has not been adjusted to keep pace with Maine’s annual minimum wage increases, a wage that has increased 60% since 2016 — let alone new government mandates such as health insurance and electronic reporting,” Belden said.

The accompanying bill introduced Tuesday manages to address both caregiver concerns and rate reimbursement concerns, according to Belden.

“It requires direct care workers across the long-term care spectrum to be paid no less than 125% of minimum wage, and it requires the Department of Health and Human Services to adopt rules that take into account the cost of this increased wage in its reimbursement rates,” she said. “Many providers serve primarily MaineCare recipients – and getting the reimbursement rates better aligned with the cost of delivering care is essential to remain viable and sustainable.”

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