Maine’s direct care workforce is in a fragile state. Low reimbursement rates for direct care work result in low pay, poor job quality, and worsening labor shortages for care providers. The consequences of undervaluing the services direct care workers provide that allow aging people, people with behavior health challenges, and people with disabilities to live with dignity are far-reaching.

Many of us or those whom we love will require the kind of support and assistance that direct care workers provide at some point in our lives. Access to stable, quality care is not only important to the person receiving services, but also to family caregivers who often struggle to balance work and other priorities with the needs of loved ones. Direct care provides working-age adults flexibility to remain in the workforce and support themselves and their families knowing loved ones are cared for properly.

The impacts of undervaluing direct care work and workers ripple beyond those individuals and families who receive services. When a family member must drop out of the labor force to provide care, businesses lose workers at a time when it is already difficult to hire staff. Health care system resources get stretched dangerously thin when options aren’t available for patients who no longer require hospitalization or when people who don’t get the care they need suffer avoidable conditions that require more costly intervention. State and federal governments incur more costs and have fewer resources available to invest in people and communities when people drop out of the labor force or aren’t paid enough to be able to provide for their families.

The costs of Maine’s care shortage are borne by hospitals, state and federal governments, consumers and their families, and direct care workers themselves.

This report details the far-reaching costs of undervaluing direct care work. Some costs — lost economic growth and turnover for businesses and direct care providers — are relatively easy to quantify. Others, such as the mental and physical toll on clients, their families, and direct care workers, are more abstract but no less real. These costs will continue to rise until we properly value care work, confront the profound consequences of inaction, and commit to meaningful change.

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