AMHERST — Paralyzed in a motor vehicle crash more than 30 years ago, Daniel Greaney lives on his own at a South Amherst residence with assistance from six personal care attendants.
But Greaney, who works as the director of personal care attendants, or PCAs, for Stavros Center for Independent Living, said Friday that he worries new rules that cap overtime pay by those workers will compromise the opportunity he and other disabled people have to remain in their homes.
Gov. Charlie Baker and the state Executive Office of Health and Human Services launched the new regulations Thursday.
“This definitely affects me and other folks with disabilities, and elderly and people with end-stage illnesses, living at home with their loved ones,” Greaney said.
As a longtime client of PCAs, Greaney said he and others who get up to 60 hours per week of service from them will find it more difficult to find replacements if their eligibility for overtime is lost.
“Unfortunately, the way they wrote the regulations, folks at that level of need are at most jeopardy of being institutionalized with this new rule,” Greaney said.
On Thursday, Greaney was among 55 people affiliated with the Disability Policy Consortium, a statewide advocacy organization run by and for people with disabilities, who participated in a rally at the Statehouse in Boston to call for rescinding the new rule and asking for an audience with the governor.
“We demanded a meeting and if we don’t get a meeting within a week or so we’ll return with bigger numbers, and at that time we won’t leave,” said Charles Carr, legislative liaison for the consortium.
The executive office released information Thursday stating that there would be no cut in services for the 26,000 members of MassHealth who receive PCA services. MassHealth is the state’s subsidized health insurance program for 1.8 million low-income residents.
Robin Callahan, the state’s deputy Medicaid director, met with MassHealth members and their PCAs at the Statehouse on Thursday.
“MassHealth is committed to a sustainable, robust PCA program to provide critical service for our members to maintain their community independence, and there will be no cuts in the program or change in authorized work hours,” Callahan said in a statement.
She added that the program will see an $80 million increase in the fiscal year that began July 1, representing a $130 million increase over the past two years. This helps to pay the 36,700 people who work in the PCA profession. The changes in overtime rules are a way of ensuring the long-term sustainability of the program, she said.
“There has been and continues to be ongoing discussions among all of the parties as the overtime management program is implemented over the next several months,” Callahan said.
The new regulations come a year after a ruling by the D.C. Circuit Court of Appeals in which PCAs in Massachusetts who have contracts with MassHealth became eligible for overtime pay for the first time.
Organizers in the disabled community remain concerned despite these assurances. They are already planning a Sept. 20 event at the capital in which they intend to appeal to senators and representatives seeking legislation to protect overtime.
Carr said Baker essentially imposed a 40-hour limit on PCAs, even though many have to work for more than one person.
“Prior to that, PCAs could work more than 40 hours and be paid overtime,” Carr said.
PCAs will only get permission to exceed 40 hours if they live with their client and get prior authorization. Clients may also be allowed to keep a PCA working overtime for a limited time while they find a second PCA.
According to the executive office, until Oct. 22, PCAs who have been working overtime can continue to do so without receiving notices about non-compliance. Then, between Oct. 22 and the end of 2016, there will be focused outreach about the new overtime rule, and PCAs who work overtime in the absence of an overtime approval will be paid time and half for overtime hours in accordance with the federal Fair Labor Standards Act. No services will be disrupted at that time.
What happens beginning Jan. 1 for the 7,100 clients who use PCAs for more than 40 hours per week is unclear.
John Winske, executive director of the consortium, issued a statement calling on Baker to make changes before care is disrupted.
“Thousands of people across Massachusetts are going to have their lives dramatically upended because of these new restrictions,” Winske said.
His organization has requested a delay until Jan. 1 to implement the new rules and offered a compromise that would set a 66-hour threshold for overtime by PCAs, and create a special-cirumstances exemption for members with needs that place them at serious risk of being institutionalized or segregated.
And if making the change in rules is about cost savings, Carr said that is unlikely, observing that there is $700 million spent to serve 26,000 people, half of which is reimbursed through fees, whereas nursing homes are a $1.3 billion industry serving 38,000 people.
Carr anticipates that the new rule will force more people into nursing homes and other assisted-living facilities, at greater cost to the state and the individuals.
“It makes no sense, even fiscally. It’s one of the worst pieces of public policy I’ve seen in a long time,” Carr said. “It’s shortsighted, it’s looking at the bottom line only and not looking at vulnerable people’s lives.”
Greaney said many of the 4,500 people Stavros works with in the Pioneer Valley were concerned when they learned about the changes.
“We had people coming to Stavors crying that they’re going to lose their PCA or be back in an institution,” Greaney said.
Greaney said he understands the fear and anger because he lived in a nursing home when he was first injured, and he does not want to return there.
“I knew this was coming down the road, and it still upsets me,” Greaney said.
Scott Merzbach can be reached at smerzbach@gazettenet.com.
