Following debate in both the House of Representatives and the Senate, the legislature approved raises, increased time off and holidays, and a bonus for 12,000 personal care assistants covered under a three-year union contract valued at $19.3 million on an annualized basis.
The contract with SEIU 1199 NE is for PCAs working under the state’s self-directed care model, in which the individual receiving in-home care receives the money to pay the PCAs. Connecticut has increasingly moved toward an in-home model of care for seniors and persons with disabilities to avoid the higher costs of nursing homes and residential care.
Under the terms of the contract negotiated by Gov. Ned Lamont’s administration, roughly 12,000 PCAs caring for 8,000 individuals will move from $18.25 per hour to $23 per hour by 2026, and PCAs will receive longevity bonuses upwards of $800 for each consumer-employer they work for, according to the fiscal analysis.
The votes were along party lines with a few Republicans in the House voting to approve the resolution. During debate, Republicans argued the increased spending prioritizes one group of PCAs under a union contract while leaving many more PCAs who work for nonprofit companies with no similar increases.
Rep. Tammy Nuccio, R-Tolland, argued that the purported savings attributed to the in-home care model and used to justify the PCA raises under the union contract have yet to be shown in hard numbers.
“The state has not met that burden of proof, and it’s a pretty low bar, so that’s a problem for me. Fundamentally, the dollar signs don’t add up,” Nuccio said, questioning why the Appropriations Committee has not advocated for similar raises for nonprofits who supply a larger number of PCAs. “If there is a will of commitment to truly support aging in place and support our seniors, where’s the will of the legislature to demand that we put $45 million in appropriations to support the rest of these PCAs and not just 1199 union?”
Nuccio’s comments on the House mirrored the arguments made by Senate Republicans, with Sen. Heather Somers, R-Groton, saying the program allows for PCAs to care for family members, and that the raises are not unreasonable, but that there is little oversight.
“One of the issues I have is the PCAs working for nonprofit agencies doing the same type of work are not receiving this increase,” Somers said. “The agency based PCAs have oversight, they have management, and they have accountability. Self-directed PCAs do not have these things; they’re self-directed, they self-report.”
“If this contract passes, self-directed PCAs will be more expensive than agency PCAs, because we have created an unlevel playing field,” Somers continued.
Connecticut nonprofits and home companion providers submitted testimony regarding the PCA contract seeking an increase in funding, as well, saying that the increases to self-directed care could imperil their agencies.
Lewis Bower, CEO of KeepMeHome Care and Companions in Berlin, wrote in testimony that he was not opposed to the contract, but that the dramatic wage increase creates an imbalance if nonprofit PCA providers do not receive funding increases as well.
“Wage increases of 26% over the life of the three-year contract create a significant imbalance that will cause the agency-based workforce to collapse,” Bower wrote. “Both models are necessary to provide choice and equal access to care for seniors and consumers participating in Medicaid.”
“Nonprofit providers are in competition for workers with other entities, including work as PCAs and for the state itself,” wrote Gian-Carl Casa, president of the CT Community Nonprofit Alliance. “Without adequate funding for nonprofits they will continue to lose employees because they can’t compensate them enough.”
However, funding is already tight at the Capitol despite years of revenue surpluses under the state’s fiscal guardrails, a point driven home by Senate President Pro-Tem Martin Looney, D-New Haven, who said if Republicans were willing to adjust the guardrails to free up more discretionary spending, he would support it.
“Hearing the comments of our Republican colleagues it would seem to suggest they would be in favor of making the spending cap perhaps more flexible, perhaps finding some greater flexibility under the guardrails to accommodate increases to wages and benefits for the PCA workers who are not addressed in this bill,” Looney said. “I would certainly be on record to support doing that, if we could find a way to accommodate that.”
In the House, Rep. Michael D’Agostino, D-Stamford, argued that “we are not sending a single dime to 1199 itself,” and that the money is both federal and state money that reimburses the individuals receiving care.
“I’d love to see a hard dollar figure on the savings, but because the population fluctuates, it’s very difficult to compute on a daily basis,” D’Agostino said. “It’s exponentially more expensive to put someone in an institutionalized setting, and it’s obviously much, much less supportive emotionally as well.”
“Those savings are over time and it’s not just financial savings, its quality-of-life savings,” D’Agostino continued. “These costs have gone up over time because we have more and more people over time using these services. That’s a good thing.”
The General Assembly will soon have to contend with another labor contract, as a wage re-opener deal struck between Lamont and the state employee unions represented by State Employees Bargaining Agent Coalition will soon require a General Assembly vote, as well. Meanwhile, state agencies, particularly higher education, are all clamoring for more funding during this budget adjustment session.
Gov. Lamont praised passage of the PCA contract in a press release and said the agreement must still be approved by the Centers for Medicare and Medicaid Services.
“Personal care assistants provide essential services to help some of our most vulnerable residents stay in their homes and in their communities,” Lamont said. “I am incredibly thankful to the General Assembly for their swift action approving this agreement, and I appreciate all of those who helped negotiate it.”
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I would like to know who is paying the Workmen’s Compensation insurance, the liability insurance, the disability insurance and bond of all these PCA’s. Along with the state and federal taxes and the FMLA tax. Homecare Agency owners are responsible for all these. Are the individuals or the non profits ?