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The Case for Universal Family Care in Maine- and Beyond

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University of Maine
University of Southern Maine, Portland

The state of Maine has a historic opportunity to provide universal family care to citizens at both ends of the life span. In 2017, legislators introduced a new proposal called “An Act to Support Maine Families through Universal Family Care – and this bill has been carried over into 2018 for further consideration.

Supporting Maine Families

This groundbreaking proposal puts Maine on the brink of providing important support for families in need of care-based services. It aims to ensure high-quality caregiving across the lifespan while also establishing workforce standards that improve the jobs of professional caregivers. The proposed act advocates for both free childcare for all children less than three years of age and free in-home services to medically eligible elders and disabled persons who need assistance with daily living. If the legislation passes, it will implement a single system for determining eligibility, where income is not the issue. Eligibility for child care would be based on the age of the child and in-home services would be based on medical need. Supporters argue that each of these forms of publicly supported care would help working families and enhance people’s independence and dignity, while also strengthening the economy.

Caring for Children

Women have always worked. But over the last 60 years, there has been a marked increase in women’s workforce participation and enrollment in postsecondary education. Current studies estimate that almost two-thirds of U.S. mothers with dependent children are employed, and many are also pursuing higher education. At present, nearly 75% of the country’s children rely on their mothers’ earnings, and both single and married mothers need help with child care.

For many of these families, lack of access to affordable, quality day care puts both parents and their children at a disadvantage. Research resoundingly affirms that the earliest years of life are the most critical – a time of rapid development for children, the bedrock of lifelong health, intellectual ability, emotional well-being, and social functioning. The new legislation, if passed, will allow Maine to create an early foundation of support for tomorrow’s workforce, investing in the state’s human capital while simultaneously supporting parents.

Caring for Elders and People with Disabilities in the Community

The need for in-home services for older adults and people with disabilities who want to live in the community is also indisputable. The trend toward community-based care began in the 1960s, just as more and more women were entering the workforce. Efforts to move people with disabilities out of restrictive institutional environments into more home-like settings were based on the ideal that people should be able to choose their care settings. A similar, more recent trend has led to a preference for community and home-based care over skilled nursing facilities for older adults needing assistance. Most people favor allowing disabled people to stay in their homes – whether they are younger adults with developmental, mental, or physical disabilities or older adults with the chronic health conditions that frequently accompany old age. And this approach is also usually cheaper than institutional care.

Most home care is now provided by informal, usually unpaid, caregivers, such as spouses, daughters, or parents. But many of these caregivers compromise their own health and employment status while carrying out these duties. Given today’s workforce realities, respite benefits and other kinds of support for unpaid family caregivers become essential. Access to professional home care workers is financially out of reach for many who are not eligible for Medicaid-funded programs. Expanding such help for home caregivers would be beneficial to both society and the state economy. 

Improving Care Work Jobs

With increased access to childcare and home care for families, the demand for workers would rise. Already at the national level, home care occupations are predicted to add more jobs to the economy than any other single occupation between 2014 and 2024 while an anticipated shortfall of workers to meet the demand still exists. These jobs often pay very low wages and offer minimal benefits and are filled largely by women, frequently single mothers and immigrants. Average hourly wages for both childcare and home care workers were just over $10 in 2016, and the value of these wages, when adjusted for inflation, has decreased over the decades, leaving many workers eligible for public assistance. Not surprisingly, these occupations face high turnover rates as workers seek other jobs that pay slightly higher wages, and may offer benefits, more secure hours, and career mobility.

The newly proposed Maine bill acknowledges the workforce issues by directing the Department of Health and Human Services, the Department of Labor, and the Community College system to develop workforce training programs for home care and childcare workers. It does not, however, go as far as the 2017 white paper, Universal Family Care: A Maine Plan, jointly produced by the Maine People’s Alliance and a national group called Caring Across Generations. This report underscores the need to raise wages by at least 50%, provide paid sick and vacation days, offer career ladders, and maintain respectful work environments.

Where Would the Money Come From?

Funding for the Universal Family Care Program would come from a number of existing federal and state sources such as federal child care subsidies and federal matching funding for Medicaid services and Medicaid waiver programs, and all state funding now available for elder in-home services. According to the bill, new resources would be derived from state taxes on income above the current Social Security payroll cap. A second source of new funding for the program would come from a state tax on unearned income – such as dividends on stocks.

Devoting existing and new resources for family care in Maine would be well worth it. As columnist Leonard Pitts writes, “Obligation to care for all is where our goodness, and thus our greatness, resides.” The proposed Universal Family Care program offers Maine the chance to show its greatness.