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Missing personal care attendant payments strain an already taxed workforce

On Jan. 1, the state streamlined the way it pays workers who assist people with disabilities, consolidating payroll operations from three providers to one. But the transition hit a major snag, resulting in payment delays for thousands of personal care attendants who count on each paycheck landing in their bank account on time.

Deposits resumed within a few weeks, but industry observers say the fiasco has caused some members of an already short-staffed workforce to quit, and may inflict long-term damage on a vital but vulnerable workforce.

“We’ve gotten tons of calls from PCAs who are worried about losing their car insurance, being evicted. It’s a real-life crisis for these people,” said Rebecca Gutman, vice president of homecare at 1199SEIU United Healthcare Workers East, which represents the workers.

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And it could result in a crisis for the profession. PCA pay is currently $17.71 an hour, but is scheduled to drop back to $16.10 when the pandemic premium ends in June. With so many better-paying jobs available, the disruption in pay is driving PCAs to tell the union they may apply elsewhere.

“There’s already concern about the availability of PCAs,” she said, “and then something like this happens, and [they] say, ‘I’m going to go look for another job, I can’t afford to do this.’”

It’s difficult to know how short staffed the personal care attendant program is, the union said, but industry turnover is high — an estimated 40 to 60 percent of workers quit every year — and the need is growing. Many people who need PCA services are elderly, and the number of adults over the age of 85 is expected to nearly triple between 2016 and 2060. Between 2018 and 2028, more than 1 million home care jobs will be added — the largest growth of any sector in the country, according to PHI, an elder care and disability services advocacy organization.

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The PCA program, which has a workforce of 55,000, is funded largely through MassHealth, the state’s Medicaid program, and serves more than 40,000 residents who need help with bathing, dressing, and other aspects of daily living. The payment delays occurred because of issues transferring information and operations to Tempus Unlimited, based in Stoughton, according to the state’s Executive Office of Health and Human Services. Previously, Tempus had shared payroll duties with two other “fiscal intermediaries” and was responsible for administering payments to about half of the state’s PCAs.

It’s not clear exactly how many workers were affected during the changeover. Tempus did not return messages seeking information about the issue, but the company wrote on its Facebook page Jan. 8 that it had received 32,000 phone calls the previous week. “Many timesheets that were rejected because they were submitted before the hours were worked are being processed and will be paid on Monday, January 10th,” the company wrote.

But many workers went without pay after that date. The state said that during the last week of January, it directed Tempus to make payments to about 4,000 attendants who had not been paid since the transition, and that MassHealth would reimburse workers for overdraft and late fees related to the transition.

Bruce Rivest of Chicopee is among those whose bank account was depleted when his check didn’t arrive on time. He received his Jan. 14 check, but the one scheduled for his next payday, on Jan. 28, didn’t show up. His car insurance payment was deducted, though, and he got hit with a $34 overdraft fee. He said he had faxed Tempus his hours and received a confirmation, but when he went to the agency he was told there was no record of his hours.

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Rivest, a former truck driver and house builder who became a PCA eight years ago to help a friend who had broken her spine, finally got a check for $1,222 on Feb. 1, and a $167 overtime payment a few days later. But going without that money for even a few days forced Rivest to pull out his credit card to tow his car and rent another one after he got into an accident.

“I pretty much live check to check,” he said. “I was going through a lot and I needed that money really bad.”

The people who rely on PCA services have also gotten caught up in the paycheck debacle, and some have gone without help after their regular attendants quit. Charlie Carr, 68, who was paralyzed in a diving accident at Revere Beach when he was 14, has three personal care attendants: one on weekday mornings, another in the afternoons, and a third on weekends. His afternoon PCA quit when the checks stopped coming and took a job as a delivery driver, he said, leaving him with a gap in caregiving for several weeks. His morning PCA, who went without pay for three weeks, covered a few shifts, and his wife helped out, but the level of care he needs is intense. Carr is quadriplegic, with no movement from the neck down. “I don’t get the care I need, I get sick, and I wind up going where?” he said. “To the nursing home, where I started.”

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Carr, a longtime disability advocate who helped launch the state’s PCA program in the early 1970s, said most attendants in the Lawrence area, where he lives, are Latina immigrants, many of them single mothers. Some people who rely on their care have been lending them money to get by.

“One interruption in a payment, or two, let alone three, they can’t survive,” he said. “What a colossal disaster.”

The state has directed Tempus to issue payments multiple times a week to make up for delayed checks, but some people are still waiting on money. The state also hired two contractors to help Tempus with its call center and other operations. The company’s call center was understaffed in part due to COVID-related staff absences, according to the state, which exacerbated the problems caused by the surge in calls.

Rachel Abbott, a nursing student at the University of Massachusetts Amherst who started working as a PCA in late December, went without pay until Jan. 20 and didn’t get a paystub until Feb. 1. Without a paystub to verify her income, she couldn’t apply for MassHealth, and she briefly went without health insurance. She spent hours on hold trying to get the problem fixed and her e-mail messages were never returned, she said. She’s thankful her parents were able to help her out but has been questioning if she should continue working in the field.

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“Tempus is really putting a lot of vulnerable people in a difficult situation,” she said. “It just feels like people don’t see this work as valuable.”


Katie Johnston can be reached at katie.johnston@globe.com. Follow her on Twitter @ktkjohnston.