A man walks by the Maine Center for Disease Control on Water Street in Augusta in March 2020.

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As the coronavirus begins to crop up in group homes for the people with intellectual disabilities and autism, the providers who run them say they are encountering more financial trouble than usual and having trouble securing protective gear to keep staff and residents from becoming infected.

At least four group homes where people with intellectual disabilities live have seen outbreaks in Maine.

Three cases were reported at the John F. Murphy Homes in Auburn in late April, and none have been reported since.

This week, three other group homes reported outbreaks. A Residential and Community Support Services home in Sanford recorded four cases, and there were three positive tests at a Spurwink facility in Portland, according to the Maine Center for Disease Control and Prevention. Granite Bay Care Inc., which runs 80 group homes across much of southern Maine, saw two residents and four staff members at a Brunswick home test positive. That outbreak brought Granite Bay’s total of coronavirus cases to 20 since the start of April, according to the organization.

[Our COVID-19 tracker contains the most recent information on Maine cases by county]

Outbreaks at these homes are likely to unfold differently from how they do in the larger congregate care settings such as nursing homes and homeless shelters where most outbreaks have occurred. They are typically standalone homes with just a few residents and the staff members who care for them, which can limit the scope of the outbreak. Those receiving services under the Section 21 MaineCare waiver — through which group home providers are paid — often need 24-hour supervision.

The group home setting also makes it difficult to prevent the entire household from getting sick, Maine CDC Director Nirav Shah said Wednesday. Like nursing home staff, employees have to be especially careful outside the home, because it is nearly impossible to track how the virus — often carried by those without symptoms — arrives once it is in the home, he said.

To combat the spread of the virus, some providers have begun assigning their staff to certain homes rather than having them move around. But that can be a challenge in a field that has historically faced workforce shortages due to low pay, and some providers say they have had a hard time securing personal protective gear.

For about eight weeks, the organization OHI, which runs group homes in the Bangor area, has been delivering food to houses. It also stopped community outings and in-person visits to try to prevent people from getting sick, said Bonnie-Jean Brooks, the organization’s president and CEO. They also divided homes into “neighborhoods” to which designated staff are assigned.

Granite Bay and Residential Community Support Services have undertaken similar efforts, officials with those organizations said earlier this week.

Those measures have prevented anyone in OHI from getting sick, but Brooks said the organization is running a budget deficit and struggling with the costs of delivering food, providing stipends to direct care workers to incentivize them to show up to work, and providing extra amenities to help their clients stay at home, such as Netflix subscriptions for every house.

OHI has had to provide its own personal protective gear, although Shah said on Wednesday that the CDC is providing PPE to group homes. The cost of such gear is expensive, and providers have to be on the lookout for scams.

Those budget woes are exacerbated by four resident vacancies at OHI homes. Despite plenty of demand for Section 21 services — the statewide waitlist stood at 1,694 at the start of April, according to the Department of Health and Human Services — Brooks said she is hesitant to bring in new residents for fear of unknowingly bringing a sick person into a household.

“The deeper we’ve gotten into quarantine, the more training we’ve acquired, the safer we’ve felt,” Brooks said, adding that OHI is looking to fill those four vacancies soon.

Some families are also choosing to bring their family members in group homes to their own homes to wait out the pandemic, which causes additional revenue stresses. Those individuals are entitled to their spots when they return, Brooks said, but providers are not allowed to bill for services they are providing.

Meanwhile, some families with children or other family members at home have been left without services, said Cathy Dionne, executive director of the Autism Society of Maine. In a survey her group conducted with the Maine Developmental Disabilities Council, Dionne said 26 percent of families who have adults with intellectual disabilities or autism had not been contacted by their case managers.

That could lead to a regression in social skills and independence, Dionne said.

The state has been approved for an emergency Medicaid waiver that may bring some relief to service providers. The provisions include allowing providers to hire 17-year-olds to be direct care workers, an increased stipend for technology, and a 10 percent rate increase for additional costs incurred due to the pandemic, such as overtime and infection control supplies.

The waiver’s rate increase is in effect retroactively from March 1 to May 31.

Watch: Why Maine is tracking number of tests instead of people tested

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