The BDN Opinion section operates independently and does not set news policies or contribute to reporting or editing articles elsewhere in the newspaper or on bangordailynews.com
Felix Hagenimana is chief executive officer of Beyond Residential Care, a MaineCare Section 21 provider.
Maine should demand accountability from every provider entrusted to support adults with intellectual disabilities and autism. People served through MaineCare Section 21 deserve safe homes, qualified staff, meaningful community lives, and prompt action when care falls short.
They also deserve a public discussion that explains what this work costs and what agency action does — and does not — establish.
Too often, debate about MaineCare reduces a complex disability-services system to large reimbursement totals. That framing suggests a provider receives a large payment and simply keeps the difference. It can also turn allegations, preliminary agency actions, and disputed facts into settled conclusions.
Section 21 does not work that way.
Section 21 is Maine’s home- and community-based services program for eligible adults with intellectual disabilities or autism spectrum disorder. It helps people live in their own homes or community settings rather than enter or remain in institutions. The program is person-centered: each member should have an individualized plan identifying support for health, safety, preferences, and community life.
Services include direct support at home and in the community, daily-living assistance, transportation, employment, and community participation. Providers are not paid merely for a building or a bed. They must be approved by the Office of Aging and Disability Services, enroll in MaineCare, and meet specific service and compliance requirements.
Those requirements should be enforced. No one should overlook safety concerns, inadequate supervision, or failures to provide promised care. Regulators need resources and authority to protect members and families.
But accountability requires precision.
A MaineCare reimbursement is not an owner’s salary or personal profit. It funds direct-support wages, payroll taxes, benefits, overnight and weekend coverage, crisis staffing, supervision, clinical and administrative expertise, training, transportation, insurance, compliance systems, and home and household operations.
Direct-support professionals help adults with disabilities manage routines, take medication, attend appointments, participate in their communities, and avoid unnecessary institutionalization. Their work can involve complex behavioral needs, overnight coverage, crisis response, and substantial emotional and physical demands.
For certain Section 21 service arrangements, gross reimbursement may work out to roughly $33 per hour. But that figure funds far more than a direct-support professional’s base wage. At BRC, direct-support professionals starting wages were approximately $17 per hour. The balance supports staffing, supervision, training, coverage, and the infrastructure needed to provide care around the clock.
MaineCare accountability requires accuracy, too.
State rate-setting materials recognize this reality. Maine’s 2025 proposed rate model used a direct-staff wage of $19.76 per hour and an employee-benefit rate of 38.3 percent — an estimated wage-and-benefit cost of $27.33 per staff hour before productivity adjustments and operating costs such as supervision, administration, transportation, and facilities.
Beyond Residential Care’s 2025 results show why reimbursement figures alone do not prove excess profit. BRC employed more than 100 people, received $5,397,390 in MaineCare reimbursements, and reported net income of $185,601 — approximately 3.44 percent of that figure. Its management team included four senior professionals with advanced degrees, including two doctorates.
These facts do not place BRC, or any provider, above scrutiny. They make a narrower point: reimbursement totals reflect the scale and cost of care. Without more, they do not prove personal income, extraordinary profit, or fraud.
Maine must also confront its workforce challenge. When agencies cannot recruit and retain direct-support professionals, people with disabilities may lose trusted staff, experience disrupted services, or have fewer choices about where and how they live.
Maine should welcome qualified people willing to build careers in this essential work — lifelong Mainers, newcomers, immigrants, and refugees alike. The measure should be training, professionalism, integrity, supervision, and care quality. Treating immigrant participation in direct care as suspicious does not make consumers safer. It stigmatizes essential workers, narrows an already strained labor pool, and distracts from our shared obligation: safe, stable, person-centered support.
Maine can insist on strong enforcement, fair process, and careful reporting. Together, those values offer the best path toward a disability-services system that protects people, respects their choices, sustains a qualified workforce, and earns public trust.