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Staff Pressures and More Money for Institutions

At the end of 1969, Superintendent Bowman declared that the medical staff of Pineland Center would stop “donat[ing] 14 hours of the time to the state of Maine…” by working 54 hours per week, despite the $9 per week raise the 104th Legislature had given all state workers. “The staff assured him, Dr. Bowman said, that despite the reduction in hours ‘no patient would suffer in any way’”. (Lewiston Evening Journal, September 10, 1969)

On the ballot in 1969 was a referendum bond issue for $2.5 million in funds to “enlarge and improve” institutions, which passed by a large margin.

A question form on a public referendum ballot from 1969, titled: Referendum Question No. 12. Under the title reads: “Shall our mental and correctional institutions be enlarged and improved to better accommodate person with mental, emotional, or social disorders by issuing bonds in the amount of $2,515,000?”. To the right of the question language are two checkboxes labeled “Yes” and “No”.
1969 Referendum Question No. 12
Document showing the outcomes of the votes by county for two referendum questions in 1969.
1969 Referendum Questions 11 and 12 outcomes of vote

Complaints brought by staff around pay and hours were also addressed:

Newspaper clipping from the Lewiston Daily Sun, February 3, 1970
Lewiston Daily Sun, February 3, 1970

Even after this, Superintendent Bowman would rail against the Legislature and State government for “rigid and monolithic” administration of the institutional system. Bowman would be pushed out of the superintendent position in 1971, after running Pineland for 18 years.

Newspaper clipping from the Lewiston Evening Journal, May 15, 1970 – Headline: Dr. Bowman Says Administration of Socialized Medicine In State Hospitals Inadequate, Antiquated
Lewiston Evening Journal, May 15, 1970
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From the beginning of the institutional period, the cost of providing care for people with developmental disabilities was both the reason for building larger and larger congregate settings and an excuse for any evidence of neglect or poor treatment that came to light.

Throughout the history of Pineland you can see the frequent requests for more funding.  When Pineland was closed a new pool of money was flooded into the community.  This followed a series of cuts and the same types of pleas for additional funds that can be seen through the institutional period.

To this day, disagreements over the amount of funding put towards services plague this system. Reimbursement rates and workers’ paychecks, infrastructure and innovative care – the question of “how do we pay for this?” hangs over all the decisions made.

Workforce Crisis

Workforce Crisis

The bulk of the labor that supports people with developmental disabilities has historically been done by “low wage” earners – high school graduates or those with associate degrees working for minimum wage or very close to it. In addition to “low wages”, society at large can view the job as low skilled and akin to “babysitting.”  In addition to a lack of workers to fill the shifts and perform the vital tasks, those that are employed in this field often feel undervalued and overworked. Expectations are low – and services suffer as a result. People with developmental disabilities often don’t get the supports they need from the staff hired to serve them – and the behaviors and reactions that may occur with this lack of support can then lead to abuse and neglect, including an overdependence on traumatic interventions like restraint.

Good direct care providers are also promoted to “supervisor” roles without the training and skills needed to support direct care workers (as the skillset of the two jobs are not the same.)  Of course, this assumption of the skills is simply untrue.  The lack of value placed on those doing this essential work has led to labor shortages again and again.