Maine Department of Health and Human Services
Jeanne M. Lambrew, Commissioner
February 9, 2022
FOR MORE INFORMATION, PLEASE CONTACT:
Jackie Farwell, Maine Department of Health and Human Services
Maine DHHS Distributes Payments to Fund Bonuses for 20,000 Direct Support Workers
Mills Administration’s provides $116 million for new-hire and retention bonuses for home- and community-based employees
AUGUSTA—The Maine Department of Health and Human Services (DHHS) announced that it is distributing this week the first half of $116 million in MaineCare payments to home- and community-based services (HCBS) providers to fund bonuses for more than 20,000 direct support workers. The second half will be distributed later in February.
The bonus payments, first announced in November, are available through the American Rescue Plan and represent a major component of the Department’s plan to improve access to high-quality services that help ensure Maine people of all ages, including those living with disabilities and behavioral health challenges, can remain in their communities. The Department's plan has received full federal approval, bringing federal matching Medicaid funds to Maine for these bonuses and other elements of the plan. These HCBS services include a broad range of personal care, home health, and behavioral health, shared living, and community and work supports.
The bonuses will benefit 20,184 current direct support workers at 311 providers throughout the state. In addition, the providers may pay recruitment bonuses to fill vacancies with new workers. The bonuses aim to address COVID-related, short-term health care worker shortages and are also closely aligned with the health care workforce priorities included in Governor Janet Mills’ Maine Jobs and Recovery Plan.
“Direct support workers are a vital part of the health care workforce that has been the backbone of Maine’s response to COVID-19,” said Governor Mills. “They’ve risked their own health for nearly two years to care for Maine people so they can stay in their homes and communities throughout the state. These bonus payments are a recognition of their vital work and central to our broader investment in strengthening our system of care and services for older adults and those with disabilities and mental health challenges now and into the future.”
“These payments are aimed at providing much-needed relief to Maine’s dedicated direct support workers and an incentive to anyone considering a career caring for older Mainers as well as for Mainers of all ages with disabilities and behavioral health challenges,” said DHHS Commissioner Jeanne Lambrew. “Beyond their extraordinary care during the pandemic, the direct support workforce is central to our ongoing work to provide accessible, high-quality services to help Maine people maintain health and fulfill their goals.”
“These bonus payments are very good news for direct care and support professionals who provide essential care to older Maine people and those with disabilities,” said Brenda Gallant, Maine’s Long-Term Care Ombudsman. “These dedicated professionals have expressed to us that wages are among their top concerns, and they deserve compensation that reflects the difficulty and importance of the work they perform. The bonus payments are a greatly needed investment in a workforce that is critical to the wellbeing of so many Maine people who need care.”
“This funding is crucial to attracting and retaining Maine’s behavioral health workforce, who help Maine people with mental health and substance use disorders stay in their homes and communities,” said Eric Meyer, Board President of the Alliance for Addiction and Mental Health Services and President and CEO of Spurwink Services. “The Alliance applauds the Mills Administration for providing this funding for direct support workers as part of its broader plan to improve access to services for people with behavioral health challenges, particularly as the COVID-19 pandemic continues to stress the residents of our state. We look forward to these bonuses reaching the hardworking employees on the front lines.”
“We are thankful to share the great news of these payments with our staff, the people we support, our Board of Directors and others looking forward to this relief,” said Melinda Ward, CEO of OHI in Bangor. “It is our hope that these dollars will help retain our staff who have worked many, many hours with some of the state’s most vulnerable citizens with intellectual and developmental disabilities and mental illness, and who have successfully kept them safe from serious illness with COVID-19 over the past two years. The bonuses will be just the lift that many of our staff need right now, and hopefully will attract new applicants to our organization. We’re grateful to the Mills Administration for delivering on this promise.”
“Providers of Home and Community Based Services across Maine welcome the release of these ARPA-funded bonuses and will put these monies to good use to retain and recruit staff,” said Michael Stair, Secretary for the Home Care and Hospice Alliance of Maine and Chief Integration Officer for Androscoggin Home Healthcare and Hospice. “Speaking both on behalf of licensed and registered members of the Home Care and Hospice Alliance of Maine, and as a statewide provider of home and behavioral health services, we know all too well how acute the workforce shortage has become. We look forward to putting these dollars to work immediately to keep staff on the job, and to attract new employees to care for those we serve.”
Starting this week, DHHS is distributing the funds to qualified provider agencies in two phases. Provider agencies will receive a payment amount based on their HCBS MaineCare revenue and will pay bonuses directly to workers, shared living providers, therapeutic foster care providers and supervisors by June 30, 2022. Individual employee bonus amounts will be determined by the provider agency in accordance with a bonus policy that the agency will adopt and share with its employees. DHHS developed this system in consultation with provider agencies to reduce the administrative burden, give agencies more certainty about available funding and allow agencies to create specific bonus policies that are best for their employees. All provider agencies that receive funds for bonuses are required to pay at least 80 percent of funds in direct payments to staff, not including agency leadership. Agencies will be subject to both Federal and State audit.
The $116 million allocated for bonus payments, based on registration and 2019 data, is part of DHHS’s broader plan to invest approximately $229 million in Federal Medicaid matching funds for Maine’s HCBS system improvement plan. This plan was developed in consultation with stakeholders, including providers and families. The plan reflects the consensus that the most immediate challenge facing Maine’s HCBS system is attracting and retaining direct support workers. As part of the HCBS system improvement plan, the Department is also creating a direct support worker council, developing career ladders, making worker certification more portable and pursuing other longer-term initiatives. The Administration has summarized these and other workforce initiatives in a report submitted earlier this month to the Legislature.
Governor Mills’ Maine Jobs and Recovery Plan includes a slate of initiatives to encourage people to pursue health care jobs in Maine and strengthen the state’s health care workforce. This includes $4 million to provide scholarships and student loan relief to enable more people to become behavioral health specialists, long term support workers, emergency medical services staff, and other health professionals. An additional $8 million supports a program to help people who work in the health care field gain skills and advance with their employer. The Jobs and Recovery Plan also includes a $1.5 million recruitment effort, with $500,000 dedicated specifically to promoting direct support worker jobs, such as aides for older Mainers or individuals with disabilities.
The Mills Administration has taken a number of actions to support HCBS providers during the pandemic. The Department recently proposed to raise MaineCare rates effective in January for many home- and community-based services, accelerating higher rates initially planned for July 1, 2022 and supporting providers in increasing pay for direct care workers to at least 125 percent of the state’s minimum wage.
As provided in the biennial budget, the Administration allocated $160 million primarily for workforce recruitment and retention support: $14 million for behavioral health providers (Sections 17, 8 and 65), $123 million for nursing facilities, residential care facilities (Private Non Medical Institution (PNMI) Cs), and adult family care homes, and $23 million for hospitals. This is in addition to the award of $25 million in Coronavirus Relief Funds to health care organizations to help them recover from the COVID-19 pandemic.
In November, Substance Use Treatment facilities (PNMI Appendix B providers) received MaineCare rate increases for a variety of services. Children’s Residential Care Facilities (PNMI D providers) also received rate increases, effective November 1, 2021 to help providers meet new requirements associated with the federal Family First Prevention Services Act.
Additionally, during the pandemic, Maine DHHS adopted emergency provisions in MaineCare to give agencies more flexibility with staffing and outbreak rates for residential care facilities, which remain ongoing. The Department has also connected providers to potential sources of staff, including the state’s ASPIRE program, vocational rehabilitation services, college job boards and the Department of Labor’s Maine JobLink. These and other resources are available in a Recruitment and Retention Tool Kit.