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April 27, 2022 Human Services

New round of support from the American Rescue Plan complements rapid implementation of increased rates in the budget for direct care staff who serve older adults and people with disabilities

AUGUSTA— The Maine Department of Health and Human Services (DHHS) announced today its plan to award $11 million in federal funds to home- and community-based service (HCBS) providers early this summer as part of a new round of support to help older adults and Maine people living with disabilities to remain in their communities.

Of this amount, the Department plans to award $5 million to HCBS providers to support their compliance with federal and state rules designed to ensure that individuals receiving HCBS enjoy the same access to and benefits of community living as people without disabilities.The MaineCare funding will help providers make changes to their policies, procedures, and facilities by a federal deadline in March 2023 to better support individuals in engaging in community life, controlling their personal resources, and seeking employment. The $5 million represents an increase of $3 million from the amount the Department originally proposed through its broader plan to invest in Maine’s HCBS system under the American Rescue Plan (ARP HCBS improvement plan). Pending Federal approval for the increase, the Department expects to award the full $5 million in June.

These HCBS services include a broad range of community and work supports for older adults and people with intellectual and physical disabilities, brain injury, and autism under MaineCare Sections 18, 19, 20, 21, and 29.

Second, the Department is seeking Federal approval to use the same American Rescue Plan funding for a one-time $6 million payment to support group homes for adults with intellectual and developmental disabilities. The Department is pursuing the MaineCare payment to this subset of HCBS providers in recognition of the significant toll of the COVID-19 pandemic on their operations and to support them in maintaining safe staffing levels. The Department will develop a simple, expedient methodology with public input to determine the award amounts per provider, with funds expected to be issued this summer.

“This latest round of support will bolster providers at a critical time as they recover from the pandemic and work toward changes that help advance health, independence, well-being, and fulfilment for Maine people living with disabilities,” said DHHS Commissioner Jeanne Lambrew. “It also recognizes the valuable work of direct support staff who continue to provide compassionate and high-quality care that enriches lives in homes and communities throughout Maine.”

These payments align with the Department’s overarching HCBS improvement plan to improve access to high-quality services. A cornerstone of the plan is approximately $120 million in recruitment and retention payments the Department issued in February and March to HCBS agencies for bonuses to more than 20,000 direct support workers.The initiative included workers providing aging, behavioral health, and intellectual disability services. Agencies originally had until June 30, 2022 to make the bonus payments. As another measure of support, and in response to provider requests, the Department is extending the deadline to December 31, 2022. The extension will support this critical workforce by helping to retain current workers or recruit new ones to fill vacancies.

Developed in consultation with stakeholders, including providers and families, the ARP HCBS improvement 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 plan, the Department is also supporting a direct support worker council in partnership with the Long Term Care Ombudsman Program, developing career advancement pathways, making worker certification more portable, collaborating with the Maine Department of Labor and higher education on direct care worker recruitment and training, and pursuing other longer-term initiatives. The Administration summarized these and other workforce initiatives in a report (PDF) submitted earlier this year to the Legislature.

The bipartisan supplemental budget passed last week by the Legislature and signed by Governor Mills made additional appropriations to provide the Department with sufficient resources to ensure the wage component of MaineCare rates support 125% of minimum wage for direct care workers. These rates will take effect retroactively to January 1, 2022 for agencies that provide HCBS to older adults and persons with disabilities under MaineCare policy sections 12, 18, 19, 20, 21, 29, and 96, as well as state-funded programs under Sections 63 and 69 and chapters 5 and 11. Most providers of these MaineCare services may start billing at the new rates on May 4, while retroactive billing for group homes under Section 21 will become available on May 20.

Above and beyond the ARP HCBS improvement plan, DHHS is also making historic investments in the HCBS system to support MaineCare rate increases and improve access to services through expanded slots. The biennial and supplemental budgets for fiscal years 2022 and 2023 invests $159.1 million to increase MaineCare rates for HCBS waiver services for older adults and people with disabilities and brain injury.

These investments follow increased funding that the Governor has provided each year since 2019 to provide greater access to these services.

Despite the strain of the COVID-19 pandemic, over 10 percent more Maine residents were receiving services under the HCBS waivers and their state-funded equivalent (Section 63) in January of 2022 compared to January of 2019 (8,669 compared to 7,791).