AUGUSTA— The Maine Department of Health and Human Services (DHHS) is issuing $11 million this month to providers of home and community-based services (HCBS) in the latest round of support to help Maine people living with disabilities remain in their communities.

The funding, provided through two complementary payments under the federal American Rescue Plan Act (ARPA), is part of the Department’s HCBS Improvement Plan (PDF) to increase access to high-quality services.

“My Administration is committed to supporting the independence of Maine people living with disabilities and this additional round of funding will help to ensure they can continue to live in the homes and communities they love,” said Governor Mills. “This funding will also support the direct care workers who dedicate themselves to providing around the clock, high quality care to people across the state. My Administration will continue to do all we can to support our community providers and the people they serve.”

“Maine designed and secured federal approval for this latest round of funding to accelerate the recovery of home and community-based service providers from the pandemic and to help advance the health, independence, and well-being of Maine people living with disabilities,” said DHHS Commissioner Jeanne Lambrew. “This latest round of funding is also in recognition of the valuable work of direct support workers who provide compassionate and high-quality care that enriches lives in homes and communities throughout Maine.”

“Our network of providers and direct support professionals continue to face severe staff shortages and increased costs due to both overtime pay and inflation,” said Laura Cordes, Executive Director of the Maine Association for Community Service Providers (MACSP).“We are grateful for the support of both Governor Mills and state legislators for these funds that will help to maintain vital daily supports and community access for thousands of Mainers with disabilities while making changes to service models and improvements in homes throughout the state.”

On Wednesday, the Department issued $4.75 million in grants to HCBS providers that have been working to comply with a federal rule that promotes greater inclusion in the community for individuals with disabilities. The funding helps providers make changes to their policies, procedures, and facilities by a federal deadline of March 2023 to better support individuals in engaging in community life, controlling their personal resources, and seeking employment. While most eligible providers registered for the payments, the Department has re-opened registration for an additional two weeks from September 12th to September 26, 2022 to ensure all eligible providers can access these funds. Eligible providers that have not yet registered may do so online using this web form.

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 Benefits Manual Sections 18, 19, 20, 21, and 29.

Next Wednesday, September 28, the Department will make a one-time MaineCare payment of $6 million to group homes and family-centered homes serving adults with intellectual and developmental disabilities under Section 21. The payment assists a subset of HCBS providers who are addressing continuing COVID-related staffing challenges in recognition of the significant toll of the pandemic on their residential operations. Registration is not necessary for this payment. Eligible providers have been identified through MaineCare claims and the payments are prorated based on those claims.

These two payments align with the Department’s overarching HCBS improvement plan to bolster access to high-quality services for adults with disabilities. The funding supporting the improvement plan was made available to states through the American Rescue Plan specifically for home and community-based activities. 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 payments to workers providing aging, behavioral health, and intellectual disability services.

Developed in consultation with stakeholders, including providers and families, the ARPA 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 portable across types of disability and settings of care, collaborating with the Maine Department of Labor and higher education institutions 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.

Above and beyond the ARPA HCBS improvement plan, DHHS is also making historic investments in the HCBS system to support MaineCare rate increases and to improve access to services through an expanded number of slots. The biennial and supplemental budgets for fiscal years 2022 and 2023 invest $159 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 Governor Mills 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).