February 21, 2023
Maine is making progress in restoring access to a range of long-term support services in the wake of the COVID-19 pandemic, according to the Second Annual Report on Efforts and Progress in Implementing the Recommendations of the Commission to Study Long-term Care Workforce Issues (PDF). This new report shows actions taken in the face of the significant challenges posed by the pandemic as well as preliminary results.
Compared to a year earlier, data show modest increases in the number of residential care homes and beds, and the occupancy rate in nursing homes and residential care homes has improved. Enrollment is up in several home care programs and wait lists have declined. Although the improvement is slight in some cases, the positive year-over-year data across a number of services suggest that providers have been able to reduce staff vacancies in the past year and the direct support workforce is stabilizing.
The report highlights progress made on several workforce development strategies:
Payments to providers increased significantly. A key recommendation of the Commission was to increase rates in MaineCare and other state-funded programs to ensure the labor component is equal to at least 125% of minimum wage (Part AAAA of (PL21, Ch. 398). This provision was implemented for several services in May 2022, retroactive to January 1, 2022. Other services received monthly supplemental “ramp” payments in 2022 while rate studies were conducted. All services subsequently received permanent cost of living increases effective January 1, 2023.
Additional investments were made in 2022 as well. For example, beginning in February 2022, home- and community-based providers received over $120 million in payments from the American Rescue Plan to provide bonuses to direct support workers and their supervisors. Nursing homes and certain residential homes received an interim supplemental wage add-on to their rates from January to June 2022 and permanent increases in July. The report describes these and several other one-time and permanent increases in rates during 2022.
Media campaigns launched and expanded. With support from the Governor’s Maine Jobs and Recovery Plan, the Department of Labor (DOL) launched Caring for ME in April 2022. Through a combination of digital outreach, traditional media and social media, the Caring For ME website, featuring current job opportunities, events and career pathways information, attracted 40,000 visitors, 3,000 of whom continued to MaineJobLink to access current job postings in the field. DOL and DHHS worked closely together on the initiative, and in December, the campaign transitioned to DHHS for a second marketing wave that further promotes jobs in aging, disability, and behavioral health.
Also in 2022, DHHS contracted with Live and Work in Maine to develop health career exploration and outreach tools aimed at encouraging graduating high school students and younger workers to enter health care professions. Funded by $1.5 million from the Maine Jobs and Recovery Plan, this strategy is part of a public/private partnership with the Maine Hospital Association, Maine Primary Care Association, and the Maine Health Care Association. This campaign has created 22 career exploration videos, a job board, and a career toolkit distributed across all high schools in Maine. The multimedia advertising strategy includes radio, video, traditional and social media, and has resulted in 58,533 job views for positions in the health care sector, and 699 applications to health care jobs posted on the Live and Work in Maine job board.
Access to training expanded. DOL and DHHS worked closely with the Department of Education (DOE), the Maine Community College System (MCCS) and the University of Maine System to coordinate a centralized approach to health care training opportunities and funding via Healthcare Training For ME (launched in April 2022). The funding is a combination of approximately $7 million in tuition remission funding from the Maine Jobs & Recovery Plan as well as MCCS funding. The focus is working with employers to connect existing health care workers in entry level jobs with training funding to support attaining certifications and credentials to move up the career ladder and to improve retention and quality of care.
Also, DHHS launched the Worker Portability and Advancement initiative to create a base credential usable by individuals in at least two current roles, the Personal Support Specialist (PSS) and Direct Support Professional (DSP). Consideration for inclusion in this initiative is also being given to Mental Health and Rehabilitation Technician I. The curriculum is based on key competencies endorsed by the federal Centers for Medicare and Medicaid Services for these roles. This will simplify and advance the ability of workers to fill related jobs with credentials, and to advance within the field.
Information and career opportunities expanded for individuals receiving public assistance. Families Forward (through the TANF ASPIRE program) now offers a health and human services career development on ramp program. Participants learn about career ladders in both fields and how they intersect. Course activities include writing assignments, simulation activities including mock interviews, lectures, speakers, and videos. Students participate in weekly networking events with employer and educational partners geared toward the geographical locations of each cohort and their specific interests. Beginning in week four, most students are placed in a field training experience, employment, or educational opportunity. English language learners are given additional supports through a partnership with adult education, in-person and online language classes, and tutoring delivered by Greater Portland Immigrant Welcome Center.
As a complement to this and other opportunities, a new financial planning tool was piloted in 2022, in partnership with the federal Administration for Children and Families (ACF) and the Federal Reserve Bank of Atlanta. The Benefits Cliff Tool Pilot enables workers to receive coaching and see how starting in entry level health care jobs can provide a pathway to greater economic mobility while helping them plan for how it will or will not impact their benefits.
Early in 2023, the PHI Direct Care Workforce Index ranked Maine as the 4th best state in the nation for direct support worker policies and economic status. Although more progress is needed, the ranking is another indicator that Maine is making strides in growing and retaining its direct support workforce.