Maine Health Care Services Strengthened by Bipartisan Supplemental Budget for 2022-2023

April 25, 2022

On April 20, 2022, Governor Mills signed a bipartisan supplemental budget that invests $522 million in total funding ($202 million in State General Fund) in the programs run by the Maine Department of Health and Human Services (DHHS). This will enable the Department to tackle some of the state’s most pressing problems, including ongoing impacts of the pandemic and Maine’s longstanding health care and child care workforce shortages. Five key areas with support through the budget are described below.

COVID-19 and Behavioral Health Crisis Response: While the economic recovery in Maine has been strong, the health system continues to experience strain. This is why the budget includes one-time payments to help providers of health care, long-term care, and behavioral health services.

  • $50 million ($14 million General Fund) MaineCare COVID-19 supplemental payment in fiscal year 2023 for hospitals, nursing facilities, and certain residential care facilities. This will help pay for the continued need for COVID-19 precautions – isolation units, frequent testing, higher labor costs, personal protective equipment – as well as caring for long-stay patients with the disease and pent-up demand for other types of care.
  • $21.4 million ($15 million General Fund) to providers of Home and Community Treatment, Assertive Community Treatment, outpatient therapy for children and adults, Targeted Case Management, and children’s residential services (PNMI-Ds) to help address immediate challenges facing Maine’s behavioral health system in the wake of the winter COVID-19 surge. 
  • $5.3 million ($5 million General Fund) add-on payment in fiscal year 2023 for high MaineCare utilization in private non-medical institutions that care for residents who are older or have disabilities (PNMI-Cs), which have been critical to decompressing hospitals and maintaining the full range of long-term care residential beds.

MaineCare Reform and Improvements: The biennial budget signed by Governor Mills on July 1, 2021 included significant MaineCare payment rate increases to support higher wages for front-line workers and implement data-driven rates studies. The supplemental budget continues this work and expands coverage to children. Separate from rate increases and investments, the FY22 Supplemental Budget adjusted on a one-time basis the MaineCare General Fund appropriation to account for the enhanced Federal Medical Assistance Percentage (FMAP) matching payments, which had no impact on providers.  

  • $100 million ($35.8 million General Fund) to fully implement biennial budget rate increases to support 125 percent of minimum wages for direct support services, which are more expensive as a result of higher-than-expected inflation, and to accelerate the cost-of-living adjustment for some providers to align with the start of the minimum wage policy on January 1, 2022.
  • $21.5 million ($6.4 million in General Fund) to implement rates studies for behavioral health, consistent with bipartisan legislation (LD 1867) to codify a new system for setting MaineCare payment rates that promotes equity, consistency, and transparency.
  • $12 million ($3.1 million General Fund) to expand the Children’s Health Insurance Program that will improve health coverage for thousands of Maine children.

Child Care. Quality child care is critical to the early development of children and a pillar of a strong economy and growing workforce. The budget builds on the Department’s Child Care Plan for Maine that outlines the vision and uses of over $100 million in new Federal funding.

  • $12.1 million in General Fund dollars to increase pay for child care workers and early childhood educators, with higher amounts going to higher trained and educated workers.
  • $5.2 million in General Fund dollars to increase the Maine Jobs & Recovery Plan initiative to support construction and expansion of child care facilities, helping to address geographic gaps and supporting additional sites across Maine.

Child Welfare: As part of a comprehensive plan to improve Child Protective Services, DHHS has embraced a number of recommendations from Maine’s Child Welfare Ombudsman, nationally recognized experts at Casey Family Programs, and others. The budget includes an investment of over $10 million, and separate funding to strengthen the Office of Maine’s Child Welfare Ombudsman.

  • $2.8 million ($2.2 million General Fund) investment in staff, including an additional 16 caseworkers and three caseworker supervisors dedicated to night and weekend shifts.
  • $3.2 million investment ($2.6 million General Fund) to extend and expand the Homebuilders Program to support families.
  • $2 million investment of General Fund dollars to expand Family Visit Coaching from a successful pilot to a statewide program.
  • $1 million investment of General Fund dollars in the Parents as Teachers Program, allowing it to expand services.
  • $822,000 investment to expand access to Kinship Navigators services, to create a Parent Mentor Program, and to create a Child Protective Services’ contingency fund.

Workforce and Infrastructure: DHHS is the largest department in state government and provides as well as manages privately delivered services. The budget strengthens its ability to meet its mission by including:

  • 62 new positions, including child welfare workers, limited period positions for workers who help verify eligibility for benefits, an Oral Health Coordinator, a new Developmental Disabilities Resource Coordinator to help manage the growth in the waiver programs, new psychiatric nurse practitioners, and a Chief Operating Officer for the Division of Licensing and Certification.
  • Several million for infrastructure such as roof repairs at the Dorothea Dix Psychiatric Center and expanded specialized PFAS testing at the State Health and Environmental Testing Laboratory (HETL), and relocation of HETL to a new building.

It is likely that the Maine State Legislature will enact additional legislation affecting DHHS before it is scheduled to adjourn today.