State Budget Improves Health Care and Pandemic Recovery in Maine

July 1, 2021

Highlights of the Department of Health and Human Services’ Components of 2022-23 Part 2 Biennial Budget (LD 221)

As passed by the Legislature and signed by the Governor, the 2022-23 Biennial Budget Part 2 for the Department of Health and Human Services supports a range of vital activities, including services for Maine’s most vulnerable residents, public health infrastructure, and expanding access to affordable health coverage to better serve and protect Maine families.

This Part 2 Budget includes initiatives that build on the current services that were funded in the Part 1 Biennial Budget signed into law on March 31, 2021. The budget is complemented by the Maine Jobs & Recovery Plan that proposes how the over $1 billion coming to the State of Maine from the American Rescue Plan will be spent. The Plan includes a $15 million investment in the health care workforce, $20 million for the Maine Drinking Water Program at Maine CDC, and $10 million to enable child care providers to renovate, expand, or construct child care facilities to increase accessible and affordable child care. This complements the historic increases in Federal funding from the coronavirus relief laws as detailed in the Child Care Plan for Maine. Direct Federal funding is also significantly expanding services as described in the Behavioral Health Plan for Maine. The Maine Center for Disease Control and Prevention (CDC) is also receiving significant, direct support for capacity from the U.S. CDC.

Supports Hospitals, Nursing Homes, and Direct Care Workers Affected by COVID-19 Pandemic

The Part 2 budget supports providers who were on the front lines and particularly hard-hit by the COVID-19 pandemic, including long-term care facilities, hospitals and behavioral health providers. Highlights include:

  • $57.6 million ($13.7 million GF) for one-time supplemental payments to Nursing Facilities to support workforce needs and lower occupancy rates;
  • $22.2 million ($6.3 million GF) for one-time supplemental payments to Residential Care Facilities (PNMI Cs) facilities and Adult Family Care Homes to support workforce and occupancy needs;
  • $23 million ($5.4 million GF) for one-time supplemental payments to Hospitals to support their response to the COVID-19 pandemic;
  • $9.6 million ($2.9 million GF) for short-term bonus payments as ramps to ongoing higher wages for direct support professionals.

In addition to one-time COVID-19 support, the budget also provides $23 million ($6.9 million GF) for Nursing Facilities in FY23 for cost-of-living and rebasing increases and $3.6M ($2 million GF) for Residential Care Facilities in FY23 for cost-of-living increases. Corresponding funding for Nursing Facilities and PNMI Cs for FY22 cost-of-living increases was previously provided in Part I of the FY22-23 Biennial Budget that is current law.

Expands Access to Affordable, Sustainable Health Care through MaineCare

The budget extends MaineCare’s dental coverage for adults to include preventive and routine care with an investment of $42.4 million ($12.3 million GF), and provides $8.6 million ($2.6 million GF) to further ensure that dental rates are adequate to promote access. This will prevent more expensive dental costs down the road and, as studies show, improves employment, wellbeing and confidence.

The budget also makes a sizable investment in MaineCare reform, providing funding to implement the first set of proposals related to MaineCare’s comprehensive rate system evaluation. The budget increases provider payment rates for dozens of services and also makes short-term investments to improve members’ health and save over the long term, including bolstering diabetes prevention. Specific highlights of MaineCare reform initiatives in the budget include:

  • $32.5 million ($9.8 million GF) investment in rates for Section 21 and Section 29 services in FY23 ($32.5 million ($9.8 million GF) was already provided for rate increases for FY22);
  • $28.6 million ($8.4 million GF) to provide funding to ensure MaineCare services receive an annual cost of living adjustment;
  • $30.7 million ($9.7 million GF) to standardize Medicare payment benchmarks across numerous sections of MaineCare policy, which will provide a net increase to MaineCare rates to ensure that MaineCare members have access to high value services.

The budget also makes a down payment for future rate reform by adding $40 million to the MaineCare Stabilization Fund.

The budget also restores health coverage for immigrant pregnant women and children through an investment of $3.5 million.

Extends Behavioral Health Services and Supports

The budget further strengthens mental health and substance use disorder prevention and treatment services, including:

  • $7 million ($1.6 million GF) to implement an evidence-based early-intervention Coordinated Specialty Care model to treat MaineCare members for a first episode of psychosis;
  • $500,000 for a crisis center in Cumberland County to connect individuals with support and help stabilize them for reintegration back into the community;
  • $19.8 million ($4.2 million GF) to expand eligibility for Intensive Outpatient Programs (IOP) for MaineCare members by including other serious behavioral health diagnoses in addition to Substance Use Disorder (the budget also provides $3.6 million ($510,000 GF) for Substance Use Disorder IOP service rates);
  • $2 million from the Fund for Healthy Maine to support the Overdose Prevention through Intensive Outreach, Naloxone and Safety (OPTIONS) program to raise awareness about drug overdose risks and to promote the new Substance Use Disorder and Mental Health Treatment Locator;
  • $2.6 million ($360,00 GF) to increase MaineCare rates for Substance Use Disorder residential treatment facilities (PNMI Bs). Together with the Department’s approved Medicaid 1115 waiver to enable facilities to expand treatment beyond a 16-bed limit, this investment will help to improve treatment capacity in the State;
  • $13.7 million ($4.8 million GF) to support innovative MaineCare pilots associated with the 1115 waiver and the MaineMOM program to provide treatment and parenting supports to promote recovery and family unity;
  • $19 million ($6.4 million GF) to increase the rates for Children’s Residential Treatment facilities (PNMI Ds) to ensure services will meet the requirements of the Family First Prevention Services Act (funding was also separately provided in Part 1 of the Biennial budget).

The Department is also conducting MaineCare rate studies for behavioral health services and an assessment to lay the groundwork for certified community behavioral health clinics.

Rebuilds Public Health and Department Infrastructure

The budget makes necessary and critical investments in positions for the Department. There are 88 new positions included in the budget, 72 permanent and 16 new limited-period positions (LPP). Highlights include:

  • 31 positions for Maine Center for Disease Control and Prevention (CDC) to reinvest in the state’s public health infrastructure;
  • 15 positions for the Office of Behavioral Health to strengthen the state’s response to mental health and substance use disorders, including 10 positions to create a Health and Justice team to help individuals with behavioral health challenges avoid unnecessary institutionalization or incarceration;
  • 10 positions to support ongoing and future MaineCare reform related to rate-setting, policy, and access to high-value services;
  • 15 positions for the Office of Child and Family Services to continue to strengthen child welfare.

The budget also includes $6 million to address structural financial gaps at the Maine CDC, including at the State’s Health and Environmental Testing Laboratory that has been critical to COVID-19 response.