Quarterly Update: Enrollment in Home and Community Based Services Waiver Programs Up Despite Pandemic and Staffing Challenges

August 6, 2021

Since our last update, the number of adults with intellectual or developmental disabilities (IDD) and brain injury who are enrolled in home-and community-based services (HCBS) waiver programs increased by 76:

  • 63 individuals were added to the Section 29 program (Support Services for Individuals with IDD),
  • Seven individuals were added to the Section 18 program (Individuals with Brain Injury), and
  • Six individuals were added to the Section 21 program (Comprehensive Services for Individuals with IDD).

This increase in enrollment occurred despite the continuing challenges of the pandemic and significant staffing challenges statewide. During this period (January-March 2021) the wait lists for these services also increased slightly, adding 21 individuals.

The staffing shortages are particularly challenging in Section 21 group homes. In response, DHHS is investing heavily in workforce-related initiatives and support, including:

  • $126 million for worker retention and signing bonuses as part of the total $229 million proposed for HCBS across all population groups,
  • $65 million in the form of a permanent rate increase for group homes and related services,
  • Ensuring that rates support an average starting wage that is 125% of the state minimum wage, and
  • Funding for 720 additional people to be added to the Section 29 program (30 per month over the two-year biennium) to ensure ongoing access for new individuals needing services.

In addition to taking action to stabilize and ensure the future sustainability of Maine’s HCBS workforce, DHHS has taken numerous steps to support adults with IDD and brain injury in their homes and communities throughout the COVID-19 pandemic. These provisions include:

  • Temporary rate increases for providers serving all of Maine’s HCBS waiver programs to offset the costs of hazard pay for direct support workers, personal protective equipment, and other COVID-19-related costs.
  • Allowing payment of family members to provide care and to increase payment for additional members in shared living.
  • Adding an emergency quarantine service for COVID-19 positive HCSB waiver recipients.
  • Temporary increases to limits for several key services, such as assistive technology, data transmission charges to support use of the technology, and case management hours,
  • Giving agencies flexibility with staffing to ensure they can follow best practices for preventing the spread of infection across homes.

These measures will remain in effect for up to six months after the federal COVID-19 emergency ends.

Table 1 provides a snapshot of the programs as of March 31, 2021, and additional data is available on our website.

Table 1. Developmental Disabilities and Brain Injury Program Participants and Wait Lists, as of March 31, 2021
Waiver Program Participants Waitlist With Other Coverage Without Other Coverage (Percent of Current Participants)
Brain Injury (Section 18) 212 118 71 47 (22%)
Other related Conditions (Section 20) 38 24 10 14 (37%)
Comprehensive Services for IDD/ASD (Section 21) 3,246 1,891 1,520 371 (11%)
Support Services for IDD/ASD (Section 29) 2,420 180 70 110 (5%)
Totals 5,916 2,132 1,503 629 (11%)