Recruitment and Retention Toolkit

This page contains resources for providers of health care, behavioral health, and long-term services and supports in recruiting and retaining workers.

The page will be updated as additional resources are identified. If you have suggestions for other resources to include, for behavioral health please email OBH.TownHall@maine.gov and aging and disability programs email OADS@maine.gov.

Public Health Emergency Staffing and Program Waivers

Appendix K Provisions for HCBS Waiver Program Providers

The temporary, emergency changes to the Section 18, 20, 21 and 29 Waiver Programs include:

  • Allows relatives to provide care for their family member when hired by the provider agency or when established as a contractor with the provider agency.
  • Allows providers to waive the minimum age limitation which is currently age 18 and older and allow a provider to hire staff age 17 years and older.
  • Allows providers to waive the educational requirement of a high school diploma or GED.
  • Changes training and certification requirements which allow more time for the paid provider to receive training and certification prior to the effective end date of the Appendix K.
  • Allows staff with expiring/expired credentials in the administration of medication to continue to dispense medication during the emergency period as long as the staff actively work towards obtaining re-certification. 

Skilled Nursing Facility Staffing-Ratio Waiver

In recognition of the ongoing challenges of the COVID-19 Public Health Emergency and the immediate need for skilled nursing and nursing facility services, the DHHS Division of Licensing and Certification is supporting conditional waivers of minimum staff-to-patient ratios for skilled nursing facilities. Please see the letter of guidance posted below for instructions to request a waiver.

Hospitals

This memorandum is to clarify the option for Acute Care Hospitals to transfer skilled nursing and nursing level of care patients to Critical Access Hospitals (CAHs) during the ongoing Public Health Emergency.

Financial Support for Providers

New MaineCare Resources

  • Retainer Payments for Community and Work Support
    • Up to $18.9M for MaineCare Sections 18, 20, 21 & 29
    • Provider guidance on claiming issued August 30
  • Supplemental Payments for Nursing Homes, PNMI C and Adult Family Care Homes
    • $123M for MaineCare Sections 2, 67 & 97C
    • Provider information issued on September 10
  • Temporary monthly supplemental “ramp” payments for Behavioral Health providers
    • Begin January 2022, through calendar year 2022
    • Sections 17, 26, 28, 65
  • Behavioral health rate increases
  • PNMI E guidance
  • HCBS FMAP bonuses for new and existing direct support workers and supervisors across several MaineCare Sections, including behavioral health
    • Up to $126M, pending CMS approval
    • Draft guidance issued August 19 for comment
    • Changes expected in final guidance

For more information on FMAP bonuses and other HCBS FMAP initiatives, please visit the Initial Plan.

Federal Financial Support

Non-Profit Provider Grant Resources

Behavioral Health Staffing, Credentialing, and Regulatory Flexibilities

As of October 2021 the following flexibilities are permitted under the Public Health Emergency (PHE) and for 30 days after the end of the PHE.

Note: Flexibilities marked with an asterisk (*) are ongoing, regardless of the status of the PHE.

Eligibility and Authorization

  • Signature requirements – waving signatures and allowing verbal approval for services
  • Telehealth
    • Telehealth waiver of advance written notice
    • Telehealth waiver of comparability
  • Allowance of telephonic services when appropriate to deliver via telephone
    • Telehealth addition of telephone-only Evaluation and Management codes
  • Section 17 retention of eligibility through previously rendered diagnoses and clinical judgment
  • Community Integration eligibility verification required day 61

Staffing changes that are currently allowable and billable

  • Adds Direct Support Professional (DSP) as qualified providers to provide the following services:
    • Residential care services, emotional development skills training, daily living skills training, Interpersonal skills training, and community skills training.
    • HCT
    • PNMI
  • Crisis Services
    • Both mobile and residential (includes conditional and provisional categories): BHP, DSP, MHRT/C, MD, PA, Psychiatrist, psychologist, LCSW, LCPC, LMFT, APRN, NP
      • Completion of Safety and Hospitalization Domains of CSP training curriculum and at least 3 years of experience in behavioral health recommended for those staffing mobile crisis
    • Residential only: Peers (Intentional Peer Support and Family Support Specialist)
  • PNMI E
    • DSP and MHRT/C
  • Substance Use Services under Sections 65 and 97
    • Alcohol and Drug Counseling Aid allowed where CADC is allowed

Credentialing Flexibilities

  • *Psychology “post-docs” can provide MaineCare reimbursable services, only under the conditions that the designated supervising Clinical Psychologist must:
    • Adhere to all applicable federal and state laws and rules to include, the State of Maine Board of Examiners of Psychologists laws and rules (M.R.S. 32, Chapter 56 and 02-415 Board of Examiners of Psychologists – Consolidated Rules).
    • Accept responsibility for all services rendered, fees charged, and reimbursement received (i.e. submits claims as the rendering MaineCare provider).
    • Accept clinical responsibility for all services provided to include required documentation (i.e. review, accept and co-signatures).
  • Adds additional 90 days for BHP to get certified
  • *New pathways to full MHRT I and MHRT/C Certification
    • MHRT I: CRMA training will no longer be required to obtain full certification; CRMA will only be required as a separate credential for staff who are passing medication.
    • MHRT/C: full certification will be granted for related degrees, with missing competency domains to be completed prior to renewal; provisional certification will now be granted for 2 year related degrees or 30 related academic credits or 12 months prior related behavioral health experience with missing priority competency domains required to be completed within 60 days.
    • Detailed guidance can be found here: Summary of Pathways to Mental Health Rehabilitation Technician (MHRT) Certificates (PDF)

Licensing and Other Regulatory Flexibilities

  • OTPs/Methadone Clinics: State Opioid Treatment Authority (SOTA), OMS, and DLC will consider requests for clinics closures on Saturdays and/or Sundays on a case-by-case basis
  • All services can seek waivers from DLC for flexibility in licensing rules. Agencies can apply for a waiver of specific regulations that are not mandated by state or federal law, and do not violate resident rights by submitting a waiver request application.
    • For example:
      • If more than one staff is scheduled for overnights and it would be helpful to allow other staff to sleep during shift, request a waiver describing how that would be safely managed.
      • Facilities can apply for a temporary waiver to operate over licensed capacity.
Recruitment for New Staff

Maine Jobs and Recovery Healthcare Workforce Initiatives

  • $4M in financial support, including scholarships and student loan relief, to allow more people to become doctors, nurses, behavioral health specialists, and long-term care professionals.
  • $1.5 million recruitment initiative promoting value of work in health care, encouraging young people to enter careers in health care, promoting direct care worker jobs, and launch of Maine’s Health Care Career Navigators charged with helping people interested in health care jobs figure out the best career path.

No Cost Recruitment Resources

Maine Department of Labor MAINE JOBLINK

  • Create, edit, and manage an unlimited number of job postings for free.
  • Search for qualified candidates and save those searches.
  • Promote your company through your profile.
  • Receive resume match alerts and referrals.
  • Connect with CareerCenter staff for advice and support.
  • Recruit staff through free in-person and virtual job fairs

CareerCenter Employer Guide

FEDCAP Maine Internship Program

Student Recruitment

University of Maine

Maine Community College System

National College Job Boards

  • Employer Central Job Board
    • The nation's largest network of entry-level job candidates at small and midsize colleges and universities, community and technical colleges, and art & design schools. All jobs are viewed through CollegeCentral.com, one of the most visited entry-level recruitment sites on the Internet.

Partnering with Career and Technical Education High Schools

Staffing Agencies

Home Health Care Agencies and Temporary Nursing Agencies are licensed and registered with the State to provide temporary staffing assistance to facilities.  You can locate these providers by county or city at the DHHS Division of Licensing and Certification website.

Local Workforce Boards

There are 3 regional workforce boards that can connect employers with resources and assistance in finding qualified workers (Northern, Central Western, Coastal).

Flexible Training for Staff

Per guidance issued on 9/24/21, as part of the emergency staffing plan, facilities may consider utilizing the AHCA training for temporary nurse aide and temporary feeding assistant roles. Please note, these do not replace the full CNA and feeding assistant trainings but may be a short term option until staff complete the full training.

Temporary Nurse Aid (TNA) Training:

There are readily available short (8 hour) training programs such as the American Health Care Association (AHCA) and more information can be obtained at https://educate.ahcancal.org/products/temporary-nurse-aide.

Temporary Feeding Assistant Training:

CMS has issued blanket 1135 waivers including a waiver of the required time for this course to allow for a 1 hour course to be used instead of the current 16 hour course.  Information and details can be found on page 21 of the CMS 1135 Blanket waivers at https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf.

Retaining Existing Staff

Maine Jobs and Recovery Healthcare Workforce Initiatives

$8.5 million for tuition remission program to help employees attain advanced health care credentials

CoverME.gov

  • Maine’s state-based health insurance marketplace for staff who are not eligible for employer sponsored benefit

Child Care Options

Maine Child Care Subsidy Program

  • The Child Care Subsidy Program (CCSP) helps eligible families to pay for childcare so parents can work, go to school, or participate in a job training program. CCSP is also available for eligible families where the adult(s) are retired and are the legal guardian of a child.

Maine Child Care Tax Credit

On-site Child Care Development Models

Student Costs

National COVID-19 Higher Education Emergency Relief Fund (HEEF)

Housing Resources

Maine State Housing Authority

Maine Housing address problems of unsafe, unsuitable, overcrowded, and unaffordable housing and administers a number of federal housing-related programs, including the Low Income Housing Tax Credit Program, the Section 8 Rental Assistance programs, the Emergency Solutions Grant Program, the Weatherization Program, the Low Income Home Energy Assistance Program, and others. Such programs reduce the costs associated with housing for Maine people.

Emergency Rental Assistance Programs

Rental Assistance Programs

National data on recruitment and retention of care workers

Health Care Worker Resiliency Resources

StrengthenME

  • StrengthenME is a DHHS-funded program that provides free stress management and resiliency resources to Maine residents coping with the pandemic-related stress.

Work Force Employment Assistance Programs (EAP)

  • StrengthenME offers a range of free programs and services designed by Work Force EAP, a leading provider of employee assistance and work/life programs, specifically for healthcare workers who are experiencing heightened stress due to the ongoing effects of COVID-19 in communities across Maine

Maine FrontLine WarmLine

  • The Maine FrontLine WarmLine is a warm line for healthcare workers, emergency responders, teachers and other school staff, and other frontline workers coping with pandemic-related stress. Individuals seeking support can call between 8 a.m. and 8 p.m. 7 days a week at (207) 221-8196 to speak with someone. The service is free and anonymous.

  • FrontLine WarmLine Posters for the Workplace

Health Care Worker Support Groups

  • Maine Medical Association Zoom Meeting for Providers During COVID-19 Pandemic: Virtual discussions every Tuesday from 6-7:30 p.m. each week. The intent is not a clinical discussion but, instead, to simply empathize and commiserate with your fellow physicians during this difficult and trying time for medical providers working under such difficult conditions. https://zoom.us/j/111313123  or 1-646-876-9923, 111313123#  Email dmorin@mainemed.com for password.
  • Maine Osteopathic Association: Weekly "Open Forums" for members and other healthcare providers. Wednesday nights at 7pm. Please email Amanda Richards at arichards@mainedo.org for password. https://zoom.us/j/9869604626?pwd=RG5hRlJYRzRPNWovNFhUSFVKTXp1dz09   Meeting ID: 986 960 4626
  • Hanley Virtual Peer Support Sessions: Thursdays from 4-6 pm https://zoom.us/j/9756185852?pwd=cjMrdkt0Ny96eHZxdlVpc0tyaDFGUT09
  • COVID-19 Women Physicians' Emotional Well-Being Facebook Group: (@PoojaLakshmin): https://www.facebook.com/groups/235295047624227/
  • MaineHealth's Resiliency ECHO Sessions: ECHO will focus on sustaining well-being and resilience in trauma-exposed health care teams. Experts from MaineHealth, Maine Medical Partners, and Maine Behavioral Healthcare will lead sessions focused on taking care of your emotional health during the coming months to help you sustain your well-being and enable you to better react to urgent needs. Every Wednesday from 12:00pm-12:50pm https://echo.zoom.us/j/156379662 (Free Zoom Conference Call)

Articles and Podcasts ​​​

Other Resiliency Resources for Health Care Workers

Emergency Responders/Critical Incident Stress Management

Law Enforcement

  • COPLINE - dedicated to serving law enforcement officers and their families by providing 24/7 trained peer support for crisis intervention along with referral to specifically skilled mental health professionals for follow up and continued assistance.

Maine EMS