Portland officials are providing hazard and incentive pay for workers at a city-run nursing home that’s confronting a COVID-19 outbreak.

The city says it’s able to offer the additional $6 an hour for workers at the Barron Center through Saturday, because the state is offering enhanced Medicaid reimbursements to nursing homes and long-term care facilities when confronted with a COVID-19 outbreak, which is defined as three or more connected cases.

As of Thursday, 12 Barron Center residents with COVID-19 had died and 71 residents and 30 staff members had tested positive, the Maine Center for Disease Control and Prevention said. The agency had previously reported larger numbers of deaths and positive cases, but said Thursday that “data transmission error” led to the double counting of some cases.

The city’s decision to raise wages comes after Portland voters overwhelmingly voted in November for a 50 percent hazard pay raise to all minimum wage workers reporting to Portland workplaces during declared emergencies, such as the pandemic. The city has said that ordinance doesn’t apply to city employees, and doesn’t take effect for private employers until next year.

City Hall Communications Director Jessica Grondin stressed in an email that the hazard pay being provided at the Barron Center is unrelated to the requirement in the new minimum wage ordinance, which is being challenged by businesses in court.

“These are two very different things,” Grondin said. “First, when we started paying these stipends, the minimum wage/hazard pay law was months away from being approved. Second, the subsequent rounds of stipends/incentive pay at the Barron Center are specifically tied to outbreak status – except of course for those working on the COVID positive unit.”

Nursing staff employees working in the COVID unit have been receiving $4 an hour in additional pay since Jan. 10 and will continue to receive it as long as the unit is open. That’s a $1 increase over the previous $3 an hour stipend they have been receiving since the start of the pandemic, according to the city.

Jackie Farwell, spokeswoman for the Maine Department of Health and Human Services, said the state extended MaineCare support to a variety of congregate care facilities last June to help pay for added expenses in dealing with outbreaks, including nursing homes, intermediate care facilities and private nonmedical institutions. The additional money can be used to hire more workers, increase pay for existing workers, purchase personal protective equipment and other supplies to help control an outbreak, she said. MaineCare is Maine’s version of Medicaid.

Farwell said operators must request the enhanced reimbursement and then submit a financial reconciliation statement within 30 days of the end of the outbreak, which ends when a facility has gone 28 days without a confirmed case. She said the outbreak reimbursement rate is $23.58 per resident per day for nursing home facilities and that the state has provided an additional $1.5 million in state and federal MaineCare funding to help with outbreaks. She said the average standard rate for nursing facilities is estimated to be $277.50 per patient per day.

Farwell said the assistance became available for outbreaks as of June 1 and will be available until the end of the federal public health emergency.

There are also ongoing outbreaks at two city-run homeless shelters, but because they don’t receive a MaineCare reimbursement, staff members there are not receiving hazard pay. Grondin said they did receive a temporary $2-an-hour hazard pay stipend early in the pandemic, along with police officers and firefighters, but that ended June 30.

Richard Erb, president and CEO of the Maine Health Care Association, said the enhanced MaineCare reimbursement has been a lifeline for the group’s more than 200 member nursing homes and assisted living-residential care facilities, allowing them to provide bonus pay to staff, hire additional workers when possible, purchase personal protective equipment and increase testing.

Erb said about 75 percent of that total cost is paid by the federal government, while the rest is picked up by the state.

“It’s very common for it to be used for enhanced wages,” Erb said. “I think there’s a desire to hire additional staff, but the problem is finding them.”

A survey of 953 nursing home providers conducted by the American Health Care Association and the National Center for Assisted Living Centers highlights the financial strain on nursing homes during the pandemic. The survey indicated that 65 percent of the nursing homes surveyed were operating at a loss. And staffing was the top cost driver, with 86 percent of the nursing homes reporting bonus, or “hero,” pay and 94 percent reporting that staff members are being asked to work overtime or double shifts to make up for staffing shortages.

Portland has been providing several layers of incentives and hazard pay since the start of the pandemic, according to city officials.

Grondin said all staff at the Barron Center received a temporary $2-an-hour boost at the onset of the pandemic, from May 10 to through the end of June. The $2-an-hour increase was restored for all Barron Center workers on Dec. 27, a month after the outbreak was officially declared by the state on Nov. 21. That stipend was increased to $6 an hour from Jan. 17 to Feb. 6, at which point it will revert to $2 an hour, she said.

Also, all nursing staff members working in the COVID unit have received an additional $3 an hour throughout the pandemic, and that rate was recently increased to $4 an hour.

“It’s been a fluid situation dependent on available reimbursement opportunities, and/or federal money to cover the additional costs,” Grondin said. “The hazard pay was something that was discussed at the leadership level back in the beginning of the pandemic, and something that (City Manager) Jon (Jennings) has been supportive of and approved when we had resources to cover the expense.”

Some staff members at the Barron Center are among city workers who earn less than $18 an hour and would have been eligible for hazard pay under the voter-approved ordinance if the city extended it to municipal employees during the pandemic. While the city has said it will not provide the time-and-half hazard pay to municipal employees, the Portland Board of Public Education voted in favor of honoring the hazard pay provision and raising school employee salaries to a minimum of $18 an hour.

Grondin said no city staffers, including Kristen Dow, the city’s health and human services director, who has discretion over the hazard pay, were available for interviews.

In response to written questions, Dow said hazard pay wasn’t immediately extended to all Barron Center staff at the beginning of the outbreak Nov. 21, when there were relatively few positive residents and they were moved to the COVID unit. “The decision was made to move to a stipend for all staff at the end of December due to additional cases in the building as the outbreak was more widespread,” she said.

Maine CDC spokesman Robert Long said the last positive COVID-19 test associated with the Barron Center was Jan. 26. If no more cases are detected within 28 days, the outbreak would be over as of Feb. 23. Meanwhile, the city’s $6-an-hour hazard pay agreement for all Barron Center employees reverts back to $2 an hour on Thursday.

“Feb 6th was the end of the 3-week pay period in which we chose to offer the additional pay to staff while in the outbreak,” Dow said. “We had been told previously that 14 days is the end of the outbreak. Barron Center staff are confirming this with CDC today as we are now approaching day 14 of no new positive cases.”

An agreement signed with the city’s largest union, the City Employee Benefits Association, states that “as a result of the current outbreak status at the Barron Center that has impacted staffing levels, CEBA employees assigned to the Barron Center will receive the incentive pay stipend(s) as described below for each hour of actual work performed at Barron Center facilities.”

James Durkin, the director of legislation, political action and communications with the AFSME Council 93, said in a Jan. 26 email that he would “look into” the hazard pay being provided. He did not respond to follow-up requests for comment.

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