Tens of thousands of workers providing direct support and care to people with disabilities, behavioral health challenges and substance use disorders could soon get bonuses of as much as $1,000 to $1,500, and some could receive more.

Gov. Janet Mills announced this week that the federal government approved a request to use $126 million in American Recovery Act funds to give bonuses to new and existing workers providing home- and community-based services. The Mills administration hopes the payments will help relieve staffing challenges made worse during the pandemic.

The approval this week by the U.S. Centers for Medicare and Medicaid Services marks the first time enhanced payments for home- and community-based services can be awarded for behavioral health services. Funds will be distributed in January and agencies will be subject to state and federal audits.

The agency is reviewing additional documentation that will authorize matching funds for the program, the Mills administration said Tuesday.

Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, said in a written statement that the program, created in partnership with the state Department of Health and Human Services and community providers, will help ensure timely access to services.

“The fact that this enhanced HCBS (home- and community-based services) funding can be applied to behavioral health services for the first time is also critical to recognizing the importance of the behavioral health workforce, and supporting Mainers with mental health and substance use disorders to remain in their home communities,” Shaughnessy said.

Provider agencies must adopt a policy governing the bonuses. And individual amounts will vary, the state said.

According to the Health Affairs journal, Maine is among 25 states to provide bonuses to help retain and recruit workers, and was one of only three states to specify bonus amounts.

Maine’s plan says that current workers and supervisors would be eligible for as much as a $1,000 bonus retroactive to July 1 and again on Dec. 1. New workers hired during this period would be eligible for a $1,500 bonus, with a prorated bonus for part-time workers. And providers would receive an additional $500 to help pay for training for new employees.

Illinois proposed bonuses of $500 and $1,000, while California and Nevada proposed bonuses of $500 each, according to Health Affairs.

DHHS spokeswoman Jackie Farwell said that while bonus amounts were included in the plan, agencies will have flexibility to set their own amounts, which may exceed the initial estimates.

“We estimate the budget for this initiative will enable them to pay more than what was originally proposed,” Farwell said. “One of the additional benefits of the initiative is that we’ll learn much more about this workforce based on reports that provider agencies will submit detailing the size and nature of their staffs. That should allow for accurate estimates in the future.”

The plan also calls for, among other investments, a $13.5 million investment in “workforce portability and expansion,” which would help Maine establish a base certification that makes it easier for workers to apply their credentials to other qualifying populations.

The bonus program is one of several initiatives to address COVID-19-related and short-term staffing shortages in the profession.

In May, lawmakers heard testimony from direct care agencies and workers about how low pay is making it difficult to retain workers and forcing some to work long hours to make ends meet.

Managers said workers were leaving for less stressful and better paying jobs at fast-food restaurants and retailers such as Walmart. And the shortage of workers has left many group homes leaving beds unfilled, while waiting lists for those who need care or in-home services continue to grow.

The bonus program is intended to provide bridge funding to higher regular wages that are expected to take effect next year.

“This funding for recruitment and retention bonuses is welcome relief – particularly during this workforce shortage,” Laurie Belden, executive director of the Home Care and Hospice Alliance of Maine, said in a written statement. “These incentives, as well as other initiatives being developed by the Mills administration, are critical to ensure care in the home remains a viable choice for Maine’s older adults and those with disabilities.”

The Mills administration said in a news release that the state also is creating a workers council and is making worker certification more portable.

The administration also touted previous efforts to help home- and community-based service providers, noting that group-home providers received an increase in MaineCare reimbursement rates last July and would be included in another rate adjustment in January to support an average wage that’s 25 percent higher than the minimum wage, currently set at $12.15 an hour. The wage adjustment was estimated to affect 33,576 workers.

Providers eligible to receive the bonuses must register with DHHS to receive payments for workers, shared-living providers and supervisors. Registration will open Monday and continue for 10 business days.

“These bonuses are welcomed and honor the hard work and commitment of direct care workers who have stayed the course over these long months of the pandemic,” Laura Cordes, executive director of the Maine Association for Community Service Providers, said in a written statement.

“Direct care workers deliver amazing care to Maine children and adults with intellectual disabilities and autism,” Cordes said. “At a time when many provider agencies and programs are walking the fine line of collapse due to the critical staffing shortage, these bonuses can help stem the loss of direct care workers across the state.”


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