Lawmakers voted Monday to advance the governor’s nominee to lead the state’s largest agency, the Department of Health and Human Services, which has seen its share of challenges in recent years.

Sara Gagné-Holmes, the current acting commissioner and the department’s No. 2 administrator for five years, faced some tough questioning by members of the Legislature’s Health and Human Services Committee, but the panel ultimately voted 10-2 in favor of her nomination.

The matter now goes to the Maine Senate, although her confirmation is likely a formality. Democrats have a strong majority there.

If confirmed, Gagné-Holmes would replace Jeanne Lambrew, who served as DHHS commissioner from 2019 until May 2024, when she left to take a job in Washington, D.C.

Sara Gagné-Holmes, Maine Department of Health and Human Services

Gagné-Holmes, an attorney, former café owner and previous leader of liberal advocacy group Maine Equal Justice Partners, said during the confirmation hearing that despite improvements made during the Mills administration, “we must do more to ensure our children are safe.”

DHHS has faced increased scrutiny over lack of access to behavioral health services, and failures in the Child Protective Services system, although some challenges existed long before either Lambrew and Gagné-Holmes arrived.

Just last week, the U.S. Department of Justice filed a lawsuit against the Mills administration for failing to provide timely access to services for children with behavioral health needs, pointing out lengthy waiting lists and many children languishing in emergency departments waiting months for placements.

Sen. Joe Baldacci, D-Bangor, the co-chair of the committee, acknowledged that being health commissioner is a difficult job, but he said more needs to be done to improve access.

“The federal government filing the lawsuit means our discussions (with federal authorities) have not worked out,” Baldacci said. “The federal government expects more from us.”

Gagné-Holmes said she “couldn’t agree more the issue is significantly important to the state of Maine” and that she would work to “deliver services to our communities, to the people of Maine as fast as possible.”

Mills said in a statement on Monday that “acting Commissioner Gagné-Holmes’ deep policy and managerial experience, her intimate knowledge of the department, and her collaborative approach to solving problems, along with the respect she has earned from her colleagues, lawmakers and others, make her the right person at the right time to take on this important role.”

Although the committee hearing didn’t delve into the topic of reimbursement rates, leaders of the nonprofit agencies that deliver many of the services offered by DHHS have long complained that reimbursement rates are not high enough to offer competitive wages to workers. With Maine already dealing with a tight labor market, many workers are taking other jobs, exacerbating the workforce shortage problem. The Mills administration has increased reimbursement rates recently, but advocates say the improvements have not kept up with what other employers are paying.

Several people spoke in favor Monday of Gagné-Holmes’ nomination during the public hearing portion. No one spoke in opposition.

Some Republicans on the committee did question whether it made sense to promote someone from within.

Rep. Michael Lemelin, R-Chelsea, one of the two legislators voting against the nomination (Rep. Ann Fredericks, R-Sanford, was the other), said DHHS is a “mess” and that Gagne-Holmes has worked there for five years.

“We have had a plethora of issues within DHHS, and those issues have been going on for years and years,” he said. “The changes to the system have been small, but the problems are big.”

Lemelin said he sees part of the problem is that DHHS is part of the “good ol’ boy network.”

But Gagné-Holmes said she has the “right team in place and they will make a difference.”

“I have never been part of the old boys’ network, and never could be,” she said.