Payments to approximately 80 facilities to support direct care staff

AUGUSTA? The Maine Department of Health and Human Services (DHHS) announced today that it has issued $19 million in one-time Medicaid (MaineCare) payments to Maine nursing facilities to support their continued recovery from the pandemic, particularly for direct care staff who tend to the health and wellbeing of residents.

The Department issued the payments, consistent with language in the biennial budget the Governor signed into law in July, to approximately 80 nursing facilities on Wednesday.

?This investment will help to keep vital staff employed at nursing facilities all across Maine?safeguarding the high-quality and consistent care that Maine people rely on,? said Governor Janet Mills. "My Administration will continue to work to strengthen Maine?s health care workforce and improve the availability of affordable long-term care for Maine people.?

?A clear body of research links the availability of consistent, well trained, hands-on staff to quality of life and care in nursing facilities,? said DHHS Commissioner Jeanne Lambrew. ?These payments are designed to support those dedicated staff and reflect Governor Mills? commitment to ensuring that high-quality long-term care is affordable and accessible for Maine people.?

?We appreciate these targeted, temporary funds that will help address the extraordinarily high costs of labor that have caused unprecedented challenges for nursing homes,? said Angela Westhoff, President and CEO of the Maine Health Care Association. ?These payments are an essential step in safeguarding the well-being of residents and ensuring more stability of Maine?s vital nursing homes. Looking toward our state?s future, we are optimistic about continuing our collaborative efforts with the Mills Administration and the Legislature to sustain access to care for Maine?s residents.?

A growing body of evidence links the delivery of high-quality care in nursing homes to adequate and consistent staffing. An article published in The JAMA Network Open in January 2023 showed that maintaining constant staffing day-to-day, especially with licensed practical nurses (LPNs) and certified nursing assistance (CNAs), is a marker of better quality in nursing homes.

Each qualifying nursing facility was eligible for a payment amount that was informed by their direct care costs in 2022.

This week?s payments follow $50 million DHHS issued to long-term care facilities for pandemic recovery in two rounds of payments in April 2023 and August 2022. Those payments and the funding issued this week will facilitate pandemic recovery as the Department continues to work with stakeholders to reform how nursing homes are paid to reward quality and streamline payment administration.

These investments build on the Mills Administration?s historic financial and operational support for nursing facilities, which includes:

• In June 2019, Governor Mills signed into law a biennial budget that dedicated $25 million to provide a cost-of-living adjustment to nursing facilities. As a result, nursing facility rates increased, on average, by five percent for Fiscal Year 2020;

• In March 2020, at the onset of the pandemic, the Mills Administration began $9 million in temporary payment rate increases to nursing facilities for extra costs associated with COVID-19, including staffing above and beyond customary levels to maintain proper ratios and to monitor residents and screen visitors, supplies and PPE, such as face masks and gowns, beyond the amounts typically purchased;
• In November 2020, the Mills Administration announced that it would reimburse nursing facilities for their costs to conduct Federally-required surveillance testing using commercial laboratories;
• In December 2020, the Mills Administration awarded $5.1 million to health care facilities, most of which were nursing facilities, to cover expenses resulting from the pandemic;
• In July 2021, Governor Mills signed the FY22-23 biennial budget that dedicated $36.4 million in cost-of-living adjustments and rebasing funding for nursing facilities;
• In August 2021, the Mills Administration awarded $12.5 million to nursing and residential care facilities to help them cover expenses resulting from the pandemic;

• In September 2021, the Mills Administration delivered $123 million in one-time funding, including $30 million in General Fund dollars authorized through the biennial budget signed into law by the Governor, for nursing facilities, residential care facilities, and adult family care homes to help address workforce issues by retaining current staff or hiring new staff;
• In December 2021, the Mills Administration announced its plan to increase rates for long-term care facilities by $4.5 million from January to June 2022, and add another $7.6 million through the budget for supplemental wage adjustments for fiscal year 2022;
• Effective July 1, 2022, payment rates increased to support paying direct care workers at least 125 percent of minimum wage, on top of rebasing rates which resulted in rates increasing, on average, by 20 percent over the prior year; and on January 1, 2023, rates increased further to support 125 percent of minimum wage;
• In August 2022, the Mills Administration issued $25 million in one-time funding for nursing facilities, residential care facilities, and adult family care homes to help address ongoing workforce issues and relatively low occupancy;
• In April 2023, the Mills Administration issued $25 million in one-time funding for nursing facilities, residential care facilities, and adult family care homes to help address ongoing workforce issues and relatively low occupancy;
• In July 2023, payment rates were increased by a cost of living adjustment of approximately 4.5 percent
• Since January 2021, the Department has used over $2 million in Federal funds to support emergency nurse and related staffing to nearly one-third of Maine long-term care facilities to support care for residents during the pandemic.

This is in addition to at least $50 million in financial relief distributed directly by the Federal government to nursing facilities across Maine.

Recognizing the need to address the workforce challenges exacerbated by the COVID-19 pandemic, Governor Mills included $20 million in the Maine Jobs and Recovery Plan to support health care workforce training. The Jobs Plan additionally supports marketing campaigns aimed at promoting health care careers in Maine and Healthcare Training for ME, a program to expand the availability of free and low-cost career training to help health care workers advance their careers, support workforce training needs of health care employers, and attract new workers to fast-growing fields. The Jobs Plan is also supporting the Caring for ME campaign to educate and encourage residents to become direct care providers.