AUGUSTA, Maine — Maine Department of Health and Human Services Commissioner Jeanne Lambrew will step down from her position at the end of May, according to a department announcement Tuesday.
Lambrew served as the deputy assistant to President Barack Obama for health policy from 2013 to 2017. One of her most notable achievements during his presidency was drafting, implementing, and defending the Affordable Care Act.
Starting on June 10, 2024, Lambrew will become the director of health reform and system design for the Century Foundation, a Washington-based think tank that conducts research, develops solutions, and drives policy change. Lambrew has also been invited by the Harvard T.H. Chan School of Public Health to join them as an adjunct professor of health policy, according to the Office of Gov. Janet Mills.
"I also think it's time with two and a half years left for the governor, for her to be able to find somebody with some fresh energy and new ideas to help ensure that when Gov. Mills term ends, the state is even stronger than it is today," Lambrew said.
Lambrew was the first cabinet member announced by Mills following her gubernatorial election in 2018. As commissioner, Lambrew expanded affordable health care in Maine to more than 100,000 people, led the nation in COVID-19 response, made historic investments in health and human services, and rebuilt the department after years of cuts under the prior administration. Maine DHHS credits those accomplishments to the investments Mills proposed, which the Maine Legislature supported, as well as a 70 percent increase in the amount of federal dollars to support health and human services in Maine since 2018.
At the governor’s direction on her first day in office, DHHS expanded Medicaid and later implemented a state-based marketplace called CoverMe.gov. Maine’s uninsured rate dropped the fastest of any state in 2021 and in the last few years has been lower than ever, according to DHHS.
Lambrew also led Maine through the COVID-19 pandemic. Maine has been widely regarded as one of the best-rated state responses, according to the Commonwealth Fund and the National Bureau of Economic Research. Maine had the highest COVID-19 vaccination rate of older residents in the nation and one of the lowest death rates in the nation. DHHS also implemented policies, supported by voters, that yielded a record-high childhood immunization rate in the 2023 to 2024 school year.
Under her leadership, DHHS launched the state’s first crisis receiving center in Portland and launched the 988 crisis line. In the past five years, Riverview Psychiatric Center was recertified by the federal government, and Dorothea Dix Psychiatric Center opened the state’s first unit to serve older people who have severe, persistent mental illness. It also continues to work closely with Lewiston and affected communities on mental health support in the wake of the tragedy in October 2023, according to DHHS.
"To be a viable, vibrant health care provider, we need to pay sufficiently. So we've invested over half a billion dollars in MaineCare payment rates for behavioral alone. But I also was a specialty in the wake of the pandemic and Lewiston and our storms. We are very focused on crisis services. We know that is critical to be able to have someplace to call, like 988; somewhere to go, like a crisis receiving center; or someone to respond," Lambrew said.
Mills' supplemental budget funds proposals to add crisis receiving centers in Lewiston, Penobscot County, Aroostook County, and a hybrid center in Kennebec County. Mills said her upcoming biennial budgets will continue to fund those locations. Lambrew said the department is working on a new model called Certified Comprehensive Behavioral Health Centers, funded by Medicaid to make sure staff gets paid and that people can get the wide range of services they need.
The department has faced criticism regarding how many children have died in state custody. DHHS was involved in the cases of four children who died of abuse in the span of one month in 2021. There were two others in the span of four months in between December 2017 and March 2018.
Staff vacancy rates have risen among caseworkers charged with preventing the maltreatment of children since 2020. They have reported feeling overworked, overburdened, and underpaid. Lambrew said they have started hiring legal aides and trainers to expand teams for caseworkers so they can focus their time and energy on engagement with children and families, follow-up for services, investigations, and deciding what is best for the child.
"We're working on the night and weekend hours. We revised our overtime policy to make it more fair," Lambrew said. "[OCFS Director} Bobbi Johnson has walked the walk. She gets it. She's spending lots of time with every office, every team, because we've heard a lot about culture and respect. And that's very important for us to inculcate. But the last thing I will say is because evidence matters, we are very committed to a child safety and family well-being plan that we announced last year. We're developing places where families can go and developing community partnerships, because doing this within the four squares of just the child welfare system is not sufficient. The more we can support these families before that fork in the road where there might be abuse, there might be neglect, that's really what we're trying to do. I think the Governor has that plan, and I hope that she and my successor continue that work."
Mills also said she would sign a bill introduced by Sen. Lisa Keim if it makes it to her desk. That bill is a resolve directing DHHS to create a pilot program to recruit and retain case aides, with a public campaign aimed at retirees and other people not currently in Maine’s workforce.
Second, she has directed her administration to review the classification of child welfare positions to "ensure that the compensation properly reflects the difficulty and complexity of the work to attract and retain people in this vital workforce."
Third, Mills said she has authorized DHHS to implement additional recruitment and retention payments for child welfare workers to "provide them with a much-needed boost this year."
DHHS has also invested in the child welfare system in response to challenges and to improve child safety, including support for front-line workers, reducing the vacancy rate by 25 percent between January and April 2024. As of the end of April 2024, there were 55 open caseworker positions. The Department is also using $1 million to jumpstart a plan to prevent the need for child welfare intervention.
When the commissioner named Bobbi Johnson as the new director of DHHS' Office of Child and Family Services, the department also announced structural changes, moving the Children's Behavioral Health Services division out of OCFS and into the Office of Behavioral Health.
On child care, Maine made permanent worker stipends totaling about $2.5 million monthly and expanded subsidies for parents to 125 percent of state median income starting in July 2024. Through the Maine Jobs & Recovery Plan, more than 4,100 child care slots have been created.
For people requiring long-term services and supports, the department worked to promote community living for adults with intellectual or developmental disabilities. Those efforts resulted in a 46 percent increase between 2017 to 2022 in the number of those adults receiving residential services supports rather than living in group homes. DHHS plans to further promote such choices through an innovative lifespan waiver for individuals with disabilities and long-overdue nursing facility reform in the next year as part of Maine’s award-winning Medicaid payment reform system.
The governor will name an acting commissioner for the department before Lambrew’s departure if a permanent commissioner has not yet been nominated. Any candidate for commissioner will be subject to a hearing before the Legislature’s Health and Human Services Committee and confirmation by the Maine State Senate.