Cutler Institute for Health and Social Policy

Disability and Aging

Disability and Aging Products: Workforce Development and Training

Development of Cross-disciplinary Training Programs for Direct Service Workers 

Personal and Home Care Aide State Training (PHCAST) Program
The Maine Department of Health and Human Services (DHHS), together with the Muskie School of Public Service, is developing a competency-based curriculum and a coordinated training and credentialing system to prepare direct service workers for employment:  The Personal Support Specialist (PSS) who provides personal care and daily living support; the Direct Support Professional (DSP), who provides direct supports to persons with intellectual and developmental disabilities; and the Mental Health Rehabilitation Technician-1 (MHRT-1), who provides daily living supports to persons with severe and persistent mental illness. 

The program, funded under a grant from the federal Health Resources and Services Administration (HRSA), has involved:

  • Developing and implementing a coordinated, competency-based system of training and certification comprised of a core curriculum and three tracks of specialized training delivered in the classroom and on-line which will enable career progression, specialization and cross training for certified PSS, DSP, and MHRT-1.
  • Developing and implementing a sustainable delivery system which addresses financial sustainability; governance over the training and certification system; and the training, qualifications, continuing education and quality assurance requirements for instructors and on-the-job trainers.
  • Developing a web-based portal to promote easy access to training-related information for workers, employers, and consumers. 
  • Partnering with the USM’s Center for Education Policy, Applied Research, and Evaluation to measure and improve the effectiveness of the curriculum and document lessons learned.

For more information contact Nadine Edris or visit

Profile of Maine Direct Service Workforce 

Chartbook: Maine Direct Service Workforce Survey Results
Prepared as part of Maine’s State Profile Tool Grant, this Chartbook provides results of two surveys conducted in the summer of 2012: one of Personal Attendants who work for adults with disabilities in participant directed programs; and a second of Provider Organizations that serve adults with intellectual disabilities and older adults with disabilities who receive long term services and supports. The report shows results for worker satisfaction, wages, health insurance, length of employment for people employed by those who self-direct services. Results for provider organizations show types of organizations that employ direct care workers in Maine ;length of employment, wages, insurance levels of workers; turnover rates; and workforce challenges. 

For more information, contact Eileen Griffin

Strengthening Maine’s Mental Health Workforce

For over fifteen years, the Muskie School of Public Service has partnered with Maine’s Department of Health and Human Services’ Office of Substance Abuse and Mental Health Services (SAMHS) to ensure that workers employed in SAMHS-funded positions and delivering community supports to adults with serious mental illness are adequately trained to provide quality, recovery-oriented, community-based services. 

Major program innovations during this ongoing partnership include:

  • A competency-based certification program for Maine’s Adult Mental Health Workforce, and
  • Detailed certification guidelines and policies.

Muskie has also:

  • Collaborated with Maine’s universities and colleges to incorporate mental health competencies into behavioral health degree and certificate programs.
  • Developed and administered standards for non-academic mental health courses.
  • Regularly revised competency requirements to incorporate emerging trends and best practices in the mental health field.
  •  Designed and implemented quality assurance processes to monitor compliance with certification guidelines and policies.
  • Served as the hub of stakeholder activities, convening project-specific task forces, gathering feedback from workers, agencies, and educators in the field, and disseminating knowledge on best practices in mental health services and treatment.

Presently, Muskie supports and coordinates Adult Mental Health Workforce training and development efforts by:

  • Providing technical support to employers, workers, and academic and non-academic providers seeking to understand certification requirements;
  • Reviewing individuals’ transcripts, training backgrounds, work experience, as well as issuing certificates and processing requests for extensions; and
  • Developing and maintaining databases, which track certification applications and certificates awarded.

This work is funded through a cooperative agreement with Maine’s Department of Health and Human Services, Office of Substance Abuse and Mental Health Services. Visit

For more information contact Janice Daley

Managed Long Term Care Services and Supports (MLTSS)
The Muskie School, in partnership with L&M Policy Research, designed and developed an online curriculum offering states guidance on program design, Medicaid authorities and other information related to the effective management of MLTSS.  Conducted for the Centers for Medicare & Medicaid Services, the tool is structured in accordance with the decisions a state must make when considering MLTSS, including the implications of the various options and their trade-offs. Visit

HCBS Waiver Assurances – online training
This training focuses on the vital role of the case manager in meeting federal HCBS waiver assurances. This training reviews the basics of the HCBS Waiver assurances, reviews the roles and responsibilities of case managers in meeting the assurances, and provides video case studies of case managers putting the assurances into action. Visit



Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

Adults with Intellectual Disabilities or Autism Spectrum Disorder: Population and Service Use Trends in Maine 2014 Chartbook

Adults with Intellectual Diabilities or ASD Chartbook

Adults with Intellectual Disability or Autism Spectrum Disorder: Population and Service Use Trends in Maine, 2014 Edition provides a detailed look at the historical trends and current utilization and cost of institutional and community based services for adults with intellectual disability or autism spectrum disorder.

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Dementia in Maine

Dementia in Maine

As the oldest state in the nation, Maine faces the impending impact of Alzheimer’s disease on its social systems, community resources, and its health and long term care systems. This report provides a baseline picture of the current use of services by people with and without dementia in Maine. Learn more in Dementia in Maine: Characteristics, Care, and Cost Across Settings.

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Report on Maine's Older Adults

With the aging of Maine’s population and its status as the oldest state in the nation, the use of long term services continues to be a critical public policy issue in the state and nationally. Learn more in Older Adults and Adults With Disabilities: Population and Service Use Trends in Maine, 2012 Edition.

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