AP-ME–Foster Care Reimbursements
Betsey Grant, who owns Tiny Tikes Daycare in Trenton, has been fighting the state of Maine to pay her for the services she provides foster children for years.
She isn’t the only one who has had trouble. Last month, lawmakers ordered an investigation into the delayed foster care reimbursement payments to child care providers from the state’s Department of Health and Human Services.
“We expect these people to take in these foster children, give them daycare, change their diapers, feed them, take care of them and yet we are not paying them in a timely manner,” said Sen. Jeff Timberlake (R-Androscoggin). “These children are going through hell to begin with… they get pulled out of one daycare and thrown into another because we can’t pay our bills on time. I find that totally obnoxious.”
In Grant’s case, it took months of emails and phone calls, plus the involvement of three lawmakers, to get DHHS to pay Grant the roughly $30,000 she was owed in payments for caring for dozens of foster children in state custody.
“The state did not deny what they owed her,” said Rep. Nina Milliken (D-Blue Hill), one of several lawmakers with whom Grant pleaded her case. When Grant threatened to close due to insufficient funding, said Milliken, “the department’s response wasn’t ‘what can we do to make sure you don’t have to?’ The department’s response was ‘when are you closing?’”
Tiny Tikes cared for more than 50 foster children between 2019 and 2023, according to Grant. Based on data obtained by The Maine Monitor, Grant was reimbursed roughly $130,000 between September 2022 and August 2024. But the state was months behind in paying several invoices totaling around $30,000 to Tiny Tikes for the care of foster children, according to emails and records reviewed by The Monitor.
DHHS declined to answer questions about these payments, and was unable to verify the number of foster children who attended Tiny Tikes. In emails viewed by The Monitor, state officials told Grant that the invoices were missing specific information, the caseworker was no longer employed by the state, or the program administrator needed approval.
In one email, a department employee apologized for the number of emails Grant had to send regarding repayment.
“I’m sorry that you have to constantly be emailing about payments,” the employee wrote.
“What would have happened to that money if I hadn’t been nagging about it like that?” Grant wondered.
‘Lack of organization’
There are more than 2,300 children in state custody in Maine, roughly 42 percent of whom are five or under.
Maine, like much of the nation, is facing a child care crisis, with the number of providers declining dramatically in recent years. With roughly 5,000 infant child care spots for the 10,000 to 12,000 babies born each year, waitlists can stretch for years.
For children in foster care, finding a placement can be even more difficult: of more than 1,400 licensed child care providers across the state, only 319 currently offer care to foster children, according to state data (this figure changes frequently based on who bills the state, per DHHS). Providers operate on thin margins, and a delay in payment — from a family or from the state — can be catastrophic.
In interviews with more than a dozen child care providers across the state who accept children in foster care, many expressed frustration over long delays in state reimbursements. Some providers said that it has taken months, even years, to receive payment. Others have stopped billing entirely or been forced to close down due a lack of funds.
Lawmakers have been hearing about this issue for two years, and in February ordered the Government Oversight Committee to investigate late payments from the Department of Health and Human Services.
“Most of them are mom-and-pop-type daycares and they’re doing this because they just love kids. Then the state pulls this little game that they play, ‘You didn’t get the paperwork right. And this is missing that,’” said Sen. Timberlake. “You shouldn’t have to call your senator or a representative or the governor’s office or anybody else to get this done.”
Based on data obtained by The Maine Monitor, between September 2022 and August 2024 the state has reimbursed licensed child care providers roughly $13.5 million dollars for the care of foster children. The state has a set market rate providers can bill for children in foster care that varies depending on age of the child, length of care and the county of the daycare facility.
The state has been unable to provide much detail about the late payments. WMTW submitted a records request for a spreadsheet showing when each daycare invoice came in and when each payment went out, and DHHS responded by saying it would take four years and $250,000 to fulfill the request. The Maine Monitor also submitted a FOAA request for similar information that has yet to be fulfilled.
DHHS didn’t know how many invoices it processed each week, said Sen. Timberlake during a February 28 Government Oversight Committee meeting.
“This lack of organization is troubling and must be addressed,” he said.
Kaitie Gilmor, who opened Laugh and Learn Academy in Houlton after adopting her son through the foster system, said it has taken months for reimbursement to arrive.
Given her experience with her son, Gilmor said she is committed to ensuring foster children won’t be denied care because their families can’t pay.
“That’s kind of always been our mission is to not deny somebody’s care because of their payment situation, whether that means foster care or another subsidy program,” she said. “But it gets to a point with us — we’re a big center, but six kids not being paid for, that’s huge.”
Gilmor claims the state owes her roughly $15,000. (DHHS did not comment on this specific claim but noted that there was a delay paying Gilmor in January because of an address discrepancy.) And she said the late payments have made it difficult to keep her doors open.
“When you have one kid, one spot, who’s not being paid for essentially or not being paid for consistently, you can’t pay your bills,” Gilmor said. “You can’t pay staff, you can’t pay for things that you need.”
“It kind of goes into this black hole”
Gilmor and other child care providers blamed the issue in part on the state’s computer system.
Providers must complete a paper form for each foster child in their care, which is then sent to the appropriate case worker and approved by multiple people within the state department before the daycare can be reimbursed. This lengthy process is especially challenging for home-based daycare providers on tight budgets.
“We’re doing the community a service. But you’re making us go through nine different hoops in order to do this service that’s supposed to be helping,” said Nichole Johnson, owner of Golden Sun Childcare in Blue Hill.
Providers across the state said that when they voiced concerns over the delay of these payments they were at times told that it was a computer issue or a glitch.
In 2021, the state overhauled the technology used in child welfare cases. Cases are now processed through a software system called Katahdin, which was developed by Deloitte and purchased by the state for $30 million. The state’s child welfare ombudsman has called the system “inefficient” and a “struggle to use.”
“There have been some issues with Katahdin, but it’s like any other new system, you got to work the bugs out,” said Sen. Marianne Moore (R-Washington). “It’s getting better, but it’s still not there.”
But Sen. Timberlake was skeptical that the issue was only related to technology. “I would say it’s a computer error if it happened to just one person. But you’re hearing this with multiple daycares, so they’re not getting paid on time,” he said.
“Issues with delayed payments can most often be attributed to invoicing issues, misaligned provider information in the State’s payment system, or other administrative issues,” DHHS spokesperson Lindsay Hammes said in an email.
Providers said they have been required to fix errors and resubmit paperwork with the state, yet in some cases have still not received payments.
Foster parent Melanie Blair said she has had to contact DHHS about missing payments several times — regarding both money she is owed as well as money owed to the daycare where she sends her foster children, Totally Kidz Childcare in Lewiston. She said each time she has been bounced around between caseworkers and the central office.
“It kind of goes into this black hole,” she said.
In emails to DHHS viewed by The Monitor, Totally Kidz Childcare expressed their increasing frustration.
“I have waited since March for this problem to be taken care of, only to receive another response from a supervisor to be forwarded to someone else,” they wrote in a September email.
Hammes, the DHHS spokesperson, declined to comment on specific reimbursement queries.
“In order to protect confidentiality of kids in care, we’re unable to provide specific details about individual providers,” she wrote. “Some are fully paid and have no outstanding invoices.”
In recent months, the state’s child welfare system has faced intense scrutiny for failing to follow its own policies. Part of the issue lies in the complications around the reunification process.
Child care providers told The Monitor they are often left out of the loop when children are removed from foster care and reunited with their parents, and may continue to bill the state for services that should now be the responsibility of the parents. This leaves parents either unaware of their financial obligations or unable to pay, while providers are left struggling to recover the costs.
In November, DHHS began trying to centralize the payments process once daycares are approved in the system, Hammes said. For foster parents experiencing payment issues, the department has created a single point of contact.
Dwindling options
In early February, Nichole Johnson of Golden Sun Childcare in Blue Hill had a tough week. She had to notify her parents that she was increasing her daily rate by 6 dollars.
“It doesn’t sound like it’s a lot, but it is a lot, it adds up,” said Johnson, “But I said, if not, I’m going to have to close.”
Johnson grew up in and out of the foster care system in Maine. After becoming a single mom, she decided to open her own daycare.
As her days at Golden Sun grew busier and reimbursement payments from the state were delayed, Johnson stopped billing the state for foster care kids altogether and took the loss to her business. While she doesn’t currently have foster care children at her center, Johnson said she would accept them in the future at a financial loss.
“The only reason why any child care provider does this subsidy or works with foster kids is because it pulls at their heart,” she said. “Otherwise they wouldn’t do it. It’s not financially smart for a business to do it at all.”
In mid-February, one day after receiving an inquiry from The Maine Monitor, DHHS sent Johnson an email to ask if the department owed her money.
“Can you please tell me if we do owe money to you for the services you have provided, or is the Department caught up for payments for you?” a DHHS employee wrote in an email to Johnson. “If the Department does still owe you for child care invoices, can you please send them to me so that I can reach out to the district office for resolution.”
Johnson believes the department owes her roughly $30,000 for caring for foster children between 2020 and 2023.
A growing number of child care providers have chosen to close their doors to foster children because they can’t afford to offer them care. Others have had to close down or temporarily shut their doors due to the financial strain.
Grant, the provider in Trenton, closed for a month in 2023, in part because of delayed payments from the state. A daycare in Presque Isle recently closed due to late payments from the state, according to WAGM.
Bree Collins, owner of Honey B’s in Ellsworth, opened her family daycare after working at her local YMCA center. She saw firsthand how delayed payments from the state could be and decided to opt out of accepting them.
“I absolutely know that I would not have been able to survive if I was taking subsidy payments,” said Collins.
Over in Albany Township, Laurie Harmon and her husband were planning on letting their foster care parent license lapse when a particular girl was put back into state care. The couple, who had already cared for her for “pretty much half her life,” decided to renew their license and take her in.
But she would be the last one, said Harmon. Caring for foster children is hard due to the emotional strain, she said, but the delayed payments are an added frustration.
“They say, ‘we’ll reimburse’ but then it takes over a year, year and a half in some cases to get the reimbursements,” she said. “It’s not about the money. It’s about the state’s accountability.”