Resolve, To Establish a Responsive, Community-based, Cost-effective and Comprehensive Adult Mental Health System
Maine Legislature, Session 122, LD 1515
Committee Amendment CA_A_H479 (House)

COMMITTEE AMENDMENT "A" to H.P. 1060, L.D. 1515, "Resolve, 
To Establish a 
Responsive, 
Community-based, Cost-effective and 
Comprehensive Adult Mental Health System" 
Amend the resolve by striking out everything after the title 
and before the summary and inserting in its place the following: 
'Sec. 1. AMHI Consent Decree Plan and system transformation 
plan. Resolved: That the Department of Health and Human Services 
shall ensure that the plan presented for court approval 
to 
achieve 
compliance with 
the 
Augusta Mental 
Health Institute 
Consent Decree Plan and that the system transformation plan as 
referenced 
in 
Public 
Law 
2005, 
chapter 
12, 
Part 
XXX 
are 
consumer-directed, community-based and comprehensive. 
Any plan 
development must be done in collaboration with a working group 
inclusive of consumers, 
families, providers and advocates. The 
plan must address, at a minimum, 
service delivery structures, 
service options, financing of those services, quality assurance 
and quality improvement strategies to be reflected as part of the 
management 
of 
the 
system. 
The 
plan must 
also 
address 
the 
development of a local system to ensure continuity of care and to 
identify utilization management strategies for all components of 
the mental health system as referenced in section 3; and be it 
further 
Sec. 2. System values and standards. Resolved: That the system 
for adult mental health services must be based on those values 
and standards already adopted by this State so that: 
Page l-LR1402(2) 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT .-A .. to H.P. 1060. L.O. 1515 
1. 
All services and support promote recovery and resiliency; 
2. 
Planning and services are consumer-driven, 
holistic, 
flexible and strength-based; 
3. 
The system is stigma-reducing and promotes a posi ti ve 
image of mental health care and treatment and consumers of mental 
health care; 
4. 
Services are based in research or evaluation of efficacy; 
5. 
Performance improvement decisions are based on data; 
6. 
The 
system works 
in collaboration with public 
and 
private partners; 
7. 
The system 
and includes respect 
of race, ethnicity, 
challenges: 
is culturally and linguistically competent 
and inclusion for all consumers regardless 
disability, sexual orientation or economic 
8. 
The 
system 
is 
outcome-based 
and 
demands 
cost 
effectiveness, accountability, standards and best practices; 
9. 
Grievance 
procedures 
are 
readily 
accessible 
and 
transparent; 
10. 
Services 
are 
locally 
responsive 
and 
promote 
an 
individual's integration into community life: 
11. 
System care is integrated with primary health care; and 
12. 
Consumers have a choice of providers and services; and 
be it further 
Sec. 3. Service reform and improvement. Resolved: 
That the 
mental health system must reflect at a minimum the following 
components: 
1. 
Urgent care, including crisis services; 
2. 
Inpatient services; 
3. 
Outpatient clinical and medication management services; 
4. 
Community support services; 
5. 
Housing; 
6. 
Residential support services; 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT .. A 
.. to H.P. 1060, L.D. 1515 
7. 
Evidence-based practices, including, but not limited to, 
those currently identified by the federal Substance Abuse and 
Mental Health Services Administration; 
8. 
Peer counseling and peer support services; 
9. 
Vocational supports; 
10. 
Transportation services; 
11. 
Socialization supports; and 
12. 
Family support services; and be it further 
Sec. 4. Diverse populations. Resolved: 
That the mental health 
system must define and be responsive to the needs of diverse 
populations including: 
1. 
Persons with serious mental illness; 
2. 
Persons with co-occurring substance abuse disorders; 
3. 
Persons who are older; 
4. 
Persons in the criminal justice system; 
5. 
Persons who have trauma and abuse histories; and 
6. 
Persons with co-occurring serious physical illnesses or 
conditions; and be it further 
Sec. 5. System readiness. Resolved: 
That service reform must be 
undertaken within the following parameters: 
1. 
Significant changes in reimbursement methodology must 
include actuarial analysis; 
2. 
Administrative burdens must be managed, consistent with 
Public Law 2003, chapter 673, Part 000, section 2; 
met. 
data 
3. 
Federal and state reporting data requirements must be 
Information technology systems must be in place to support 
collection and quality management systems that drive reform; 
4. 
The system must use consistent tools for measurement of 
outcomes, including, but not limited to, individual benefits that 
are grounded in the values in section 2; and 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT .. A 
.. to H.P. 1060, L.D. 1515 
5. 
Required 
MaineCare 
waivers 
must 
be 
approved, 
when 
needed, prior to changes being implemented; and be it further 
Sec. 6. Implementation. Resolved: That any substantive changes 
in financing and service delivery of adult mental health services 
must be phased in with an evaluation process for each phase, with 
adjustments being made accordingly; and be it further 
Sec. 7. Report. Resolved: 
That the Department of Health and 
Human 
Services 
shall 
provide 
a 
report 
and 
recommendations, 
including any recommendations of the working group required under 
section 1, to the Joint Standing Committee on Health and Human 
Services no later than January 15, 2006.' 
SUMMARY 
This amendment replaces the resolve. 
It requires that the 
Department of Health and Human Services ensure that the plan 
presented to the court to achieve compliance with the Augusta 
Mental 
Health Institute 
Consent 
Decree 
Plan 
and 
the 
system 
transformation plan required in Public Law 2005, chapter 12, Part 
XXX are consumer-directed, community-based and comprehensive. 
The 
amendment 
also 
specifies 
the 
values 
and 
standards, 
service 
reform 
and 
improvement 
components 
and 
readiness 
parameters to be used in the transformation of the adult mental 
health services system. 
The amendment also requires the Department of Health and 
Human Services to provide a report and recommendations, including 
any recommendations of the working group required under section 1 
of this resolve, to the Joint Standing Committee on Health and 
Human Services no later than January 15, 2006. 
FISCAL :\OTE H.EQllRED 
(See attached) 
COMMITTEE AMENDMENT 
· -
Approved: 05/20105 ;t;?ac. 
LD 1515 
LR 1402(02) 
Resolve, To Establish a Responsive, Community-based, Cost-effective and Comprehensive Adult 
Mental Health System 
Fiscal Note for Bill as Amended by Committee Amendment ,A" 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Fiscal Detail and Notes 
Any additional costs to the Department of Health and Human Services can be absorbed by the department utilizing 
existing budgetary resources. 
LR1402(2) - Fiscal Note - Page 1 of 1