Resolve, To Ensure the Availability of Consumer-directed Personal Assistance Services
Maine Legislature, Session 122, LD 1991
Committee Amendment CA_A-SA_A_S600 (Senate)

SENATE AMENDMENT "A" to COMMITTEE AMENDMENT "A" to S.P. 769, 
L.D. 1991, "Resolve, To Ensure the Availability of Consumer-directed Personal 
Assistance Services" 
Amend the amendment by striking out the first 2 indented paragraphs after the title 
(page 1, lines 11 to 15 in amendment) and inserting in their place the following: 
'Amend the resolve by striking out all of sections 1 and 2 (page 1, lines 1 to 12 in 
L.D.) and inserting in their place the following: 
'Sec. 1. State plan amendment. Resolved: That the following provisions 
apply to consumer-directed personal assistance services provided by the Department of 
Health and Human Services and the Department of Labor. 
1. 
The Department of Health and Human Services shall submit to the federal 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
a MaineCare state plan amendment to establish a new state plan program for personal 
assistance services for persons with physical disabilities. The program must provide 
services through the self-directed program model authorized in the federal Deficit 
Reduction Act of 2005, Section 6086. The state plan amendment must be designed to 
transfer some participants in the current physical disabilities waiver to the new state plan 
program for personal assistance services for persons with physical disabilities. 
2. After approval of the state plan amendment by the federal Department of Health 
and Human Services, Centers for Medicare and Medicaid Services and no earlier than 
January 1, 2007, the Department of Health and Human Services may increase 
reimbursement for providers of consumer-directed personal assistance services in the 3 
programs administered by the department up to a rate of $10 per hour as long as the 
conditions of this subsection are satisfied. 
A. Savings to the General Fund must be generated from the transfer of participants 
from the current physical disabilities waiver program to the new state plan program 
for personal assistance for persons with physical disabilities and those savings must 
be sufficient, together with any federal matching funds, to fund any increase in 
reimbursement above $9 per hour. 
SENATE AMENDMENT 
:,::~('. 
SENATE AMENDMENT ,~" to COMMITIEE AMENDMENT "A" to S.P. 769, L.D. 1991 
B. This subsection does not authorize an increase in General Fund expenditures for 
reimbursement for providers of consumer-directed personal assistance services above 
the level budgeted for reimbursement of $9 per hour. 
3. Beginning on the effective date of the new reimbursement level established under 
subsection 2 by the Department of Health and Human Services for the 3 programs of 
consumer-directed personal assistance services administered through that department, the 
Department of Labor may increase the reimbursement rate for consumer-directed 
personal assistance services in the program administered by the Department of Labor by 
an amount equal to the increase granted by the Department of Health and Human 
Services; and be it further' , 
Further amend the amendment by striking out all of the 5th and 6th indented 
paragraphs after the title (page 1, lines 27 to 30 in amendment) 
Further amend the amendment by striking out all of section 7 (page 1, lines 31 to 34 
and page 2, lines 1 to 14 in amendment) 
Further amend the amendment by relettering or renumbering any nonconsecutive Part 
letter or section number to read consecutively. 
SUMMARY 
This amendment amends Committee Amendment "A". This amendment is intended 
to provide for an increase in reimbursement rates for providers of consumer-directed 
personal assistance services through the maximization of federal Medicaid funds. The 
amendment directs the Department of Health and Human Services to 
submit a 
MaineCare state plan amendment to establish a new consumer-directed personal 
assistance program under the federal Deficit Reduction Act of 2005. The amendment 
authorizes the Department of Health and Human Services to increase reimbursement rates 
for consumer-directed personal assistance services up to a rate of $10 per hour no earlier 
than January 1,2007 if the state plan amendment is approved and rates can be increased 
through the use of General Fund funds and any matching federal funds without cost to the 
General Fund. The amendment allows the Department of Labor to increase rates in that 
department's consumer-directed program if the Department of Health and Human 
Services increases rates. 
FISCAL NOTE REQUIRED 
(S e 
SPONSORED BY: ~t1-'!."'J~=------Ir+----.~+--+-.,t-=:...-
(Senator MAYO 
COUNTY: Sagadaboc 
SENATE AMENDMENT 
Approved: 04111106 ~ae 
LD 1991 
LR2791(04) 
Resolve, To Ensure the Availability of Consumer-directed Personal Assistance Services 
Fiscal Note for Senate Amendment ,A" to Committee Amendment ,4" 
Sponsor:Sen.~ayo 
Fiscal Note Required: Yes 
Fiscal Note 
Potential current biennium revenue increase - Federal Expenditures Fund 
2005·06 
2006-07 
Projections 
2007·08 
Projections 
2008·09 
Net Cost (Savings) 
General Fund 
($1,112,287) 
($1,201,270) 
($1,297,371) 
Appropriations/Allocations 
General Fund 
Fiscal Detail and Notes 
($1,112,287) 
($1,201,270) 
($1,297,371) 
This amendment replaces the Committee Amendment language that required the rates be increased to $10.00 per hour, 
with language allowing the Department to increase the rate up to $10.00 only if it achieves General Fund savings by 
securing additional federal matching funds for the program. In order to secure these additional federal funds, the 
amendment requires the Department take the necessary steps to secure federal approval for program changes 
authorized under the federal Deficit Reduction Act of 2006. As a result of the changes made in this amendment the 
General Fund costs assumed for the Committee Amendment can be removed. 
LR2791(4) - Fiscal Note - Page 1 of 1