An Act To Improve the Organizational Structure of the Department of Health and Human Services
Maine Legislature, Session 123, LD 2153
Committee: Health and Human Services
Sponsors: RA YE, MILLER
Amends: 22 MRSA §2, 22 MRSA §3, 22 MRSA §3-A, 22 MRSA §3-B, 22 MRSA §3-C, 22 MRSA §4, 22 MRSA §6, 22 MRSA §6-A, 22 MRSA §6-B, 22 MRSA §8, 22 MRSA §9, 22 MRSA §9-A, 22 MRSA §10, 22 MRSA §10-A, 22 MRSA §11, 22 MRSA §12, 22 MRSA §12-A, 22 MRSA §12-B, 22 MRSA §13, 22 MRSA §4088, 22-A MRSA §201, 22-A MRSA §20, 22-A MRSA §206, 22-A MRSA §207, 22-A MRSA §209, 22-A MRSA §210, 22-A MRSA §213, 22-A MRSA §216, 22-A MRSA §217, 22-A MRSA §218, 8 MRSA §1201-A, 8 MRSA §1201, 8 MRSA §1203, 8 MRSA §1204, 8 MRSA §1401, 8 MRSA §3201, 8 MRSA §3202, 8 MRSA §6251, 8 MRSA §6252, 4 MRSA §807, 22 MRSA §2804, 22 MRSA §3731, 24-A MRSA §10, 26 MRSA §1403, 34-B MRSA §5475, 8 MRSA §505

Legislative Document 
No. 2153 
S.P.822 
January 15,2008 
An Act To Improve the Organizational Structure of the Department 
of Health and Human Services 
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204. 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Senator RA YE of Washington. 
JOY J. O'BRIEN 
Secretary of the Senate 
Cosponsored by Representative MILLER of Somerville and Representative: eRA VEN of 
Lewiston. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
PART A 
Sec. A-I. 2 MRSA §l04, sub-§9, ~A, as amended by PL 2007, c. 441, §1, is 
further amended to read: 
A. The following organizations shall forward data that documents key public health 
needs, organized by region of the State, to the council annually: 
(1) The Department of Health and Human Services, Maine Center for Disease 
Control and Prevention; and 
(2) The Maine Center for Public Health Practice established pursuant to Title 22, 
section 3 D; and 
(3) A statewide public health association. 
Sec. A-2. 22 MRS A §l, as amended by PL 1995, c. 560, Pt. J, §2 and PL 2003, c. 
689, Pt. B, §§6 and 7, is repealed. 
Sec. A-3. 22 MRSA §l-A is enacted to read: 
§l-A. Definitions 
As used in this Title, unless the context otherwise indicates, the following terms have 
the following meanings. 
1. Commissioner. "Commissioner" means the Commissioner of Health and Human 
Services. 
2. 
Department. 
"Department" means the Department of Health and Human 
Services. 
Sec. A-4. 22 MRSA §2, as amended by PL 1973, c. 567, §20, is repealed. 
Sec. A-S. 22 MRSA §3, as amended by PL 1989, c. 167, §1 and PL 2003, c. 689, 
Pt. B, §6, is repealed. 
Sec. A-6. 22 MRSA §3-A, as amended by PL 2003, c. 708, § 1, is repealed. 
Sec. A-7. 22 MRSA §3-B, as enacted by PL 1977, c. 454, §1, is repealed. 
Sec. A-S. 22 MRSA §3-C, as enacted by PL 1987, c. 730, §2, is repealed. 
Sec. A-9. 22 MRS A §3-D, as enacted by PL 1995, c. 598, Pt. A, §1, is repealed. 
Sec. A-lO. 22 MRSA §4 is repealed. 
Sec. A-ll. 22 MRSA §6 is repealed. 
Sec. A-12. 22 MRSA §6-A, as amended by PL 2005, c. 397, Pt. A, §18, is 
repealed. 
Sec. A-13. 22 MRSA §6-B, as enacted by PL 1993, c. 738, Pt. F, §1 and amended 
by PL 1995, c. 560, Pt. K, §82 and affected by §83 and amended by PL 2001, c. 354, §3, 
is repealed. 
Sec. A-14. 22 MRS A §6-C, as repealed and replaced by PL 2005, c. 397, Pt. A, 
§ 19, is repealed. 
Sec. A-IS. 22 MRS A §7, as amended by PL 1985, c. 785, Pt. B, §83 and Pt. C, §3, 
is repealed. 
Sec. A-16. 22 MRSA §8, as enacted by PL 1965, c. 132, is repealed. 
Sec. A-17. 22 MRSA §9, as amended by PL 1989, c. 400, §§4 and 14 and PL 
2003, c. 689, Pt. B, §6, is repealed. 
Sec. A-18. 22 MRSA §9-A, as amended by PL 2001, c. 439, Pt. UU, § 1, is 
repealed. 
Sec. A-19. 22 MRSA §10, as amended by PL 1975, c. 771, §210, is repealed. 
Sec. A-20. 22 MRSA §10-A, as enacted by PL 2005, c. 634, §10, is repealed. 
Sec. A-21. 22 MRSA §11, as enacted by PL 1967, c. 544, §56, is repealed. 
Sec. A-22. 22 MRSA §12, as amended by PL 1995, c. 694, Pt. 0, §27 and 
affected by Pt. E, §2, is repealed. 
Sec. A-23. 22 MRSA §12-A, as amended by PL 1995, c. 691, §2, is repealed. 
Sec. A-24. 22 MRSA §12-B, as enacted by PL 1995, c. 368, Pt. IT, §1, is 
repealed. 
Sec. A-2S. 22 MRSA §13, as amended by PL 2005, c. 12, Pt. QQ, §l, is repealed. 
Sec. A-26. 22 MRS A §4088, sub-§l, ~-1, as amended by PL 2003, c. 399, §2, 
is repealed. 
Sec. A-27. 22 MRSA §4088, sub-§3, ~, as amended by PL 2003, c. 399, §3, is 
further amended to read: 
B. 
Shall investigate all reports received by the department or services center 
regarding alleged out-of-home abuse and neglect occurring in facilities or by persons 
subject to licensure pursuant to this Title; 
Sec. A-28. 22 MRSA §4088, sub-§3, ~, as amended by PL 2003, c. 399, §3, is 
further amended to read: 
D. 
Shall coordinate and consult with the bureau or services center staff department 
performing general licensing functions to eliminate duplicative or redundant 
investigations to the extent possible and to prevent, correct or eliminate the abuse or 
neglect or threat of abuse or neglect in out-of-home settings; 
Sec. A-29. 22 MRSA §4088, sub-§3, ~E, as amended by PL 2003, c. 399, §3, is 
further amended to read: 
E. 
Shall provide the results of the investigation to the bureau, services center 
department or another department for appropriate action. The team shall complete 
the investigation within a time frame not to exceed 6 months from the date of the 
initiation of the investigation, except in circumstances when the information 
necessary to complete the investigation is unavailable to the team; 
Sec. A-30. 22 MRSA §4088, sub-§3, ~G, as amended by PL 2003, c. 399, §3, is 
further amended to read: 
G. 
When a report alleges out-of-home abuse and neglect in facilities or by persons 
not subject to licensure by the department or services center, shall immediately refer 
the report to the services center or agency or department charged with the 
responsibility to investigate such a report or, if applicable, to the state department 
operating the facility; 
Sec. A-31. 22 MRSA §4088, sub-§6, as enacted by PL 1989, c. 400, §9, IS 
amended to read: 
6. Assistance. Staff performing general licensing functions may assist the team in 
conducting out-of-home investigations upon the request of the Director of the Bureau of 
Child and Family Services department, provided that as long as the licensing staff 
member has neither currently licensed nor monitored for compliance the subject of the 
investigation. 
Sec. A-32. 22-A MRSA §201, sub-§2, as amended by PL 2005, c. 412, §5, is 
repealed. 
Sec. A-33. 22-A MRS A §205, first~, as enacted by PL 2003, c. 689, Pt. A, §I, 
is amended to read: 
The commissioner has all of the powers and duties necessary to carry out the mission 
and responsibilities of the department. The commissioner has the power to distribute the 
functions and duties given to the commissioner under this Title, Title 5, Title 19-A, Title 
and Title 34-B among the various offices of the department so as to integrate the work 
properly and to promote the most economical and efficient administration of the 
department. Wherever in this Title, Title 5, Title 19-A, Title 22 or Title 34-B powers and 
duties are given to the commissioner or the department, these must be assumed and 
carried out by such of the offices that the commissioner designates and these powers and 
duties may in tum be delegated to subordinates by those office directors with the approval 
of the commissioner. 
Sec. A-34. 22-A MRSA §20S, sub-§4, as amended by PL 2005, c. 236, §3 and 
amended by c. 412, §6, is further amended to read: 
4. Appointments. The following positions are appointed by the commissioner and 
serve at the pleasure of the commissioner: all deputy commissioners; all office directors; 
the regional systems integration directors; and the superintendents of any state 
institutions. 
A. The Deputy Commissioner of Integrated Services; 
B. The Deputy Commissioner of Health, Integrated Access and Strategy; 
C. The Deputy Commissioner of Finance; 
D. The Deputy Commissioner of Operations and Support; 
Eo The Director of the Office of Maine Care Services; 
F. The Director of the Maine Center for Disease Control and Pre','ention; 
C. The Director of the Office of Integrated Access and Support; 
H. The Director of the Office of Adult Mental Health Services; 
I. 
The Director of the Office of Adults with Cognitive and Physical Disability 
Services; 
J. The Director of the Office of Child and Family Services; 
K. The Director of the Office of Elder Services; 
L. The Director of the Office of Substance Abuse Services; 
M. 
The regional system integration directors; 
N. 
The Director of Dorothea Dix Psychiatric Center; and 
O. 
The Director of Rivervie'N Psychiatric Center. 
Deputy commissioners and office directors appointed pursuant to this subsection must 
have educational qualifications and professional experience directly related to the 
functions of and services provided by the relevant unit or office. 
Sec. A-3S. 22-A MRSA §206 is enacted to read: 
§206. Additional duties of the commissioner 
In addition to other duties set out in this Title, the commissioner has the following 
duties. 
1. General. The commissioner has general supervision, management and control of 
the research and planning, grounds, buildings, property, officers, employees and clients of 
all state institutions. 
2. Enforcement of laws. The commissioner shall enforce all laws concerning the 
institutions within the department, unless specific law enforcement duties are given by 
law to other persons. 
3. Rules. Rules must be established as set out in this subsection. 
A. The commissioner shall establish such rules, regulations, procedures and practices 
as the commissioner may determine appropriate or necessary for the care and 
management of the property of all state institutions, for the production and 
distribution of the products of the institutions, for guiding the institutions in 
determining whether to approve admissions and for the execution of the statutory 
purposes and functions of the institutions. 
B. The central principle underlying all rules relating to residents of the institutions 
within the department is that the residents retain all rights of an ordinary citizen, 
except those expressly or by necessary implication taken from them by law. 
4. Grievance procedures. The commissioner shall establish procedures for hearing 
grievances of clients who receive mental health services or mental retardation services or 
l3 
of children who receive behavioral health services. The procedures must include the 
opportunity for a timely hearing before a state hearing examiner or an independent fair 
hearing examiner. 
The commissioner may contract for the services of the hearing 
examiner or examiners, who shall conduct all adjudicatory proceedings pursuant to the 
Maine Administrative Procedure Act. 
5. Residential child care facilities. The commissioner shall approve all programs 
for the provision of mental health services to residential child care facilities, as defined in 
Title 22, section 8101, subsection 4, and shall participate in licensure of these programs 
in accordance with Title 22, section 8104. 
6. 
Abuse allegations in state institutions. 
The commissioner shall ensure 
appropriate intervention and remediation in cases of substantiated abuse and neglect in 
state institutions. The commissioner shall ensure, through inspection on a periodic basis, 
that all state institutions meet appropriate federal and state standards relating to the 
health, safety and welfare of clients of these institutions. 
7. Establish standards of care. The commissioner shall establish standards of care 
for patients at the Riverview Psychiatric Center and the Dorothea Dix Psychiatric Center. 
8. Substance abuse prevention and treatment. The commissioner shall administer 
and carry out the purposes of the Maine Substance Abuse Prevention and Treatment Act. 
Sec. A-36. 22-A MRSA §207 is enacted to read: 
§207. Additional powers of the commissioner 
In addition to other powers granted in this Title, the commissioner has the powers set 
out in this section. 
1. General powers. The commissioner may perform any legal act relating to the 
care, custody, treatment, relief and improvement of the residents of state institutions or 
may purchase residential services when the department does not provide the appropriate 
institutional services for the client. 
2. 
Appointments of deputy commissioner and other employees. 
The 
commissioner's powers to appoint any deputy commissioner and other employees are as 
set out in this section. 
A. The commissioner may appoint, subject to the Civil Service Law and except as 
otherwise provided, any employees who may be necessary. 
B. 
The commissioner may appoint and set the salaries for one or more deputy 
commissioners to assist in carrying out the responsibilities of the department. Each 
appointment must be for an indeterminate term and until a successor is appointed and 
qualified or during the pleasure of the commissioner. 
C. 
The commissioner may appoint the following officials to serve at the 
commissioner's pleasure: 
(1) Superintendent, Riverview Psychiatric Center; 
(2) Superintendent, Dorothea Dix Psychiatric Center; 
(3) Director, Elizabeth Levinson Center; 
(4) Assistant to the Commissioner; 
(5) Regional Systems Integration Directors; and 
(6) Directors of office units. 
D. The commissioner, with the approval of the Governor, may employ and set the 
salaries up to the maximum adjusted pay grade for clinical director positions. Clinical 
director positions are excluded from the definition of state employee under Title 26, 
section 979-A, subsection 6 and are not subject to the Civil Service Law. Employees 
in that classification hired after July 1, 1989 serve at the pleasure of the commissioner 
and must, as a condition of continued employment, maintain clinical privileges to 
practice medicine as determined by the respective medical staff and the 
superintendent of the facility. 
E. Employees in the classification of clinical director may elect to retain current 
bargaining unit and civil service status. Employees so grand fathered retain salary and 
benefit entitlements provided for in current pay schedules and collective bargaining 
agreements. 
3. 
Delegation. 
The commissioner's delegation powers are as set out in this 
subsection. 
A. The commissioner may delegate powers and duties given under this Title to any 
deputy commissioner and chief administrative officers of state institutions. 
B. 
The commissioner may empower any deputy commissioner and chief 
administrative officers of state institutions to delegate further powers and duties 
delegated to them by the commissioner. 
4. Funding sources. In carrying out this Title the commissioner may apply for and 
accept from any other agency of government, person, group or corporation any funds that 
may be available. 
5. Lease of unused buildings. The commissioner may, with the approval of the 
Director of the Bureau of General Services, lease unused buildings at the state institutions 
for the purposes of providing services to departmental clients. 
A. The leases must be for a period not to exceed one year. 
B. The commissioner shall submit a plan of the proposed leases and their impact on 
the institutions and departmental clients to the joint standing committee of the 
Legislature having jurisdiction over health and institutional services no later than 
January 31 st of each year. 
6. Nurse training. The commissioner may provide for the training of nurses. 
7. Appearance of designated employees in Probate Court. The commissioner 
may designate employees of the department to represent the department in Probate Court 
only in: 
A. 
Matters relating to the performance of duties in uncontested guardianship, 
conservatorship or termination of guardianship or conservatorship proceedings; and 
B. 
Requests for emergency guardianships arising from the need for emergency 
medical treatment or placement in adult foster homes, boarding homes or nursing 
homes or for orders necessary to apply for or preserve an estate in emergency 
situations. 
8. Physicians. Department employees in the classifications of physician I, II and III 
are unclassified state employees, as defined by Title 26, section 979-A, subsection 6, and 
are members of bargaining units, subject to Title 26, chapter 9-B. An employee in any of 
these classifications must, as a condition of continued employment, maintain necessary 
clinical privileges to practice medicine in that employee's position as determined by the 
respective medical staff and the superintendent of the facility. 
Any termination of 
employment due to a loss of clinical privileges to practice medicine under this subsection 
is not subject to the grievance procedure under any collective bargaining agreement. 
9. Contracts with health care servicing entities. The commissioner may enter into 
contracts with health care servicing entities for the financing, management and oversight 
of the delivery of mental health, mental retardation and substance abuse services to 
clients pursuant to a state or federally sponsored health program in which the department 
participates or that the department administers. 
For the purposes of this subsection, 
"health care servicing entity" means a partnership, association, corporation, limited 
liability company or other legal entity that enters into a contract with the State to provide 
or arrange for the provision of a defined set of health care services; to assume 
responsibility for some aspects of quality assurance, utilization review, provider 
credentialing and provider relations or other related network management functions; and 
to assume financial risk for provision of such services to clients through capitation 
reimbursement or other risk-sharing arrangements. "Health care servicing entity" does 
not include insurers or health maintenance organizations. In contracting with health care 
servicing entities, the commissioner: 
A. Shall include in all contracts with the health care servicing entities standards, 
developed in consultation with the Superintendent of Insurance, to be met by the 
contracting entity in the areas of financial solvency, quality assurance, utilization 
review, network sufficiency, access to services, network performance, complaint and 
grievance procedures and records maintenance; 
B. Prior to contracting with any health care servicing entity, must have in place a 
memorandum of understanding with the Superintendent of Insurance for the 
provision of technical assistance, which must provide for the sharing of information 
between the department and the superintendent and the analysis of that information 
by the superintendent as it relates to the fiscal integrity of the contracting entity; 
C. May require periodic reporting by the health care servicing entity as to activities 
and operations of the entity, including the entity's activities undertaken pursuant to 
commercial contracts with licensed insurers and health maintenance organizations; 
D. May share with the Superintendent of Insurance all documents filed by the health 
care servicing entity, including documents subject to confidential treatment if the 
information is treated with the same degree of confidentiality as is required of the 
department; and 
E. May make all necessary rules for the administration of contracts with health care 
servicing entities. All rules adopted pursuant to this paragraph are routine technical 
rules as defined in Title 5, chapter 375, subchapter 2-A. 
10. Ad hoc committee compensation. The commissioner is authorized to provide 
compensation to persons who are consumers or family members of consumers of 
departmental services who are members of ad hoc committees. The compensation may 
not exceed $25 per day and payment of expenses. Total compensation expenses of the 
department under this subsection in any fiscal year may not exceed $7,500. 
Sec. A-37. 22-A MRS A §20S is enacted to read: 
§208. Maintenance 
The commissioner shall maintain 2 state mental health institutes for the mentally ill, 
one at Bangor called the Dorothea Dix Psychiatric Center and the other at Augusta called 
the Riverview Psychiatric Center. 
Sec. A-3S. 22-A MRSA §209 is enacted to read: 
§209. Maintenance of facilities 
The department shall maintain and is responsible for the supervision of services in the 
Elizabeth Levinson Center for children in need of treatment. 
Sec. A-39. 22-A MRSA §210 is enacted to read: 
§210. Elizabeth Levinson Center 
1. Establishment. There is established the Elizabeth Levinson Center at Bangor, 
referred to in this section as "the center," which must be maintained for the training, 
education, treatment and care of persons who are mentally retarded and children in need 
of treatment. 
2. Director. The chief administrative officer of the Elizabeth Levinson Center is the 
director of the center. 
A. The commissioner shall appoint and set the salary for the director. 
B. The director is appointed for an indefinite tenn and serves at the pleasure of the 
commissioner until a successor is appointed and Qualified. 
C. In order to Qualify for appointment as the director, a person must have sufficient 
education and experience to administer a facility providing services to children in 
need of treatment. 
3. Duties of the director. The director: 
A. 
Is responsible for the training, education, treatment and care of all persons 
received into or receiving services from the center; 
B. Is responsible for the discharge of all persons received into the center; and 
C. 
Shall maintain direct supervision, management and control of the grounds, 
buildings, property, officers and employees of the center, subject to the approval of 
the commissioner. 
4. Admission to the center. Persons or children with mental retardation in need of 
treatment may be admitted to the center in any of the ways described in this subsection. 
A. 
When considered necessary by a planning team and with the consent of the 
director, persons may be admitted to the center's short-tenn evaluation program for a 
period of 40 program days, excluding weekends, without certification. 
B. Respite care may be provided to any person by the center without full compliance 
with the procedures for admission by judicial certification under Title 34-B, section 
5475 if the purpose of the respite care is for evaluation, diagnosis or other clearly 
stated and broadly defined therapeutic purposes of the person or the person's family. 
(1) Respite care may be provided, upon application to the department by the 
person, the person's guardian or the person's parent, for not more than 21 days at 
a time and not more than 60 days during any 12-month period. 
(2) 
Continuing placement in the center beyond the time periods stated in 
subparagraph 1, if indicated, is pennitted only upon full compliance with Title 
34-B, section 5475. 
C. Admission to the center by judicial certification may be accomplished according 
to the procedures in Title 34-B, section 5475. 
5. Applicability of laws. If a child with mental retardation in need of treatment is 
admitted to the center, all provisions in Title 34-B, chapter 5 that are applicable to state 
institutions apply to the center with respect to that child. 
Sec. A-40. 22-A MRS A §211 is enacted to read: 
§211. Municipal grants 
The department is authorized to make grants to cities and towns within the State, or 
to nonprofit corporations organized for purposes related to public health or welfare, out of 
federal funds when such grants are permitted by the terms under which the federal funds 
are available. 
Such grants must be made in conformity with applicable federal 
requirements and standards and with appropriate state accounting requirements and in 
accordance with regulations of the department. 
Sec. A-41. 22-A MRS A §212 is enacted to read: 
§212. Service delivery regions 
The commissioner shall organize regional service delivery in accordance with the 
regional boundaries set out in this section. 
1. Region I. Region I is all of York County and Cumberland County. 
2. Region II. Region II is all of Franklin County, Oxford County, Androscoggin 
County, Somerset County, Kennebec County, Waldo County, Knox County, Lincoln 
County and Sagadahoc County. 
3. Region III. Region III is all of Piscataquis County, Penobscot County, Hancock 
County, Washington County and Aroostook County. 
Sec. A-42. 22-A MRSA §213 is enacted to read: 
§213. Fees for service 
1. Reasonable fees authorized. The department may charge reasonable fees for any 
services provided under this Title, Title 5, Title 22 or Title 34-B, whether directly or 
indirectly provided by the department. Any fees thus received constitute a permanent 
fund for use by the department as special revenue income and do not become part of the 
General Fund. Fees so generated must be used in accordance with federal regulations. 
2. 
Sliding fee scale. The department may establish a sliding fee scale for the 
provision of community-based purchased services administered by the department. 
A. The sliding fee scale must be based on gross family income and family size. 
B. Any fees charged as a result of implementing this subsection must be paid to the 
provider of the service and be used by the provider for additional services of the same 
or related type for which the fees were paid. 
Sec. A-43. 22-A MRS A §214 is enacted to read: 
§214. Federal funds and commodities 
The commissioner, with the consent and approval of the Governor, is authorized and 
empowered to accept any allotments of federal funds and commodities, to manage and 
dispose of the same in whatever manner required by federal law and put into effect the 
United States Social Security Act and any amendments of that act and of other federal 
acts relating to public welfare. 
Sec. A-44. 22-A MRS A §215 is enacted to read: 
§215. Coordination and reporting on expenditure of funds pertaining to homeland 
security and bioterrorism prevention 
The commissioner shall coordinate in a mutually agreed upon manner with the 
Director of the Maine Emergency Management Agency within the Department of 
Defense, Veterans and Emergency Management on the planning and expenditure of all 
federal funds received by the department for homeland security emergency preparedness 
purposes or for the prevention of bioterrorism and provide a report annually, beginning 
December 15, 2006, to the Homeland Security Advisory Council established in Title 37-
B, section 708. The advisor for the Homeland Security Advisory Council shall report by 
January 15th of each year, beginning in 2007, on the expenditure of such funds to the 
joint standing committee of the Legislature having jurisdiction over health and human 
services matters and the joint standing committee of the Legislature having jurisdiction 
over criminal justice and public safety matters. The report must include, but is not 
limited to, the amount of funds expended in the prior year, the purpose of those 
expenditures, the effect of those expenditures on homeland security and bioterrorism 
prevention and the plans for coordination with the Maine Emergency Management 
Agency for the expenditure of the funds received or anticipated for such purposes in the 2 
years following submission of the report. 
Sec. A-45. 22-A MRSA §216 is enacted to read: 
§216. Funds for social services 
The department shall administer any funds that may be available from private, local, 
state or federal sources for the provision of social services as defined by the department. 
Within any limitation that may apply from the sources of such funds, the department may 
provide said social services itself, or assure itself of the provision of such services by 
purchase of services, by contracts or by grants, or by joint provision of services, by 
contracts or by grants, or by joint provision of services with other agencies through 
matching agreements. 
The department shall adopt rules as necessary to define eligibility for social services, 
contractual terms, conditions for grants, matching ratios and quality of performance 
standards and such others as are necessary for the administration of this section. These 
rules must be published and subject to a 30-day public review prior to taking final effect. 
The department may expend any unidentified child support payments and any interest 
earned on those funds that the department has received when the department cannot 
identify the child for which payment was made. The department may expend these funds 
only in its efforts to enforce child support laws in accordance with Title 19-A, chapters 
53, 63, 65 and 67. Before making any expenditure, the department must wait at least 12 
months from the date the unidentified funds were received. 
Sec. A-46. 22-A MRSA §217 is enacted to read: 
§217. Performance-based contracts 
In addition to other applicable requirements and unless precluded by other restrictions 
on the use of funds, the commissioner shall manage all funds available for the provision 
of social services in accordance with the provisions of this section. 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. 
"Agreement" means a legally binding written document between 2 or more 
parties, including such documents as are commonly referred to as accepted 
application, proposal, prospectus, contract, grant, joint or cooperative agreement, 
purchase of service or state aid. 
B. 
"Performance-based contract" means an agreement for the purchase of direct 
client services employing a client-centered, outcome-oriented process that is based on 
measurable performance indicators and desired outcomes and includes the regular 
assessment of the quality of services provided. 
2. Performance-based contract. The commissioner shall ensure that all agreements 
to purchase social services are performance-based contracts. 
3. Rules. The commissioner shall adopt rules to implement this section, including, 
but not limited to, the establishment of program goals, outcome measures, an information 
management system to collect and manage contract data, a system of ongoing assessment 
of program effectiveness and hold-harmless guidelines for provider agencies during the 
first contract period or 12 months, whichever is greater. 
4. Procedures. The procedures in this subsection apply whenever the commissioner 
commences a request-for-proposal procedure. 
A. The commissioner shall hold at least one informational meeting at least 30 days 
before the due date for submission of the notice of intent to bid. Any informational 
meeting must be advertised in newspapers of general circulation stating the location, 
date, time and purpose of the meeting. At the meeting the commissioner shall provide 
detailed information to any interested party about the contract to be bid or rebid, 
provide notice of anticipated major changes from any previous contract and respond 
to questions. 
B. The commissioner shall require any interested party to submit a notice of intent to 
bid at least 30 days before the date bids will be accepted as a precondition to 
submitting a formal bid. The notice of intent must contain minimal requirements that 
demonstrate a prospective bidder's competence and ability to comply with the 
requirements of the contract. 
C. If only one community service provider submits a notice of intent to bid, the 
commissioner may enter into negotiations concerning a contract with that provider in 
accordance with the procedures established for performance-based contracts. 
D. For purposes of this section, the commissioner retains the right to reject any bids 
submitted and any proposals made during negotiations pursuant to paragraph C. 
Sec. A-47. 22-A MRSA §218 is enacted to read: 
§218. State wards 
When a state ward becomes 18 years of age and the state ward and the department 
agree that need for care and support for educational, social or physical reasons exists, the 
department is authorized to continue care and support of this person up to 21 years of age. 
When a state ward who is enrolled in a postsecondary education program becomes 21 
years of age prior to the completion of the postsecondary education program, the 
department is authorized, at its discretion and by agreement with that state ward, to 
continue providing support for room, board and related education expenses until the state 
ward becomes 23 years of age. Funds allocated under this section must come from an 
identified education and training account specifically established for the postsecondary 
education-related costs of state wards after they become 21 years of age and before they 
become 23 years of age. 
Sec. A-48. 34-8 MRS A §1201, as amended by PL 2001, c. 354, §§1 and 3, is 
repealed. 
Sec. A-49. 34-8 MRSA §1201-A, as amended by PL 2005, c. 397, Pt. A, §42, is 
repealed. 
Sec. A-50. 34-8 MRSA §1201-8, as enacted by PL 1993, c. 738, Pt. F, §2, is 
repealed. 
Sec. A-51. 34-8 MRS A §1202, as amended by PL 2001, c. 439, Pt. J, §§4 and 5 
and PL 2003, c. 689, Pt. B, §7, is repealed. 
Sec. A-52. 34-8 MRSA §1203, as amended by PL 2007, c. 80, § 1, is repealed. 
Sec. A-53. 34-8 MRSA §1204, as amended by PL 2007, c. 286, §1, is repealed. 
Sec. A-54. 34-8 MRSA §1401, as amended by PL 1995, c. 560, Pt. K, §§25 and 
and PL 2005, c. 236, §§3 and 4, is repealed. 
Sec. A-55. 34-8 MRSA §3201, as amended by PL 2005, c. 236, §2, is repealed. 
Sec. A-56. 34-8 MRSA §3202, as amended by PL 1995, c. 560, Pt. K, §35 and 
PL 2005, c. 236, §§3 and 4, is repealed. 
Sec. A-57. 34-8 MRSA §6251, as amended by PL 1995, c. 560, Pt. K, §75, is 
repealed. 
Sec. A-58. 34-8 MRSA §6252, as amended by PL 2003, c. 389, §25, is repealed. 
PARTB 
Sec. B-1. 4 MRSA §807, sub-§3, ~H, as corrected by RR 2003, c. 2, § 1, is 
amended to read: 
H. 
A person who is not an attorney but has been designated to represent the 
Department of Health and Human Services under Title 22, section 3473, subsection 3 
or under Title 34 B, section 1204, subsection 7 Title 22-A, section 207, subsection 7 
in Probate Court proceedings; 
Sec. B-2. S MRSA §19203, sub-§8, as amended by PL 1989, c. 487, §1, is 
further amended to read: 
8. 
Department of Health and Human Services. 
To the Bureau of Health 
Department of Health and Human Services, which may disclose results to other persons 
only if that disclosure is necessary to carry out its duties as provided in Title 22, sections 
3,7 and section 42 and chapters 250 and 251; 
Sec. B-3. S MRS A §20006-A, sub-§3, as enacted by PL 1995, c. 560, Pt. L, §8 
and affected by § 16, is amended to read: 
3. Other duties and powers. Carry out other duties and exercise other powers 
granted to the director under this Act and delegated to the director by the commissioner 
under Title J4-B 22-A, section ~ 
207, subsection 3. 
Sec. B-4. 22 MRSA §2804, as amended by PL 1987, c. 259, § 1, IS further 
amended to read: 
§2804. Index 
The Registrar of Vital Statistics shall prepare and keep an alphabetical index, by the 
names of both parties, of all annulments and divorces reported. When requested, the 
registrar shall cause a search to be made of his the files for the record of any divorce or 
annulment and shall furnish a copy thereof. The fee for such search and copy 5flal.l must 
reasonably reflect the cost of the service, as specified in section 9 Title 22-A, section 213, 
subsection 1. 
Sec. B-S. 22 MRSA §3731, sub-§4, as enacted by PL 1993, c. 158, §2, is 
amended to read: 
4. Region. "Region" means a service delivery region established pursuant to section 
6-A Title 22-A, section 212. 
Sec. B-6. 22 MRSA §S10S, 3rd~, as repealed and replaced by PL 1975, c. 771, 
§231, is amended to read: 
The bureau shall be i.§ administered by a director 'tyho shall be appointed as pro",ided 
in section 1. 
Sec. 8-7. 22 MRS A §5309, first~, as repealed and replaced by PL 1975, c. 771, 
§233, is amended to read: 
The bureau shall be i.§ administered by a director It'{ho shall be appointed as provided 
in section 1. 
Sec. 8-8. 24-A MRSA §10, sub-§6, as enacted by PL 1997, c. 676, §4 and 
amended by PL 2001, c. 354, §3 and PL 2003, c. 689, Pt. B, §6, is further amended to 
read: 
6. 
The government contracting activities of a health care servicing entity, as defined 
in Title 34 B, section 1204 Title 22-A, section 207, subsection 9, contracting, whether 
directly or as a subcontractor, with the Department of Health and Human Services, unless 
otherwise expressly provided by this Title. This Title may apply to any other insurance 
or managed care activities of a health care servicing entity. 
Sec. 8-9. 26 MRSA §1403, sub-§I, as enacted by PL 1997, c. 443, §l, IS 
amended to read: 
1. 
Nondisplacement of existing employees; nonavailability for layoff 
replacement; 
noninfringement 
on 
promotional 
opportunities 
or 
collective 
bargaining agreements; labor disputes. A participant who is required to work as a 
condition of receiving public assistance, as defined in Title 22, section 9 A, subsection 1, 
paragraph A, may not be employed in or assigned to: 
A. 
A position that was previously filled by a regular employee when that employee 
is on layoff from the same or an equivalent position or when the vacancy was created 
by terminating an employee or otherwise reducing the workforce; 
B. 
An established position that is vacant; 
C. 
A worksite where there is a labor dispute, including a strike or lockout; or 
D. 
A worksite in a manner that violates an existing contract or collective bargaining 
agreement or infringes on the promotional opportunities for any employees. 
Sec. 8-10. 34-B MRSA §5475, sub-§I, ~B, as enacted by PL 1983, c. 459, §7, 
is amended to read: 
B. 
The petition may not be filed by the chief administrative officer of a regional 
office until he the chief administrative officer of the regional office has obtained 
approval for the admission by the chief administrative officer of the facility under 
rules promulgated adopted by the commissioner under section 1203, subsection 3. 
Sec. 8-11. 37-8 MRSA §505, sub-§5, as enacted by PL 2001, c. 439, Pt. UU, 
§2, is amended to read: 
5. Public assistance designation. Assistance granted to veterans or their dependents 
pursuant to this section is designated public assistance for the purposes of providing 
public assistance within the meaning of Title 22, section 9 A. The department retains 
administrative responsibility for assistance granted under this section. 
SUMMARY 
Part A of this bill consolidates provisions in the Maine Revised Statutes, Titles 22 
and 34-B with existing provisions in Title 22-A to the extent that Titles 22 and 34-B 
described the Department of Health and Human Services' organizational structure and the 
Commissioner of Health and Human Services' powers and duties. Some provisions are 
repealed because redundant; some are repealed or rewritten to give the commissioner 
more flexibility in organizing the department, appointing staff and delegating the various 
duties of the department among staff. 
1. It repeals redundant text in Title 22, section I concerning the establishment of the 
department and appointment of the commissioner. The bill also repeals language about 
the qualifications required of certain bureau directors. 
2. It repeals Title 22, section 2, which referred to legal services obtained from the 
Attorney General or the district attorneys. 
3. It repeals Title 22, section 3, which referred to the jurisdiction of the department 
and the requirement to report annually about services contracted with community 
providers. 
4. It repeals Title 22, section 3-A, which referred to support for certain state wards. 
This text is moved to Title 22-A, section 218. 
5. 
It repeals Title 22, section 3-B, which referred to the ability of a licensed 
children's home to consent to a state ward's medical treatment. 
6. It repeals Title 22, section 3-C, which established a clearinghouse of information 
about handicapped housing accessibility. 
7. It repeals Title 22, section 3-D, which permitted the department to establish a 
center for public health practice. 
8. It repeals Title 22, section 4, which required the department to render opinions 
about the organization of certain institutions subject to the department's inspection. 
9. It repeals Title 22, section 6, which described the commissioner's authority to 
distribute the functions of the department among the various offices. This text is moved 
to Title 22-A, section 205. 
10. It repeals Title 22, section 6-A, which described the 3 service delivery regions. 
This text is moved to Title 22-A, section 212. 
11. It repeals Title 22, section 6-B, which described the requirement of joint location 
of services offered by the former Department of Behavioral and Developmental Services 
and the former Department of Human Services. 
12. It repeals Title 22, section 6-C, which described the Community Services Center, 
its purposes and its functions. 
13. It repeals Title 22, section 7, which described the department's additional duties 
to provide services to sick, dependent, defective and delinquent persons. 
14. It repeals Title 22, section 8, which described the department's authority to 
provide complementary services to persons unable to provide for themselves. 
15. It repeals Title 22, section 9, which authorized the department to charge fees for 
services. This text is moved to Title 22-A, section 213. 
16. It repeals Title 22, section 9-A, which described public assistance eligibility by 
cross-reference to other statutory provisions. 
17. It repeals Title 22, section 10, which empowered the commissioner to accept 
federal funds and commodities. This text is moved to Title 22-A, section 214. 
18. It repeals Title 22, section 10-A, which required the Director of the Maine Center 
for Disease Control and Prevention to work with other state agencies on homeland 
security preparedness. This text is moved to Title 22-A, section 215 substituting the 
commissioner for the director as the responsible party. 
19. It repeals Title 22, section 11, which authorized the department to make grants to 
municipalities for purposes related to public health or welfare. This text is moved to Title 
22-A, section 211. 
20. It repeals Title 22, section 12, which required the department to administer social 
services funds from any source and to adopt rules regarding eligibility and standards. 
This text is moved to Title 22-A, section 216. 
21. 
It repeals Title 22, section 12-A, which established requirements for 
performance-based contracts. This text is moved to Title 22-A, section 217. 
22. It repeals Title 22, section 12-B, which required the commissioner to distribute 
funds available within the aid to charitable institutions program to certain named 
agencies. 
23. It repeals Title 22, section 13, which authorized the commissioner to create a 
human services fraud investigation unit. 
24. 
It amends Title 22-A, section 201, which established the department. 
It 
eliminates the detailed list of 4 units of the department, as well as the offices to be located 
within each unit, in order to give the commissioner more flexibility to establish and 
change the structural organization of the department from time to time. 
25. It amends Title 22-A, section 205 by moving text in from Title 22 to explain the 
commissioner's authority to delegate and reassign functions of the department to different 
offices from time to time. It describes the commissioner's authority to appoint senior 
staff without listing detailed titles for each. 
26. It repeals Title 34-B, section 1201, which described the establishment of the 
department. 
27. It repeals Title 34-B, section 1201-A, which described the 3 service delivery 
regions. 
28. 
It repeals Title 34-B, section 1201-B, which required the joint location of 
services with the fonner Department of Behavioral and Developmental Services and the 
fonner Department of Human Services. 
29. 
It repeals Title 34-B, section 1202, which described the appointment of the 
commissioner. 
30. It repeals Title 34-B, section 1203, which described additional duties of the 
commissioner, and moves the text to Title 22-A, section 206. It amends the text by 
eliminating the prohibition against using department employees as hearing officers for 
grievances and by amending the commissioner's duty to establish grievance procedures 
for clients to include clients receiving mental health services or mental retardation 
services and children who receive behavioral health services. 
31. It repeals Title 34-B, section 1204, which described additional powers of the 
commissioner relating to state institutions, clinical directors, lease of buildings, nurse 
training, appearances by employees in Probate Court, physicians, contracts with health 
care servicing entities and ad hoc committee compensation, and moves the text, with 
minor amendments, to Title 22-A, section 207. 
32. It repeals Title 34-B, section 1401, which described the appointment of officers 
to operate state institutions. 
33. It repeals Title 34-B, section 3201, relating to the maintenance of 2 state mental 
health institutes, and moves the text to Title 22-A, section 208. 
34. 
It repeals Title 34-B, section 3202, which described the position of 
superintendent at both state mental health institutions. 
35. It repeals Title 34-B, section 6251, which required the department to maintain 2 
facilities for children in need of treatment, and moves the text to Title 22-A, section 209. 
The text is updated to include only the one remaining institution for children, the 
Elizabeth Levinson Center. 
36. It repeals Title 34-B, section 6252, which described the establishment of the 
Elizabeth Levinson Center, the qualifications and duties of the director and the standards 
for admission to the center. This text is moved to Title 22-A, section 210, with minor and 
technical amendments. 
Part B of this bill corrects statutory cross-references to reflect changes made in Part 
A.