An Act To Reduce Administrative Costs in Programs Delivered to People with Mental Retardation
Maine Legislature, Session 123, LD 1686
Committee: Health and Human Services
Sponsors: ROSEN, PINGREE, BRANNIGAN, RA YE
Amends: 34-B MRSA §5003, 34-B MRSA §5203

Legislative Document 
No. 1686 
S.P.593 
March 23,2007 
An Act To Reduce Administrative Costs in Programs Delivered to 
People with Mental Retardation 
Reference to the Committee on Health and Human Services suggested and ordered printed . 
Presented by Senator ROSEN of Hancock. 
JOY J. O'BRIEN 
Secretary of the Senate 
Cosponsored by Representative PINGREE of North Haven and Senators: BRANNIGAN of 
Cumberland, RA YE of Washington. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 26 MRS A §1411-D, sub-§3, as enacted by PL 1995, c. 560, Pt. F, §13, is 
amended to read: 
3. Community rehabilitation programs. May establish, construct and operate 
community rehabilitation programs and make grants to public or other nonprofit 
organizations for those purposes~.:. 
A. The department may require the programs to meet state accreditation standards, 
which must be less stringent than accreditation standards established by national, 
nonprofit or quasi-public organizations that accredit rehabilitation facilities. 
B. The department may not require any additional accreditation above the standards 
set pursuant to paragraph A; 
Sec. 2. 34-B MRSA §5003, sub-§2, ,E, as amended by PL 1993, c. 410, Pt. 
CCC, §26, is further amended to read: 
E. 
Eliminate its own duplicative and unnecessary administrative procedures and 
practices in the system of care for mentally retarded persons, encourage other 
departments to do the same and clearly define areas of responsibility in order to 
utilize present resources economically~, including, but not limited to: 
(1) Eliminating duplication of data entry and reducing paperwork and mailing 
costs through use of technology and electronic transmission of data; 
(2) 
Assessing the fiscal impact that proposed laws or rules would have on 
providers prior to their enactment and publishing the fiscal analysis on the 
department's publicly accessible website in a conspicuous location; 
(3) Modifying the computerized information system known as the Enterprise 
Information System to allow providers to enter more data directly, use query 
functions to obtain information and accomplish all reporting requirements 
electronically; 
(4) Ensuring that all documentation required by the department from providers 
be in a universal electronic format that can be completed and transmitted to the 
department electronically; 
(5) Streamlining the site survey program by: 
(a) Requiring providers to submit the survey report directly to one office of 
the department and giving the department the responsibility for circulating 
the survey reports to other offices and state agencies as needed; and 
(b) Considering the surveys valid for a period of not less than 5 years, unless 
sufficient cause warrants a survey prior to the expiration of the 5-year period; 
and 
(6) Exempting certain programs that do not serve mentally retarded persons who 
require medication from the requirement that a medication-certified staff person 
Page I - 123LR1572(Ol)-1 
.. 
• 
.. 
• 
be on duty at all times and instead allowing medication-certified staff to be 
available on an on-call basis should the need to administer medication arise; 
Sec. 3. 34-B MRSA §5003, sub-§2, ~F, as amended by PL 1993, c. 410, Pt. 
CCC, §26, is further amended to read: 
F. 
Strive toward having a sufficient number of personnel who are qualified, trained 
and experienced to provide treatment that is beneficial to the mentally retarded 
clientst while balancing the need to streamline training requirements by: 
(1) Allowing an experienced direct support staff person to take a test covering a 
particular training subject and be exempt from that particular training if the staff 
person scores at a level that demonstrates thorough knowledge on the subject 
matter of the training as determined by the department; and 
(2) Allowing direct support staff persons to be exempt from training that is not 
directly related to the condition of individuals served in the staff persons' 
employment setting; 
Sec. 4. 34-B MRSA §5003, sub-§2, ~G, as amended by PL 1995, c. 560, Pt. K, 
§43, is further amended to read: 
G. 
Encourage other departments to provide to persons with mental retardation those 
services that are required by law, and in particular: 
(1) The commissioner shall work actively to ensure that persons with mental 
retardation, as provided for in Title 20-A, chapter 303, receive educational and 
training services beginning at 5 years of age regardless of the degree of 
retardation or accompanying disabilities or handicaps; 
(2) 
The commissioner shall advise the D6flartm8Ht of Humafl Serviees 
department about standards and policies pertaining to administration, staff, 
quality of care, quality of treatment, health and safety of clients, rights of clients, 
community relations and licensing procedures and other areas that affect persons 
with mental retardation residing in facilities licensed by the D6flartmeflt of 
Humafl SePliees department; and 
(3) 
The commissioner shall inform the joint standing committee of the 
Legislature having jurisdiction over health and human reSOl:H'ees services matters 
about areas where increased cooperation by other departments is necessary in 
order to improve the delivery of services to persons with mental retardation; aM 
Sec. 5. 34-B MRSA §5003, sUb-§2, ~, as amended by PL 1995, c. 560, Pt. K, 
§44, is further amended to read: 
II. 
Report annually to the joint standing committee of the Legislature having 
jurisdiction over health and human reSOl:H'ses services matters on the activities of the 
Consumer Advisory Board established by the community consent decree to oversee 
compliance with the terms of that decree. The commissioner or the commissioner's 
designee shall appear in person before the committee and shall provide the committee 
with the most recent annual audit of decree standards and the corrective action plans 
required by the audit. The members of the Consumer Advisory Board may attend the 
commissioner's presentation and provide an independent report of its activities to the 
committee~~ 
Sec. 6. 34-B MRS A §5003, sub-§2, ~I is enacted to read: 
I. Conduct eligibility assessments and reclassification of clients every 5 years and 
not earlier than 5 years unless there is a substantial change in the client's abilities, 
condition and needs; and 
Sec. 7. 34-B MRSA §5003, sub-§2, ~J is enacted to read: 
J. Publish an annual document for community rehabilitation programs that describes 
practices that are acceptable to the department, specific documentation standards for 
all services required by the Federal Government or the department and information 
on current best practices for administering those programs. 
Sec. 8. 34-B MRS A §5003, sub-§3, ~A, as amended by PL 1989, c. 628, § 1, is 
further amended to read: 
A. 
The plan must indicate the most effective and efficient manner in which to 
implement services and programs for persons with mental retardation, while 
safeguarding and respecting the legal and human rights of these persons. 
The 
department shall create an advisory group of providers to provide input into this 
process. The department shall work with the advisory group to review business 
practices and requirements and identify additional cost-efficiency practices. 
Sec. 9. 34-B MRS A §5003, sub-§3, ~C, as amended by PL 1989, c. 628, §l, is 
further amended to read: 
C. The committee shall study the plan and make recommendations to the Legislature 
with respect to funding improvements in programs and services to persons with 
mental retardation including the identification of savings that can be returned to 
providers to fund additional services and defray business expenses related to 
regulatory requirements. 
Sec. 10. 34-B MRSA §5203, sub-§2, ~E is enacted to read: 
E. The department shall identify savings from efficiencies and administrative cost 
containment measures and return those savings to providers for additional services 
and to defray providers' costs of doing business. 
Sec. 11. 34-B MRS A §5471, sub-§4, ~C, as amended by PL 2003, c. 389, § 15, 
is further amended to read: 
C. 
A service plan or personal plan may not be in effect longer than one year 5 years 
and 2 weeks from the day on which the last person signed the service agreement for 
the plan. 
Sec. 12. 
Affordable housing for adults with mental retardation. 
The 
department shall facilitate the development of residential accommodations for adults with 
mental retardation by doing research and creating a plan that identifies appropriate 
mechanisms for developing affordable housing, including but not limited to the creation 
... 
, 
of a nonprofit organization, state bonding and other methods for financing affordable 
housing. 
SUMMARY 
This bill requires the Department of Health and Human Services to eliminate 
duplicative and unnecessary administrative procedures and practices in the system of care 
for mentally retarded persons by eliminating duplicate data entry, reducing paperwork, 
streamlining the survey program, requiring programs to meet one set of state 
accreditation standards and reducing mailing costs through use of technology and 
electronic transmission of data. It requires that the department assess the fiscal impact of 
proposed laws or rules prior to enactment and publish the fiscal analysis on its website. It 
requires that programs be exempt from certain certified medication staffing requirements 
and exempts experienced direct support staff from specific employee training under 
certain circumstances. It limits employee training requirements to those relevant to the 
condition of individuals served. 
It requires the department to conduct eligibility assessments and reclassification of 
clients every 5 years and not earlier than 5 years unless there is a substantial change in the 
client's abilities, condition and needs. It requires the department to publish an annual 
document for community rehabilitation programs that describes practices that are 
acceptable to the department, specific documentation standards for all services required 
by the Federal Government or the department and information on current best practices 
for administering those programs. 
It requires the department to create an advisory group of providers to provide input 
into the process of developing a plan and to work with the advisory group to review 
business practices and requirements and identify additional cost-efficiency practices. 
It requires that the department identify savings that can be returned to providers to 
fund additional services and defray business expenses related to regulatory requirements. 
It 
reqUIres 
the 
department 
to 
facilitate 
the 
development 
of residential 
accommodations for adults with mental retardation by creating a plan that identifies 
appropriate mechanisms for developing affordable housing, including but not limited to 
the creation of a nonprofit organization, state bonding and other methods for financing 
affordable housing.