An Act To Increase Health Insurance Coverage for Front-line Direct Care Workers Providing Long-term Care March 23,2007
Maine Legislature, Session 123, LD 1687
Committee: Insurance and Financial Services
Sponsors: EDMONDS, PINGREE, MARRACHE, BEAUDOIN, CAMPBELL, CONNOR, MILLER, PERRY
Amends: 24-A MRSA §6903

Legislative Document 
No. 1687 
S.P.594 
An Act To Increase Health Insurance Coverage for Front-line 
Direct Care Workers Providing Long-term Care 
March 23,2007 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by President EDMONDS of Cumberland. 
JOY J. O'BRIEN 
Secretary of the Senate 
Cosponsored by Representative PINGREE of North Haven and Senator: MARRACHE of 
Kennebec, Representatives: BEAUDOIN of Biddeford, CAMPBELL of Newfield, CONNOR 
of Kennebunk, MILLER of Somerville, PERRY of Calais. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24-A MRSA §6903, sub-§5, as enacted by PL 2003, c. 469, Pt. A, §8, is 
amended to read: 
5. Eligible business. "Eligible business" means a business that employs at least 2 
but not more than 50 eligible employees, the majority of whom are employed in the State, 
including a municipality that has 50 or fewer employees. 
Notwithstanding this 
subsection, "eligible business" includes a business with more than 50 employees that 
provides long-term care services. 
After one year of operation of Dirigo Health, the board may, by rule, define "eligible 
business" to include larger public or private employers. 
Sec. 2. 24-A MRS A §6903, sub-§7, ~, as enacted by PL 2003, c. 469, Pt. A, 
§8, is amended to read: 
B. An unemployed individual who resides in this State; 6f 
Sec. 3. 24-A MRSA §6903, sub-§7, ~C, as enacted by PL 2003, c. 469, Pt. A, 
§8, is amended to read: 
C. 
An individual employed in an eligible business that does not offer health 
insurance~.;,.Q! 
Sec. 4. 24-A MRSA §6903, sub-§7, ~ 
is enacted to read: 
D. An individual employed as a direct care worker who works an average of 10 or 
more hours per week and who is not eligible for MaineCare or employer-sponsored 
health insurance. 
Sec. 5. 24-A MRS A §6908, sub-§2, ~, as amended by PL 2005, c. 400, Pt. C, 
§6, is further amended to read: 
D. Develop and implement a program to publicize the existence of Dirigo Health and 
the Dirigo Health Program and the eligibility requirements and the enrollment 
procedures for the Dirigo Health Program, including a program targeted at enrolling 
eligible individuals employed as direct care workers, and to maintain public 
awareness of Dirigo Health and the Dirigo Health Program; 
Sec. 6. Department of Health and Human Services demonstration project 
for health coverage of direct care workers providing long-term care. 
By 
October 1, 2007, the Department of Health and Human Services shall establish a 
demonstration project to provide financial assistance to providers of long-term care 
.. 
services to increase health insurance coverage among uninsured direct care employees 
who are not eligible for MaineCare. The department provide financial assistance to 
eligible providers who provide a health insurance benefit plan to full-time and part-time 
direct care employees that meets minimum standards as determined by the department 
taking into consideration the health benefits package provided under the Dirigo Health 
Program. The department shall establish a cap on the number of providers of long-term 
care services that receive financial assistance through the demonstration project and must 
evaluate the demonstration project for its impact on workforce retention. The department 
may not expend more than $500,000 to fund the costs of the demonstration project under 
this section. Rules adopted pursuant to this section are routine technical rules as defined 
in the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A. 
Sec. 7. Dirigo Health Program health insurance plan for long-term care 
providers and direct care workers. The Board of Directors of Dirigo Health shall 
design a targeted DirigoChoice health coverage plan to meet the needs of long-term care 
employers and their employees who provide direct care services pursuant to Title 24-A, 
section 6908, subsection 2, paragraph D. The health coverage plan designed by the board 
pursuant to this section must allow long-term care employers to offer monthly premium 
assistance to direct care workers eligible for coverage under DirigoChoice as an 
individual and accommodate contributions for premium assistance from more than one 
long-term care employer. In designing the plan, the board shall consult with and seek 
input from long-term care employers and direct care workers. The board may not expend 
more than $400,000 in subsidy costs for direct care workers eligible for the health 
coverage plan designed by the board pursuant to this section. 
SUMMARY 
This bill amends the definition of "eligible business" for the Dirigo Health Program 
to allow providers of long-term care services with more than 50 employees to participate 
in the DirigoChoice health insurance plan. The bill also allows uninsured direct care 
workers who work an average of 10 or more hours per week to participate in the 
DirigoChoice health insurance plan. The bill directs the Board of Directors of Dirigo 
Health to develop a marketing and outreach program to enroll those newly eligible direct 
care workers and to design a targeted DirigoChoice health coverage plan that allows 
multiple long-term care employers to contribute monthly premium assistance to direct 
care employees eligible to enroll in Dirigo as an individual. The bill limits the costs to 
Dirigo Health for subsidies to direct care workers in the targeted DirigoChoice plan to 
$400,000. 
The bill also requires the Department of Health and Human Services to establish a 
demonstration project for long-term care providers who provide health insurance 
coverage to their full-time and part-time employees. The bill requires the department to 
provide financial assistance to allow those providers to start or expand health care 
coverage for their direct care employees. The bill limits the funding of the demonstration 
project to no more than $500,000.