An Act To Improve Continuity of Care within Maine's Community-based Mental Health Services
Maine Legislature, Session 123, LD 1745
Committee: Health and Human Services
Sponsors: BRANNIGAN, CRAVEN
Amends: 34-B MRSA §1204, 34-B MRSA §1220, 34-B MRSA §1221, 34-B MRSA §3604, 34-B MRSA §3607, 34-B MRSA §360, 8 MRSA §3610

Legislative Document 
No. 1745 
S.P.612 
March 27,2007 
An Act To Improve Continuity of Care within Maine's Community-
based Mental Health 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 BRANNIGAN of Cumberland. 
Cosponsored by Representative CRAVEN of Lewiston. 
Printed on recycled paper 
JOY J. O'BRIEN 
Secretary of the Senate 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 34-B MRSA §1204, sub-§2, ~C, as amended by PL 2001, c. 493, §3 and 
PL 2005, c. 236, §§3 and 4, is further amended to read: 
C. 
The commissioner shall appoint the following officials to serve at the 
commissioner's pleasure: 
(1) Associate Commissioners; 
(2) Superintendent, Riverview Psychiatric Center; 
(3) Superintendent, Dorothea Dix Psychiatric Center; 
(6) Director, Elizabeth Levinson Center; 
(8) Assistant to the Commissioner; 
(10) Regional Direetors, who shall report to the Assoeiate Commissioner of 
Systems Operations; 
(11) 
Director, Office of Substance Abuse, who shall report directly to the 
commissioner; and 
(12) Deputy Commissioner. 
Sec. 2. 34-B MRS A §1207, sub-§l, ~, as corrected by RR 2005, c. 2, §22, is 
amended to read: 
B. 
Information may be disclosed if necessary to carry out any-ef the statutory 
functions of the department, the hospitalization provisions of chapter 3, subchapter 4, 
the purposes of sections ~ 
3607-A and 3608, the purposes of Title 5, section 
19506 or the purposes of United States Public Law 99-319, dealing with the 
investigatory function of the independent agency designated with advocacy and 
investigatory functions under United States Public Law 88-164, Title I, Part C or 
United States Public Law 99-319; 
Sec. 3. 34-B MRSA §1220, first ~, as enacted by PL 1997, c. 422, §3, IS 
amended to read: 
The department shall designate at least one individual within each of the 7 areas 
described in section ~ 
3608, subsection J I-A to act as liaison to the District Courts 
and Superior Courts of the State and to the Department of Corrections in its 
administration of probation and parole services and the Intensive Supervision Program 
established pursuant to Title 17 -A, section 1261. 
Sec. 4. 34-B MRSA §1221, first~, as amended by PL 2005, c. 380, Pt. B, §14, is 
further amended to read: 
The regional housing coordinator for each region shall convene a working group 
annually to develop a plan that states how mental health or substance abuse services 
needed by individuals using homeless shelters will be provided. Each working group 
shall submit a plan annually to the loeal quality impfO .. 'ement eOl;lneil community service 
• 
network established pursuant to section ~ 
3608. 
The 10Gal Et\iality i~rovemeH:t 
GounGil community service network shall review the plan and submit it, with any 
suggested changes, to the Statewide Homeless Council, established pursuant to Title 30-
A, section 5046. 
Sec. 5. 34-B MRSA §3604, sub-§5, as enacted by PL 1995, c. 691, §6, is 
amended to read: 
5. Exclusion. Beginning October 1, 1996, an entity that applies for the award or 
renewal of a grant or contract for the provision of mental health services must be a 
participating member of the Et\iality impro'/emeH:t institute councilor the lesal community 
service network, as defined established in section ~ 
3608, for the region of the State 
subject to that grant or contract or an interested party assisting a council pursuant to 
section 3607, subsection 8. 
Sec. 6. 34-B MRSA §3607, as amended by PL 1997, c. 683, Pt. B, §22 and PL 
2005, c. 236, §§3 and 4, is repealed. 
Sec. 7. 34-B MRS A §3607-A is enacted to read: 
§3607-A. Institute councils 
1. 
Definitions. As used in this section and sections 3608 and 3609, unless the 
context otherwise indicates, the following tenns have the following meanings. 
A. 
"Consumer" means a recipient or fonner recipient of publicly funded mental 
health services or an adult who has or had a major mental illness. 
B. 
"Family member" means a relative, guardian or household member of an adult 
consumer. 
C. 
"Institute council" means an institute council, at either the Riverview Psychiatric 
Center or the Dorothea Dix Psychiatric Center, approved by the commissioner 
pursuant to subsection 2, paragraph B. 
D. 
"Major mental illness" means a diagnosis of mental illness as defined in rules 
adopted by the department. Rules adopted pursuant to this paragraph are routine 
technical rules as defined by Title 5, chapter 375, subchapter 2-A. 
E. 
"Network" means a community service network established pursuant to section 
3608. 
F. 
"Service provider" or "provider" means a person or organization providing 
publicly funded mental health services to consumers or family members. 
2. Institute councils established. There are established institute councils, one for 
the Riverview Psychiatric Center and one for the Dorothea Dix Psychiatric Center, to 
evaluate the delivery of mental health services and advise the department regarding 
quality assurance and operations and functions of the mental health institute. 
The 
councils operate under the authority of the department. 
A. 
Each institute council consists of no more than 25 members, taking into 
consideration local geographic factors. The membership on each institute council 
consists of consumers, family members, community members and providers. 
A 
resident or former resident of the Riverview Psychiatric Center or the Dorothea Dix 
Psychiatric Center, a family member of a resident or former resident, a community 
member in the Augusta or Bangor region and a service provider at those institutes 
may make recommendations regarding membership on the institute councils to the 
commissioner. 
B. 
The institute councils shall adopt bylaws that establish membership, the terms 
and qualifications of membership and the internal governance and rules. 
The 
commissioner shall approve the bylaws of each institute council prior to designating 
it as an approved institute council. 
3. 
Institute council directors; responsibilities. 
The superintendents of the 
Riverview Psychiatric Center and the Dorothea Dix Psychiatric Center are responsible for 
the operation of the institute councils and for dispute resolution within those institute 
councils. The superintendents shall receive reports from the institute councils, consider 
the recommendations of the institute councils and report periodically to the commissioner 
on their performance. 
4. Institute councils. Within the limitations of state and federal law, the Riverview 
Psychiatric Center and the Dorothea Dix Psychiatric Center, referred to in this subsection 
as "the mental health institutes," and the department shall provide information to the 
institute councils adequate to perform their duties, including, but not limited to: 
A. Input into the annual budgets of the mental health institutes; 
B. Achievement of the goals and objectives of the department as they pertain to the 
mental health institutes; 
C. Compliance with all professional accreditation standards applicable to the mental 
health institutes; 
D. Review, oversight and assessment of services and programs provided to residents 
of the mental health institutes and their families; 
E. 
Review of personnel policies and employment patterns, including staffing 
requirements and patterns, the use of overtime assignments and training and job 
development; 
F. 
Input into public relations efforts of the department and the mental health 
institutes and community education initiatives; and 
G. 
Monitoring building and grounds maintenance and safety and risk management 
on the campuses of the mental health institutes. 
Sec. S. 34-B MRSA §360S, as amended by PL 1997, c. 423, §§1 and 2 and PL 
2003, c. 689, Pt. B, §6, is further amended to read: 
.. 
§360S. Community service networks 
The department shall establish and oversee community service networks with the 
collective responsibility to 13artiei13ate with the area eOl:laeils, as aefiaea ia seetioa 3607, 
sl:l9seetioa 2, ia the aeli¥eI)' of coordinate and ensure continuity of care within the 
delivery of mental health services to ehilclrea aaa aoolts adult mental health consumers 
under the authority of the department. A network consists of organizations providing 
mental health services funded by the General Fund aad or Medicaid in the corresponding 
area specified in seetioa 3807, subsection.). I-A. The leeal community service networks 
must be established and operated in accordance with standards that are eoasisteat with 
staaaaras aao13tea by aeereaitea health eare orgaail3atioas aad other staadards adopted by 
the department to establish and operate networks. Oversight ffil:lst iaell:lde Departmental 
oversight includes, but is not limited to, establishing and overseeing protocols, quality 
assurance, writing and monitoring contracts for service, establishing outcome measures 
and ensuring that each network provides an integrated system of care. The department 
may adopt rules to carry out this section. Rules adopted pursuant to this section are FHajer 
sl:lbstaative routine technical rules as defined in Title 5, chapter 375, subchapter Il-A 2-A. 
This section may not be construed to supersede the authority of the department as the 
single state Medicaid agency under the Social Security Act, Title XII or to affect the 
professional standards and practices of nonnetwork providers. 
1. Responsibilities. Each network shall13erform the followiag res13oasibilities: 
A. 
Deliyer and eoordiaate Ensure 24-hour access to a consumer's community 
support services records for better continuity of care during a psychiatric crisis 
res130ase seryiees aeeessible throl:lgh a siagle 130iHt of eHtry to adl:llts 'Nith meatal 
illaess and to ehilclrea and adoleseeHts with se'.'ere emotioaal aistl:lrbanee and their 
families; 
B. 
Ensure continuity, accountability and coordination regarding service delivery; 
C. 
Participate in a l:llliform eli eat data base collection of uniform data; 
D. 
In conjunction with the regioaal direetor aad the area emHleil department, 
conduct planning activities based on data and client outcomes; aad 
E. 
Develop techniques for identifying and providing services to consumers at risk~~ 
based on the principle that services will be provided as close to the consumer's home 
as possible; and 
F. Enable, among other things, the sharing of confidential client information to the 
extent necessary to protect the client's health and safety when it is determined the 
client has an urgent need for mental health services. The network members shall 
share confidential client information, even without a client's consent, to the extent 
necessary to protect the client's health and safety in a period of urgent need for 
mental health services when the client lacks the capacity to give consent for the 
information sharing or when an exigency exists so that the client's health and safety 
is better protected if the information is shared without a delay to obtain consent. A 
person or entity participating in good faith in sharing information under this 
paragraph is immune from civil liability that might otherwise result from these 
actions, including, but not limited to, a civil liability that might otherwise arise under 
state or local laws or rules regarding confidentiality of information. The department 
shall adopt rules to identify the limits and requirements to be included in the 
memoranda. These rules are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
I-A. Areas. A community service network shall operate in each of the following 
geographic areas: 
A. Aroostook County; 
B. 
Hancock County, Washington County, Penobscot County and Piscataquis 
County; 
C. Kennebec County and Somerset County; 
D. Knox County, Lincoln County, Sagadahoc County and Waldo County; 
E. Androscoggin County, Franklin County and Oxford County; 
F. Cumberland County; and 
G. York County. 
1. AeeoHRtailility. Each network is accountable to the area council and the regional 
director. 
3. 
PHillie oHtreaeh. 
Each net\llork shall solicit the participation of interested 
prO'riders to serve on the area council, the network or advisory corrunittees. 
4. 
PartieipatioR. gtate operated direct serViCe programs shall participate in the 
actiYities of the nehllorks. 
5. Data collection. The department shall collect data to assess the capacity of the 
looal community service networks, including, but not limited to, analyses of utilization of 
mental health services and the unmet needs of persons receiving publicly funded mental 
health services. 
Sec. 9. 34-B MRS A §3609, as enacted by PL 1995, c. 691, §7, is amended to 
read: 
§3609. Statewide quality improvement council 
Each cOl:Hlcil The commissioner shall designate a member and an alternate persons to 
be members to serve on a statewide quality improvement council to advise the 
commissioner on issues of system implementation that have statewide impact. 
The 
commissioner shall appoint such other members to serve on the council as required by 
law. 
Sec. 10. 34-8 MRSA §3610, first ~, as repealed and replaced by PL 1997, c. 
683, Pt. A, §19, is amended to read: 
The department is responsible for providing a safety net of adult mental health 
services for people with major mental illness who the department or its designee 
.. 
detennines can not otherwise be served by the leeal community service networks. The 
department may develop contracts to deliver safety net services if the department 
detennines contracts to be appropriate and cost-effective. The state-operated safety net 
must include, but is not limited to: 
Sec. 11. 34-B MRS A §15002, sub-§2,~, as enacted by PL 1997, c. 790, Pt. A, 
§ 1 and affected by §3, is amended to read: 
E. 
Planning for the delivery of care takes into account the advice of the quality 
improyemeat institute councils established under section ~ 
3607 -A and the leeal 
community service networks established under section 3608. 
SUMMARY 
This bill clarifies references to the area quality improvement councils in the mental 
health laws. The bill also renames the local service networks as the community service 
networks and requires them to be established in each of the geographical areas that were 
previously covered by area quality improvement councils. 
The bill requires each 
community service network to participate in the delivery of mental health services in a 
system that ensures continuity of care to adults experiencing psychiatric crises. The bill 
also describes the circumstances when client information can be shared during a crisis 
situation or when necessary to protect the consumer's health and safety.