An Act To Assist Maine Schools To Obtain Federal Funds for Medically Necessary Services
Maine Legislature, Session 125, LD 1003
Committee Amendment CA_A_H788 (House)

COMMITTEE AMENDMENT" A" to H.P. 739, L.D. 1003, Bill, "An Act To 
Assist Maine Schools To Obtain Federal Funds for Medically Necessary Services" 
Amend the bill by striking out the title and substituting the following: 
'Resolve, To Assist Maine Schools To Obtain Federal Funds for Medically Necessary 
Services' 
Amend the bill by striking out everything after the title and inserting the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, this resolve is intended to provide guidance regarding those portions of 
the Department of Health and Human Services' MaineCare rules that relate to 
implementation of special education and related services provided through the Child 
Development Services System and school administrative units to eligible children served 
in these settings; and 
Whereas, it is critical that the Department of Education and the Department of 
Health and Human Services work together with key stakeholders to develop refinements 
to existing MaineCare policies or develop new policies and guidance on billing 
procedures as soon as possible to ensure the provision of medically necessary services to 
students in school-based settings; and 
Whereas, the Department of Education and the Department of Health and Human 
Services must begin the process of refining current MaineCare policies, developing 
guidance on billing procedures and preparing any necessary revisions to the state plan to 
submit to the Federal Government for review and approval prior to the adoption of rules 
governing Medicaid payment for medically necessary services to eligible children in 
school-based settings that qualify for reimbursement; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" 4" to H.P. 739, L.D. 1003 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, be it 
Sec. 1. Refinement of MaineCare policies. Resolved: That the Department of 
Education and the Department of Health and Human Services, referred to in this section 
as "the departments," shall work together to refine existing policies, develop new policies 
or prepare nonregulatory guidance on billing procedures, as appropriate, to ensure the 
provision of medically necessary services to students in school-based settings. 
The 
refinements to MaineCare policies must: 
1. Be in compliance with federal law; 
2. Provide local school districts with options and give them the authority to choose 
the best option with regard to local needs and capacities; 
3. Take into consideration the input of stakeholders, including representatives of the 
Department of Education, the Department of Health and Human Services, the Child 
Development Services System, the Maine School Management Association, the Maine 
Administrators of Services for Children with Disabilities and special purpose private 
schools and agencies that are approved to provide early intervention or special education 
programs pursuant to the Maine Revised Statutes, Title 20-A, section 7252-B. In order to 
gather input from stakeholders, the departments shall establish work groups to explore 
problems with current Medicaid policies and to consider possible solutions to both 
policies and billing processes. 
The work groups must include stakeholders and 
representatives of the following groups, who participate as nonvoting members: 
A. Two representatives of parents of children with developmental delays or 
disabilities, one who is appointed by the Disability Rights Center and one who is 
appointed by the Maine Developmental Disabilities Council; and 
B. Two representatives of directly affected local school administrative units with 
expertise in this area, one who is appointed by the President of the Senate and one 
who is appointed by the Speaker of the House; 
4. 
Include provisions for training and support for school staff, including the 
development of policy and billing manuals and other resources written with school-based 
providers in mind; and 
5. 
Set up an interagency stakeholder body, including representatives of the 
Department of Education, the Department of Health and Human Services, the Child 
Development Services System, the Maine School Management Association, the Maine 
Administrators of Services for Children with Disabilities and special purpose private 
schools and agencies that are approved to provide early intervention or special education 
programs pursuant to the Maine Revised Statutes, Title 20-A, section 7252-B, to 
coordinate the implementation of the program refinements. The interagency stakeholder 
body must also include representatives of the following groups, who participate as 
nonvoting members: 
A. Two representatives of parents of children with developmental delays or 
disabilities, one who is appointed by the Disability Rights Center and one who is 
appointed by the Maine Developmental Disabilities Council; and 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "An to H.P. 739, L.D. 1003 
B. Two representatives of directly affected local school administrative units with 
expertise in this area, one who is appointed by the President of the Senate and one 
who is appointed by the Speaker of the House; and be it further 
Sec. 2. State plan amendment. Resolved: That, after due consideration of the 
input of the stakeholders and relevant work groups established pursuant to section 1, if 
determined to be appropriate by the Department of Education and the Department of 
Health and Human Services, the Department of Health and Human Services shall propose 
changes to the state plan for Medicaid services provided pursuant to the Maine Revised 
Statutes, Title 22, chapter 855 to permit reimbursement for school-based services by July 
1, 2012; and be it further 
Sec. 3. Report to Legislature. Resolved: That the Department of Education 
and the Department of Health and Human Services shall report to the joint standing 
committee of the Legislature having jurisdiction over education and cultural affairs and 
the joint standing committee of the Legislature having jurisdiction over health and human 
services matters on March 30, 2012 on the status of the work undertaken to that date 
pursuant to this resolve. The report must include, but is not limited to, a time line that 
establishes specific dates for each of the following initiatives: 
1. Proposed policy changes, including refinements to existing policies, new policies 
to be developed or the preparation of nonregulatory guidance on billing procedures; 
2. 
A communication plan to provide details on the implementation of proposed 
policy changes to the field; 
3. A plan to provide the training required to school administrative units and the Child 
Development Services System; 
4. 
A detailed budget, including the amount and sources of funding and other 
resources needed to implement proposed policy changes; 
5. 
If determined to be appropriate by the Department of Education and the 
Department of Health and Human Services, a plan to make any necessary changes to 
rules; and 
6. 
If determined to be appropriate by the Department of Education and the 
Department of Health and Human Services, a time line for the preparation, submission 
and anticipated approval of amendments to the state plan for Medicaid services provided 
pursuant to the Maine Revised Statutes, Title 22, chapter 855 related to the provision of 
medically necessary services to eligible children in school-based settings. 
In addition, the Department of Education and the Department of Health and Human 
Services shall jointly submit a status report on a monthly basis through June 2012 on the 
work completed by the Department of Education and the Department of Health and 
Human Services and the interagency stakeholder body pursuant to this resolve; and be it 
further 
Sec. 4. Goal. Resolved: That the goal of this resolve is to make sure eligible 
children get the services they need in the settings they need them in and to ensure those 
services that qualify as medically necessary services are reimbursed. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT 'If" to H.P. 739, L.D. 1003 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
SUMMARY 
This amendment strikes and replaces the bill with a resolve to accomplish the 
following. 
1. It adds an emergency preamble and an emergency clause. 
2. It directs the Department of Education and the Department of Health and Human 
Services to work together with an interagency stakeholder group to refine existing 
MaineCare policies, develop new policies or prepare nonregulatory guidance on billing 
procedures, as appropriate, to ensure the provision of medically necessary services to 
students in school-based settings. 
3. 
It provides that, after due consideration of the input of the stakeholders and 
relevant work groups involved in the interagency stakeholder group and if determined to 
be appropriate by the Department of Education and the Department of Health and Human 
Services, the departments shall pursue amendments to the MaineCare rules and to the 
state plan related to the provision of medically necessary services to eligible children in 
school-based settings by July 1, 2012. 
4. It requires the Department of Education and the Department of Health and Human 
Services to report jointly to the Joint Standing Committee on Education and Cultural 
Affairs and the Joint Standing Committee on Health and Human Services on March 30, 
2012 on the status of the work undertaken by that date. 
The report must include a 
timeline that establishes specific dates for each of the initiatives included in any proposed 
changes to existing MaineCare policies, any new policies to be developed or any 
nonregulatory guidance on billing procedures to be developed by the departments. 
FISCAL .\OTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/14/12 
~ac 
LD 1003 
LR 1574(02) 
An Act To Assist Maine Schools To Obtain Federal Funds for Medically Necessary Services 
Fiscal Note for Bill as Amended by Committee Amendment "A''l H 
-7g~ 
Committee: Education and Cultural Affairs 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Fiscal Detail and Notes 
Additional costs to the Department of Education to work with the Department of Health and Human Services and an 
interagency stakeholder group associated with refining MaineCare policies related to the provision of medically 
necessary services to students in school-based settings and to prepare the required report can be absorbed within 
existing budgeted resources. 
LR1574(02) - Fiscal Note - Page 1 of 1