Resolve, To Implement the Recommendations of the Report on Services for Elders and Other Adults Who Need Long-term Home-based and Community-based Care
Maine Legislature, Session 125, LD 1461
Committee: Health and Human Services
Sponsors: RAYE, CAIN, CRAVEN, FARNHAM, MASON, EVES, NUTTING, STRANG BURGESS

Legislative Document 
No. 1461 
S.P. 452 
In Senate, April 12, 2011 
Resolve, To Implement the Recommendations of the Report on 
Services for Elders and Other Adults Who Need Long-term Home-
based and Community-based Care 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
JOSEPH G. CARLETON, JR. 
Secretary of the Senate 
Presented by President RAYE of Washington. 
Cosponsored by Representative CAIN of Orono and 
Senators: CRAVEN of Androscoggin, FARNHAM of Penobscot, MASON of Androscoggin, 
McCORMICK of Kennebec, Representatives: EVES of North Berwick, MacDONALD of 
Boothbay, Speaker NUTTING of Oakland, STRANG BURGESS of Cumberland. 
Preamble.  Whereas, as a result of legislation in the 124th Legislature, the 
Department of Health and Human Services engaged over 30 interested parties in a so-
called "lean thinking" process that examined Maine's system of long-term services and 
supports; and 
Whereas, this process resulted in a report to the Legislature that included 
recommendations and a specific Lean Implementation Plan; and 
Whereas, the Lean Implementation Plan contains important changes and 
modifications that improve the efficiency, cost-effectiveness and quality of services 
delivered to consumers of long-term services; and 
Whereas, it is the intent of the 125th Legislature to promote equity and optimize 
consumer use by streamlining the long-term care system into one structure that meets all 
long-term care needs within existing resources; now, therefore, be it 
Sec. 1.  Plan adoption.  Resolved:  That the Commissioner of Health and Human 
Services shall adopt the Lean Implementation Plan and make its action items a work 
priority.  For the purposes of this resolve, "Lean Implementation Plan" means the plan 
developed as part of the report prepared for the 124th Legislature by the Department of 
Health and Human Services entitled "Services for Elders and Other Adults Who Need 
Long-Term Home- and Community-Based Care," dated January 20, 2010; and be it 
further 
Sec. 2.  Elements.  Resolved:  That the specific action items under section 1 
include, but are not limited to: 
1.  Consolidating the 2 existing waivers for adult and elderly community-based 
services, currently codified under MaineCare rule as Chapter II, Section 19 and Section 
and taking any appropriate action with the United States Department of Health and 
Human Services, Centers for Medicare and Medicaid Services to achieve the 
consolidation; 
2.  Consolidating the 2 personal care assistant programs currently codified under 
MaineCare rule as Chapter II, Section 12 and Section 96, exploring the feasibility of 
providing homemaker services under the consolidated programs and taking any 
appropriate action with the United States Department of Health and Human Services, 
Centers for Medicare and Medicaid Services to achieve the consolidation; 
3.  Consolidating the 2 state-funded in-home care and community support services 
programs for elderly and other adults, currently codified under Chapter 65, Section 63 of 
the Office of Elder Services manual and Chapter 11 of the Office of Cognitive and 
Physical Disabilities Services manual; 
4.  Developing a long-term care services statewide plan that ensures access to care in 
the least restrictive environment; 
5.  Maximizing federal opportunities available through the United States Department 
of Health and Human Services, Centers for Medicare and Medicaid Services; 
6.  Consolidating the 3 existing consumer-directed service models into a single 
uniform self-directed model; 
7.  Maximizing individualization and flexibility of plan of care to ensure that 
appropriate and timely services are provided, including, but not limited to, allowing a 
care coordinator to make adjustments within a plan of care without requiring a new 
assessment as long as the net adjustment remains below the maximum value under the 
consumer's level of care; 
8.  Improving value and respect for direct care workers through initiatives that 
include, but are not limited to, creating strategy and standards for ensuring workforce 
training for all persons accountable to the long-term care system and exploring the 
feasibility of equalizing hourly reimbursement rates across the direct care worker 
continuum; and 
9.  Designing and establishing effective quality management strategy across funding 
streams and population groups to ensure a high-quality long-term care service system; 
and be it further 
Sec. 3.  Report.  Resolved:  That the Commissioner of Health and Human 
Services shall report to the Joint Standing Committee on Health and Human Services on 
the progress of the Department of Health and Human Services, in completing the Lean 
Implementation Plan action items under section 2 by January 5, 2012. 
SUMMARY 
This resolve directs the Commissioner of Health and Human Services to implement 
the recommendations included in the report submitted to the 124th Legislature entitled 
"Services for Elders and Other Adults Who Need Long-Term Home- and Community-
Based Care" to make systemic changes to Maine's long-term home-based and 
community-based care.