An Act To Improve Access to Home-based and Community-based Care in the MaineCare Program
Maine Legislature, Session 126, LD 0488
Committee Amendment CA_A_H325 (House)

COMMITTEE AMENDMENT "A" to H.P. 338, L.D. 488, Bill, "An Act To 
Improve Access to Home-based and Community-based Care in the MaineCare Program" 
Amend the bill by striking out the title and substituting the following: 
'Resolve, Directing the Department of Health and Human Services To Develop a 
Process To Provide Additional Home-based and Community-based Services in the 
MaineCare Program' 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Sec. 1. Department of Health and Human Services to provide additional 
home-based and community-based services in the MaineCare program. 
Resolved: That by October 1,2013 and upon the approval of the federal Department of 
Health and Human Services, Centers for Medicare and Medicaid Services, the 
Department of Health and Human Services shall develop a process in the MaineCare 
home-based and community-based waiver program for the elderly and the disabled to 
provide additional services for up to 25 unduplicated participants per year whose annual 
cap on services may exceed the current cap by up to 25% as long as the department 
determines that such additional services are medically necessary, are likely to delay or 
prevent the institutionalization of the person and are not likely to result in the cost of 
services under the waiver for that person exceeding the estimated cost of comparable 
services in a nursing facility for that person; and be it further 
Sec. 2. 
Appropriations and allocations. 
Resolved: 
That the following 
appropriations and allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
Medical Care - Payments to Providers 0147 
Initiative: Provides funding for the costs of additional services for up to 25 unduplicated 
participants per year whose costs exceed the home-based and community-based waiver 
COMMITTEE AMENDMENT 
.,. 
~ 
COMMITTEE AMENDMENT 'A" to H.P. 338, L.D. 488 
program for the elderly and disabled annual cap on services in order to prevent the 
institutionalization of the participants. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
SUMMARY 
2013-14 
$93,265 
$93,265 
2013-14 
$150,916 
$150,916 
2014-15 
$124,768 
$124,768 
2014-15 
$200,807 
$200,807 
This amendment replaces the bill. It requires the Department of Health and Human 
Services to develop a process in the MaineCare home-based and community-based 
waiver program for the elderly and the disabled to provide additional services for up to 25 
unduplicated participants per year whose annual cap on services may exceed the current 
cap as long as the department determines that the additional services are medically 
necessary, are likely to delay or prevent the institutionalization of the person and are not 
likely to result in the cost of the services exceeding the estimated costs of comparable 
services in a nursing facility. The department is required to develop the process, which 
requires the approval of the federal Department of Health and Human Services Centers 
for Medicare and Medicaid Services, by October 1,2013. The amendment includes an 
appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/23/13 ;'.vae 
LD488 
LR 971(02) 
An Act To Improve Access to Home-based and Community-based Care in the MaineCare Program 
Fiscal Note for Bill as Amended by Committee Amendment 'fJ\ l H -3 ~5 ') 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Federal Expenditures Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
Potential future biennium savings - General Fund 
FY 2013-14 
$93,265 
$93,265 
$150,916 
FY 2014-15 
$124,768 
$124,768 
$200,807 
Projections 
FY 2015-16 
$124,768 
$124,768 
$200,807 
Projections 
FY 2016-17 
$124,768 
$124,768 
$200,807 
Provides appropriations of $93,265 in 2013-14 and $124,768 in 2014-15 for the State costs of the MaineCare program 
to provide additional services for up to 25 participants per year whose costs exceed the home and community-based 
waiver program for the elderly and disabled annual cap on services in order to prevent the institutionalization of the 
participants. The fiscal impact of the potential reduction in higher cost institutionalizations cannot be determined at 
this time. 
LR0971(02) - Fiscal Note - Page 1 of I