Resolve, Directing the Department of Health and Human Services To Reduce and Limit the Adult Developmental Services Waiting Lists by Implementing a More Efficient, Responsive and Individualized Model of Service Delivery
Maine Legislature, Session 126, LD 0969
Committee: Health and Human Services
Sponsors: STUCKEY, CRAVEN, EVES, FARNSWORTH, MALABY, MONAGHAN-DERRIG, POULIOT, WEAVER, MILLETT

Legislative Document 
No. 969 
H.P. 683 
House of Representatives, March 12, 2013 
Resolve, Directing the Department of Health and Human Services 
To Reduce and Limit the Adult Developmental Services Waiting 
Lists by Implementing a More Efficient, Responsive and 
Individualized Model of Service Delivery 
(EMERGENCY) 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative STUCKEY of Portland. 
Cosponsored by Senator CRAVEN of Androscoggin and 
Representatives: Speaker EVES of North Berwick, FARNSWORTH of Portland, 
MacDONALD of Boothbay, MALABY of Hancock, MONAGHAN-DERRIG of Cape 
Elizabeth, POULIOT of Augusta, WEAVER of York, Senator: MILLETT of Cumberland. 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, children with disabilities have an entitlement under state and federal law 
to receive services as needed in order to succeed in the most appropriate educational 
settings, but there is no entitlement to services for young adults with disabilities who exit 
the public school system; and 
Whereas, intellectual disabilities and autism are life-long conditions requiring 
various degrees of support, both paid and unpaid, throughout adulthood; and 
Whereas, the MaineCare program Chapter 101, Chapter II, Sections 21 and 29 are 
the only funding mechanisms available to support adults with intellectual disabilities and 
autism in Maine; and 
Whereas, waiting lists for services under the MaineCare program Chapter 101, 
Chapter II, Sections 21 and 29 have grown dramatically so that approximately 1,000 
Maine citizens are on these waiting lists, a situation that is unacceptable and demands a 
solution; and 
Whereas, the individuals on the waiting lists are in danger of losing skills every day 
they go without services, and their families experience stress, economic hardship and 
other pressures associated with caring for adult family members; and 
Whereas, the Maine Coalition for Housing and Quality Services formed in May 
2006 has developed a white paper describing a model of service designed to streamline 
and improve services and this white paper has been generally supported by the 
Department of Health and Human Services and a stakeholder working group formed 
pursuant to Public Law 2011, chapter 477, Part W; 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 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, be it 
Sec. 1.  Department of Health and Human Services directed to request 
approval to amend the MaineCare program Chapter 101, Chapter II, 
Sections 21 and 29 waivers to permit reimbursement for the use of 
appropriate technology.  Resolved:  That the Department of Health and Human 
Services shall request approval from the federal Centers for Medicare and Medicaid 
Services to amend the waivers for the MaineCare program Chapter 101, Chapter II, 
Section 21, Home and Community Benefits for Members with Intellectual Disabilities or 
Autistic Disorder, and Section 29, Support Benefits for Adults with Intellectual 
Disabilities or Autistic Disorder, to permit the reimbursement for use of appropriate 
electronic technology as a means of reducing the costs of supporting people currently 
being served.  Appropriate use of technology includes, but is not limited to, increasing 
independence and reducing reliance on staff during overnight hours.  The department 
shall submit the application for both waivers by July 1, 2013; and be it further 
Sec. 2.  Rulemaking to implement technology updates.  Resolved:  That, 
upon the approval of the amended waivers by the federal Centers for Medicare and 
Medicaid Services pursuant to section 1, the Department of Health and Human Services 
shall undertake rulemaking to amend the rules on the MaineCare program in Chapter 101, 
Chapter II, Sections 21 and 29 to add electronic technology.  Rules adopted pursuant to 
this section are routine technical rules as defined in the Maine Revised Statutes, Title 5, 
chapter 375, subchapter 2-A; and be it further 
Sec. 3.  Department of Health and Human Services directed to amend the 
Section 29 waiver to add home support services.  Resolved:  That the 
Department of Health and Human Services shall request approval from the federal 
Centers for Medicare and Medicaid Services to amend the waiver for the MaineCare 
program Chapter 101, Chapter II, Section 29 to add as a covered service home support as 
an option under the current service cap.  Home support is a direct support provided to a 
member in the member's home by a direct support professional to improve and maintain 
the member's ability to live as independently as possible in that member's own home and 
primarily consists of personal assistance, such as preparing meals, cleaning and personal 
care.  The department shall submit the application for the waiver by October 1, 2013; and 
be it further 
Sec. 4.  Rulemaking to implement home support services.  Resolved:  That, 
upon approval of the waiver by the federal Centers for Medicare and Medicaid Services 
pursuant to section 3, the Department of Health and Human Services shall undertake 
rulemaking to amend the rules on the MaineCare program in Chapter 101, Chapter II, 
Section 29 to add home support services as a covered service.  Rules adopted pursuant to 
this section are routine technical rules as defined in the Maine Revised Statutes, Title 5, 
chapter 375, subchapter 2-A; and be it further 
Sec. 5.  Savings generated by electronic technology and home support 
services.  Resolved:  That savings generated by the use of electronic technology and 
home supports, particularly in preventing the need for individuals who are to receive 
services under the MaineCare program Chapter 101, Chapter II, Section 29 from 
requiring residential services under Section 21, must be used to serve additional people 
currently on the waiting list for these waiver programs; and be it further 
Sec. 6.  Implementation of adult developmental services working group 
interim recommendations.  Resolved:  That the Department of Health and Human 
Services shall report to the Joint Standing Committee on Health and Human Services and 
the Joint Standing Committee on Appropriations and Financial Affairs by June 1, 2013 
describing the status of the implementation of recommendations from interim reports by 
the adult developmental services working group formed pursuant to Public Law 2011, 
chapter 477, Part W, section 1.  The department shall incorporate the following 
recommendations from the adult developmental services working group for individuals 
with intellectual disabilities and autism into a plan: 
1.  Each person will receive a strength-based standardized individualized assessment 
of that person's strengths or needs to inform a person-centered plan; 
2.  Each person will be assessed for the natural family and community support 
networks potentially available to that person; 
3.  The State will establish a broad menu option model designed to match the amount 
and kind of paid support services needed by each individual; 
4.  Each person will have a designated community resource assistant whose job it is 
to help individuals at any age navigate the local array of services; 
5.  The State will develop a thorough and accessible information repository; 
6.  The State will establish early support and planning for steps to transition 
individuals from childhood services to adult services; 
7.  The State will undertake educational efforts in each neighborhood to educate and 
foster inclusiveness and awareness of the community; 
8.  The State's developmental services will deliver only the paid services needed; and 
9.  Formal services will be based on individual and realistic needs. 
The department shall develop a plan with clear steps and a timeline with a goal that 
current and future waiting lists do not exceed 6 months.  The Joint Standing Committee 
on Health and Human Services is authorized to report out legislation to the Second 
Regular Session of the 126th Legislature pursuant to this section. 
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This resolve requires the Department of Health and Human Services to request 
approval from the federal Centers for Medicare and Medicaid Services to amend the 
MaineCare waivers for Section 21, Home and Community Benefits for Members with 
Intellectual Disabilities or Autistic Disorder, and Section 29, Support Benefits for Adults 
with Intellectual Disabilities or Autistic Disorder, to permit the reimbursement for the use 
of appropriate electronic technology as a means of reducing the costs of supporting 
people currently being served.  It also requires the department to apply to the Centers for 
Medicare and Medicaid Services to amend the Section 29 waiver to add as a covered 
service home support as an option under the current service cap.  Home support is direct 
support provided to a member in the member's home by a direct support professional to 
improve and maintain the member's ability to live as independently as possible in the 
member's own home and primarily consists of personal assistance, such as preparing 
meals, cleaning and personal care.  Upon the granting of the amended waivers, the 
department is required to undertake rulemaking to amend the Section 21 and 29 rules to 
reflect the changes in the waiver.  Any savings from the use of electronic technology and 
the provision of home support services must be used to serve additional people on 
Sections 21 and 29 waiting lists. 
The resolve also requires the Department of Health and Human Services to report to 
the Joint Standing Committee on Health and Human Services and the Joint Standing 
Committee on Appropriations and Financial Affairs on the status of the recommendations 
of the adult developmental services working group formed pursuant to Public Law 2011, 
chapter 477, Part W, section 1.  The department is required to develop a plan to 
incorporate the recommendations of the working group, including specific steps and a 
timeline with a goal that current and future waiting lists do not exceed 6 months.