An Act To Fully Fund the Homemaker Services Program" '1"{
Maine Legislature, Session 126, LD 0020
Senate Amendment SA_A_S331 (Senate)

SENATE AMENDMENT" A "to S.P. 12, L.D. 20, Bill, "An Act To Fully Fund the 
Homemaker Services Program" '1"{ 
Amend the bill by striking out the title and substituting the following: 
'Resolve, Directing the Department of Health and Human Services To Review the 
Need for and the Costs of Services That Enable Populations Who Are Elderly or 
Have Disabilities To Live Independently' 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Sec. 1. 
Review of need for services, costs and potential savings. 
Resolved: That by December 1, 2013 the Department of Health and Human Services 
shall begin a review and analysis of the need for services for instrumental activities of 
daily living among the State's populations who are elderly or who have disabilities, the 
costs of providing services and the potential for savings. For the purposes of this section, 
"instrumental activities of daily living" means essential, nonmedical tasks that enable the 
consumer to live independently in the community, including light housework, preparing 
meals, taking medications, shopping for groceries or clothes, using the telephone, 
managing money and other similar activities. The department shall evaluate: 
1. The needs and costs for services for instrumental activities of daily living for 
persons receiving services under the state-funded homemaker services program and 
persons on the waiting list for those services; 
2. The needs and costs for other services including Medicaid services and services at 
an institutional level of care for persons receiving services under the state-funded 
homemaker services program and persons on the waiting list for those services; 
3. 
The possibility of achieving savings from obtaining a Medicaid waiver for 
instrumental activities of daily living; 
4. 
The possibility of prioritizing the provision of services among applicants for 
homemaker services based on the needs of the applicants; 
5. 
The possibility of prioritizing the provision of services among applicants for 
homemaker services based on the applicants' access to other supports; and 
SENATE AMENDMENT 
'" 
.. ,. 
SENATE AMENDMENT ';( .. to S.P. 12, L.D. 20 
6. Projections for service needs and costs over the next 5 years. 
In performing the review and analysis under this section, the department may work 
with the Muskie School of Public Service at the University of Southern Maine; and be it 
further 
Sec. 2. Inquiry regarding Medicaid waiver or state plan amendment. 
Resolved: That by January 1,2014 the Department of Health and Human Services shall 
submit an inquiry to the United States Department of Health and Human Services, 
Centers for Medicare and Medicaid Services regarding the feasibility of obtaining a 
Medicaid waiver or a state plan amendment to enable the State to provide coverage for 
instrumental activities of daily living, as defined in section I, under the MaineCare 
program. The inquiry must provide to the Centers for Medicare and Medicaid Services 
information regarding the need for services for instrumental activities of daily living 
among persons currently receiving services under the state-funded homemaker services 
program and persons currently on the waiting list for those services and the potential for 
savings from providing services under the Medicaid program; and be it further 
Sec. 3. Application for waiver or state plan amendment. Resolved: That if 
based on the review of costs and potential savings in section 1 and if, in response to the 
inquiry made under section 2, the United States Department of Health and Human 
Services, Centers for Medicare and Medicaid Services indicates that it is feasible for the 
State to obtain a Medicaid waiver or state plan amendment to enable the State to provide 
coverage for instrumental activities of daily living, as defined in section 1, the 
Department of Health and Human Services shall apply by July 1, 2014 for the necessary 
waiver or submit the state plan amendment using the information gathered pursuant to the 
review of the need for services, the analysis of costs and potential savings and the 
projection of needs and costs undertaken pursuant to section 1.' 
SUMMARY 
This amendment replaces the bill with a resolve and directs the Department of Health 
and Human Services to begin by December 1, 2013 reviewing and analyzing the need for 
services for instrumental activities of daily living among Maine's populations who are 
elderly or who have disabilities, the costs of providing services, the potential for savings 
and projections of need. This amendment directs the Department of Health and Human 
Services based on its review of costs and potential savings to submit by January 1, 2014 
an inquiry to the United States Department of Health and Human Services, Centers for 
Medicare and Medicaid Services regarding the feasibility of obtaining a Medicaid waiver 
or a state plan amendment to enable the State to provide coverage for instrumental 
activities of daily living under the MaineCare program. If in response to the inquiry the 
Centers for Medicare and Medicaid Services indicates that it is feasible to obtain a 
SENA TE AMENDMENT 
... 
'". 
SENATE AMENDMENT "A" to S.P. 12, L.D. 20 
Medicaid waiver or state plan amendment to enable the State to provide coverage for 
instrumental activities of daily living, the Department of Health and Human Services 
must apply for the necessary waiver or submit the state plan amendment by July 1, 2014. 
FISCAL NOTE REQUIRED 
~ 
(See~tb 
SPONSORED 
'l:2...-..>:u. ~ 
(Senator HILL) 
COUNTY: York 
SENA TE AMENDMENT 
Approved: 06/26/13 ;tvae 
LD20 
LR 100(06) 
Resolve, Directing the Department of Health and Human Services To Review the Need for and the 
Costs of Services That Enable Populations Who Are Elderly or Have Disabilities To Live 
Independently 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Fiscal Detail and Notes 
Fiscal Note for Senate Amendment~' to Original Bill 
Sponsor: Sen. Hill of York 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2013-14 
FY 2014-15 
Projections 
FY 2015-16 
Projections 
FY 2016-17 
($1,500,000) 
($1,500,000) 
($1,500,000) 
($1,500,000) 
($1,500,000) 
($1,500,000) 
($1,500,000) 
($1,500,000) 
The amendment eliminates the bill's ongoing annual appropriation of $1.5 million for the independent support services 
(homemaker services) program in the Department of Health and Human Services. Additional costs resulting from the 
amendment for the Department of Health and Human Services for the review, analysis and preparation of a federal 
waiver or State plan amendment are assumed to be minor and can be absorbed within existing budgeted resources. 
LROlOO(06) - Fiscal Note - Page 1 of 1