An Act To Provide a More Efficient and Reliable System of Nonemergency Transportation for MaineCare Members
Maine Legislature, Session 126, LD 1636
Committee: Health and Human Services
Sponsors: LACHOWICZ, THERIAULT, CRAVEN, JOHNSON, BECK, FARNSWORTH, GATTINE, GILBERT, GRAHAM, GRANT

Legislative Document 
No. 1636 
S.P. 627 
In Senate, December 23, 2013 
An Act To Provide a More Efficient and Reliable System of 
Nonemergency Transportation for MaineCare Members 
(EMERGENCY) 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203. 
Received by the Secretary of the Senate on December 23, 2013.  Referred to the Committee 
on Health and Human Services pursuant to Joint Rule 308.2 and ordered printed. 
DAREK M. GRANT 
Secretary of the Senate 
Presented by Senator LACHOWICZ of Kennebec. 
Cosponsored by Representative THERIAULT of Madawaska and 
Senators: CRAVEN of Androscoggin, JOHNSON of Lincoln, Representatives: BECK of 
Waterville, FARNSWORTH of Portland, GATTINE of Westbrook, GILBERT of Jay, 
GRAHAM of North Yarmouth, GRANT of Gardiner. 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, the current nonemergency transportation system provided for MaineCare 
members, referred to as the brokerage system, which became operational on August 1, 
2013, is deficient and ineffective and provides a very poor level of service to MaineCare 
members; and 
Whereas, thousands of MaineCare members have been unable to access medically 
necessary health care services and other MaineCare services since the brokerage system 
went into operation, thereby endangering their health and lives; and 
Whereas, the Legislature finds that the current nonemergency transportation system 
is performing at such a low level that a new system is needed to serve the people of 
Maine; and 
Whereas, this legislation, which provides for the implementation of a new 
nonemergency transportation system for MaineCare members, must take effect as soon as 
possible; 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 enacted by the People of the State of Maine as follows: 
Sec. 1.  Nonemergency transportation for MaineCare members.  Within 30 
days of the effective date of this Act, the Department of Health and Human Services, 
referred to in this Act as "the department," shall in accordance with this section contract 
with regional public transportation agencies, as described in the Maine Revised Statutes, 
Title 23, section 4209, subsection 1, and implement a new system of providing 
nonemergency transportation services for MaineCare members, referred to in this Act as 
"the MaineCare regional transportation system," to replace the current brokerage system. 
1.  Procedure and structure.  The MaineCare regional transportation system must 
meet the following requirements. 
A.  The MaineCare regional transportation system must use sole source contracts in 
each of the transportation regions established by the Department of Transportation 
pursuant to Title 23, section 4209, subsection 1.  In each transportation region the 
department shall enter into a contract to manage and provide transportation to 
MaineCare members with at least one regional public transportation agency that had 
an agreement with the department on July 31, 2013 to provide MaineCare 
transportation services. 
B.  The contracts entered into under paragraph A must include the following terms. 
(1)  The transportation provided to a MaineCare member must be the most cost-
effective and appropriate means of transportation to meet the needs of the 
MaineCare member. 
(2)  The transportation must be provided at no cost to the MaineCare member. 
(3) The regional public transportation agency must establish and use a network of 
transportation providers, including but not limited to family and friends of 
MaineCare members, volunteer drivers, transit and paratransit vans, taxi 
companies and other community-based transportation providers. 
(4)  The regional public transportation agency must provide staff and resources 
sufficient to handle transportation request telephone calls during regular business 
hours for at least 8 hours every day. 
(5)  The regional public transportation agency must provide a high level of 
customer service, must be able to respond to calls from MaineCare members, 
must provide an adequate level of prompt service and must maintain accurate 
records in compliance with state and federal standards. 
(6)  The regional public transportation agency must meet the performance 
standards adopted by the department under subsection 2. 
(7)  The department must pay the regional public transportation agency a monthly 
contract fee based on the number of MaineCare members served, subject to 
adjustment for changed circumstances, including but not limited to fuel price 
increases, transportation use increases, material change in circumstances and 
other cost increases that are beyond the control of the regional public 
transportation agency. 
(8)  The regional public transportation agency must report data to the department 
in the format and on a schedule established by the department. 
(9)  The term of the contract must be one year, with the option of renewal for up 
to 3 years if the regional public transportation agency meets performance 
standards adopted under subsection 2 and complies in all other ways with the 
requirements of the contract. 
2.  Performance standards.  The department shall adopt performance standards that 
ensure that regional public transportation agencies provide efficient and effective 
transportation services to MaineCare members so that the members may obtain the 
MaineCare services to which they are entitled, that are appropriate for the different 
geographic regions of the State and the differing needs of MaineCare members and that 
meet the requirements of this section. 
3.  Termination.  If the department determines that a regional public transportation 
agency has not met the terms of a contract entered into under this section, the department 
shall terminate the contract upon the provision of 60 days' notice to the regional public 
transportation agency. 
Sec. 2.  Transition period.  The department shall provide a transition period 
during the first 90 days of a contract for MaineCare transportation services entered into 
pursuant to this Act.  During the transition period, a regional public transportation agency 
must fully perform the duties under the contract, including data collection, except that the 
agency's reporting of data to the department must be suspended until the end of the first 
days of operation under the contract.  
Sec. 3.  Federal Medicaid waiver and approval.  The department shall apply to 
the federal Department of Health and Human Services, Centers for Medicare and 
Medicaid Services by April 1, 2014 for all necessary Medicaid waiver and state plan 
amendment approvals to allow the department to terminate the current brokerage system 
and to design and implement the MaineCare regional transportation system in a manner 
that is consistent with the provisions of this Act. 
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill requires the Department of Health and Human Services to implement a new 
system to contract for and provide nonemergency transportation for MaineCare members 
within 30 days after the effective date of the bill.  The bill requires the new system to use 
sole source contracts with regional public transportation agencies that had agreements on 
July 31, 2013 to provide MaineCare transportation services.  The bill provides specific 
requirements for the contracts, requires the department to adopt performance standards 
and allows termination of contracts if the department determines that a regional public 
transportation agency has not met its contractual obligations.  The bill requires one-year 
contracts that are renewable for up to 3 years.  The bill provides a transition period during 
which regional public transportation agencies are not required to submit data to the 
department.  The bill requires the department to apply to the federal Department of 
Health and Human Services, Centers for Medicare and Medicaid Services by April 1, 
2014 for all necessary Medicaid waiver and state plan amendment approvals.