An Act To Improve Hospital-based Behavioral Health Treatment for Persons with Intellectual Disabilities or Autism
Maine Legislature, Session 126, LD 1598
Committee: Health and Human Services
Sponsors: FARNSWORTH, BOYLE, BRIGGS, CHIPMAN, GATTINE, GRAHAM, MORRISON, PRINGLE, VEROW
Amends: 34-B MRSA §5605

Legislative Document 
No. 1598 
H.P. 1169 
House of Representatives, December 30, 2013 
An Act To Improve Hospital-based Behavioral Health Treatment 
for Persons with Intellectual Disabilities or Autism 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203. 
Received by the Clerk of the House on December 23, 2013.  Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint 
Rule 401. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative FARNSWORTH of Portland. 
Cosponsored by Senator BOYLE of Cumberland and 
Representatives: BRIGGS of Mexico, CHIPMAN of Portland, GATTINE of Westbrook, 
GRAHAM of North Yarmouth, MORRISON of South Portland, PRINGLE of Windham, 
VEROW of Brewer. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  34-B MRSA §5605, sub-§13, as amended by PL 2013, c. 310, §7, is 
further amended to read: 
13.  Behavioral support, modification and management.  Behavior modification 
and behavior management of and supports for a person with an intellectual disability or 
autism who is not a patient in an acute psychiatric unit of a hospital are governed as 
follows. 
A.  A person with an intellectual disability or autism may not be subjected to a 
behavior modification or behavior management program to eliminate dangerous or 
maladaptive behavior without first being assessed by a physician to determine if the 
proposed program is medically contraindicated and that the dangerous or maladaptive 
behavior could not be better treated medically. 
A-1.  Support programs may contain both behavior modification and behavior 
management components.   
A-2.  The following practices are prohibited as elements of behavior modification or 
behavior management programs: 
(1)  Seclusion; 
(2)  Corporal punishment; 
(3)  Actions or language intended to humble, dehumanize or degrade the person; 
(4)  Restraints that do not conform to rules adopted pursuant to this section; 
(5)  Totally enclosed cribs or beds; and 
(6)  Painful stimuli. 
B.  Behavior modification and behavior management programs may be used only to 
correct behavior more harmful to the person than the program and only: 
(1)  On the recommendation of the person's personal planning team; 
(2)  For an adult 18 years of age or older, with the approval, following a case-by-
case review, of a review team composed of a representative from the department, 
a representative from the advocacy agency designated pursuant to Title 5, section 
19502 and, a representative designated by the Maine Developmental Services 
Oversight and Advisory Board and a licensed psychologist who has training and 
experience in the development of behavioral support plans. The advocacy agency 
representative serves as a nonvoting member of the review team and shall be 
present to advocate on behalf of the person. The department shall provide 
sufficient advance notice of all scheduled review team meetings to the advocacy 
agency and provide the advocacy agency with any plans for which approval is 
sought along with any supporting documentation; and 
(3)  For a child under 18 years of age, with the approval, following a case-by-
case review, of a review team composed of a representative from the advocacy 
agency designated pursuant to Title 5, section 19502, a team leader of the 
department's children's services division and the children's services medical 
director or the director's designee.  The advocacy agency representative serves as 
a nonvoting member of the review team and shall be present to advocate on 
behalf of the person.  The department shall provide sufficient advance notice of 
all scheduled review team meetings to the advocacy agency and provide the 
advocacy agency with any plans for which approval is sought along with any 
supporting documentation.  Until rules are adopted by the department to govern 
behavioral treatment reviews for children, the team may not approve techniques 
any more aversive or intrusive than are permitted in rules adopted by the 
Secretary of the United States Department of Health and Human Services 
regarding treatment of children and youth in nonmedical community-based 
facilities funded under the Medicaid program. 
SUMMARY 
This bill amends the laws concerning the rights and basic protections of a person with 
an intellectual disability or autism. 
1.  It clarifies that the provisions governing behavioral support, modification and 
management do not apply to a person who is a patient in an acute psychiatric unit of a 
hospital. 
2.  It adds to the team of persons who must review behavior modification and 
behavior management programs a licensed psychologist who has training and experience 
in the development of behavioral support plans.