An Act Regarding the Maine Registry of Certified Nursing Assistants and Direct Care Workers
Maine Legislature, Session 127, LD 1426
Committee: Health and Human Services
Sponsors: ESPLING
Amends: 22 MRSA §1717, 22 MRSA §1724, 22 MRSA §1812-G, 22 MRSA §1812-J, 22 MRSA §2137, 22 MRSA §2138, 22 MRSA §2149-A, 22 MRSA §7706, 22 MRSA §7851, 22 MRSA §8606, 22 MRSA §9005, 34-B MRSA §1225

Legislative Document 
No. 1426 
H.P. 972 
House of Representatives, May 20, 2015 
An Act Regarding the Maine Registry of Certified Nursing 
Assistants and Direct Care Workers 
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204. 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
ROBERT B. HUNT 
Clerk 
Presented by Representative ESPLING of New Gloucester. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §1717, sub-§1, ¶¶A-1 to A-3 are enacted to read: 
A-1.  "Direct access" means access to the property, personally identifiable 
information, financial information or resources of an individual or physical access to 
an individual who is a Medicare or Medicaid beneficiary or other individual served 
by a provider subject to this chapter. 
A-2.  "Direct access personnel" means individuals employed in positions that have 
direct access. 
A-3.  "Direct care worker" means a worker who by virtue of employment has direct 
access to provide direct contact assistance with activities of daily living for 
individuals in homes, assisted living centers, residential care facilities, hospitals and 
other health care settings. "Direct care worker" does not include a certified nursing 
assistant employed in that person's capacity as a certified nursing assistant. 
Sec. 2.  22 MRSA §1717, sub-§1, ¶C, as amended by PL 2007, c. 324, §2, is 
further amended to read: 
C.  "Personal care agency" means a business entity or subsidiary of a business entity 
that is not otherwise licensed by the Division of Licensing and Regulatory Services 
and that hires and employs unlicensed assistive direct access personnel or individuals 
who work in direct contact with clients, patients or residents to provide assistance 
with activities of daily living and related tasks to individuals in the places in which 
they reside, either permanently or temporarily.  An individual who hires and employs 
unlicensed assistive direct access personnel or individuals who work in direct contact 
with clients, patients or residents to provide care for that individual is not a personal 
care agency, except when permitted by rule of the department. 
Sec. 3.  22 MRSA §1717, sub-§1, ¶D, as amended by PL 2007, c. 324, §2, is 
repealed. 
Sec. 4.  22 MRSA §1717, sub-§2, as amended by PL 2007, c. 324, §2, is further 
amended to read: 
2.  Registration of personal care agencies and placement agencies.  Beginning 
August 1, 1998, a personal care agency not otherwise licensed by the department shall 
register with the department.  Beginning January 1, 2008, a placement agency not 
otherwise licensed by the department shall register with the department. The department 
shall adopt rules establishing the annual registration fee, which must be at least between 
$25 and $250.  Rules adopted pursuant to this section are routine technical rules as 
defined in Title 5, chapter 375, subchapter 2-A. 
Sec. 5.  22 MRSA §1717, sub-§3, as amended by PL 2011, c. 257, §1, is further 
amended to read: 
3.  Prohibited employment based on disqualifying offenses.  A personal care 
agency or a placement agency shall obtain criminal history record information about 
applicants for positions as unlicensed assistive personnel or home care services workers 
and may not hire or place an individual who: conduct a comprehensive background check 
for direct access personnel in accordance with state law and rules adopted by the 
department and is subject to the employment restrictions set out in section 1812-G and 
other applicable federal and state laws when hiring, employing or placing direct access 
personnel, including, but not limited to, a certified nursing assistant or a direct care 
worker. 
A.  Has worked as a certified nursing assistant and has been the subject of a notation 
by the state survey agency for a substantiated complaint of abuse, neglect or 
misappropriation of property in a health care setting that was entered on the Maine 
Registry of Certified Nursing Assistants and Direct Care Workers; 
B.  Has been convicted in a court of law of a crime involving abuse, neglect or 
misappropriation of property in a health care setting; or 
C.  Has a prior criminal conviction within the last 10 years of: 
(1)  A crime for which incarceration of 3 years or more may be imposed under 
the laws of the state in which the conviction occurred; or 
(2)  A crime for which incarceration of less than 3 years may be imposed under 
the laws of the state in which the conviction occurred involving sexual 
misconduct or involving abuse, neglect or exploitation in a setting other than a 
health care setting. 
Sec. 6.  22 MRSA §1717, sub-§3-A is enacted to read: 
3-A.  Verification of listing on the registry.  Prior to hiring a certified nursing 
assistant or a direct care worker, a personal care agency or a placement agency shall 
check the Maine Registry of Certified Nursing Assistants and Direct Care Workers 
established pursuant to section 1812-G and verify that a certified nursing assistant or 
direct care worker listed on the registry has no disqualifying notations. 
The department may adopt rules necessary to implement this subsection.  Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
Sec. 7.  22 MRSA §1717, sub-§4, ¶B, as amended by PL 2007, c. 324, §2, is 
further amended to read: 
B.  A person who operates a personal care agency or placement agency in violation of 
the employment prohibitions in subsection 3 or 3-A commits a civil violation for 
which a fine of not less than $500 per day of operation in violation but not more than 
$10,000 per day may be adjudged, beginning on the first day that a violation occurs.  
Each day of violation constitutes a separate offense. 
Sec. 8.  22 MRSA §1724, first ¶, as reallocated by RR 2009, c. 2, §49, is further 
amended to read: 
Beginning October 1, 2010, a facility or health care provider subject to the licensing 
or certification processes of chapter 405, 412 or 419 shall obtain, prior to hiring an 
individual who will work in direct contact with a consumer, criminal history record 
information on that individual, including, at a minimum, criminal history record 
information from the Department of Public Safety, State Bureau of Identification.  A 
facility or provider subject to licensing under chapter 419 shall conduct a comprehensive 
background check for individuals employed in positions that have direct access to a 
consumer's property, personally identifiable information, financial information or 
resources in accordance with applicable federal and state laws.  The comprehensive 
background check must be conducted in accordance with state law and rules adopted by 
the department.  The facility or health care provider shall pay for the comprehensive or 
criminal background check required by this section as applicable.  
Sec. 9.  22 MRSA §1812-G, as amended by PL 2011, c. 257, §2, is further 
amended to read: 
§1812-G.  Maine Registry of Certified Nursing Assistants and Direct Care Workers 
1.  Established.  The Maine Registry of Certified Nursing Assistants and Direct Care 
Workers is established in compliance with federal and state requirements.  The 
Department of Health and Human Services shall maintain the registry and make it 
accessible through a public website portal. 
1-A.  Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Certified nursing assistant" means an individual who has successfully completed 
an approved nursing assistant training program, holds a certificate of training and 
meets the eligibility requirements established by the State Board of Nursing for 
listing on the registry. 
B.  "Registry" means the Maine Registry of Certified Nursing Assistants and Direct 
Care Workers established in subsection 1, which is a list of certified nursing 
assistants, with notations if applicable, and a list of unlicensed assistive persons with 
notations. 
C.  "Unlicensed assistive person" or "direct care worker" means an individual 
employed to provide hands-on assistance with activities of daily living or other 
services to individuals in homes, assisted living programs, residential care facilities, 
hospitals and other health care and direct care settings. "Unlicensed assistive person" 
and "direct care worker" include but are not limited to a direct support professional, 
residential care specialist, personal support specialist, mental health support 
specialist, mental health rehabilitation technician, behavior specialist, other qualified 
mental health professional, certified residential medication aide and registered 
medical assistant and other direct care workers as described in rules adopted by the 
department.  "Unlicensed assistive person" and "direct care worker" do not include a 
certified nursing assistant employed in the capacity of a certified nursing assistant. 
1-B.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Abuse" means the infliction of injury, unreasonable confinement, intimidation or 
cruel punishment that causes or is likely to cause physical harm or pain or mental 
anguish; sexual abuse or sexual exploitation; or the intentional, knowing or reckless 
deprivation of essential needs.  "Abuse" includes acts and omissions. 
B.  "Certified nursing assistant" means an individual who has successfully completed 
an approved nursing assistant training program, holds a certificate of training and 
meets the eligibility requirements established by the State Board of Nursing for 
listing on the registry. 
C.  "Direct access" means access to the property, personally identifiable information, 
financial information or resources of an individual or physical access to an individual 
who is a Medicare or Medicaid beneficiary or other individual served by a provider 
subject to this chapter. 
D.  "Direct care worker" means an individual employed in a home, community or 
other health care or direct access setting who provides direct contact assistance with 
personal care, activities of daily living or other services to individuals.  "Direct care 
worker" does not include certified nursing assistants employed in their capacity as 
certified nursing assistants. 
E.  "Disqualifying offense" means a substantiation for abuse, neglect or exploitation, 
or a criminal conviction identified in rules adopted by the department that prohibits 
employment as a certified nursing assistant or a direct care worker in accordance with 
subsection 2-C. 
F.  "Employer" means a person or licensed, certified or registered provider or other 
entity that employs direct access workers, including certified nursing assistants and 
direct care workers, to provide direct contact services in home, community or other 
health care or direct access settings. An individual who employs an unlicensed person 
to provide care for that individual is not an employer for the purposes of this section, 
except when required by rules adopted by the department. 
G.  "Health care or direct access setting" means a setting in which individuals receive 
services that require direct access by a certified nursing assistant or a direct care 
worker or other employee in providing care and related services. 
H.  "Misappropriation of property" means the deliberate misplacement, exploitation 
or wrongful, temporary or permanent use of a client's, patient's or resident's 
belongings or money without that person's consent. 
I.  "Neglect" means a threat to a person's health or welfare by failure to provide goods 
or services necessary to avoid physical or mental injury or impairment or the threat of 
injury or impairment. 
J.  "Nondisqualifying criminal conviction" means a criminal conviction identified in 
rules adopted by the department pursuant to subsection 18 that is included as a 
notation on the registry but does not prohibit employment as a certified nursing 
assistant or a direct care worker. 
K.  "Registered direct care worker" means an individual listed on the registry for 
training, education or compliance purposes in accordance with rules adopted pursuant 
to this chapter.  "Registered direct care worker" does not include a certified nursing 
assistant employed in the capacity of a certified nursing assistant or a direct care 
worker listed on the registry with notations for disqualifying offenses. 
L.  "Registry" means the Maine Registry of Certified Nursing Assistants and Direct 
Care Workers established in subsection 1, which identifies individuals qualified and 
eligible for employment as a certified nursing assistant or a registered direct care 
worker and individuals who are not eligible for employment as a certified nursing 
assistant or direct care worker due to notations for disqualifying offenses. 
M.  "Substantiated finding" means an administrative determination made by the 
department after investigation of a complaint against a certified nursing assistant or a 
direct care worker of abuse, neglect or misappropriation of property of a client, 
patient or resident. 
N.  "Unsubstantiated finding" means an administrative determination made by the 
department after investigation of a complaint against a certified nursing assistant or a 
direct care worker that no evidence of abuse, neglect or misappropriation of property 
of a client, patient or resident was found to support a substantiated finding. 
2.  Contents.  The registry must contain a listing of certified nursing assistants.  The 
listing must include, for any certified nursing assistant listed, a notation of: 
A.  Any criminal convictions, except for Class D and Class E convictions over 10 
years old that did not involve as a victim of the act a patient, client or resident of a 
health care entity; and 
B.  Any specific documented findings by the state survey agency of abuse, neglect or 
misappropriation of property of a resident, client or patient.  For purposes of this 
section, "state survey agency" means the agency specified under 42 United States 
Code, Sections 1395aa and 1396 responsible for determining whether institutions and 
agencies meet requirements for participation in the State's Medicare and Medicaid 
programs. 
The registry must also contain a listing of any unlicensed assistive persons who have 
notations pursuant to section 1812-J. 
2-A.  Registry listing.  All active certified nursing assistants employed in the State 
must be listed on the registry.  The registry must contain a listing of certified nursing 
assistants and direct care workers that are ineligible for employment based on notations 
for disqualifying offenses. Direct care workers registered for training, education or 
compliance purposes may apply for registration and listing on the registry.  Direct care 
workers who may be listed on the registry include but are not limited to the following: 
A.  Behavior specialists; 
B.  Behavioral health professionals; 
C.  Certified residential care aides; 
D.  Certified residential medication aides; 
E.  Direct support professionals; 
F.  Mental health rehabilitation technicians; 
G.  Mental health support specialists; 
H.  Other qualified mental health professionals; 
I.  Personal care or support specialists; 
J.  Registered medical assistants; 
K.  Residential care specialists; 
L.  Community health workers; and 
M.  Other direct care workers described in rules adopted by the department pursuant 
to subsection 18. 
2-B.  Individual information.  The registry must include information for each listed 
certified nursing assistant and direct care worker as required by rules adopted by the 
department pursuant to subsection 18. 
2-C.  Registry notations.  The registry must include for a certified nursing assistant 
and direct care worker listed on the registry a notation of: 
A.  Disqualifying criminal convictions; 
B.  Nondisqualifying criminal convictions, except that a notation is not required on 
the registry for Class D and Class E criminal convictions over 10 years old that did 
not involve as a victim of the act a patient, client or resident; 
C.  Substantiated findings, including but not limited to the following information: 
(1)  Documentation of an investigation of a certified nursing assistant or a direct 
care worker, including the nature of the allegation and evidence supporting a 
determination that substantiates the allegation of abuse, neglect or 
misappropriation of property of a client, patient or resident; 
(2)  Documentation of substantiated findings of abuse, neglect or 
misappropriation of property of a client, patient or resident; 
(3)  If the certified nursing assistant or direct care worker appealed the 
substantiated finding, the date of the hearing; and 
(4)  The statement of the certified nursing assistant or direct care worker 
disputing the allegation of abuse, neglect or misappropriation of property of a 
client, patient or resident if the certified nursing assistant or direct care worker 
submitted such a statement; and 
D.  Petitions filed by a certified nursing assistant or direct care worker for removal of 
an employment ban issued by the department that was based on a criminal conviction 
and the department’s review and determination. 
3.  Eligibility requirements for listing; certified nursing assistant.  The State 
Board of Nursing shall adopt rules pursuant to the Maine Administrative Procedure Act 
defining eligibility requirements for listing on the registry as a certified nursing assistant, 
including rules regarding temporary listing of nursing assistants who have received 
training in another jurisdiction.  The rules must permit certified nursing assistants to work 
under the supervision of a registered professional nurse in a facility providing assisted 
living housing services as defined in chapter 1664 and must recognize work in those 
facilities for the purpose of qualifying for and continuing listing on the registry.  Rules 
adopted regarding the work of certified nursing assistants in facilities providing assisted 
living housing services are routine technical rules as defined by Title 5, chapter 375, 
subchapter 2-A. 
3-A.  Listing on the registry; direct care worker.  A direct care worker listed for 
purposes other than a disqualifying notation may be listed on the registry as a registered 
direct care worker for 2-year renewable periods.  The department shall adopt routine 
technical rules regarding listing direct care workers on the registry, including but not 
limited to the following:  
A.  Direct care workers with disqualifying offenses must be listed on the registry; and 
B.  Direct care workers without disqualifying offenses who are registered for training, 
education or compliance purposes must comply with requirements for continued 
listing on the registry. 
The rules may include provisions for direct care workers registered for training, education 
or compliance purposes including provisions for the temporary listing of direct care 
workers who received training in another jurisdiction. 
A certified nursing assistant in good standing on the registry may qualify for registration 
as a direct care worker. 
4.  Department verification of credentials and training.  The department shall may 
verify the credentials and training of all certified nursing assistant applicants to the 
assistants and registered direct care workers listed on the registry. 
4-A.  Provider verification fee.  The department may establish a provider 
verification fee not to exceed $25 annually per provider for verification of a certified 
nursing assistant's or registered direct care worker's credentials and training. Providers 
may not pass the cost on to the individual certified nursing assistant or registered direct 
care worker. Provider verification fees collected by the department must be placed in a 
special revenue account to be used by the department to operate the registry, including 
but not limited to the cost of criminal history record checks. The department may adopt 
rules necessary to implement this subsection.  Rules adopted pursuant to this subsection 
are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A. 
5.  Employment eligibility verification; certified nursing assistant.  A An 
employer, including a health care institution, facility or other organization that employs 
an individual as a certified nursing assistant, shall, before hiring a certified nursing 
assistant, verify with the registry that the certified nursing assistant is listed as active and 
has no disqualifying notations on the registry. 
5-A.  Employment eligibility verification; direct care worker.  An employer, 
including a health care institution, facility or other organization that employs an 
individual as a direct care worker, shall verify that the direct care worker, if listed on the 
registry, has no disqualifying notations and has complied with the training or education 
requirements for registration, if applicable. 
6.  Prohibited employment based on disqualifying offenses. Except as otherwise 
provided in this section: An individual with a disqualifying offense including a 
substantiated complaint or a disqualifying criminal conviction may not work as a certified 
nursing assistant or a direct care worker and an employer is subject to penalties for 
employing a disqualified or otherwise ineligible person in accordance with applicable 
federal or state laws. 
A.  An individual may not be employed in a hospital, nursing facility, home health 
agency or assisted housing program as a certified nursing assistant if that individual 
has been convicted in a court of law of a crime involving abuse, neglect or 
misappropriation of property in a health care setting; and 
B.  An individual may not be employed in a hospital, nursing facility, home health 
agency or assisted housing program as a certified nursing assistant if that individual: 
(1)  Has been the subject of a complaint involving abuse or neglect that was 
substantiated by the department pursuant to its responsibility to license hospitals, 
nursing facilities, home health agencies and assisted housing programs and that 
was entered on the registry; or 
(2)  Has been the subject of a complaint involving the misappropriation of 
property in a health care setting that was substantiated by the department and 
entered on the registry. 
6-A.  Background check.  Certified nursing assistants and  direct care workers are 
subject to a background check as defined by rules adopted by the department and 
according to the following: 
A.  A training program for certified nursing assistants or direct care workers must 
secure and pay for a background check on each individual who applies for 
enrollment. The individual's current name and all previous names are subject to the 
background check. A copy of the background check is given to the individual who, 
upon successful completion of the training, submits it with an application to be listed 
on the registry as a certified nursing assistant or a registered direct care worker. 
(1)  Prior to enrolling an individual, a training program for certified nursing 
assistants or direct care workers must notify individuals that a background check 
will be conducted and that certain disqualifying offenses, including criminal 
convictions, may prohibit an individual from working as a certified nursing 
assistant or a direct care worker. 
B.  Pursuant to sections 1717, 1724, 2137, 2149-A, 7706, 8606, 9005 and Title 34-B, 
section 1225, licensed, certified or registered providers must secure and pay for a 
background check prior to hiring an individual who will work in direct contact with 
clients, patients or residents, including a certified nursing assistant or a direct care 
worker. 
C.  The department may secure a background check on certified nursing assistants 
and registered direct care workers on the registry every 2 years. 
D.  A person or other legal entity that is not otherwise licensed by the department and 
that employs or places a certified nursing assistant or direct care worker to provide 
services allowing direct access must secure and pay for a background check in 
accordance with state law or rules adopted by the department. 
6-B.  Convictions within previous 10 years; impact on employment eligibility.  
The department shall determine the effect of a criminal conviction within the previous 10 
years on the employability of an individual as a certified nursing assistant or direct care 
worker based on rules adopted by the department pursuant to subsection 18. 
6-C.  Table of crimes.  Department rules must include a table of crimes. Specific 
crimes listed on the table must be considered substantive offenses under Title 17-A, Part 
or crimes identified in federal or state law that prohibit employment of an individual 
subject to this chapter. Convictions of specific crimes must be categorized in the table of 
crimes as disqualifying criminal convictions or nondisqualifying criminal convictions. 
Convictions in other jurisdictions for similar crimes must be identified as disqualifying or 
nondisqualifying convictions. 
A.  A disqualifying criminal conviction within the previous 10 years prohibits 
employment as a certified nursing assistant or a direct care worker. 
(1)  An individual with a disqualifying criminal conviction is subject to an 
employment ban of 10 or 30 years. The department shall adopt rules that specify 
disqualifying criminal convictions that prohibit employment for 10 years and 
disqualifying criminal convictions that prohibit employment for 30 years. 
B.  Nondisqualifying criminal convictions do not prohibit employment as a certified 
nursing assistant or a direct care worker. 
6-D.  Petition for removal of an employment ban; criminal conviction. Prior to 
the expiration of an employment ban under subsection 6-C, paragraph A, subparagraph 
(1), an individual may petition the department for removal of an employment ban that is 
based on a disqualifying criminal conviction. Unless otherwise prohibited, removal of the 
employment ban allows the individual to work as a certified nursing assistant or a direct 
care worker. 
A.  No sooner than 5 years after an individual is discharged from the legal restraints 
imposed by the criminal conviction, an individual may petition the department for 
removal of a 10-year employment ban. 
B.  No sooner than 15 years after an individual is discharged from the legal restraints 
imposed by the criminal conviction, an individual may petition the department for 
removal of a 30-year employment ban. 
C.  A successful petitioner must meet the criteria established by department rules for 
removal of an employment ban.  Criteria must include but not be limited to an 
assessment of the risk of reoffending and the conduct of the petitioner since the 
conviction. 
A petition for removal of an employment ban submitted by a certified nursing 
assistant or a registered direct care worker must be denied if the conduct that led to 
the conviction would have resulted in a lifetime ban if that conduct had been 
investigated as a complaint that resulted in a substantiated finding under subsection 
13. 
D.  When the department grants a petition for removal of an employment ban, the 
individual, unless otherwise prohibited, may work as a certified nursing assistant or a 
direct care worker. The notation of the criminal conviction remains on the registry. 
7.  Time limit on consideration of prior criminal conviction.  Except as otherwise 
provided in this section, an individual may not be employed in a hospital, nursing facility, 
home health agency or assisted housing program as a certified nursing assistant if that 
individual has a prior criminal conviction within the last 10 years of: 
A.  A crime for which incarceration of 3 years or more may be imposed under the 
laws of the state in which the conviction occurred; or 
B.  A crime for which incarceration of less than 3 years may be imposed under the 
laws of the state in which the conviction occurred involving sexual misconduct or 
involving abuse, neglect or exploitation in a setting other than a health care setting. 
8.  Exception; certified nursing assistant convictions prior to June 2, 2003.  The 
restrictions on employment under subsections 6 and 7 based on criminal convictions prior 
to June 2, 2003 do not apply to an individual listed and active on the registry as a certified 
nursing assistant prior to the effective date of this subsection June 2, 2003, as long as the 
individual meets other state and federal requirements for certified nursing assistants and 
continues to maintain an active status by timely reregistration renewal as required by the 
rules. 
9.  Notification.  A nursing assistant training program must notify applicants to that 
program of the restrictions under subsections 6 and 7 prior to the acceptance of any 
applicant. 
10.  Complaint investigation.  The department may investigate complaints and 
allegations against certified nursing assistants or registered direct care workers of abuse, 
neglect, exploitation or misappropriation of property of a client, patient or resident. 
11.  Issue a decision.  After an investigation under subsection 10, the department 
shall issue a written decision that the allegation of abuse, neglect, exploitation or 
misappropriation of property of a client, patient or resident is unsubstantiated or 
substantiated. Each allegation of abuse, neglect or misappropriation of property must be 
considered separately. A substantiated finding must be based on factors established by 
department rules. The written decision must include at least the following information: 
A.  Whether the allegation is unsubstantiated or substantiated; 
B.  A description of the factors supporting a substantiated finding; 
C.  If a notation of a substantiated finding is entered on the registry; 
D.  A description of the employment prohibition, if any; and 
E.  Notice of the right to appeal the department’s decision pursuant to subsection 12. 
12.  Right to hearing; appeal.  In accordance with department rules, a certified 
nursing assistant or registered direct care worker may request an administrative hearing to 
appeal a substantiated finding under subsection 11. 
13.  Substantiated finding; lifetime employment ban.  A certified nursing assistant 
or a registered direct care worker with a notation of a substantiated finding on the registry 
is banned for life from employment as either a certified nursing assistant or a direct care 
worker. 
14.  Registration requirements; direct care workers.  An individual registered by 
the department as a direct care worker for training, education or compliance purposes 
must comply with requirements established by department rules, including but not limited 
to the following: 
A.  Submission of a completed department-approved application form with required 
documents; 
B.  Successful completion of training requirements; and 
C.  Submission to a background check, if required. 
15.  Department review of application; decision. After review of an application for 
an initial or renewed registration for a direct care worker for training, education or 
compliance purposes, the department shall render a written decision to either deny or 
approve the application. The decision must be based on factors established by department 
rules and the factors must be included in the written decision. 
A.  A department-issued registration for a direct care worker for training, education 
or compliance purposes is for a term of 2 years. The issued date and the expiration 
date must be on the registration. 
16.  Renewal of registration.  Prior to expiration of a direct care worker's 
registration for training, education or compliance purposes, the direct care worker shall 
secure a department-issued renewed registration. 
17.  Failure to renew registration prior to expiration.  Upon expiration of the 2-
year registration under subsection 15, a direct care worker registered for training, 
education or compliance purposes pursuant to subsection 14 who fails to secure a 
department-issued renewed registration will receive a notation on the registry that may 
disqualify the direct care worker for employment in the capacity for which the training, 
education or compliance purposes were required.  A direct care worker who elects not to 
renew a registration remains eligible for employment as a direct care worker in a capacity 
that does not require registration-level training or education pursuant to subsection 14, 
paragraph B. 
18.  Rules.  The department shall adopt rules necessary to implement this section. 
Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A. 
Sec. 10.  22 MRSA §1812-J, as amended by PL 2011, c. 257, §§3 to 8, is 
repealed. 
Sec. 11.  22 MRSA §2137, first ¶, as enacted by PL 2009, c. 621, §5, is amended 
to read: 
Beginning October 1, 2010, a temporary nurse agency shall obtain, prior to hiring, 
employing or placing an individual who will work in direct contact with a consumer, 
criminal history record information on that individual, including, or who has direct access 
to a consumer's property, personally identifiable information, financial information or 
resources, shall obtain a comprehensive background check in accordance with applicable 
federal and state laws.  The comprehensive background check must include, at a 
minimum, criminal history record information from the Department of Public Safety, 
State Bureau of Identification.  The temporary nurse agency shall pay for the criminal 
background check required by this section. 
Sec. 12.  22 MRSA §2138, as amended by PL 2011, c. 257, §16, is repealed and 
the following enacted in its place: 
§2138.  Prohibited employment based on disqualifying offenses 
A temporary nurse agency shall conduct a comprehensive background check for 
direct access personnel, as defined in section 1717, subsection 1, paragraph A-2, in 
accordance with state law and rules adopted by the department and is subject to the 
employment restrictions set out in section 1812-G and other applicable federal and state 
laws when hiring, employing or placing direct access personnel including a certified 
nursing assistant or a direct care worker. 
The department may adopt rules necessary to implement this section.  Rules adopted 
pursuant to this section are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
Sec. 13.  22 MRSA §2149-A, sub-§2, as amended by PL 2011, c. 257, §17, is 
further amended to read: 
2.  Prohibited employment based on disqualifying offenses.  A home health care 
provider shall obtain criminal history record information about applicants for positions as 
unlicensed assistive personnel as defined in section 1717, subsection 1, paragraph D and 
may not hire an individual who: conduct a comprehensive background check for direct 
access personnel, as defined in section 1717, subsection 1, paragraph A-2, in accordance 
with state law and rules adopted by the department and is subject to the employment 
restrictions set out in section 1812-G and other applicable federal and state laws when 
hiring, employing or placing direct access personnel including a certified nursing 
assistant or a direct care worker. 
A.    Has worked as a certified nursing assistant and has been the subject of a notation 
by the state survey agency for a substantiated complaint of abuse, neglect or 
misappropriation of property in a health care setting that was entered on the Maine 
Registry of Certified Nursing Assistants and Direct Care Workers; 
B.    Has been convicted in a court of law of a crime involving abuse, neglect or 
misappropriation of property in a health care setting; or 
C.    Has a prior criminal conviction within the last 10 years of: 
(1)  A crime for which incarceration of 3 years or more may be imposed under 
the laws of the state in which the conviction occurred; or 
(2)  A crime for which incarceration of less than 3 years may be imposed under 
the laws of the state in which the conviction occurred involving sexual 
misconduct or involving abuse, neglect or exploitation in a setting other than a 
health care setting. 
The department may adopt rules necessary to implement this subsection.  Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
Sec. 14.  22 MRSA §7706, first ¶, as reallocated by RR 2009, c. 2, §61, is 
amended to read: 
Beginning October 1, 2010, a facility or health care provider subject to the licensing 
or certification processes of chapter 1663, a nursery school subject to chapter 1675 or a 
hospice provider subject to chapter 1681 shall obtain, prior to hiring an individual who 
will work in direct contact with a consumer, criminal history record information on that 
individual, including, or who has direct access to a consumer's property, personally 
identifiable information, financial information or resources, shall obtain a comprehensive 
background check in accordance with applicable federal and state laws.  The 
comprehensive background check must include, at a minimum, criminal history record 
information from the Department of Public Safety, State Bureau of Identification.  The 
entity seeking to employ the individual shall pay for the criminal background check 
required by this section. 
Sec. 15.  22 MRSA §7851, sub-§4, as enacted by PL 2003, c. 634, §6, is amended 
to read: 
4.  Prohibited employment based on disqualifying offenses.  A licensed assisted 
housing program may not hire as unlicensed assistive personnel as defined in section 
1717, subsection 1, paragraph D an individual who is prohibited from employment as a 
certified nursing assistant pursuant to section 1812-G, subsection 6 or 7 must conduct a 
comprehensive background check for direct access personnel, as defined in section 1717, 
subsection 1, paragraph A-2, in accordance with state law and rules adopted by the 
department and is subject to the employment restrictions set out in section 1812-G and 
other applicable federal and state laws when hiring, employing or placing direct access 
personnel including a certified nursing assistant or a direct care worker. 
The department may adopt rules necessary to implement this subsection.  Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
Sec. 16.  22 MRSA §8606, as amended by PL 2011, c. 257, §18, is further 
amended to read: 
§8606.  Prohibited employment based on disqualifying offenses 
1.  Prohibited employment based on disqualifying offenses.  An adult day care 
program shall obtain criminal history record information about applicants for positions as 
unlicensed assistive personnel as defined in section 1717, subsection 1, paragraph D and 
may not hire an individual who: conduct a comprehensive background check for direct 
access personnel, as defined in section 1717, subsection 1, paragraph A-2, in accordance 
with state law and rules adopted by the department and is subject to the employment 
restrictions set out in section 1812-G and other applicable federal and state laws when 
hiring, employing or placing direct access personnel, including, but not limited to, a 
certified nursing assistant or a direct care worker. 
A.    Has worked as a certified nursing assistant and has been the subject of a notation 
by the state survey agency for a substantiated complaint of abuse, neglect or 
misappropriation of property in a health care setting that was entered on the Maine 
Registry of Certified Nursing Assistants and Direct Care Workers; 
B.    Has been convicted in a court of law of a crime involving abuse, neglect or 
misappropriation of property in a health care setting; or 
C.    Has a prior criminal conviction within the last 10 years of: 
(1)  A crime for which incarceration of 3 years or more may be imposed under 
the laws of the state in which the conviction occurred; or 
(2)  A crime for which incarceration of less than 3 years may be imposed under 
the laws of the state in which the conviction occurred involving sexual 
misconduct or involving abuse, neglect or exploitation in a setting other than a 
health care setting. 
The department may adopt rules necessary to implement this section.  Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
Sec. 17.  22 MRSA §9005, as enacted by PL 2011, c. 444, §1, is amended to read: 
§9005.  Prohibited employment based on disqualifying offenses 
1.  Prohibited employment based on disqualifying offenses.  A veterans' adult day 
health care program shall obtain criminal history record information about applicants for 
positions as unlicensed assistive personnel as defined in section 1717, subsection 1, 
paragraph D and may not hire an individual who: conduct a comprehensive background 
check for direct access personnel, as defined in section 1717, subsection 1, paragraph 
A-2, in accordance with state law and rules adopted by the department and is subject to 
the employment restrictions set out in section 1812-G and other applicable federal and 
state laws when hiring, employing or placing direct access personnel, including, but not 
limited to, a certified nursing assistant or a direct care worker. 
A.  Has worked as a certified nursing assistant and has been the subject of a notation 
by the state survey agency for a substantiated complaint of abuse, neglect or 
misappropriation of property in a health care setting that was entered on the Maine 
Registry of Certified Nursing Assistants; 
B.  Has been convicted in a court of law of a crime involving abuse, neglect or 
misappropriation of property in a health care setting; or 
C.  Has a prior criminal conviction within the last 10 years of: 
(1)  A crime for which incarceration of 3 years or more may be imposed under 
the laws of the state in which the conviction occurred; or 
(2)  A crime for which incarceration of less than 3 years may be imposed under 
the laws of the state in which the conviction occurred involving sexual 
misconduct or involving abuse, neglect or exploitation in a setting other than a 
health care setting. 
The department may adopt rules necessary to implement this section.  Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
Sec. 18.  34-B MRSA §1225, first ¶, as reallocated by RR 2009, c. 2, §94, is 
amended to read: 
Beginning October 1, 2010, a facility or health care provider subject to the licensing 
provisions of section 1203-A shall obtain, prior to hiring an individual who will work in 
direct contact with a consumer, criminal history record information on that individual, 
including, or who has direct access to a consumer's property, personally identifiable 
information, financial information or resources, shall obtain a comprehensive background 
check in accordance with applicable federal and state laws.  The comprehensive 
background check must include, at a minimum, criminal history record information from 
the Department of Public Safety, State Bureau of Identification.  A facility or provider 
licensed under section 1203-A is subject to the employment restrictions set out in Title 
22, section 1812-G and other applicable federal and state laws when employing direct 
access personnel, as defined in section 1717, subsection 1, paragraph A-2.  The facility or 
health care provider shall pay for the criminal background check required by this section. 
Sec. 19.  Department implementation.  The Department of Health and Human 
Services shall begin registering direct care workers for training, education or compliance 
purposes and listing them on the registry established pursuant to the Maine Revised 
Statutes, Title 22, section 1812-G after the department adopts rules pursuant to Title 22, 
section 1812-G. 
SUMMARY 
This bill amends the Maine Registry of Certified Nursing Assistants and Direct Care 
Workers in the following ways. 
1.  It clarifies the circumstances under which a person employed as a direct care 
worker is listed on the registry. 
2.  It amends the requirements for listing certified nursing assistants and direct care 
workers. 
3.  It requires employers to verify that an individual listed on the registry is eligible 
for employment as a certified nursing assistant or direct care worker. 
4.  It consolidates information and aligns language used across programs based on 
federal and state laws related to background checks, disqualifying offenses, prohibited 
employment, criminal convictions and substantiated findings related to complaints of 
abuse, neglect or misappropriation of property. 
5.  It describes the process of identifying the disqualifying offenses that adversely 
affect an individual's eligibility for employment as a certified nursing assistant or direct 
care worker. 
6.  It establishes the department's authority to adopt eligibility for listing on the 
registry and other requirements by rule. 
7.  It establishes statutory background check requirements and employment 
restrictions based on disqualifying offenses, including criminal convictions. 
8.  It replaces current ambiguous statutory language that bases employment bans on 
the length of the sentence that may be imposed with a requirement that the department 
adopt by rule a table of named crimes that form the rational basis for employment bans 
based on convictions. 
9.  It requires the department to adopt rules that list nondisqualifying criminal 
convictions that do not ban employment leaving hiring decisions to employer discretion. 
10.  It provides that disqualifying criminal convictions result in 10-year or 30-year 
employment bans and that the length of an employment ban may be shortened by filing a 
petition with the department to lift an employment ban prior to its expiration. 
11.  It consolidates complaint investigation requirements.