An Act To Reestablish the Office of Advocacy within the Department of Health and Human Services
Maine Legislature, Session 128, LD 1676
Committee Amendment CA_A_H769 (House)
Amends: 5 MRSA §12004-J, 34-B MRSA §1971, 22 MRSA §1711-C, 22 MRSA §3474

SF,COND REGULAR SESSION 
COMMITTEE AMENDMENT "/)" to H.P. 1164, L.D. 1676, Bill, "An Act To 
Reestablish the Office of Advocacy within the Department of Health and Human 
Services" 
Amend the bill by strildng out the title and substituting the following: 
'An Act To Establish an Independent Oversight Panel To Review Deaths of and 
Serious Injuries to Persons with Intellectual Disabilities or Autism' 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 5 MRSA §12004-J, sub-§18 is enacted to read: 
.18; 
Intellectual 
Disability or 
Autism 
Panel To Review 
Deaths of and 
Serious Injuries to 
Persons with 
Intellectual 
Disabilities or 
Autism 
Expenses for 
uncompensated 
members 
34-B MRSA §1971 
Sec. 2. 22 MRSA §1711-C, sub-§6, 1T, as amended by PL 2017, c. 203, §3, is 
further amended to read: 
T. To a lay caregiver designated by an individual pursuant to section 1711-G; an4 
Sec. 3. 22 MRSA §1711-C, sub-§6, 1U, as enacted by PL 2017, c. 203, §4, is 
amended to read: 
U. To a panel coordinator of the maternal, fetal and infant mortality review panel 
pursuant to section 261, subsection 4, paragraph B-1 for the purposes of reviewing 
health care information of a deceased person and a mother of a child who died within 
one year of birth, including fetal deaths after 28 weeks of gestation. For purposes of 
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this paragraph, 
11panel coordinator" has the same meaning as in section 261, 
subsection 1, paragraph E and 
11deceased person
has the same meaning as in section 
261, subsection 1, paragraph B,; and 
Sec. 4. 22 MRSA §1711-C, sub-§6, ,Vis enacted to read: 
V. To the panel coordinator, appointed under Title 34-B, section 1972, subsection 1, 
of the Panel To Review Deaths of and Serious Injuries to Persons with Intellectual 
Disabilities or Autism, established in Title 5, section 12004-J, subsection 18, for the 
purposes of reviewing health care information of a person with an intellectual 
disability or autism receiving adult developmental services as defined in Title 34-B, 
section 1001, subsection 1-A who has died or experienced a serious injyry in the last 
months. 
Sec. 5. 22 MRSA §3474, sub-§3, tjfC, as corrected by RR 1991, c. 2, §80, is 
amended to read: 
C. A grand jury on its determination that access to those records is necessary in the 
conduct of its official business; arul 
Sec. 6. 22 MRSA §3474, sub-§3, 41ID, as corrected by RR 1991, c. 2, §81, is 
amended to read: 
D. 
An advocacy agency conducting an investigation under chapter 961, United 
States Public Law 88-164, Title I, Part C or United States Public Law 99-319, 
regarding a developmentally disabled person or mentally ill person who is or who, 
within the last 90 days, was residing in a facility rendering care or treatment, when a 
complaint has been received by the agency or there is probable cause to believe that 
that individual has been subject to abuse or neglect, and that person does not have a 
legal guardian or the person is under public guardianship. The determination of 
which information and records are relevant to the investigation is made by agreement 
between the department and the agency,; and 
Sec. 7. 22 MRSA §3474, sub-§3, ,iE is enacted to read: 
E. The panel coordinator, appointed under Title 34-B, section 1972. subsection 1, of 
the Panel To Review Deaths of and Serious Injuries to Persons with Intellectual 
Disabilities or Autism, established in Title 5, section 12004-J. subsection 18. 
Sec. 8. 34-B MRSA c. 1, sub-c. 9 is enacted to read: 
SUBCHAPTER 9 
PANEL TO REVIEW DEATHS OF AND SERIOUS INJURIES TO 
PERSONS WITH INTELLECTUAL DISABILITIES OR AUTISM 
§1971. Panel To Review Deaths of and Serious Injuries to Persons with Intellectual 
Disabilities or Autism 
The Panel To Review Deaths of and Serious Injuries to Persons with Intellectual 
Disabilities or Autism, referred to in this subchapter as 
11the panel, 11 is established to 
conduct comprehensive. multidisciplinary reviews of cases of death of or serious injury to 
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persons with intellectual disabilities or autism receiving adult developmental services in 
the State as described in this subchapter. 
§1972. Panel membership; compensation; staffing 
1. Membership. The panel consists of 14 members as provided in this subsection. 
A. The commissioner shall appoint a member to the panel who is an employee of the 
Maine Center for Disease Control and Prevention within the department and who is a 
registered nurse. The member appointed pursuant to this paragraph is the panel 
coordinator. 
B. The Maine Developmental Services Oversight and Advisory Board, established in 
Title 5, section 12004-J, subsection 15, shall appoint a member to the panel. The 
board may appoint a new member to the panel annually or as the board determines 
;necessary. 
C. The Governor shall appoint 4 members to the panel as follows: 
(1) A representative of the judicial branch; 
(2) A physician licensed under Title 32, chapter 36 or chapter 48 who is a 
primary ca-re physici@.;. 
(3) A law enforcement officer; and 
(4) A provider of community services to persons with intellectual disabilities or 
autism in the State. 
D. The President of the Senate shall appoint 4 members to the panel as follows: 
(1) A nurse licensed in the State with expertise in intellectual disabilities or 
autism; 
(2) A person licensed to practice law in the State working in the public sector; 
(3) A person with expertise in forensic pathology; and 
( 4) A person with expertise in the field of community mental health. 
E. The Speaker of the House of Representatives shall appoint 4 members to the panel 
as follows: 
(1) A person with expertise in the field of public health; 
(2) A person licensed to practice law in the State working in the private sector; 
(3) A person employed by a university or who is a doctoral candidate in a 
relevant area of study; and 
( 4) A provider of community services to persons with intellectual disabilities or 
autism in the State. 
2. 
Terms. 
The term of office of each member of the panel appointed under 
subsection 1, not including the panel coordinator and the member appointed pursuant to 
subsection 1, paragraph B, is 3 years. A member serves until a successor is appointed. A 
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COMMITTEEAMENDMENT"A "toH.P.1164,L.D.1676 
vacancy must be filled as soon as practicable by appointment for the unexpired term, 
Members may be reappointed. 
3. Chair. Every year, the panel shall elect a chair from among its members. 
4. 
Compensation. 
Members of the panel not otherwise compensated by their 
employers or other entities whom they represent are entitled to reimbursement of 
reasonable expenses incurred in serving on the panel. 
5. Panel coordinator duties; staffing. The panel coordinator shall act as staff to the 
panel. The panel coordinator may procure specialist expertise when the panel coordinator 
considers it necessary or when it is requested by the panel. The panel coordinator shall 
conduct an initial review as described in section 1973 of any death of or serious injury to 
a person with an intellectual disability or autism receiving adult developmental services. 
The panel coordinator shall compile reports required pursuant to this subchapter. 
§1973. Initial review by the panel coordinator 
The panel coordinator shall conduct an initial review of any death of or serious injury 
to a person with an intellectual disability or autism receiving adult developmental 
services to determine whether to refer a case to the panel for a review. · The panel 
coordinator shall refer a case to the panel if the panel coordinator determines that any of 
the following circumstances exist: 
1. Unexpected. The death or serious injury was unexpec~ 
2. Preventable. Facts and circumstances indicate that the death or serious injury 
could have been prevented; 
3. System issues. Issues with the system of care described in section 5003-A are 
implicated; or 
4. 
Other issues. 
Other issues related to the case indicate the case should be 
reviewed. 
§1974. Access to information and records 
1. Department records. Notwithstanding any other provision of law, the panel 
coordinator may access information or records from the department determined by the 
panel coordinator to be necessary to carry out the panel coordinator's responsibilities. 
The department shall provide the panel coordinator with direct access to the information 
or records or provide information or records necessary and relevant as soon as practicable 
upon oral or written request of the panel coordinator. Records that must be provided 
include, but are not limited to, the following: 
A. Personal plans developed pursuant to section 5470-B: 
B. Service plans and agreements developed pursuant to section 5471; 
C. Documents from providers of residential services to persons with intellectual 
disabilities or autism pursuant to chapters 5 and 6 or caseworkers: 
D. Documents related to any adult protective case or investigation: 
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COMMITTEEAMENDMENT" A"toH.P.1164,L.D.1676 
;E. Reports related to a person with an intellectual disability or autism who was 
receiving adult developmental services of incidents that occurred in the 12-month 
period prior to the person's death or serious injury; 
F. Death certificates: 
G. 
Health care information related to a person with an intellectual disability or 
autism who was receivinLIQ1!J.t developmental services from the 12-month period 
prior to the person's death or serious injury. For the purposes of this paragraph, 
"health care information" has the same meaning as in Title 22, section 1711-C, 
subsection 1, paragraph E; and 
H. Records from any autopsy performed on a deceased person. 
2. Duty to provide records. A person that possesses medical records or information 
that is necessary and relevant to the review under section 1973 shall provide those 
medical records or information to the panel coordinator as soon as practicable, This 
subsection does not authorize the disclosure of a record generated by a hospital that is 
otherwise confidential, including, but not limited to, a sentinel event record, a root cause 
analysis and a professional competency review. As used in this subsection, "sentinel 
event" has the same meaning as in Title 22, section 8752, subsection 4-A and "root cause 
analysis" has the same meaning as in Title 22, section 87521 subsection 3-B. 
§1975. Cases referred to the panel by o.thers 
A case of death of or serious injury to a person with an intellectual disability or 
autism receiving adult developmental services may be referred to the panel by the 
commissioner, the agency designated as the protection and advocacy agency for persons 
with disabilities pursuant to Title 5, section 19502, a member of the panel or any other 
person who presents credible evidence, as determined by the panel coordinator, that a 
death of or serious injury to a person with an intellectual disability or autism receiving 
adult developmental services warrants review by the panel. 
§1976. Monthly report 
The panel coordinator shall compile a monthly report that includes a list of all cases 
of death of or serious injury to a person with an intellectual disability or autism receiving 
adult developmental services reviewed by the panel coordinator, a list of all cases the 
panel coordinatorhas. referre4 for review to the panel and a list of aU cases referred . 
pursuant to section 1975. For each case referred for review, the report must include the 
name of the person receiving adult developmental services who has died or experienced 
serious injury, the name of the guardian, the status of guardianship and a short description 
of the circumstances of the death or serious injury that occurred. The panel coordinator 
shall provide the monthly report to the panel, the department and the Maine 
Developmental Services Oversight and Advisory Board, established in Title 5, section 
12004-J, subsection 15. The monthly report compiled pursuant to this section is not a 
public record as defined in Title 1, section 402, subsection 3, 
§1977. Review by the panel 
1. Cases reviewed by the panel. The panel shall review all cases of death of or 
serious injury to a person with an intellectual disability or autism receiving adult 
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COMMITIEEAMENDMENT"A "toH.P.1164,L.D.1676 
developmental services that are referred by the panel coordinator or are referred pursuant 
to section 1975; all medical examiner cases pursuant to Title 22, section 3025, subsection 
1, paragraph E that pertain to a person with an intellectual disability or autism who 
received adult developmental services; all cases from the last 12 months that are reported 
incidents pursuant to section 5604-A: and all cases of death or serious injury that are 
being reviewed by the Maine Developmental Services Oversight and Advisory Board, 
established in Title 5, section 12004-J, subsection 15. The panel may also choose to 
review any other case from the monthly report of the panel coordinator under section 
1976. 
2. Records provided to the panel. The panel coordinator shall determine records as 
listed in section 1974 that must be made available to the panel for the purpose of 
reviewing cases of death of or serious injury to persons with intellectual disabilities or 
autism receiving adult developmental services. The panel coordinator shall maintain 
custody of all records. 
3. Review. A review of a case conducted by the panel is intended to be a thorough 
evaluation of circumstances surrounding the death of or serious injury to a person with an 
intellectual disability or autism receiving adult developmental services, including the 
overall care of the person, quality of life issues, the death or serious injury event and 
medical care preceding the event. The review must also include any determination of 
whether the case is suspicious. 
4. Investigations. A review under this section is subject to and may not interfere 
with the authority and responsibility of the Attorney General to investigate and prosecute 
homicides pursuant to Title 5, section 200-A. 
§1978. Report of findings 
After a review of all materials related to a case of death of or serious injury to a 
person with an intellectual disability or autism receiving adult developmental services 
reviewed by the panel pursuant to section 197'1, the panel shall make findings and 
recommendations and submit those findings and recommendations in a report to the 
commissioner and to the Maine Developmental Services Oversight and Advisory Board, 
established in Title 5, section 12004-J, subsection 15. The report must identify trends and 
patterns in deaths or serious injuries that indicate necessary systemic changes and reforms 
in the delivery of services to reduce adverse outcomes for persons with intellectual 
disabilities or autism receiving adult developmental services as well as recommendations 
for corrective actions. All personally identifying information must be removed from the 
report before it is submitted to the commissioner and the Maine Developmental Services 
Oversight and Advisory Board. 
§1979. Legislative reports 
1. Annual report. The panel shall provide to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters an annual report 
by January 30th with data regarding the number of deaths of and serious injuries to 
persons with intellectual disabilities or autism receiving adult developmental services, the 
number of cases reviewed by the panel, the number of cases determined suspicious, 
actions taken on recommendations submitted to the commissioner and the Maine 
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COMMITTEE AMENDMENT"~ "to H.P. 1164, L.D. 1676 
Developmental Services Oversight and Advisory Board, established in Title 5, section 
12004-J, subsection 15, and a summary of findings and recommendations. 
~. Trend analyses. The panel may provide to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters a periodic report 
with trend analyses if the panel determines that such a report is necessaty. Any periodic 
trend analysis report that is submitted must be developed in conjunction with the 
commissioner and the Maine Developmental Services Oversight and Advisory Board, 
established in Title 5, section 12004-J, subsection 15. 
§1980. Confidentiality 
Any information or record accessed by or provided to the panel coordinator or the 
panel pursuant to this subchapter that is designated confidential pursuant to state or 
federal law by the official, agency or other entity providing the information or record 
must be maintained as confidential by the panel coordinator and the panel. 
'·, 
Sec. 9. Initial appointments; staggered terms. Notwithstanding the Maine 
Revised Statutes, Title 34-B, section 1972, subsection 2, of the initial appointments to the 
Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities 
or Autism, the Governor shall appoint one member to serve an initial term of one year, 2 
members to serve an initial tetm of 2 years and one member to serve an initial term of 3 
years; the President of the Senate shall appoint 2 members to serve an initial term of one 
year, one member to serve an initial term of 2 years and one member to serve an initial 
term of 3 years; arid the Speaker, of the House of Representatives shall appoint one 
member to serve an initial tetm of one year, one member to serve an initial term .of 2 
years and 2 members to serve an initial term of 3 years. 
Sec. 10. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Maine Center for Disease Control and Prevention .0143 
Initiative: Provides funding for one Health Services Consultant position to be the panel 
coordinator for the Panel To Review Deaths of and Serious Injuries to Persons with 
Intellectual Disabilities or Autism. 
GENERAL FUND 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
All Other 
GENERAL FUND TOTAL 
SUMMARY 
2017-18 
2018-19 
0.000 
1.000 
$0 
$84,899 
$0 
$6,286 
$0 
$91,185 
This amendment, which is the majority report of the committee, replaces the bill. It 
establishes the Panel To Review Deaths of and Serious Injuries to Persons with 
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COMMI'ITEE AMENDMENT" A 
"to H.P. 1164, L.D. 1676 
Intellectual Disabilities or Autism. The panel consists of 14 members, including a panel 
coordinator who is an employee of the Department of Health and Human Services, Maine 
Center for Disease Control and Prevention and is a registered nurse and a member 
appointed by the Maine Developmental Services Oversight and Advisory Board. Other 
members of the panel are appointed by the Governor, the President of the Senate and the 
Speaker of the House of Representatives. Terms are for 3 years, and members receive 
expenses if they are not already compensated by their employers. The panel coordinator 
must review all cases of death of and serious injury to persons with intellectual 
disabilities or autism receiving adult developmental services and determine those that 
require further review by the panel. Other individuals may refer cases to the panel, and 
the panel may choose additional cases from the list of cases provided by the panel 
coordinator. The panel has access to records necessary for the review. The panel must 
provide reports to the Commissioner of Health and Human Services and the Maine 
Developmental 
Services 
Oversight 
and Advisory Board with findings 
and 
recommendations. The panel is required to provide reports to the Legislature on an 
annual basis and may provide trend analyses to the Legislatu.-re as necessary. Legislative 
reports are public documents. 
The amendment also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Revised: 04/13/18 feae.. 
LD 1676 
LR2500(02) 
An Act To Reestablish the Office of Advocacy within the Department of Health and Human Services 
Fiscal Note for Bill as Amended by Committee Amendment ,f/, (JI· 7 h ~ 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2017-18 
FY 2018-19 
$0 
$91,185 
$0 
$91,185 
Projections 
FY2019-20 
$93,888 
$93,888 
Projections 
FY2020-21 
$96,477 
$96,477 
The bill includes General Fund appropriations to the Department of Health and Human Services of $91, 18 5 in fiscal 
year 2018-19 for one Health Services Consultant position to be the panel coordinator for the Panel to Review Deaths 
and Serious Injuries. 
Any additional costs to the Depaitment of the Attomey General can be absorbed within existing budgeted resources. 
LR2500(02) - Fiscal Note - Page 1 of 1