An Act To Improve Access to Services for Adults with Serious and Persistent Mental Illness
Maine Legislature, Session 128, LD 1911
Committee: Health and Human Services
Sponsors: MALABY
Amends: 34-B MRSA §3613

Legislative Document
No. 1911
H.P. 1350
House of Representatives, April 18, 2018
An Act To Improve Access to Services for Adults with Serious and 
Persistent Mental Illness
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative MALABY of Hancock.  (GOVERNOR'S BILL)
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  34-B MRSA §3613 is enacted to read:
§3613.  Access to services
1.  Department review.  An adult with serious and persistent mental illness, as 
defined in rules adopted by the department pursuant to this section, who is receiving or is 
eligible to receive mental health services from a provider operating an agency, facility or 
program under contract with the department may seek department review of the 
provider's actions in the following circumstances:
A.  When the provider refuses to accept a referral to provide a mental health service 
for which the adult is clinically eligible that is included in rules of the department 
governing the MaineCare program or otherwise required to be provided under the 
terms of the provider's contract with the department and that the adult's treatment or 
discharge planning team has determined is necessary in order for that adult to 
transition from a hospital into the community, unless accepting the referral would 
cause the provider to exceed preestablished staff-client ratios required by law, rule or 
contract or unless the service is a residential service and the provider has no 
vacancies;
B.  When the provider refuses to accept a referral to provide community integration 
services or assertive community treatment as defined in section 3801, subsection 11 
to an adult with serious and persistent mental illness who is clinically eligible for the 
services, unless accepting the referral would cause the provider to exceed 
preestablished staff-client ratios required by law, rule or contract; or
C.  When the provider terminates or suspends a mental health service included in 
rules of the department governing the MaineCare program or otherwise required to be 
provided under the terms of the provider's contract with the department in violation of 
the terms of that contract.
2.  Private right of action.  An adult with serious and persistent mental illness who 
is aggrieved by the action of a provider as described in subsection 1 and whose access to 
services has not been resolved following department review may bring a private civil 
action in District Court to restrain or enjoin a provider by restraining order or injunction, 
temporarily or permanently, or enforce by restraining order or injunction, temporarily or 
permanently, the terms of the provider's contract with the department.
A.  An individual bringing an action under this subsection is not required to allege or 
prove that the refusal, termination or suspension of services would cause irreparable 
injury or harm to that individual.
B.  An individual bringing an action under this subsection is not required to post a 
bond.
C.  The remedies available in an action under this subsection include both mandatory 
and prohibitory injunctive relief.
D.  An individual who obtains injunctive relief in an action under this subsection may 
recover reasonable attorney's fees and costs, not to exceed $1,000, from the provider 
against whom judgment was entered.
E.  An individual who brings an action under this subsection is not liable to the 
provider for damages resulting from bringing or pursuing the action unless the action 
was brought in bad faith or without a reasonable belief that the provider was not 
acting in compliance with its obligations under its contract with the department.
3.  Rulemaking.  The department shall adopt rules, which are routine technical rules 
pursuant to Title 5, chapter 375, subchapter 2-A, governing the process for department 
review described in this section.  The rules must include a definition of "adult with 
serious and persistent mental illness."
SUMMARY
This bill establishes the right of an adult with serious and persistent mental illness 
who is denied access to services by a provider contrary to the terms of the provider's 
contract with the Department of Health and Human Services to seek department review 
of that action.  If department review does not resolve the matter, the consumer may bring 
a private right of action in District Court for injunctive relief.