An Act To Allow Qualifying Medicaid Recipients To Hire Relatives and Legal Guardians for Consumer-directed Attendant Services
Maine Legislature, Session 128, LD 1708
Committee: Health and Human Services
Sponsors: COREY, DIAMOND, BICKFORD, BRYANT, FAY, MALABY, MARTIN, NADEAU, VACHON, BREEN
Amends: 22 MRSA §3174-A

Legislative Document
No. 1708
H.P. 1188
House of Representatives, December 22, 2017
An Act To Allow Qualifying Medicaid Recipients To Hire Relatives 
and Legal Guardians for Consumer-directed Attendant Services
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203.
Received by the Clerk of the House on December 19, 2017.  Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint 
Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative COREY of Windham.
Cosponsored by Senator DIAMOND of Cumberland and
Representatives: BICKFORD of Auburn, BRYANT of Windham, FAY of Raymond, 
MALABY of Hancock, MARTIN of Eagle Lake, NADEAU of Winslow, VACHON of 
Scarborough, Senator: BREEN of Cumberland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3174-AAA is enacted to read:
§3174-AAA.  Eligible caregivers
1.  Definition.  For the purposes of this section, "consumer-directed attendant 
services" means services that are reimbursable under the MaineCare program and provide 
assistance with the activities of daily living in the home or community for a MaineCare 
member who directly employs and trains the attendant, supervises the provision of 
reimbursable services and, if necessary, terminates the services of the attendant.
2.  Relatives or legal guardians as attendants.  A MaineCare member approved for 
consumer-directed attendant services under the MaineCare program may employ a family 
member, including a spouse, parent, stepparent, adult child and other legally responsible 
relative, or the legal guardian of the member as an attendant to be reimbursed by the 
MaineCare program.
3.  Rulemaking.  The department shall adopt rules 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. 2.  Waiver request.  No later than January 1, 2019, the Department of Health 
and Human Services shall submit a waiver request to the United States Department of 
Health and Human Services, Centers for Medicare and Medicaid Services that requests 
approval for Medicaid reimbursement for employment of a relative or legal guardian 
providing consumer-directed attendant services to a MaineCare member receiving those 
services under rule Chapter 101:  MaineCare Benefits Manual, Chapter II, Section 12.  
The department shall take all reasonable and necessary steps to seek approval of the 
waiver.
Sec. 3.  Rulemaking.  Within 180 days of receiving approval for coverage by the 
United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services pursuant to a waiver request in accordance with this Act, the 
Department of Health and Human Services shall adopt rules to implement the Maine 
Revised Statutes, Title 22, section 3174-AAA.  Rules adopted pursuant to this section are 
routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.
Sec. 4.  Contingent effective date.  That section of this Act that enacts the Maine 
Revised Statutes, Title 22, section 3174-AAA takes effect only if the United States 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
approves a waiver request submitted in accordance with this Act.  Upon approval of the 
waiver request, the Commissioner of Health and Human Services shall notify the 
Secretary of State, the Secretary of the Senate, the Clerk of the House of Representatives 
and the Revisor of Statutes of that fact.
SUMMARY
This bill allows a MaineCare member approved for consumer-directed attendant 
services under the MaineCare program to hire any family member, including a spouse, or 
a legal guardian to provide those services in the home or community.  It requires the 
Department of Health and Human Services to submit a waiver request to the United 
States Department of Health and Human Services, Centers for Medicare and Medicaid 
Services no later than January 1, 2019.  The department is required to adopt rules within 
days of receiving approval for the waiver.