Resolve, To Increase Access to Brain Injury Waiver Services
Maine Legislature, Session 128, LD 1000
Committee Amendment CA_A_H295 (House)

COMMITTEE AMENDMENT"~" to H.P. 701, L.D. 1000, "Resolve, To Increase 
Access to Brain Injury Waiver Services" 
Amend the resolve by striking out all of section 1 and inserting the following: 
'Sec. 1. 
Department of Health and Human Services to increase 
MaineCare rates. Resolved: That, upon approval of a waiver amendment from the 
United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services, the Department of Health and Human Services shall amend its rules 
in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 18, Allowances for 
Home and Community Based Services for Adults with Brain Injury, to increase rates for 
Home Support (Residential Habilitation) Level I to no less than $8.63 per quarter hour. 
The rules must specify that the increase in reimbursement rates must be applied to wages 
and benefits for direct support employees. 
For the purposes of this resolve, "direct 
support employees" means all employees who work directly with individuals on the 
waiver and receiving services in the home but does not include administrators and 
contract labor. Rules adopted pursuant to this section are routine technical rules pursuant 
to the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A; and be it further' 
Amend the resolve in section 3 in the last line (page 1, line 22 in L.D.) by striking out 
the following: "personnel." and inserting the following: 'personnel; and be it further" 
Amend the resolve by adding after section 3 the following: 
'Sec. 4. Department of Health and Human Services to submit waiver 
amendment. Resolved: That the Department of Health and Human Services shall 
submit a request to the United States Department of Health and Human Services, Centers 
for Medicare and Medicaid Services no later than October 1, 2017 to request approval to 
amend the brain injury waiver, rule Chapter 101: MaineCare Benefits Manual, Chapter 
III, Section 18, to increase MaineCare reimbursement rates pursuant to section 1; and be 
it further 
Sec. 5. Increase to employee wages. Resolved: That, to qualify for the rate 
increase pursuant to section 1, an agency providing direct suppmi employees must 
COMMITTEE AMENDMENT 
COMMIITEE AMENDMENT «A "to H.P. 701, L.D. 1000 
demonstrate, to the satisfaction of the Department of Health and Human Services, that an 
increase in wages and benefits for direct support employees has been granted that equals 
the amount of increase received as a result of the increased reimbursement. The increase 
must be granted or paid out retroactively from the date the Department of Health and 
Human Services begins reimbursing at the increased rates; and be it further 
Sec. 6. 
Appropriations and allocations. 
Resolved: 
That the following 
appropriations and allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS) 
Medicaid Waiver for Brain Injury Residential/Community Serv Z160 
Initiative: Provides funding to increase the rates for services provided under the brain 
injury waiver, Chapter 101: MaineCare Benefits Manual, Chapter III, Section 18 for 
members receiving Home Support (Residential Habilitation) Level I to no less than $8.63 
per quarter hour and to allow up to 400 units of care coordination each year. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY BDS) 
DEPARTMENT TOTALS 
GENERAL FUND 
DEPARTMENT TOTAL - ALL FUNDS 
2017-18 
$233,169 
$233,169 
2017-18 
$233,169 
$233,169 
2018-19 
$310,997 
$310,997 
2018-19 
$310,997 
$310,997 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
Medical Care - Payments to Providers 0147 
Initiative: Provides funding to increase the rates for services provided under the brain 
injury waiver, Chapter 101: MaineCare Benefits Manual, Chapter III, Section 18 for 
members receiving Home Support (Residential Habilitation) Level I to no less than $8.63 
per quarter hour and to allow up to 400 units of care coordination each year. 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
2017-18 
$506,052 
$506,052 
COMMITTEE AMENDMENT 
2018-19 
$674,631 
$674,631 
COMMITIEE AMENDMENT ·A- "to H.P. 701, L.D. 1000 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY DHS) 
DEPARTMENT TOTALS 
FEDERAL EXPENDITURES FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
SECTION TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
OTHER SPECIAL REVENUE FUNDS 
SECTION TOTAL - ALL FUNDS 
SUMMARY 
2017-18 
$47,184 
$47, 184 
2017-18 
$506,052 
$47,184 
$553,236 
2017-18 
$233,169 
$506,052 
$47,184 
$786,405 
2018-19 
$62,912 
$62,912 
2018-19 
$674,631 
$62,912 
$737,543 
$310,997 
$674,631 
$62,912 
$1,048,540 
This amendment clarifies that the Department of Health and Human Services must 
seek approval from the United States Department of Health and Human Services, Centers 
for Medicare and Medicaid Services to amend the brain injury waiver to increase Home 
Support (Residential Habilitation) Level I rates to no less than $8.63 per quarter hour. It 
requires the increase in reimbursement to go to direct support employees. 
This amendment also provides funding to increase the rates. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/20/17 feac. 
LD 1000 
LR 1174(02) 
Resolve, To Increase Access to Brain Injury Waiver Services 
Fiscal Note for Bill as Amended by Committee Amendment ,A, { /J-lC)S-) 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Other Special Revenue Funds 
Revenue 
Federal Expenditures Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2017-18 
$233,169 
$233,169 
$506,052 
$47,184 
$506,052 
$47,184 
FY 2018-19 
$310,997 
$310,997 
$674,631 
$62,912 
$674,631 
$62,912 
Projections 
FY 2019-20 
$310,997 
$310,997 
$674,631 
$62,912 
$674,631 
$62,912 
Projections 
FY 2020-21 
$310,997 
$310,997 
$674,631 
$62,912 
$674,631 
$62,912 
The bill includes General Fund appropriations to the Department of Health and Human Services of $23 3, 169 in fiscal 
year 2017-18 and $310 ,997 in fiscal year 2018-19 to increase the rates for services provided under the brain injury 
waiver, Chapter 101: MaineCare Benefits Manual, Chapter III, Section 18 for members receiving Home Support 
(Residential Habilitation) Level I to no less than $8.63 per quarter hour and to allow up to 400 units of care 
coordination each year. Federal Expenditures Fund allocations are also included for the FMAP match and Other 
Special Revenue Funds allocations are included for the service provider tax. 
T ."R 1174(0?'\ - Fi~"·"l NntP. - l>>10-A 1 nf 1