An Act Making Certain Supplemental Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government
Maine Legislature, Session 128, LD 0924
Committee Amendment CA_A_H790 (House)
Amends: 22 MRSA §3195

COMMITTEE AMENDMENT .. ff,, to H.P. 652, L.D. 924, Bill, "An Act Making 
Certain Supplemental Appropriations and Allocations and Changing Certain Provisions 
of the Law Necessary to the Proper Operations of State Government" 
Amend the bill by striking out everything after the title and inserting the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, this Act repeals Public Law 2017, chapter 284, Part V, section 2, which 
requires the State Controller to take action on or imniediately after July 1, 2018; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
Be it enacted by the People of the State of Maine as follows: 
PART A 
Sec. A-1. 22 MRSA §3195 is enacted to read: 
§3195. Compensation for care provided to persons with intellectual disabilities or 
autism 
1. 
Reimbursement. 
The department shall reimburse services provided to 
MaineCare member adults with intellectual disabilities or autism under a waiver granted 
by the federal Centers for Medicare and Medicaid Services for home-based and 
community-based care on the basis of rates and a methodology for application of the rates 
that reflects assessment of individual need and applies criteria for resource allocation 
established by the department pursuant to this section. This section applies to all funds, 
including federal funds, paid by any agency of the State to a provider for care covered by 
the waiver. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ,If,, to H.P. 652, L.D. 924 
2. Rulemaking. The department shall adopt rules providing reimbursement rates 
under this section that: 
A. Take into account the costs of providing care and services in conformity with 
applicable state and federal laws, rules, regulations and quality and safety standards; 
B. Are sufficient to ensure that an adequate number of providers of services are 
available to provide access to those services for all MaineCare members who require 
them, including without limitation compliance with all federal standards with regard 
to access to covered services under the Medicaid program; and 
C. Take into account competitive wage markets, state and federal requirements with 
regard to training and qualifications of staff, and increases in the cost of new 
technologies required and expected of providers since 2007. 
Rules adopted pursuant to this subsection are major substantive rules as defined in Title 
5, chapter 375, subchapter 2-A. 
Sec. A-2. Immediate rate increases. The Department of Health and Human 
Services shall increase reimbursement rates in accordance with this section, effective July 
1, 2018. 
1. Section 21 rules. The Department of Health and Human Services shall amend its 
rules to increase reimbursement rates above the rates in effect on the effective date of this 
Part for the following procedure codes provided in Chapter 101: MaineCare Bet1efits 
Manual, Chapter III, Section 21: 
A. T2017 home support; 
B. T2017 SC home support with medical add-on; 
C. T2017 GT home support- remote support; 
D. T2016 agency home support; 
E. T2016 agency home support over 168 hours; 
F. T2016 SC agency home support with medical add-on; 
G. S5140 shared living foster care, adult, one member; 
H. 
S5140 TG shared living foster care, adult, one member, increased level of 
support; 
I. S5140 UN shared living foster care, adult, 2 members; 
J. 
SS 140 UN TG shared living foster care, adult, 2 members, increased level of 
support; 
K. T2021 community support; 
L. T2021 SC community support with medical add-on; 
M. T2015 career planning; 
N. T2019 employment specialist services; 
0. T2019 SC employment specialist services with medical add-on; 
P. H2023 work support, individual; 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .. If., to H.P. 652, L.D. 924 
Q. H2023 SC work support with medical add-on; 
R. H2023 UN work support, group, 2 members; 
S. H2023 UP work support, group, 3 members; 
T. H2023 UQ work support, group, 4 members; 
U. H2023 UR work support, group, 5 members; 
V. H2023 US work support, group, 6 members; 
W. T2034 crisis intervention services; 
X. T2016 US home support, family-centered support, one member; 
Y. T2016 TG US home support, family-centered support, one member, increased 
level of support; 
Z. T2016 UN US home support, family-centered support, 2 members; 
AA. T2016 UN TG US home support, family-centered support, 2 members, increased 
level of support; 
BB. T2016 UP US home support, family-centered support, 3 members; 
CC. T2016 UP TG US home support, family-centered support, 3 members, increased 
level of support; 
DD. T2016 UQ US home support, family-centered support, 4 members; 
EE. T2016 UQ TG US home support, family-centered support, 4 members, increased 
level of support; 
FF. T2016 UR US home support, family-centered support, 5 or more members; and 
GG. T2016 UR TG US home support, family-centered support, 5 or more members, 
increased level of support. 
2. Section 29 rules. The Department of Health and Human Services shall amend its 
rules to increase reimbursement rates above the rates in effect on the effective date of this 
Part for the following procedure codes provided in Chapter 101: MaineCare Benefits 
Manual, Chapter III, Section 29: 
A. T2017 home support, 1/4 hour; 
B. T2017 GT home support, remote support; 
C. T2021 community support; 
D. T2021 SC community support with medical add-on; 
E. T2019 employment specialist services; 
F. T2019 SC employment specialist services with medical add-on; 
G. H2023 work support, individual; 
H. H2023 SC work support - supported employment with medical add-on; 
I. H2023 UN work support, group, 2 members; 
J. H2023 UP work support, group, 3 members; 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ·/f'• to H.P. 652, L.D. 924 
K. H2023 UQ work support, group, 4 members; 
L. H2023 UR work support, group, 5 members; 
M. H2023 US work support, group, 6 members; 
N. T2015 career planning; 
0. S5150 respite, 1/4 hour; and 
P. S5151 respite, per diem. 
3. Proportional increase. The increase in rates for the procedure codes specified in 
subsection 1 and subsection 2 must be accomplished in equal proportion using the 
funding provided for that purpose in this Part. 
4. Major substantive rules. Rules adopted pursuant to this section are major 
substantive rules as defined in the Maine Revised Statutes, Title 5, chapter 375, 
subchapter 2-A. 
Sec. A-3. Savings efforts. The Department of Health and Human Services and 
representatives of organizations of providers of community support services for 
individuals with intellectual disabilities and autism shall examine current reimbursement 
rates, costs of providing services, labor costs and administrative overhead costs to 
detennine opportunities for efficiencies and savings. The department and providers shall 
present a repo1t to the joint standing committee of the Legislature having jurisdiction over 
health and human services matters with findings no later than January 1, 2019. 
Sec. A-4. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Developmental Services Waiver - MaineCare Z211 
Initiative: Provides appropriations to increase the rates provided for home-based and 
community-based care for individuals with intellectual disabilities or autism. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Developmental Services Waiver - Supports Z212 
2017-18 
$0 
$0 
2018-19 
$20,100,152 
$20,100,152 
Initiative: Provides appropriations to increase the rates provided for home-based and 
community-based care for individuals with intellectual disabilities or autism. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2017-18 
$0 
$0 
COMMITTEE AMENDMENT 
2018-19 
$2,718,540 
$2,718,540 
COMMITTEE AMENDMENT .. If" to H.P. 652, L.D. 924 
Medicaid Services - Developmental Services Z210 
Initiative: Provides allocations to increase the rates provided for home-based and 
community-based care for individuals with intellectual disabilities or autism. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Medical Care - Payments to Providers 0147 
2017-18 
$0 
$0 
2018-19 
$4,644,239 
$4,644,239 
Initiative: Provides allocations to increase the rates provided for home-based and 
community-based care for individuals with intellectual disabilities or autism. 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
PARTB 
2017-18 
$0 
$0 
2017-18 
$0 
$0 
$0 
$0 
2018-19 
$49,941,047 
$49,941,047 
2018-19 
$22,818,692 
$49,941,047 
$4,644,239 
$77,403,978 
Sec. B-1. Reimbursement for personal care and related services. The 
Department of Health and Human Services shall amend its rules for reimbursement rates 
for personal care and related services provided under Chapter 101: MaineCare Benefits 
Manual, Sections 12, 19 and 96 and Chapter 5, Office of Elder Services Policy Manual, 
Section 63 to reflect the final rates modeled in the February 1, 2016 report "Rate Review 
for Personal Care and Related Services: Final Rate Models" prepared for the department 
by Bmns & Associates, Inc. Rules adopted pursuant to this section are routine technical 
rules pursuant to the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A. 
Sec. B-2. Deadline for increase established. The Department of Health and 
Human Services shall increase the reimbursement rates in accordance with section 1 of 
this Part, effective July 1, 2018. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT-:(}" to H.P. 652, L.D. 924 
Sec. B-3. Adjustment of monetary caps. 
The Department of Health and 
Human Services shall ensure that caps and limitations on home-based and community-
based services are increased to reflect increases in reimbursement rates that result from 
this Part. A recipient of services may not experience a reduction in hours solely as a 
result of increased reimbursement. 
Sec. B-4. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Long Term Care - Office of Aging and Disability Services 0420 
Initiative: Provides funding to increase rates for certain services effective July 1, 2018. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Medical Care- Payments to Providers 0147 
2017-18 
$0 
$0 
2018-19 
$884,176 
$884,176 
Initiative: Provides funding to increase rates for certain services effective July 1, 2018. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
DEPARTMENT TOTAL-ALL FUNDS 
2017-18 
$0 
$0 
2017-18 
$0 
$0 
2017-18 
$0 
$0 
$0 
COMMITTEE AMENDMENT 
2018-19 
$2,775,557 
$2,775,557 
2018-19 
$5,007,833 
$5,007,833 
2018-19 
$3,659,733 
$5,007,833 
$8,667,566 
COMMITTEE AMENDMENT "ir" to H.P. 652, L.D. 924 
PARTC 
Sec. C-1. PL 2017, c. 284, Pt. V, §2 is repealed. 
Sec. C-2. Appropriations and allocations. The following appropriations and 
allocations are made. 
CORRECTIONS, DEPARTMENT OF 
County Jails Operation Fund Z227 
Initiative: Appropriates funds for the County Jails Operation Fund program. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Reserve for County Jail Operations N266 
Initiative: Deallocates funds for county jail operations. 
OTHER SPECIAL REVENUE FUNDS 
Unallocated 
OTHER SPECIAL REVENUE FUNDS TOTAL 
CORRECTIONS, DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
2017-18 
$0 
$0 
2018-19 
$12,202,104 
$12,202,104 
2017-18 
2018-19 
$0 ($12,202,104) 
$0 ($12,202,104) 
2017-18 
2018-19 
$0 
$12,202,104 
$0 ($12,202,104) 
$0 
$0 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
SUMMARY 
This amendment replaces the bill, which was an emergency concept draft, to make 
various appropriations and allocations necessary for the proper operations of State 
Government. 
Part A requires the Department of Health and Human Services to increase the 
reimbursement rates for services provided for home-based and community-based care for 
individuals with intellectual disabilities or autism and provides funding to the department 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "H" to H.P. 652, L.D. 924 
due to the change in the rates. Federal Expenditures Fund allocations are also included for 
the federal medical assistance percentage match and Other Special Revenue Funds 
allocations for the service provider tax. 
Part B provides funding to the Department of Health and Human Services to increase 
rates for certain services to be effective July 1, 2018. 
Part C provides funding beginning in fiscal year 2018-19 for the County Jails 
Operation Fund program. It repeals the provision of law requiring the State Controller to 
make a one-time transfer of $12,202,104 in fiscal year 2018-19 from the General Fund to 
the Reserve for County Jail Operations program and makes a corresponding one-time 
Other Special Revenue Funds deallocation. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 06/15/18 fe.ac 
LD924 
LR 1297(02) 
An Act Malting Certain Supplemental Appropriations and Allocations and Changing Certain 
Provisions of the Law Necessary to the Proper Operations of State Government 
Fiscal Note for Bill as Amended by Committee Amendment f1,,(f!-1C/O) 
Committee: Appropriations and Financial Affairs 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures F:und 
Other Special Revenue Funds 
Revenue 
Federal Expenditures Fund 
Other Special Revenue Funds 
Transfers 
General Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2017-18 
FY 2018-19 
$0 
$26,478,425 
$0 
$38,680,529 
$0 
$54,948,880 
$0 
($7,557,865) 
$0 
$54,948,880 
$0 
$4,644,239 
$0 
$12,202, 104 
$0 
($12,202,104) 
Projections 
FY2019-20 
$38,680,529 
$38,680,529 
$54,948,880 
$4,644,239 
$54,948,880 
$4,644,239 
$0 
$0 
Projections 
FY2020-21 
$38,680,529 
$38,680,529 
$54,948,880 
$4,644,239 
$54,948,880 
$4,644,239 
$0 
$0 
Part A of the bill includes General Fund appropriations to the Department of Health and Human Services of 
$22,818,692 in fiscal year 2018-19 due to a change in the rates provided for home-based and community-based care 
for individuals with intellectual disabilities or autism. Federal Expenditures Fund allocations are also included for the 
FMAP match and Other Special Revenue Funds allocations for the service provider tax. 
Part B of the bill includes General Fund appropriations to the Department of Health and Human Services of 
$3,659, 733 beginning in fiscal year 2018-19 to increase rates for certain services to be effective July 1, 2018. Federal 
Expenditures Fund allocations are also included for the FMAP match. 
Part C of the bill includes an ongoing appropriation of $12,202,104 beginning in fiscal year 2018-19 for the County 
Jails Operation Fund program. It repeals the one-time transfer of $12,202,104 in fiscal year 2018-19 from the General 
Fund to the Reserve for County Jail Operations and removes the corresponding on,e-time Other Special Revenqe 
Funds allocation. 
LR1297(02) - Fiscal Note - Page 1 of 1