An Act To Ensure Access to Community Services for Persons with Intellectual Disabilities or Autism
Maine Legislature, Session 128, LD 0967
Committee: Health and Human Services
Sponsors: HERBIG, HAMPER, CEBRA, FREY, GATTINE, HARVELL, HYMANSON, MALABY, LIBBY
Amends: 22 MRSA §3195

Legislative Document
No. 967
H.P. 680
House of Representatives, March 9, 2017
An Act To Ensure Access to Community Services for Persons with 
Intellectual Disabilities or Autism
(EMERGENCY)
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative HERBIG of Belfast.
Cosponsored by Senator HAMPER of Oxford and
Representatives: CEBRA of Naples, FREY of Bangor, GATTINE of Westbrook, HARVELL 
of Farmington, HYMANSON of York, MALABY of Hancock, Senator: LIBBY of 
Androscoggin.
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, the people of the State expect and need to ensure that high-quality care is 
provided in community-based care settings for vulnerable persons with intellectual 
disabilities or autism; and 
Whereas, reimbursement rates paid for community-based services for persons with 
intellectual disabilities or autism have been reduced by 12% relative to rates established 
in 2007, while the federal Consumer Price Index medical care services index has 
increased by 17% since 2007; and 
Whereas, the capacity of community-based providers to serve persons with 
intellectual disabilities or autism has been impaired by declining reimbursement rates and 
increased costs beyond the control of those providers; and 
Whereas, in order to provide high-quality care to persons with intellectual 
disabilities or autism, the Legislature must take prompt action to correct chronic 
underfunding and to ensure the continued viability of these providers; 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: 
Sec. 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. 
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; 
C.  Are based upon the costs and reimbursement levels under the methodology and 
findings contained in a report by the department pursuant to Public Law 2005, 
chapter 12, Part CCCC, section 1 and implemented in 2007, adjusted for the 
cumulative increase in costs measured by the United States Department of Labor, 
Bureau of Labor Statistics, Consumer Price Index medical care services index in each 
year from 2007 to 2016; 
D.  Provide for and reflect, for each state fiscal year ending after 2016, an annual 
inflation adjustment using a regional inflation factor established by a national 
economic research organization; and 
E.  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. 
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill requires the Department of Health and Human Services to reimburse 
services provided to MaineCare member adults with intellectual disabilities or autistic 
disorder 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 criteria 
established in the bill.  The bill also directs the department to adopt rules providing 
reimbursement rates that take into account specified costs of care and service; suffice to 
ensure access, including compliance with federal standards; are based on a 2007 report of 
the department adjusted for cost increases from 2007 to 2016; provide future annual 
inflation adjustments; and consider competitive wage markets, training and qualification 
requirements and increased costs of new technologies.