Resolve, To Develop a Plan To Improve Service Delivery to Individuals Receiving Medicaid Home and Community-based Services
Maine Legislature, Session 129, LD 1202
Committee: Health and Human Services
Sponsors: FARNSWORTH, BRENNAN, COOPER, CRAVEN, CROCKETT, HANDY, MADIGAN, PERRY, RECKITT

Legislative Document
No. 1202
H.P. 866
House of Representatives, March 12, 2019
Resolve, To Develop a Plan To Improve Service Delivery to 
Individuals Receiving Medicaid Home and Community-based 
Services
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative FARNSWORTH of Portland.
Cosponsored by Representatives: BRENNAN of Portland, COOPER of Yarmouth, CRAVEN 
of Lewiston, CROCKETT of Portland, HANDY of Lewiston, MADIGAN of Waterville, 
PERRY of Calais, RECKITT of South Portland.
Preamble. Whereas, the United States Department of Health and Human Services, 
Centers for Medicare and Medicaid Services adopted home and community-based 
settings rules in 2014 that the State must comply with by March 17, 2022; and
Whereas, the rules are intended to ensure that individuals receiving long-term 
services and supports through Medicaid home and community-based service programs 
have full access to the benefits of community living and the opportunity to receive 
services in the most integrated setting; and
Whereas, the rules require the Department of Health and Human Services to 
develop, with stakeholder input and Centers for Medicare and Medicaid Services 
approval, a transition plan to bring the State into full compliance; and
Whereas, the State submitted proposed transition plans in 2014 and 2016 but has 
not received approval from the Centers for Medicare and Medicaid Services; and
Whereas, implementing the rules will be a complex process requiring significant 
changes to how services are delivered in the State; now, therefore, be it
Sec. 1.  Stakeholder group for working plan created.  Resolved:  That the 
Department of Health and Human Services, referred to in this resolve as "the 
department," shall convene a stakeholder group to develop a working plan to implement 
the United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services home and community-based settings rules in the State.  The 
department shall provide staff support for the stakeholder group, including but not limited 
to a facilitator and administrative support.
Sec. 2.  Membership.  Resolved:  That the membership of the stakeholder group 
under section 1 consists of the following:
1.  Two members of the Senate, appointed by the President of the Senate;
2.  Two members of the House of Representatives, appointed by the Speaker of the 
House; and
3.  A member receiving services under each home and community-based waiver, 
including department rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, 
Sections 18, 19, 20, 21 and 29.
The department shall also invite the participation of at least one representative from 
each of the following organizations:  Developmental Disabilities Partners for Positive 
Change within Disability Rights Maine; the Maine Developmental Disabilities Council; 
the University of Maine Center for Community Inclusion and Disability Studies; 
Speaking Up For Us of Maine; the Acquired Brain Injury Advisory Council under the 
Maine Revised Statutes, Title 34-B, section 19001; the Maine Long-Term Care 
Ombudsman Program; and the Maine Association for Community Service Providers.
Sec. 3.  Duties.  Resolved:  That the stakeholder group under section 1 shall 
investigate and develop a plan for the department to fully comply with the United States 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
home and community-based settings rules and bring best practices to the State by:
1.  Reviewing information about home and community-based settings best practices 
in other states;
2.  Reviewing the State's most recently submitted transition plan and making 
recommendations on how to revise the plan for resubmission to the Centers for Medicare 
and Medicaid Services; and
3.  Reviewing and making specific recommendations regarding:
A.  Changes needed to the person-centered planning process;
B.  Combining multiple target populations into one home and community-based 
settings waiver;
C.  System changes needed to ensure home and community-based services recipients 
have community access to the same extent as others, including but not limited to 
individuals' having leases, choice of providers, opportunities to seek employment, 
opportunities to engage in community life and to control personal resources and 
choice of roommates;
D.  Identification of the support service providers who will need to come into full 
compliance with the home and community-based settings rules; and
E.  Quality assurance mechanisms and regulatory changes needed, and the fiscal 
implications of those changes, to enable the implementation of the home and 
community-based settings rules. 
Sec. 4.  Report.  Resolved:  That the department shall submit a report on the 
findings and recommendations of the stakeholder group under section 1, including any 
recommended legislation, to the Joint Standing Committee on Health and Human 
Services by January 15, 2020.  The committee may submit a bill related to the report to 
the Second Regular Session of the 129th Legislature.
SUMMARY
This resolve directs the Department of Health and Human Services to convene a 
stakeholder group to review the Medicaid home and community-based settings rules, 
review past efforts by the State to come into compliance with those rules and make 
recommendations about how to bring the State into compliance and recommendations on 
necessary statutory and regulatory changes.  The department is required to submit a report 
by January 15, 2020 to the Joint Standing Committee on Health and Human Services, 
which may submit a bill to the Second Regular Session of the 129th Legislature.