An Act To Support Early Intervention and Treatment of Mental Health Disorders
Maine Legislature, Session 129, LD 1461
Committee Amendment CA_A-SA_A_S300 (Senate)
Amends: 22 MRSA §3174-C

SENATE AMENDMENT" A "to COMMITTEE AMENDMENT "A" to S.P. 446, 
L.D. 1461, Bill, "An Act To Support Early Intervention and Treatment of Mental Health 
Disorders" 
Amend the amendment by striking out everything after the title and before the last 
indented paragraph and inserting the following: 
'Amend the bill by striking out all of section 1 and inserting the following: 
'Sec. 1. 22 MRSA §3174-CCC is enacted to read: 
§3174-CCC. Coordinated specialty care reimbursement 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. 
"Coordinated specialty care" means an evidence-based recovery-oriented 
treatment model for individuals in the early years of a psychotic disorder that 
promotes shared decision making with a team of specialists to work with an 
individual to develop a personalized treatment plan. 
B. "Psychotic disorder" means a diagnosis of schizophrenia spectrum disorder and 
other psychotic disorders or mood disorders with prominent psychotic features. 
2. 
Coordinated specialty care. 
Beginning July 1, 2020, the department shall 
reimburse for coordinated specialty care for the treatment of MaineCare members within 
the first 3 years of onset of a psychotic disorder. A MaineCare member receiving 
coordinated specialty care under this section must receive all of the following services: 
A. Case management to manage services to help the MaineCare member develop 
problem-solving skills and manage medication; 
B. Family support to give the family of the MaineCare member information and 
skills to support the member receiving treatment and recovery services; 
C. Psychotherapy services that teach resiliency, managing the psychotic disorder, 
promoting wellness and developing coping skills; 
D. 
Medication management to determine the most effective medication and the 
lowest dosage to be effective; 
SENATE AMENDMENT 
Pt ot S. 
SENATE AMENDMENT "A "to COMMITTEE AMENDMENT "A" to S.P. 446, L.D. 1461 ( S · '3LiD) 
E. Suwort services to help a MaineCare member continue education or employment 
or return to education or employment; and 
F. Peer support services to connect the MaineCare member with others who have 
similar experiences. 
3. 
Bundled reimbursement rate. 
The department, in cooperation with the 
Department of Education and the Department of Labor, shall establish a bundled 
reimbursement rate for any services identified in subsection 2, paragraphs A to F that are 
not otherwise covered under MaineCare. In establishing the bundled rate, the department 
shall consider various structures of a bundled rate model, including, but not limited to, a 
daily rate or a monthly rate. 
4. Funds. The department may review, develop or apply for any source of funds that 
may be available to implement reimbursement for services under this section that are not 
otherwise covered under MaineCare. 
5. 
Evaluation assessment. 
The department shall ensure that an organization 
providing coordinated specialty care provides program evaluation assessments to the 
department. including external ratings of fidelity to the coordinated specialty care model 
and reports of clinical and functional outcomes. 
6. Rules. The department may 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.' 
Amend the bill in section 2 in the first line (page 2, line 18 in L.D.) by striking out 
the following: "The" and inserting the following: 'No later than 90 days after the effective 
date of this Act, the' 
Amend the bill in section 2 in the last 2 lines (page 2, lines 22 and 23 in L.D.) by 
striking out the following: "34-B, chapter 16. The department shall maximize coverage 
of services under the MaineCare program and private insurance" and inserting the 
following: '22, section 317 4-CCC' 
Amend the bill in section 3 in the 5th and 6th lines (page 2, lines 28 and 29 in L.D.) 
by striking out the following: "34-B, chapter 16 that are not otherwise covered by the 
MaineCare program or private insurance" and inserting the following: '22, section 317 4-
CCC that are not otherwise covered by the MaineCare program' 
Amend the bill by adding after section 3 the following: 
'Sec. 4. 
Bundled reimbursement rate. 
No later than July 1, 2020, the 
Department of Health and Human Services shall establish a bundled reimbursement rate 
for services in accordance with the Maine Revised Statutes, Title 22, section 3174-CCC. 
Sec. 5. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Medical Care-Payments to Providers 0147 
Initiative: Provides appropriations to reimburse for the treatment of MaineCare members 
showing early signs of a psychotic disorder using a coordinated specialty care model. 
SENATE AMENDMENT 
~. ot s. 
SENATEAMENDMENT"Jq "toCOMMITTEEAMENDMENT"A"toS.P.446,L.D.1461( S · 3oG) 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
SUMMARY 
2019-20 
$0 
$0 
2020-21 
$307,094 
$307,094 
This amendment amends the committee amendment. This amendment retains the 
emergency preamble and emergency clause and, as in the committee amendment and the 
bill, requires the Department of Health and Human Services to establish a reimbursement 
rate for a coordinated specialty care model to treat individuals showing early signs of 
psychotic disorder. Services must be evidence-based and treat both the individual and the 
family. 
Under this amendment, the Department of Health and Human Services is 
directed, in cooperation with the Department of Education and the Department of Labor 
and no later than July 1, 2020, to establish a bundled rate to reimburse for services 
provided under the coordinated specialty care model that are not otherwise covered under 
the MaineCare program. This amendment moves the statutory requirements for the 
reimbursement to the Maine Revised Statutes, Title 22. This amendment retains the 
requirement that the Department of Health and Human Services apply to the United 
States Department of Health and Human Services, Centers for Medicare and Medicaid 
Services for any necessary waivers and state plan amendments and to seek federal 
funding under the community mental health services block grant but changes cross-
references and requires that necessary applications be submitted no later than 90 days 
after the effective date of this legislation. 
The amendment also changes the appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(; 
(Se~~,c~ 
SPONSORBDBY:~~~~~-
(Senator BREEN) 
( / 
COUNTY: Cumberland 
V 
SENATE AMENDMENT 
Approved: 06/14/19 ;/Wae!. 
LD 1461 
LR 436(05) 
An Act To Support Early Intervention and Treatment of Mental Health Disorders 
Fiscal Note for Senate Amendment "A' to Committee Amendment "A" {S--3DDJ 
Sponsor: Sen. Breen of Cumberland 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2019-20 
FY2020-21 
($1,210,798) 
($903,704) 
($1,210,798) 
($903,704) 
Projections 
FY 2021-22 
($903,704) 
($903,704) 
Projections 
FY2022-23 
($903,704) 
($903,704) 
The amendment changes the individuals who would be eligible for reimbursement for the treatment of individuals 
showing early signs of a psychotic disorder using a coordinated specialty care model from non-MaineCare to 
MaineCare and changes the start date of the program to July 1, 2020 which reduces the ongoing General Fund 
appropriations to the Department of Health and Human Services by $1,210,798 in fiscal year 2019-20 and by 
$903,704 in fiscal year 2020-21. 
LR0436(05) - Fiscal Note - Page 1 of 1