An Act To Eliminate Waiting Lists for Home and Community-based Services for Adults with Intellectual Disabilities, Autism, Brain Injury and Other Related Conditions
Maine Legislature, Session 129, LD 1984
Committee: Health and Human Services
Sponsors: MILLETT, HYMANSON, BELLOWS, CARPENTER, CLAXTON, HERBIG, JACKSON, VITELLI, GATTINE, TIPPING
Amends: 34-B MRSA §5003-A

Legislative Document
No. 1984
S.P. 686
In Senate, January 8, 2020
An Act To Eliminate Waiting Lists for Home and Community-based 
Services for Adults with Intellectual Disabilities, Autism, Brain 
Injury and Other Related Conditions
(EMERGENCY)
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203.
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator MILLETT of Cumberland.
Cosponsored by Representative HYMANSON of York and
Senators: BELLOWS of Kennebec, CARPENTER of Aroostook, CLAXTON of 
Androscoggin, HERBIG of Waldo, President JACKSON of Aroostook, VITELLI of 
Sagadahoc, Representatives: GATTINE of Westbrook, TIPPING of Orono.
Emergency preamble.  Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, persons with disabilities have the right to dignity, and to receive the 
support they need to work and to be otherwise included in their communities; and
Whereas, many persons with disabilities have an urgent need for adult home and 
community-based services to provide support and to enable their family members to 
work; and
Whereas, as of November 2019 there were nearly 2,000 persons on the MaineCare 
Section 29, Section 21, Section 20 and Section 18 waiver waiting lists for adult home and 
community-based services; 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.  34-B MRSA §5003-A, sub-§1, as amended by PL 2011, c. 542, Pt. A, 
§83, is further amended to read:
1.  System of care.  The Legislature declares that the system of care through which 
the State provides services to and programs for persons with intellectual disabilities or 
autism must be designed to protect the integrity of the legal and human rights of these 
persons and to meet their needs consistent with the principles guiding delivery of services 
as set forth in section 5610.  The Legislature further declares that:
A.  It is the policy of the State not to impose any policy, rule, regulation or restriction 
that interferes with the opportunity for persons with intellectual disabilities or autism 
to live in the community and lead an independent life;
B.  It is the policy of the State not to impose a waiting list or other mechanism that 
delays or restricts access of persons with intellectual disabilities or autism to a 
community-based long-term service or support; and
C.  It is the policy of the State to establish an adequate rate or other payment structure 
that is necessary to ensure the availability of a workforce sufficient to support a 
person with intellectual disabilities or autism in living in the community and leading 
an independent life.
Sec. 2.  34-B MRSA §5003-A, sub-§2, ¶F, as amended by PL 2011, c. 542, Pt. 
A, §83, is further amended to read:
F.  Strive toward having a sufficient number of personnel who are qualified and 
experienced to provide treatment that is beneficial to persons with intellectual 
disabilities or autism; and
Sec. 3.  34-B MRSA §5003-A, sub-§2, ¶G, as amended by PL 2011, c. 542, Pt. 
A, §83, is further amended to read:
G.  Encourage other departments to provide to persons with intellectual disabilities or 
autism those services that are required by law, and in particular:
(1)  The commissioner shall work actively with the Commissioner of Education 
to ensure that persons with intellectual disabilities or autism receive appropriate 
services upon being diagnosed with either disability regardless of the degree of 
functional limitation or accompanying disabilities;
(2)  The commissioner shall advise other departments about standards and 
policies pertaining to administration, staff, quality of care, quality of treatment, 
health and safety of clients, rights of clients, community relations and licensing 
procedures and other areas that affect persons with intellectual disabilities or 
autism residing in facilities licensed by the department; and 
(3)  The commissioner shall inform the joint standing committee of the 
Legislature having jurisdiction over human resources matters about areas where 
increased cooperation by other departments is necessary in order to improve the 
delivery of services to persons with intellectual disabilities or autism.;
Sec. 4.  34-B MRSA §5003-A, sub-§2, ¶H is enacted to read:
H.  Post at least monthly on the department's publicly accessible website, for each 
home and community-based services waiver from the United States Department of 
Health and Human Services, Centers for Medicare and Medicaid Services in which 
the State participates, data on how many persons were on a waiting list for services 
on the first day of that month, including, for prioritized waiting lists, how many 
persons were in each prioritization category; and
Sec. 5.  34-B MRSA §5003-A, sub-§2, ¶I is enacted to read:
I.  Post at least monthly on the department's publicly accessible website, for each 
home and community-based services waiver from the United States Department of 
Health and Human Services, Centers for Medicare and Medicaid Services in which 
the State participates, data on the average time from application for waiver services to 
receipt of the same waiver services.
Sec. 6.  34-B MRSA §5003-A, sub-§3, ¶F, as amended by PL 2011, c. 542, Pt. 
A, §83, is further amended to read:
F.  The plan must include an assessment of the roles and responsibilities of 
intellectual disability and autism agencies, human service agencies, health agencies 
and involved state departments and suggest ways in which these departments and 
agencies can better cooperate to improve the service systems.  The assessment must 
include quality metrics and data collection developed with input from across 
stakeholder groups as described in paragraphs G and H.
Sec. 7.  34-B MRSA §5003-A, sub-§3, ¶H, as amended by PL 2011, c. 542, Pt. 
A, §83, is further amended to read:
H.  The commissioner must shall ensure that the development of the plan includes the 
participation of community intellectual disability and autism service providers, 
consumer and family groups and other interested persons or groups in annual 
statewide hearings, as well as informal meetings and work sessions.  The plan must 
describe how the commissioner achieved this inclusion and what feedback the 
department received from participants in each of these groups.
Sec. 8.  34-B MRSA §5003-A, sub-§3, ¶J is enacted to read:
J.  The plan must project whether, given current budget projections and anticipated 
demographic changes, there will be any waiting lists for adult developmental services 
over the next 4 years and how many people are projected to be on those waiting lists 
over that period of time.  For prioritized waiting lists, the plan must indicate how 
many persons are projected to be in each prioritization category and how many 
persons would be in a different prioritization category except for their currently living 
with a parent.
Sec. 9.  34-B MRSA §5003-A, sub-§3, ¶K is enacted to read:
K.  The plan must indicate what additional budgeted resources would be required to 
eliminate any waiting lists, if such waiting lists exist or are projected to exist over the 
next 4 years.  The budget projections must detail any anticipated savings that can be 
realized from a less expensive adult developmental service when a person 
relinquishes that less expensive adult developmental service in order to receive more 
comprehensive support from another adult developmental service.
Sec. 10.  34-B MRSA §5003-A, sub-§3, ¶L is enacted to read:
L.  The plan may consider how home and community-based services may be 
redesigned to promote self-determination by persons with intellectual disabilities or 
autism, to promote less restrictive placements over more restrictive placements and to 
promote competitive integrated employment by persons with intellectual disabilities 
or autism.
Sec. 11.  34-B MRSA §5003-A, sub-§7 is enacted to read:
7.  Committee authorized to introduce legislation.  The joint standing committee 
of the Legislature having jurisdiction over health and human services matters is 
authorized to introduce a bill in each first regular session of the Legislature and a bill in 
each second regular session of the Legislature to address the system of care for persons 
with intellectual disabilities or autism.
Sec. 12.  Department of Health and Human Services to amend rules.  The 
Department of Health and Human Services shall amend 10-144 C.M.R. Chapter 101, 
MaineCare Benefits Manual, Chapters II and III, Section 18 and Section 20 to reduce and 
eliminate waiting lists for home and community-based services for adults with brain 
injury and other related conditions.
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved.
SUMMARY
This bill amends the system of care for adults with intellectual disabilities, autism, 
brain injury and other related conditions to reduce and eliminate MaineCare waiver 
waiting lists for home and community-based services.