An Act To Implement the Recommendations of the Commission To Study Long-term Care Workforce Issues”
Maine Legislature, Session 129, LD 2109
Committee Amendment CA_A_H787 (House)

COMMITTEE AMENDMENT “      ” to H.P. 1504, L.D. 2109, Bill, “An Act To 
Implement the Recommendations of the Commission To Study Long-term Care 
Workforce Issues”
Amend the bill by striking out the title and substituting the following:
'Resolve, To Increase MaineCare Reimbursement Rates for Services Provided by 
Direct Care Workers' 
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, the 90-day period will not terminate until after the beginning of the next 
fiscal year; and
Whereas, this legislation affects obligations and expenses during the course of the 
current fiscal year and requires immediate attention; and
Whereas, current state reimbursement rates for services providing long-term 
supports and services do not account for the current minimum wage requirements; 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
Sec. 1.  Reimbursement.  Resolved:  That the Department of Health and Human 
Services shall amend its rules to increase MaineCare reimbursement rates for home and 
community-based services by no less than $2 an hour for the following services:
1.  Attendant care services provided under the provisions of Chapter 101: MaineCare 
Benefits Manual, Chapter III, Section 12, Allowances for Consumer-directed Attendant 
Services;
Date: 
(Filing No. H-          )
COMMITTEE AMENDMENT “      ” to H.P. 1504, L.D. 2109
COMMITTEE AMENDMENT
2.  Adult day care and home support services provided under the provisions of 
Chapter 101:  MaineCare Benefits Manual, Chapter III, Section 18, Allowances for Home 
and Community-based Services for Adults with Brain Injury;
3.  Attendant care services, personal care services, respite care services, home health 
aide services and certified nurse's aide services provided under the provisions of Chapter 
101:  MaineCare Benefits Manual, Chapter III, Section 19, Home and Community 
Benefits for the Elderly and Adults with Disabilities;
4.  Personal care services, home support services and community support provided 
under the provisions of Chapter 101:  MaineCare Benefits Manual, Chapter III, Section 
20, Allowances for Home and Community-based Services for Adults with Other Related 
Conditions;
5.  Home support services, shared living and community support services provided 
under the provisions of Chapter 101:  MaineCare Benefits Manual, Chapter III, Section 
21, Allowances for Adults with Intellectual Disabilities or Autism Spectrum Disorder;
6.  Day care services provided under the provisions of Chapter 101:  MaineCare 
Benefits Manual, Chapter III, Section 26, Day Health Services;
7.  Home support services, community support and respite services provided under 
the provisions of Chapter 101:  MaineCare Benefits Manual, Chapter III, Section 29, 
Allowances for Support Services for Adults with Intellectual Disabilities or Autism 
Spectrum Disorder; and
8.  Personal support services, certified nursing assistant services, home health aide 
services and chore services provided under the provisions of Chapter 101:  MaineCare 
Benefits Manual, Chapter III, Section 96, Private Duty Nursing and Personal Care 
Services.
Sec. 2.  Reimbursement.  Resolved:  That the Department of Health and Human 
Services shall amend its rules to increase reimbursement rates for state-funded home and 
community-based services by no less than $2 an hour for the following services:
1.  Personal assistance provided under the provisions of 14-197 C.M.R. Chapter 11, 
Consumer-directed Personal Assistance Services;
2.  Day care services provided under the provisions of 10-149 C.M.R. Chapter 5, 
Office of Aging and Disability Services Policy Manual, Section 61, Adult Day Services;
3.  Attendant care services, personal care services, respite care services, home health 
aide services and certified nursing assistant services provided under the provisions of 10-
C.M.R. Chapter 5, Office of Aging and Disability Services Policy Manual, Section 
63, In-home and Community Support Services for Elderly and Other Adults;
4.  Respite care services provided under the provisions of 10-149 C.M.R. Chapter 5, 
Office of Aging and Disability Services Policy Manual, Section 68, Respite Care Services 
for People with Alzheimer's or Related Disorders; and
5.  Homemaker services provided under the provisions of 10-149 C.M.R. Chapter 5, 
Office of Aging and Disability Services Policy Manual, Section 69, Office of Elder 
Services Independent Support Services Program.
COMMITTEE AMENDMENT “      ” to H.P. 1504, L.D. 2109
COMMITTEE AMENDMENT
Sec. 3.  Reimbursement.  Resolved:  That the Department of Health and Human 
Services shall amend its rules to update per diem calculations to include an increase of no 
less than $2 an hour for all direct care services for the following residential services 
provided under Chapter 101:  MaineCare Benefits Manual, Chapter III:
1.  Section 2, Adult Family Care Services;
2.  Section 50, Principles of Reimbursement for Intermediate Care Facilities for the 
Developmentally Disabled;
3.  Section 67, Principles of Reimbursement for Nursing Facilities; and
4.  Section 97, Private Non-Medical Institution Services, Appendix C.
Sec. 4.  Appropriations and allocations.  Resolved:  That the following 
appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Developmental Services Waiver - MaineCare Z211
Initiative: Provides appropriations for a rate increase of $2 an hour for certain services.
Developmental Services Waiver - Supports Z212
Initiative: Provides appropriations for a rate increase of $2 an hour for certain services.
Long Term Care - Office of Aging and Disability Services 0420
Initiative: Provides appropriations for a rate increase of $2 an hour for certain services.
Medicaid Services - Developmental Services Z210
Initiative: Provides appropriations and allocations for a rate increase of $2 an hour for 
certain services.
GENERAL FUND
2019-20
2020-21
All Other
$0
$3,845,649
GENERAL FUND TOTAL
$0
$3,845,649
GENERAL FUND
2019-20
2020-21
All Other
$0
$739,939
GENERAL FUND TOTAL
$0
$739,939
GENERAL FUND
2019-20
2020-21
All Other
$0
$1,966,046
GENERAL FUND TOTAL
$0
$1,966,046
COMMITTEE AMENDMENT “      ” to H.P. 1504, L.D. 2109
COMMITTEE AMENDMENT
Medicaid Waiver for Brain Injury Residential /Community Serv Z218
Initiative: Provides appropriations for a rate increase of $2 an hour for certain services.
Medicaid Waiver for Other Related Conditions Z217
Initiative: Provides appropriations for a rate increase of $2 an hour for certain services.
Medical Care - Payments to Providers 0147
Initiative: Provides appropriations and allocations for a rate increase of $2 an hour for 
certain services.
GENERAL FUND
2019-20
2020-21
All Other
$0
$258,196
GENERAL FUND TOTAL
$0
$258,196
OTHER SPECIAL REVENUE FUNDS
2019-20
2020-21
All Other
$0
$959,798
OTHER SPECIAL REVENUE FUNDS TOTAL
$0
$959,798
GENERAL FUND
2019-20
2020-21
All Other
$0
$210,782
GENERAL FUND TOTAL
$0
$210,782
GENERAL FUND
2019-20
2020-21
All Other
$0
$103,983
GENERAL FUND TOTAL
$0
$103,983
GENERAL FUND
2019-20
2020-21
All Other
$0
$2,216,097
GENERAL FUND TOTAL
$0
$2,216,097
FEDERAL EXPENDITURES FUND
2019-20
2020-21
All Other
$0
$35,011,339
COMMITTEE AMENDMENT “      ” to H.P. 1504, L.D. 2109
COMMITTEE AMENDMENT
Nursing Facilities 0148
Initiative: Provides appropriations and allocations for a rate increase of $2 an hour for 
certain services.
Office of Substance Abuse & Mental Health Srv-Medicaid Seed Z202
Initiative: Provides appropriations for a rate increase of $2 an hour for certain services.
FEDERAL EXPENDITURES FUND TOTAL
$0
$35,011,339
OTHER SPECIAL REVENUE FUNDS
2019-20
2020-21
All Other
$0
$2,004,532
OTHER SPECIAL REVENUE FUNDS TOTAL
$0
$2,004,532
GENERAL FUND
2019-20
2020-21
All Other
$0
$3,981,384
GENERAL FUND TOTAL
$0
$3,981,384
FEDERAL EXPENDITURES FUND
2019-20
2020-21
All Other
$0
$8,378,263
FEDERAL EXPENDITURES FUND TOTAL
$0
$8,378,263
OTHER SPECIAL REVENUE FUNDS
2019-20
2020-21
All Other
$0
$788,913
OTHER SPECIAL REVENUE FUNDS TOTAL
$0
$788,913
GENERAL FUND
2019-20
2020-21
All Other
$0
$8,565,901
GENERAL FUND TOTAL
$0
$8,565,901
COMMITTEE AMENDMENT “      ” to H.P. 1504, L.D. 2109
COMMITTEE AMENDMENT
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
SUMMARY
This amendment replaces the bill and makes it a resolve.  It implements a 
recommendation of the Commission To Study Long-term Care Workforce Issues to 
increase reimbursement rates to direct care workers.  The amendment requires the 
Department of Health and Human Services to increase reimbursement rates to all direct 
care worker services that are provided in home and community-based settings and in 
institutional settings by no less than $2 an hour.  The amendment adds an emergency 
preamble and emergency clause.  The amendment also adds an appropriations and 
allocations section.
FISCAL NOTE REQUIRED
(See attached)
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS
2019-20
2020-21
GENERAL FUND
$0
$21,887,977
FEDERAL EXPENDITURES FUND
$0
$43,389,602
OTHER SPECIAL REVENUE FUNDS
$0
$3,753,243
DEPARTMENT TOTAL - ALL FUNDS
$0
$69,030,822
Revised: 07/07/20
LD 2109
LR 3212(02)
FY 2019-20
FY 2020-21
Projections 
FY 2021-22
Projections 
FY 2022-23
Net Cost (Savings)
General Fund
$0
$21,887,977
$26,289,062
$26,289,062
Appropriations/Allocations
General Fund
$0
$21,887,977
$26,289,062
$26,289,062
Federal Expenditures Fund
$0
$43,389,602
$49,872,978
$49,872,978
Other Special Revenue Funds
$0
$3,753,243
$4,503,892
$4,503,892
Revenue
Federal Expenditures Fund
$0
$43,389,602
$49,872,978
$49,872,978
Other Special Revenue Funds
$0
$3,753,243
$4,503,892
$4,503,892
Fiscal Detail and Notes
The bill includes General Fund appropriations to the Department of Health and Human Services of $21,887,977 in 
fiscal year 2020-21 for a rate increase of $2 an hour for certain services. Federal Expenditures Fund allocations are 
also included for the FMAP match and Other Special Revenue Funds allocations for the Service Provider Tax.
Fiscal Note
An Act To Implement the Recommendations of the Commission To Study Long-term Care Workforce 
Issues
Fiscal Note for Bill as Amended by Committee Amendment " "
Committee: Health and Human Services
Fiscal Note Required: Yes
LR3212(02) - Fiscal Note - Page 1 of 1