An Act To Reduce Child Poverty by Leveraging Investments so Families Can Thrive
Maine Legislature, Session 129, LD 1774
Committee: Health and Human Services
Sponsors: GIDEON, JACKSON, HYMANSON, O'CONNOR, STEWART, STOVER, TALBOT ROSS, CLAXTON, MOORE
Amends: 22 MRSA §3109, 22 MRSA §3174-G, 22 MRSA §3762, 22 MRSA §3769-B, 22 MRSA §3790

Legislative Document
No. 1774
H.P. 1261
House of Representatives, May 23, 2019
An Act To Reduce Child Poverty by Leveraging Investments so 
Families Can Thrive
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Speaker GIDEON of Freeport.
Cosponsored by President JACKSON of Aroostook and
Representatives: HYMANSON of York, O'CONNOR of Berwick, STEWART of Presque Isle, 
STOVER of Boothbay, TALBOT ROSS of Portland, Senators: CLAXTON of Androscoggin, 
MOORE of Washington.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3109 is enacted to read:
§3109.  Promoting accountable public programs that reduce poverty, alleviate 
hardship and increase sustainable employment for low-income families with 
children
The department shall implement a system of accountability to measure access to and 
the performance of certain programs administered by the department under this Subtitle 
to ensure that those programs are working effectively to improve the health and well-
being of program participants.  The department shall establish improvement targets each 
year to ensure that the programs are being accessed by and improving the lives of as 
many eligible families and individuals as possible.
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A.  "Federal poverty level" has the same meaning as in section 3762, subsection 1, 
paragraph C.
B.  "Food supplement" means the federal supplemental nutrition assistance program 
administered by the State pursuant to section 3104.
C.  "TANF" has the same meaning as in section 3762, subsection 1, paragraph E.
D.  "WIC" means the Women, Infants and Children Special Supplemental Food 
Program described in section 3107.
2.  Identify measures of child and family economic security.  Beginning October 
15, 2019 and annually thereafter, the department shall obtain and compile the following 
data for the State from those sources reasonably available to the department, including 
data collected and maintained by the department, data available from other state or 
federal agencies and such other data as can reasonably be obtained from other public or 
private sources upon request. The data must include:
A.  The ratio of families with children receiving TANF cash assistance to the number 
of families with children and income at or below 100% of the federal poverty level in 
the current year and in the previous 4 years;
B.  The percentage of children under 5 years of age receiving TANF cash assistance 
that also receive assistance from WIC in the current year and in the previous 4 years;
C.  The percentage of children under 5 years of age receiving food supplement 
assistance that also receive assistance from WIC in the current year and in the 
previous 4 years;
D.  For all families for whom TANF cash assistance has terminated:
(1)  The number and percentage of families with no quarterly earnings from 
unsubsidized employment:
(a)  At the time participation in the program was terminated;
(b)  During the 2nd quarter after participation in the program was terminated; 
and
(c)  During the 4th quarter after participation in the program was terminated;
(2)  The number and percentage of families with quarterly earnings from 
unsubsidized employment that are at least 50% but below 100% of the federal 
poverty level:
(a)  At the time participation in the program was terminated;
(b)  During the 2nd quarter after participation in the program was terminated; 
and
(c)  During the 4th quarter after participation in the program was terminated;
(3)  The number and percentage of families with quarterly earnings from 
unsubsidized employment that are at least 100% but below 150% of the federal 
poverty level:
(a)  At the time participation in the program was terminated;
(b)  During the 2nd quarter after participation in the program was terminated; 
and
(c)  During the 4th quarter after participation in the program was terminated;
(4)  The number and percentage of families with quarterly earnings from 
unsubsidized employment that are at least 150% but below 200% of the federal 
poverty level:
(a)  At the time participation in the program was terminated;
(b)  During the 2nd quarter after participation in the program was terminated; 
and
(c)  During the 4th quarter after participation in the program was terminated;
(5)  The number and percentage of families with quarterly earnings from 
unsubsidized employment that are at least 200% of the federal poverty level:
(a)  At the time participation in the program was terminated;
(b)  During the 2nd quarter after participation in the program was terminated; 
and
(c)  During the 4th quarter after participation in the program was terminated;
(6)  The mean and median income of families with no quarterly earnings from 
unsubsidized employment:
(a)  At the time participation in the program was terminated;
(b)  During the 2nd quarter after participation in the program was terminated; 
and
(c)  During the 4th quarter after participation in the program was terminated; 
and
(7)  The number and percentage of families receiving income from the federal 
supplemental security income program or federal social security disability 
benefits:
(a)  At the time participation in the program was terminated;
(b)  During the 2nd quarter after participation in the program was terminated; 
and
(c)  During the 4th quarter after participation in the program was terminated;
E.  Cumulative data on the highest level of educational attainment of adult parents or 
caretaker relatives receiving TANF cash assistance and cumulative data on the 
highest level of educational attainment of adult parents or caretaker relatives whose 
participation in the program was terminated in the prior year;
F.  The ratio of individuals receiving food supplement assistance to the total number 
of potentially eligible persons and the ratio of households with individuals 
participating in the food supplement program to the total number of households that 
include a person 60 years of age or older, a nonelderly person with disabilities or a 
child under 18 years of age;
G.  The number and percentage of adult parents or caretaker relatives who have 
children in the household and who are receiving food supplement assistance, grouped 
by highest level of educational attainment of the adult parent or caretaker relative;
H.  The ratio of people participating in the MaineCare program, by eligibility group, 
to the total number of potentially eligible persons within each group;
I.  The number and percentage of applications received by the department for the 
MaineCare program and the children's health insurance program as defined in section 
3174-X, subsection 1, paragraph A, by eligibility group, that are processed in less 
than 24 hours; that are processed within one to 7 days; that are processed within 8 to 
days; that are processed within 31 to 45 days; and that are processed more than 45 
days after receipt;
J.  The average waiting times, by month, for a person calling the department's call 
center to speak to a person; and
K.  The number and percentage, by month, of telephone calls to the department's call 
center that are terminated by a caller prior to the caller's speaking to a person.
3.  Improvement targets established.  The department shall examine and use the 
data related to program measures compiled pursuant to subsection 2 and any 
recommendations provided by legislatively established working groups to establish 
proposed improvement targets on an annual basis to serve as a baseline against which 
progress related to program accessibility and participant well-being may be measured.  
Beginning January 15, 2020 and annually thereafter, the department shall present 
proposed improvement targets to the joint standing committee of the Legislature having 
jurisdiction over human services matters along with data compiled pursuant to subsection 
for the most recent year and comparative data for the 4 prior years for the committee's 
review. The committee's review must include the opportunity for public comment on the 
department's proposed improvement targets.  After the committee's review and by March 
15th annually, the department shall finalize improvement targets for the current year.
4.  Report.  By January 15, 2021 and annually thereafter, the department shall 
provide data describing the rates of poverty, food insecurity and health coverage for the 
State's families, children and individuals over the past 5 years.  The department shall 
specifically report on its progress in meeting improvement targets established for the 
preceding year, along with proposed improvement targets for the following year, to the 
joint standing committee of the Legislature having jurisdiction over human services 
matters.  If the improvement targets established for the preceding year are not met, the 
department shall identify the obstacles to meeting those improvement targets and present 
a plan for addressing those obstacles to increase the likelihood of success in meeting 
those improvement targets in the following year.  The joint standing committee of the 
Legislature having jurisdiction over human services matters shall conduct a public 
hearing on the department's plan and may introduce any legislation that it considers 
necessary to improve the department's ability to meet improvement targets in future 
years.
Sec. 2.  22 MRSA §3174-G, as amended by IB 2017, c. 1, Pt. A, §§1 to 3, is 
further amended to read:
§3174-G.  Medicaid coverage of certain elderly and disabled individuals, children 
and pregnant women; transitional Medicaid
1.  Delivery of services.  The department shall provide for the delivery of federally 
approved Medicaid services to the following persons:
A.  A qualified woman during her pregnancy and up to 60 days following delivery 
when the woman's family income is equal to or below 200% of the nonfarm income 
official poverty line;
B.  An infant under one year of age when the infant's family income is equal to or 
below 200% of the nonfarm income official poverty line, except that the department 
may adopt a rule that provides that infants in families with income over 185% and 
equal to or below 200% of the nonfarm income official poverty line who meet the 
eligibility requirements of the Cub Care program established under section 3174-T 
are eligible to participate in the Cub Care program instead of Medicaid. Rules 
adopted pursuant to this paragraph are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A;
C.  A qualified elderly or disabled person when the person's family income is equal to 
or below 100% of the nonfarm income official poverty line;
D.  A child one year of age or older and under 19 years of age when the child's family 
income is equal to or below 200% of the nonfarm income official poverty line, except 
that the department may adopt a rule that provides that children described in this 
paragraph in families with income over 150% and equal to or below 200% of the 
nonfarm income official poverty line who meet the eligibility requirements of the 
Cub Care program established under section 3174-T are eligible to participate in the 
Cub Care program instead of Medicaid. Rules adopted pursuant to this paragraph are 
routine technical rules as defined in Title 5, chapter 375, subchapter 2-A;
E.  On or before September 30, 2012, the parent or caretaker relative of a child 
described in paragraph B or D when the child's family income is equal to or below 
200% of the nonfarm income official poverty line, subject to adjustment by the 
commissioner under this paragraph and, beginning October 1, 2012, the parent or 
caretaker relative of a child described in paragraph B or D when the child's family 
income is equal to or below 133% of the nonfarm income official poverty line, 
subject to adjustment by the commissioner under this paragraph.  Medicaid services 
provided under this paragraph must be provided within the limits of the program 
budget.  Funds appropriated for services under this paragraph must include an annual 
inflationary adjustment equivalent to the rate of inflation in the Medicaid program.  
On a quarterly basis, the commissioner shall determine the fiscal status of program 
expenditures under this paragraph.  If the commissioner determines that expenditures 
will exceed the funds available to provide Medicaid coverage pursuant to this 
paragraph, the commissioner must adjust the income eligibility limit for new 
applicants to the extent necessary to operate the program within the program budget.  
If, after an adjustment has occurred pursuant to this paragraph, expenditures fall 
below the program budget, the commissioner must raise the income eligibility limit to 
the extent necessary to provide services to as many eligible persons as possible within 
the fiscal constraints of the program budget, as long as on or before September 30, 
2012 the income limit does not exceed 200% of the nonfarm income official poverty 
line and, beginning October 1, 2012, the income limit does not exceed 133% of the 
nonfarm income official poverty line;
F.  A person 20 to 64 years of age who is not otherwise covered under paragraphs A 
to E when the person's family income is below or equal to 125% of the nonfarm 
income official poverty line, as long as the commissioner adjusts the maximum 
eligibility level in accordance with the requirements of the paragraph.
(2)  If the commissioner reasonably anticipates the cost of the program to exceed 
the budget of the population described in this paragraph, the commissioner shall 
lower the maximum eligibility level to the extent necessary to provide coverage 
to as many persons as possible within the program budget.
(3)  The commissioner shall give at least 30 days' notice of the proposed change 
in maximum eligibility level to the joint standing committee of the Legislature 
having jurisdiction over appropriations and financial affairs and the joint standing 
committee of the Legislature having jurisdiction over health and human services 
matters; 
G.  A person who is a noncitizen legally admitted to the United States to the extent 
that coverage is allowable by federal law if the person is:
(1)  A woman during her pregnancy and up to 60 days following delivery; or
(2)  A child under 21 years of age; and
H.  No later than 180 days after the effective date of this paragraph, a person under 65 
years of age who is not otherwise eligible for assistance under this chapter and who 
qualifies for medical assistance pursuant to 42 United States Code, Section 
1396a(a)(10)(A)(i)(VIII) when the person's income is at or below 133% plus 5% of 
the nonfarm income official poverty line for the applicable family size. The 
department shall provide such a person, at a minimum, the same scope of medical 
assistance as is provided to a person described in paragraph E.
Cost sharing, including copayments, for coverage established under this paragraph 
may not exceed the maximum allowable amounts authorized under section 3173-C, 
subsection 7.
No later than 90 days after the effective date of this paragraph, the department shall 
submit a state plan amendment to the United States Department of Health and Human 
Services, Centers for Medicare and Medicaid Services ensuring MaineCare eligibility 
for people under 65 years of age who qualify for medical assistance pursuant to 42 
United States Code, Section 1396a(a)(10)(A)(i)(VIII).
The department shall adopt rules, including emergency rules pursuant to Title 5, 
section 8054 if necessary, to implement this paragraph in a timely manner to ensure 
that the persons described in this paragraph are enrolled for and eligible to receive 
services no later than 180 days after the effective date of this paragraph.  Rules 
adopted pursuant to this paragraph are routine technical rules as defined by Title 5, 
chapter 375, subchapter 2-A.
For the purposes of this subsection, the "nonfarm income official poverty line" is that 
applicable to a family of the size involved, as defined by the federal Department of 
Health and Human Services and updated annually in the Federal Register under authority 
of 42 United States Code, Section 9902(2).  For purposes of this subsection, "program 
budget" means the amounts available from both federal and state sources to provide 
federally approved Medicaid services.
1-B.  Funding.  State funds necessary to implement subsection 1-C must include 
General Fund appropriations and Other Special Revenue allocations from the Fund for a 
Healthy Maine to the elderly low-cost drug program operated pursuant to section 254-D, 
including rebates received in that program from pharmaceutical manufacturers, that are 
no longer needed in that program as a result of the Medicaid waiver obtained pursuant to 
subsection 1-C.
1-C.  Prescription drug waiver program.  Except as provided in paragraph G, the 
department shall apply to the federal Centers for Medicare and Medicaid Services for a 
waiver or amend a pending or current waiver under the Medicaid program authorizing the 
department to use federal matching dollars to enhance the prescription drug benefits 
available to persons who qualify for the elderly low-cost drug program established under 
section 254-D.  The program created pursuant to the waiver is the prescription drug 
waiver program, referred to in this subsection as the "program."
A.  As funds permit, the department has the authority to establish income eligibility 
levels for the program up to and including 200% of the federal nonfarm income 
official poverty level, except that for individuals in households that spend at least 
40% of income on unreimbursed direct medical expenses for prescription 
medications, the income eligibility level is increased by 25%.
B.  To the extent reasonably achievable under the federal waiver process, the program 
must include the full range of prescription drugs provided under the Medicaid 
program on the effective date of this subsection and must limit copayments and cost 
sharing for participants.  If cost sharing above the nominal cost sharing for the 
Medicaid program is determined to be necessary, the department may use a sliding 
scale to minimize the financial burden on lower-income participants.
C.  Coverage under the program may not be less beneficial to persons who meet the 
qualifications of former section 254 than the coverage available under that section on 
September 30, 2001.
D.  In determining enrollee benefits under the program, to the extent possible, the 
department shall give equitable treatment to coverage of prescription medications for 
cancer, Alzheimer's disease and behavioral health.
E.  The department is authorized to provide funding for the program by using funds 
appropriated or allocated to provide prescription drugs under sections 254-D and 258.
F.  The department is authorized to amend the waiver or adjust program requirements 
as necessary to take advantage of enhanced federal matching funds that may become 
available.
G.  If, upon thorough analysis, the department determines that a waiver under this 
subsection is not feasible or would not significantly benefit participants in the elderly 
low-cost drug program, the department may decide not to pursue the waiver.  Within 
days of a decision not to proceed with a waiver and before taking action on that 
decision, the department shall report to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters and shall 
provide a detailed analysis of the reasons for reaching that decision.
1-D.  Enrollment fee.  The department may assess an annual enrollment fee of $25 
for participation in the MaineCare program for a family including a parent or caretaker 
relative of a child described in subsection 1, paragraph B or D when the family's income 
exceeds 150% of the nonfarm income official poverty line.
2.  Resource test.  The department may not apply a resource test to those children 
and pregnant women who are made eligible under this section, unless these persons also 
receive Temporary Assistance for Needy Families or United States Supplemental 
Security Income benefits.
3.  Benefits authorized.  The scope of medical assistance to be provided within this 
section shall must be that authorized by the Federal Sixth Omnibus Budget Reconciliation 
Act, Public Law 99-509.
4.  Transitional Medicaid.  The department shall administer a program of 
transitional Medicaid to families receiving benefits under Section 1931 of the federal 
Social Security Act in accordance with 42 United States Code, Section 1396r-6 and this 
subsection.  The amount, duration and scope of services provided under this subsection 
must be the same as that provided to a parent or caretaker relative of a child described in 
subsection 1, paragraph B or D.
A.  The department shall provide transitional Medicaid for a 12-month extension 
period in accordance with 42 United States Code, Section 1396r-6, Subsection (a), 
Paragraph (5) to families whose eligibility for Medicaid assistance terminated due to 
an increase in earned income, an increase in hours of employment or a loss of a time-
limited earnings disregard.
B.  The department shall provide transitional Medicaid for 4 months to families 
whose eligibility for Medicaid assistance terminated due to an increase in the amount 
of child support received by the family.
Sec. 3.  22 MRSA §3762, sub-§3, ¶B, as amended by PL 2017, c. 256, §1; c. 284, 
Pt. NNNNNNN, §10; c. 290, §1; and c. 412, §2, is further amended to read:
B.  The department may use funds, insofar as resources permit, provided under and in 
accordance with the United States Social Security Act or state funds appropriated for 
this purpose or a combination of state and federal funds to provide assistance to 
families under this chapter.  In addition to assistance for families described in this 
subsection, funds must be expended for the following purposes:
(1)  To continue the pass-through of the first $50 per month of current child 
support collections and the exclusion of the $50 pass-through from the budget 
tests and benefit calculations;
(2)  To provide financial assistance to noncitizens legally admitted to the United 
States who are receiving assistance under this subsection as of July 1, 2011.  
Recipients of assistance under this subparagraph are limited to the categories of 
noncitizens who would be eligible for the TANF programs but for their status as 
aliens under PRWORA.  Eligibility for the TANF program for these categories of 
noncitizens must be determined using the criteria applicable to other recipients of 
assistance from the TANF program. Any household receiving assistance as of  
July 1, 2011 may continue to receive assistance, as long as that household 
remains eligible, without regard to interruptions in coverage or gaps in eligibility 
for service. A noncitizen legally admitted to the United States who is neither 
receiving assistance on July 1, 2011 nor has an application pending for assistance 
on July 1, 2011 that is later approved is not eligible for financial assistance 
through a state-funded program unless that noncitizen is:
(a)  Elderly or disabled, as described under the laws governing supplemental 
security income in 42 United States Code, Sections 1381 to 1383f (2010);
(b)  A victim of domestic violence; 
(c)  Experiencing other hardship, such as time necessary to obtain proper 
work documentation, as defined by the department by rule. Rules adopted by 
the department under this division are routine technical rules as defined by 
Title 5, chapter 375, subchapter 2-A; or
(d)  Unemployed but has obtained proper work documentation, as defined by 
the department by rule.  Rules adopted by the department under this division 
are routine technical rules as defined by Title 5, chapter 375, subchapter 2-A;
(3) To provide benefits to 2-parent families with children using the same 
eligibility requirements as apply to families headed by a single custodial parent or 
caretaker relative;
(4)  To provide an assistance program for needy children, 19 to 21 years of age, 
who are in full-time attendance in secondary school.  The program is operated for 
those individuals who qualify for TANF under the United States Social Security 
Act, except that they fail to meet the age requirement, and is also operated for the 
parent or caretaker relative of those individuals.  Except for the age requirement, 
all provisions of TANF, including the standard of need and the amount of 
assistance, apply to the program established pursuant to this subparagraph;
(5)  To provide assistance for a pregnant woman who is otherwise eligible for 
assistance under this chapter, except that she has no dependents under 19 years of 
age.  An individual is eligible for the monthly benefit for one eligible person if 
the medically substantiated expected date of the birth of her child is not more 
than 90 days following the date the benefit is received;
(6)  To provide a special housing allowance for TANF families whose shelter 
expenses for rent, mortgage or similar payments, homeowners insurance and 
property taxes equal or exceed 50% of their monthly income.  The special 
housing allowance is limited to $300 per month for each family.  For purposes of 
this subparagraph, "monthly income" means the total of the TANF monthly 
benefit and all income countable under the TANF program, plus child support 
received by the family, excluding the $50 pass-through payment;
(7)  In determining benefit levels for TANF recipients who have earnings from 
employment, the department shall disregard from monthly earnings the 
following:
(a)  One hundred and eight dollars;
(b)  Fifty percent of the remaining earnings that are less than the federal 
poverty level; and
(c)  All actual child care costs necessary for work, except that the department 
may limit the child care disregard to $175 per month per child or $200 per 
month per child under 2 years of age or with special needs;
(7-A)  In determining eligibility and benefit levels, the department may apply a 
gross income test only to applicants and not to recipients;
(7-C)  In determining financial eligibility and benefit levels for TANF applicants 
and TANF recipients, the department shall deduct the income less any applicable 
income disregards from the standard of need and may not apply any other income 
test;
(8)  In cases when the TANF recipient has no child care cost, the monthly TANF 
benefit is the maximum payment level or the difference between the countable 
earnings and the standard of need established by rule adopted by the department, 
whichever is lower;
(9)  In cases when the TANF recipient has child care costs, the department shall 
determine a total benefit package, including TANF cash assistance, determined in 
accordance with subparagraph (7) and additional child care assistance, as 
provided by rule, necessary to cover the TANF recipient's actual child care costs 
up to the maximum amount specified in section 3782-A, subsection 5, paragraph 
B.  The benefit amount must be paid as provided in this subparagraph.
(a)  Before the first month in which child care assistance is available to an 
ASPIRE-TANF recipient under this paragraph and periodically thereafter, the 
department shall notify the recipient of the total benefit package and the 
following options of the recipient: to receive the total benefit package 
directly; or to have the department pay the recipient's child care assistance 
directly to the designated child care provider for the recipient and pay the 
balance of the total benefit package to the recipient.
(b)  If an ASPIRE-TANF recipient notifies the department that the recipient 
chooses to receive the child care assistance directly, the department shall pay 
the total benefit package to the recipient.
(c)  If an ASPIRE-TANF recipient does not respond or notifies the 
department of the choice to have the child care assistance paid directly to the 
child care provider from the total benefit package, the department shall pay 
the child care assistance directly to the designated child care provider for the 
recipient.  The department shall pay the balance of the total benefit package 
to the recipient;
(10)  Child care assistance under this paragraph must be paid by the department 
in a prompt manner that permits an ASPIRE-TANF recipient to access child care 
necessary for work; and
(11)  The department shall adopt rules pursuant to Title 5, chapter 375 to 
implement this subsection.  Rules adopted pursuant to this subparagraph are 
routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.
Sec. 4.  22 MRSA §3762, sub-§8, ¶A, as amended by PL 1999, c. 731, Pt. OO, 
§2, is repealed.
Sec. 5.  22 MRSA §3769-B, as amended by PL 1999, c. 401, Pt. S, §4, is repealed.
Sec. 6.  22 MRSA §3790, sub-§§3-A and 3-B are enacted to read:
3-A.  Coordination with state educational institutions and programs.  The 
department shall deem a referral from an educational institution or program that is part of 
the University of Maine System; the Maine Community College System; Jobs for Maine's 
Graduates, established in Title 20-A, chapter 226; an adult education program established 
in Title 20-A, chapter 315; or the career centers established by the Department of Labor 
as an application for the Parents as Scholars Program as long as, in accordance with 
department rules, it is submitted by a qualified person at the institution or program on a 
form provided by the department for this purpose and signed by the prospective student 
expressing a desire to enroll in the Parents as Scholars Program.  The department shall 
notify these institutions and programs of the opportunity to refer prospective students in 
accordance with this subsection and make available to prospective students and these 
institutions and programs referral forms to serve as an application for purposes of this 
subsection.
3-B.  Campus-based student support and navigation; working group.   The 
commissioner or the commissioner's designee shall convene a working group to make 
recommendations to the department regarding the most effective means to establish or 
supplement personalized professional guidance, support and navigation services for 
participants in the Parents as Scholars Program in order to promote program completion 
and student success.  The working group includes the Chancellor of the University of 
Maine System or the chancellor's designees; the President of the Maine Community 
College System or the president's designees; members of advocacy or other organizations 
with expertise in policy related to supports and other assistance needed to help adults with 
low incomes successfully achieve higher education credentials or degrees; low-income 
students currently or previously enrolled in the University of Maine System or Maine 
Community College System; and other members determined appropriate by the 
commissioner.  The working group shall also make recommendations to the department 
as to how the department may best contribute, through administration of the Parents as 
Scholars Program and the Higher Opportunity for Pathways to Employment Program 
established under chapter 1054-C, to the goal established in Title 26, section 2006, 
subsection 1, paragraph K.  The department shall provide up to $500,000 annually to 
educational institutions or programs identified under subsection 3-A to implement 
services identified to achieve the purposes under this section.  These funds must be 
provided under the TANF block grant available under Title IV-A of the United States 
Social Security Act.  The commissioner or the commissioner's designee shall convene the 
first meeting of the working group no later than November 1, 2019.
Sec. 7.  Working group to improve performance of Department of Health 
and Human Services programs and systems to alleviate poverty, food 
insecurity and hardship.  The Commissioner of Health and Human Services or the 
commissioner's designee shall convene a working group to review and make 
recommendations to improve the operations of systems and programs administered by the 
Department of Health and Human Services providing services to persons in need.  The 
commissioner or the commissioner's designee shall convene the first meeting of the 
working group no later than November 1, 2019.
1.  Members.  The working group consists of at least 12 members, in addition to 
department staff as the commissioner determines appropriate, including persons that now 
receive or previously received assistance from department core safety net programs; 
members of advocacy organizations with expertise in policy or legal matters related to 
programs administered by the department; providers of health care or social services 
serving persons receiving assistance from the department; and persons with technological 
expertise who could assist with recommendations related to creating efficiencies in 
program enrollment, recertification and improved program integration.  The working 
group may create subgroups to work on specific issues or initiatives and may include 
persons who are not working group members. 
2.  Duties. In developing its recommendations under this section, the working group 
shall:
A.  Review opportunities to simplify operations and improve business processes that 
facilitate cross-enrollment and linkages connecting eligible persons enrolled in one 
program to other core services available to them related to health care, nutrition and 
help meeting basic needs;
B.  Examine the potential for improved electronic data sharing between department 
programs to streamline and promote efficiencies in verification processes required for 
eligibility and recertification determinations;
C. Review state policy and procedural options available under federal law to improve 
or increase access to services to reduce food insecurity and improve the health and 
well-being of persons in the State living in poverty; 
D. Investigate ways to transform the department into a more holistic and person-
centered and better coordinated human services system with an approach that puts the 
varying needs of persons and families first and ensures more efficient access, clarity 
of information and respectful interactions; 
E. Determine the extent to which the department could facilitate enrollment for 
families and persons receiving its services in programs administered by other 
agencies of State Government, including low-income home energy assistance 
benefits and the property tax fairness credit under the Maine Revised Statutes, Title 
36, section 5219-KK; and
F. Make recommendations related to improvement targets for reduced levels of 
poverty and food insecurity and improved health outcomes to be considered by the 
department as it establishes improvement targets pursuant to the Maine Revised 
Statutes, Title 22, section 3109, subsection 3. 
3.  Report. No later than February 15, 2020, the Commissioner of Health and Human 
Services shall submit a report including the recommendations developed pursuant to this 
section, including any suggested legislation, to the Joint Standing Committee on 
Appropriations and Financial Affairs and the Joint Standing Committee on Health and 
Human Services. 
Sec. 8.  Funding.  Any additional costs to the State resulting from the 
implementation of this Act must be paid from funds provided to the Department of Health 
and Human Services under the Temporary Assistance for Needy Families block grant 
available under Title IV-A of the United States Social Security Act or from resources 
representing the State's maintenance of effort in order to qualify for federal funds and 
may not result in an additional net cost to the General Fund.
SUMMARY
This bill makes the following changes, which are intended to reduce child poverty, 
increase food security and create stronger bridges to employment for families with 
children.
1.  It requires the Department of Health and Human Services to collect data to 
measure access to and the performance of certain programs administered by the 
Department of Health and Human Services and establish improvement targets on an 
annual basis to monitor year-to-year improvements related to program accessibility and 
participant well-being.
2. It reallocates the provisions relating to transitional Medicaid from the Maine 
Revised Statutes, Title 22, chapter 1053-B, which pertains to temporary assistance for 
needy families, to Title 22, chapter 855, which pertains to aid to needy persons, to reflect 
that the federal Personal Responsibility and Work Opportunity Reconciliation Act of 
1996, Public Law 104-193, 110 Stat. 2105 no longer just applies to families losing 
eligibility for Medicaid as a result of losing eligibility for the Temporary Assistance for 
Needy Families program but instead applies to all parents who lose eligibility for 
Medicaid.
3. It removes the requirement that a family must have received Medicaid assistance 
for at least 3 of the last 6 months in order for that family to receive transitional Medicaid.
4. It requires that the Department of Health and Human Services provide transitional 
Medicaid for a 12-month extension period pursuant to the state option provided in 42 
United States Code, Section 1396r-6, Subsection (a), Paragraph (5) when a person's 
eligibility was terminated because of an increase in earned income or hours of 
employment or a loss of a time-limited earnings disregard.
5.  It eliminates the TANF gross income test for applicants to conform the eligibility 
methodology for both applicants and recipients.
6.  It establishes a procedure by which the Department of Health and Human Services 
must consider referrals made in accordance with department rule from educational 
institutions and similar programs as applications for the Parents as Scholars Program 
under the Maine Revised Statutes, Title 22, section 3790.
7.  It provides funds from the TANF block grant to provide personalized professional 
guidance, support and navigation services for participants in the Parents as Scholars 
Program in order to promote program completion and student success and requires the 
Commissioner of Health and Human Services to convene a working group to make 
recommendations related to the most effective way to achieve this goal, along with other 
suggestions to improve the program.
8.  It requires the Commissioner of Health and Human Services to convene a working 
group to review and make recommendations to improve the operations of systems and 
programs administered by the Department of Health and Human Services providing 
services to people in need.
9.  It provides that additional costs to the State resulting from implementation of this 
legislation must be paid from funds provided to the Department of Health and Human 
Services under the Temporary Assistance for Needy Families block grant or from 
resources representing the State's maintenance of effort to qualify for federal funds.