An Act To Ensure Support for Adults with Intellectual Disabilities or Autism with High Behavioral Need
Maine Legislature, Session 130, LD 1574
Committee: Health and Human Services
Sponsors: MEYER
Amends: 34-B MRSA §5440

Legislative Document
No. 1574
H.P. 1171
House of Representatives, April 27, 2021
An Act To Ensure Support for Adults with Intellectual Disabilities 
or Autism with High Behavioral Need
(EMERGENCY)
Received by the Clerk of the House on April 23, 2021.  Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint 
Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative MEYER of Eliot.
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 Department of Health and Human Services does not currently propose 
or require specialized reimbursement rates, also known as behavior add-ons, to providers 
of positive behavioral support and behavior management services to persons with 
intellectual disabilities or autism experiencing a personal crisis that could lead to the loss 
of their home, program or employment; and
Whereas, providers of positive behavioral support and behavior management services 
to persons with intellectual disabilities or autism are unable to manage situations that 
involve specialized training because the reimbursement rates are insufficient to provide the 
services; and
Whereas, unresolved crisis situations for persons with intellectual disabilities or 
autism currently result in more traumatic and expensive outcomes and will continue if 
specialized reimbursement rates are not immediately established and funded; 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 §5440 is enacted to read:
§5440.  Reimbursement rates for plans to manage challenging behavior
The department shall develop reimbursement rates for positive behavioral support 
plans and behavior management plans, as determined in department rule, provided to 
persons with intellectual disabilities or autism.  Reimbursement rates must be adequate to 
cover the costs of clinical oversight, equipment and staff with additional training, 
qualifications and experience required to manage challenging behavior or prevent a 
personal crisis as described in section 5206, subsection 1.  The department shall adopt rules 
to implement this section.  Rules adopted pursuant to this section are major substantive 
rules as defined in Title 5, chapter 375, subchapter 2-A.
Sec. 2.  Department of Health and Human Services to develop specialized 
reimbursement rates.  No later than July 1, 2021, the Department of Health and Human 
Services shall establish by rule specialized reimbursement rates for positive behavioral 
support plans and behavior management plans as required in department rule under 14-197 
C.M.R. Chapter 5:  Regulations Governing Behavioral Support, Modification and 
Management for People with Intellectual Disabilities or Autism in Maine that is higher than 
other personal plan services required by the rule.  The reimbursement rates must be 
adequate to cover all aspects of the plans, including clinical oversight, equipment and staff 
with additional training, qualifications and experience required for managing challenging 
behavior or preventing a personal crisis.  Rules adopted pursuant to this section are major 
substantive rules as defined in the Maine Revised Statutes, Title 5, chapter 375, subchapter 
2-A and required by Title 34-B, section 5440.
Emergency clause.  In view of the emergency cited in the preamble, this legislation 
takes effect when approved.
SUMMARY
This bill requires the Department of Health and Human Services to establish by rule 
reimbursement rates for positive behavioral support plans and behavior management plans 
provided to persons with intellectual disabilities or autism.  The rates must be adequate to 
cover all parts of the plans, including clinical oversight, equipment and staff with additional 
training, qualifications and experience required for managing challenging behavior or 
preventing a personal crisis.  Rules adopted are major substantive rules and must be adopted 
by July 1, 2021.