An Act To Support Children's Healthy Development and School Success
Maine Legislature, Session 130, LD 1712
Committee: Health and Human Services
Sponsors: JACKSON, FECTEAU, BREEN, CLAXTON, MOORE, CRAVEN, MEYER, MILLETT, WHITE

Legislative Document
No. 1712
S.P. 533
In Senate, May 19, 2021
An Act To Support Children's Healthy Development and School 
Success
Received by the Secretary of the Senate on May 17, 2021.  Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by President JACKSON of Aroostook.
Cosponsored by Speaker FECTEAU of Biddeford and
Senators: BREEN of Cumberland, CLAXTON of Androscoggin, MOORE of Washington, 
Representatives: CRAVEN of Lewiston, McCREIGHT of Harpswell, MEYER of Eliot, 
MILLETT of Cape Elizabeth, WHITE of Waterville.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA c. 1064 is enacted to read:
CHAPTER 1064
HELP MAINE GROW SYSTEM
§3921.  Help Maine Grow System established
1.  Help Maine Grow System established.  The Help Maine Grow System, referred 
to in this chapter as "the system," is established in the department as a comprehensive, 
statewide, coordinated system of early identification, referral and follow-up for all children 
from prenatal care up to 8 years of age and their families.  The system must emphasize:
A.  Increasing access to the early periodic screening, diagnosis and treatment services 
required by Medicaid on a schedule recommended by the American Academy of 
Pediatrics or its successor organization; and
B.  In support of the Department of Education's child find efforts, increasing access 
and referrals to early intervention services as established and required pursuant to Title 
20-A, sections 7209 and 7252-A.
In developing and administering the system, the department shall maintain affiliate status 
with a national center that offers a system that includes technical assistance and develop a 
cross system model for strengthening early childhood systems and services to meet the 
needs of children and families and meet any requirements necessary to maintain fidelity to 
the system offered by the national center.
2.  Staffing; coordination.  The department shall provide staffing services necessary 
to meet the needs of children and families and to work collaboratively across offices within 
the department, the Children's Cabinet established in Title 5, section 19131, the Department 
of Education and other applicable departments.
§3922.  Duties of system
The system shall:
1.  Expansion of services.  Increase the percentage of children screened for 
developmental, social or emotional issues at all appropriate locations, including, but not 
limited to, early childhood education facilities, child care facilities, Head Start facilities, 
Early Head Start facilities, regional sites of the Child Development Services System under 
Title 20-A, section 7209, subsection 3 and health care providers to ensure access to early 
periodic screening, diagnosis and treatment and other related services to promote children's 
healthy development.  For purposes of this section, "Head Start" means a program operated 
under 42 United States Code, Sections 9831 to 9852c and "Early Head Start" means a 
program under 42 United States Code, Section 9840a;
2.  Coordinated system.  Develop a coordinated system of early identification, referral 
and follow-up services across early childhood education, child care facilities, home visitor 
services as defined in section 3931, subsection 2, paragraph P, Head Start, Early Head Start, 
the Child Development Services System under Title 20-A, section 7209, subsection 3, 
health care providers and family supports;
3.  Delivery of services.  Improve the delivery of services covered by early periodic 
screening, diagnosis and treatment required by Medicaid and other related services to 
promote children's healthy development;
4.  Centralized access point.  Develop a centralized access point for families, 
caregivers and professionals to obtain information about early periodic screening, diagnosis 
and treatment services.  The centralized access point must be available by telephone, the 
Internet and other communication platforms;
5.  Electronic directory.  Compile and maintain an electronic directory of resources 
with respect to service providers and use appropriate methods of communication to assist 
families and caregivers and connect them with early intervention services, primary care 
and appropriate early periodic screening, diagnosis and treatment services to children at 
risk; and
6.  Data collection.  Collect data necessary to align the system with evaluation 
requirements from the national center under section 3921, subsection 1 as well as identify 
gaps in services by type and region and barriers to obtaining appropriate services.
§3923.  Annual reports
The department shall submit any annual and evaluation reports provided by the 
department to the national center under section 3921, subsection 1 to the joint standing 
committees of the Legislature having jurisdiction over health and human services matters 
and education matters, no later than December 15th of each year, beginning in 2022.  The 
joint standing committees are authorized to report out legislation in any legislative session.
Sec. 2.  22 MRSA c. 1065 is enacted to read:
CHAPTER 1065
FIRST 4 ME EARLY CARE AND EDUCATION PROGRAM
§3931.  First 4 ME Early Care and Education Program
1.  Program established.  The First 4 ME Early Care and Education Program is 
established under the department to provide funding to projects in order to achieve 
efficiencies, create opportunities and improve social, emotional, educational and health 
outcomes for children under 6 years of age and the children's families through the provision 
of comprehensive, high-quality early child care and education by funding a holistic, whole 
family approach that integrates comprehensive resources and services into traditional child 
care center and family child care settings that improve outcomes for children, families and 
early childhood educators.
2.  Definitions.  As used in this chapter, unless the context otherwise indicates, the 
following terms have the following meanings.
A. "At risk" means, with regard to a person, that the person is a member of an 
economically disadvantaged family, a recipient or former recipient of services under 
the child protection or child welfare system of the State, in foster care, homeless, a 
member of a family exposed to substance use disorder, identified as having special 
needs, identified as having a physical or mental disability or identified as having 
limited English proficiency.
B.  "Child" means a person under 6 years of age who has not entered kindergarten.
C.  "Child care center" has the same meaning as in section 8301-A, subsection 1-A, 
paragraph A.
D.  "Community" means a geographical area represented by a community coalition and 
served or to be served by a project.
E. "Community coach" means an employee of or contractor with a community 
contractor who is trained under subsection 11 and performs administrative functions in 
carrying out the duties of a project.
F.  "Community coalition" means a group of stakeholders, service providers or other 
members within a community under subsection 7 that sponsors and collaborates in the 
implementation and administration of a project.
G.  "Community contractor" means a nonprofit organization that is the applicant and 
responsible lead member of a community coalition for a project.
H.  "Community provider" means a child care center, family child care provider or 
other service provider that has entered into a contract with a community contractor to 
provide services as part of a project.
I.  "Comprehensive, high-quality early child care and education" means supportive, 
intergenerational, age-appropriate, research-based interaction and teaching practices 
provided by a licensed provider of child care under section 8301-A that focus on all 
domains of learning, and includes embedded professional development, family 
engagement in a child's learning and progress toward family goals, using data to inform 
teaching practices and a holistic approach to a child's physical, mental and dental 
health.
J.  "Economically disadvantaged" means having a family income not exceeding 185% 
of the federal poverty level as defined in section 3762, subsection 1, paragraph C.
K. "Embedded professional development" means an activity performed by a 
community coach to encourage rule-specific knowledge, skills and dispositions to 
support responsive caregiving and developmentally appropriate teaching practices 
implemented for learning that is integrated into the work day, consists of assessing and 
finding solutions for authentic and immediate problems of practice as part of a cycle 
of continuous improvement and is grounded in day-to-day teaching practice designed 
to enhance a teacher's or caregiver's practices with the intent of improving children's 
social, emotional and cognitive development.
L.  "Family" means a child, the child's parent and all people living in the household of 
the child who are supported by the income of the child's parent and related to the child 
or child's parent by blood, marriage or adoption.
M.  "Family child care provider" has the same meaning as in section 8301-A, 
subsection 1-A, paragraph C.
N.  "Homeless" has the same meaning as in the federal McKinney-Vento Homeless 
Assistance Act, 42 United States Code, Section 11302.
O.  "Home visitor" means a person who provides services to a participant in the 
participant's home.
P.  "Home visitor services" means interactions between a home visitor and a parent that 
on the part of the home visitor are nurturing, responsive and intentional and that support 
the parent in the parent's role as the primary teacher of the parent's child and assist the 
parent in using the parent's home and the community as the child's learning 
environment.
Q.  "Parent" means the parent or parents of a child or the child's legal guardian, primary 
or authorized caregiver or foster parent or a person with whom the child has been 
placed for purposes of adoption pending a final adoption decree.
R.  "Participant" means an eligible child under subsection 5 who has been accepted to 
participate in a project.
S.  "Program" means the First 4 ME Early Care and Education Program established 
under subsection 1.
T.  "Project" means the program as implemented in a community by a community 
contractor.
3.  Application requirements.  A community contactor shall submit an application for 
approval by the department to establish a project.  An application for a project must include:
A.  Sponsorship by a community coalition under subsection 7;
B.  A provision for enrollment of an eligible person under subsection 5 who resides 
within the community of the community coalition under paragraph A;
C.  An assessment evaluating data on and the demographics of the community of the 
community coalition under paragraph A to determine the needs of the population of 
eligible persons in the community regarding care, health care and education, the 
resources available in the community to address those needs and the ability of the 
project to address those needs using the project components under subsection 4;
D.  An action plan based upon the assessment in paragraph C that states objectives, 
goals and intended outcomes and responds to the needs of the community using the 
available resources and incorporating the project components under subsection 4; and
E.  A proposed 3-year budget to implement the action plan under paragraph D and 
operate the project.
4.  Project components.  Project components must include the following:
A.  Service delivery as provided by:
(1)  A child care center or family child care provider, for at least 48 weeks per year, 
days per week excluding state holidays, available 10 hours per day and with up 
to 10 days of staff training; or
(2)  Home visitor services, including group socialization activities that include a 
child and the child's parent, for at least 48 weeks per year.  Services must focus on 
the parent-child relationship and be culturally and linguistically responsive.
A participant may receive service delivery under subparagraph (1) or (2) or both.
B.  Screening and ongoing child assessments conducted in a manner that is responsive 
to a child's home language and culture.  Screening must include an initial assessment 
of developmental, behavioral, motor, language, cognitive and social and emotional 
skills to identify a delay in development in a child's skills or identify a disability that 
may require further evaluation.  Ongoing assessment must monitor a child's 
development and progress toward individual goals with input from the child's family 
to determine a child's strengths and needs and possible adjustment of child care center 
and family child care provider teaching practices and home visit strategies and to 
support a referral to the Child Development Services System under Title 20-A, section 
7209, subsection 3 when necessary;
C.  Specialized support for participants, including for cultural and linguistic needs and 
for children with diagnosed or who have physical or mental disabilities or 
developmental delays. Support may include access to and participation in learning and 
social experiences and activities;
D.  Family engagement practiced at all levels of the project, focusing on culturally and 
linguistically responsive relationship building within the family, including:
(1)  Communicating effectively with members of a family;
(2)  Forming positive goal-focused relationships with members of a family;
(3)  Involving a parent in decision making, teaching practices, including screening, 
assessment and planning for interactions and learning environments, and 
implementing project services;
(4)  Ensuring consistency between a child's home and comprehensive, high-quality 
early child care and education; and
(5)  Ensuring project practices are responsive to a family's needs, including 
providing connections to employment and education supports;
E. Support for a child's immunization and preventive health and dental care by 
providing encouragement for a parent to comply with the department's early periodic 
screening, diagnosis and treatment program under section 3173; and
F.  Transportation options to assist a family to travel to or from health care, child care 
or education services.
5.  Participant eligibility.  A participant in a project must be a child who is at risk and:
A.  Who is receiving care in a facility licensed under section 8301-A; or
B.  Whose parent requests home visitor services.
6.  Suspension; expulsion.  In accordance with rules issued by the department, if a 
child's behavior threatens the health or safety of a participant, project staff member or other 
person, a project must follow the suspension and expulsion procedures under 45 Code of 
Federal Regulations, Section 1302.17.
7.  Community coalition; membership.  A community coalition shall assist and 
support a community contractor in sponsoring, developing and submitting a project 
application under subsection 3, including a community assessment and supporting 
comprehensive, high-quality early child care and education in the community.  
Membership of a community coalition must include the community contractor, who is the 
lead member of the community coalition, and at least one:
A.  Representative of the local business community;
B.  Child care center;
C.  Family child care provider;
D.  Parent of a child using early childhood services;
E.  Home visitor;
F.  Mental health care provider;
G.  Public school administrator;
H.  Health care provider;
I.  Representative of an organization that supports workforce development;
J. Provider of services under the federal Individuals with Disabilities Education Act, 
Part B or Part C;
K. Provider of professional development to early child care and education 
professionals; and
L.  If available in the community, a faculty member of a career and technical center or 
higher education institution specializing in early childhood.
A member of a community coalition must be located or operate within the community 
represented by the community coalition.  A community coalition may include a local 
government staff member or a representative of an agency that provides services to or a 
local judicial staff member who has engaged with an at-risk population, a library or local 
literacy program staff member, an elementary school teacher, a representative of adult 
education or other similar member of the community.
8.  Community contractor.  A community contractor shall have adequate 
infrastructure and qualified and credentialed staff to carry out the duties under this 
subsection.  Duties of a community contractor include:
A.  Representing and being the responsible member for the community coalition;
B.  Submitting an application under subsection 3;
C.  Being the lead member and coordinator of a community coalition and the coalition's 
activities;
D.  Contracting for and ensuring implementation of high-quality services with 
community providers;
E.  Employing or contracting for all required services;
F.  Implementing and maintaining a data system to collect and report aggregate data 
regarding child, family and provider information, activities and outcomes; and
G.  Participating in a collective, Internet-based system that captures data from all 
project locations in a manner that protects the confidentiality of information of 
participants.
9.  Community contractor staff requirements.  Community contractor staff 
requirements include:
A.  For education services supporting a child care center or family child care provider, 
a bachelor's degree or advanced degree in early childhood education or a related field 
with equivalent course work and experience in early childhood development;
B.  For health-related services supporting a child care center or family child care 
provider, training and experience in public health, nursing, health education, maternal 
and child health or health administration and:
(1)  If the staff member performs a health care procedure or provides health care 
services, licensure or certification authorizing the member to perform the 
procedure or provide the service;
(2)  If the staff member provides nutrition services, licensure, registration or 
certification as a dietitian or nutritionist; and
(3)  If the staff member provides mental health services, licensure or certification 
as a mental health professional and experience in serving young children and 
families;
C.  For family and community partnership services, training and experience in a field 
related to social, human or family services;
D.  For disability services, a bachelor's degree and training and experience in securing 
and individualizing services for children with physical and mental disabilities; and
E.  For home visitors, a bachelor's degree in human services or a related field and 
experience in the provision of home visitor services and knowledge of infant and child 
development.
A staff member, including a community coach under subsection 11, may be an employee 
of the community contractor or another person who contracts with the community 
contractor to provide services under this subsection.
10.  Community provider.  A community provider:
A.  Shall enter into a contract with a community contractor to provide services to a 
project;
B.  Must be in good standing with the department's division of licensing and 
certification;
C.  Shall agree to meet the highest level of requirements for the department's quality 
rating system established pursuant to section 3737, subsection 3; and
D.  Shall agree to provide the community contractor with data on a participant or 
provider consented to under subsection 12 as requested by the contractor.
11.  Community coach.  The community contractor shall employ or contract with a 
community coach to provide information and training to a community provider.  A 
community coach must receive training from a research-based early childhood program 
with experience in a comprehensive, high-quality early child care and education program.
12.  Consent to data.  A community provider or community contractor may not use 
personally identifying data derived from services provided to a participant without the 
consent of a participant's parent.  A community provider or community contractor may not 
use the personally identifying data derived from services provided to the family of a 
participant without the consent of the parent.
13.  Funding.  The department shall seek and apply for available federal funds or funds 
from any other sources to pay the costs of projects.  To the maximum extent possible, the 
department shall use state funds received for the projects to maximize its receipt of federal 
funds to be used for the projects.  A community coalition may accept  grant funding or 
other funding as appropriate  from the Federal Government, a department, agency or office 
of State Government or a political subdivision of State Government or a private entity such 
as an individual, foundation or business.
14.  Administration.  The department may design program implementation in 
consultation with an independent evaluator that has experience or expertise in early care 
and education.  In determining program outcomes and measures, the department shall craft 
guidelines to ensure the development of a common set of measures of core elements of 
evidence-based practices.  Outcome data must include reports on specific subpopulations 
of children, including by gender, race, disability and dual language learners.  The 
department and the Children's Cabinet established in Title 5, section 19131 shall facilitate 
data linkages relating to outcome data with the Department of Education to measure 
ongoing school outcome data.
15.  Rules.  The department shall adopt rules to carry out the purposes of this chapter.  
Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A.
Sec. 3.  Pilot projects.  Pursuant to the Maine Revised Statutes, Title 22, section 
3931, subsection 3, the Department of Health and Human Services shall request 
applications for a pilot project to commence June 1, 2022 to carry out the purposes of the 
First 4 ME Early Care and Education Program established under Title 22, chapter 1065.  
The department shall select up to 5 pilot projects from applications submitted.  The 
department shall prioritize funding to a project that serves a community with high numbers 
or a high percentage of children who are economically disadvantaged or that effectively 
involves a wide variety of providers or other entities in the community, including school 
administrative units.
Sec. 4.  Report.  On or before October 2, 2024, a pilot project selected under section 
shall report to the Department of Health and Human Services on the progress toward 
objectives, goals and outcomes of the project detailed in the project's proposal.  On or 
before January 1, 2025, the department shall report to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters regarding the 
project reports received under this section along with any recommended legislation.  The 
committee may report out legislation based upon the department's report to the First 
Regular Session of the 132nd Legislature.
SUMMARY
This bill:
1.  Establishes the Help Maine Grow System in the Department of Health and Human 
Services.  The system is a comprehensive, statewide, coordinated system of early 
identification, referral and follow-up for children from prenatal care up to 8 years of age 
and their families.  The system ensures access to early periodic screening, diagnosis and 
treatment services and related services to promote healthy development and develop a 
coordinated system of screening, referral and services.  The bill establishes the position of 
coordinator of the system to work collaboratively across offices within the department, the 
Children's Cabinet, the Department of Education and other applicable departments.  The 
department must submit annual reports to the joint standing committees of the Legislature 
having jurisdiction over health and human services and education matters; and
2.  Establishes the First 4 ME Early Care and Education Program under the Department 
of Health and Human Services to provide comprehensive, high-quality early child care and 
education services for at-risk children under 6 years of age who have not entered 
kindergarten and the children's parents by funding projects that integrate comprehensive 
resources and services with traditional child care center and family child care settings.  The 
projects are sponsored by coalitions of stakeholders, providers and other community 
members within the communities that the projects serve.  Each project is led and 
coordinated by a community contractor who staffs the project's operations and contracts 
with community providers to provide health care, education or parenting services, which 
may include services provided in a licensed child care center or by a licensed family child 
care provider, in a home visit or by an individual providing services to a family member 
within the individual's or family member's residence.  The community contractor employs 
or contracts with community coaches who train and provide support to community 
providers.  The department is directed to seek and apply for available federal funds or funds 
from any other sources to pay the costs of projects under the program and, to the maximum 
extent possible, use state funds received for the projects to maximize receipt of federal 
funds to be used for the projects.  This bill directs the department to request proposals for 
up to 5 pilot projects to implement the program and to report to the Legislature on the 
progress of the pilot projects toward the objectives, goals and intended outcomes of the 
projects in 2025.