An Act To Make MaineCare Rules Pertaining to Global Home and Community-based Services Waiver Programs and Person-centered Planning and Settings Major Substantive Rules
Maine Legislature, Session 130, LD 1773
Committee Amendment CA_A_H908 (House)
Amends: 22 MRSA §3197

COMMITTEE AMENDMENT ,fl-" to H.P. 1324, L.D. 1773, "An Act To Make 
MaineCare Rules Pertaining to Global Home and Community-based Services Waiver 
Programs and Person-centered Planning and Settings Major Substantive Rules" 
Amend the bill in the 3rd paragraph after the title in the first line (page 1, line 7 in L.D.) 
by striking out the following: "physical" 
Amend the bill by striking out all of sections 1 and 2 and inse11ing the following: 
'Sec, 1. 22 MRSA §3197 is enacted to read: 
§3197. 
Rulemaking relating to certain federal requirements for . home and 
community-based services 
The department shall adopt rules governing home and community-based services for 
an adult MaineCare member with a disability or an adult· who is elderly and who is 
receiving MaineCare services under a waiver granted by the federal Department of Health 
and Human Services, Centers for Medicare and Medicaid Services to implement the federal 
requirements of Section 1915(c) of the United States Social Security Act relating to person-
centered planning, requirements to facilitate an individual's dignity and individual choice, 
requirements for provider-owned or provider-controlled residential settings. provider 
qualifications and department oversight and enforcement. Notwithstanding sections 42 and 
3173 and any other provision of law to the contrary, rules adopted pursuant to this section 
after January 19, 2022 are major substantive rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
Sec. 2. Department of Health and Human Services may not enforce routine 
technical rules adopted to implement Section 1915(c) of the United States 
Social Security Act. The Department of Health and Human Services may not enforce 
the routine technical rules adopted and legally effective on January 19, 2022 as the 
department's rule Chapter 101: MaineCare Benefits Manual, Chapter I, Section 6, Global 
HCBS Waiver Person-Centered Planning and Settings Rule, until January 1, 2023. 
COMMITTEE AMENDMENT 
ROS 
COMMITTEE AMENDMENT "fr to H.P. 1324, L.D. 1773 
Sec. 3. Stakeholder group. No later than May 31, 2022, the Department of Health 
and Human Services shall convene a stakeholder group consisting of the following: 3 or 
more providers of home and community-based services including those provided under the 
department's rule Chapter 101: MaineCare Benefits Manual, Chapter II, Sections 21 and 
29; a representative from an association representing organizations that provide services 
for people with intellectual disabilities, autism and brain injury; a consumer who receives 
home and community-based services; a direct care worker who provides home and 
community-based services; a family member of a consumer who receives home and 
community-based services; and representatives from the Office of Aging and Disability 
Services, the Office of MaineCare Services, the division of licensing and certification and 
the program integrity unit within the Department of Health and Human Services. The 
department shall provide staff mg to the stakeholder group. The purpose of this stakeholder 
group is to simplify the process and documentation of evidence requirements providers use 
to demonstrate compliance with the department's rule Chapter 101: MaineCare Benefits 
Manual, Chapter I, Section 6. The stakeholder group shall review the compliance process, 
documentation requirements and auditing standards following the federal deadline for full 
state compliance. The stakeholder group shall also assess the need for additional funding 
for the department's home and community-based services settings rule grant program that 
is part of the State's approved spending plan under the federal American Rescue Plan Act 
of 2021, Section 9817. The stakeholder group shall meet monthly from June 2022 to 
September 2023. The department shall submit 2 repotts on behalf of the stakeholder group 
to the joint standing committee of the Legislature having jurisdiction over health and 
human services matters, the first no later than October 30, 2022 and the 2nd no later than 
October 30, 2023. The committee is authorized to report out legislation in response to the 
reports to the First Regular Session and the Second Regular Session of the 131st 
Legislature.' 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment is the minority report of the committee. It removes the requirement 
that rules adopted prior to January 1, 2023 be major substantive rules and replaces it with 
a requirement that any rules adopted after January 19, 2022 be major substantive rules. It 
prohibits the Department of Health and Human Services from enforcing the routine 
technical rule that was adopted on January 19, 2022 until Januaiy 1, 2023. It requires the 
department to convene a stakeholder group to simplify the process and documentation of 
evidence requirements needed to comply with the department's global settings rule, Chapter 
101: MaineCare Benefits Manual, Chapter I, Section 6, The department is directed to 
submit 2 rep01ts to the joint standing committee of the Legislature having jurisdiction over 
health and human services matters. The committee is authorized to report out legislation 
in response to the reports. The amendment also clarifies that the rules governing home and 
community-based services are not limited in application to individuals with physical 
disabilities. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/21/22 feae 
LD 1773 
LR 2429(02) 
An Act To Make MaineCare Rules Pertaining to Global Home and Community-based Services Waiver 
Programs and Person-centered Planning and Settings Major Substantive Rules 
l?iscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment ,/f{lf--CJOi) 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Potential current biennium revenue decrease - Federal Expenditures Fund 
Potential current biennium cost increase - General Fund 
This bill prohibits the Department of Health and Human Services from enforcing the routine technical rules adopted 
on January 19, 2022 relating to an adult MaineCare member with a disability or an adult who is elderly who is 
receiving MaineCare services under a waiver granted by the federal Department of Health and Human Services, 
Centers for Medicare and Medicaid Services, until January 1, 2023. There is a federal requirement that the department 
must be in compliance with the federal Home and Community Based Services settings rule, by March 17, 2023. 
Delaying the enforcement of the department's rule could impact it's ability to show compliance by March 17, 2023. If 
the department is not in compliance by this date, federal funds of around $100 million annually would be at risk. Any 
federal funds lost would need to be replaced by General Fund appropriations, as the related expenses would still be 
incurred. 
LR2429(02) - Fiscal Note - Page 1 of 1