An Act To Support Early Intervention and Treatment of Psychotic Disorders
Maine Legislature, Session 130, LD 0674
Committee: Health and Human Services
Sponsors: BREEN, CARNEY, CLAXTON, MADIGAN, MEYER, WARREN
Amends: 22 MRSA §3174-F

Legislative Document
No. 674
S.P. 261
In Senate, March 4, 2021
An Act To Support Early Intervention and Treatment of Psychotic 
Disorders
(EMERGENCY)
Received by the Secretary of the Senate on March 2, 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 Senator BREEN of Cumberland.
Cosponsored by Senators: CARNEY of Cumberland, CLAXTON of Androscoggin, 
Representatives: MADIGAN of Waterville, McCREIGHT of Harpswell, MEYER of Eliot, 
WARREN of Hallowell.
Emergency preamble.  Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, coordinated specialty care programs exist in the State that could treat more 
individuals suffering from psychotic disorders but lack a funding mechanism; and
Whereas, early treatment of symptoms of psychotic disorders helps prevent the onset 
of advanced mental illness and should begin as soon as possible; 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.  22 MRSA §3174-FFF is enacted to read:
§3174-FFF.  Coordinated specialty care reimbursement
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A.  "Coordinated specialty care" means an evidence-based, recovery-oriented 
treatment model for individuals in the early years of a psychotic disorder that promotes 
shared decision making with a team of specialists to work with an individual to develop 
a personalized treatment plan.
B.  "Psychotic disorder" means a diagnosis of schizophrenia spectrum disorder and 
other psychotic disorders or mood disorders with prominent psychotic features.
2.  Coordinated specialty care.  Beginning July 1, 2021, the department shall 
reimburse for coordinated specialty care for the treatment of MaineCare members within 
the first 3 years of onset of a psychotic disorder.  A MaineCare member receiving 
coordinated specialty care under this section must have access to all of the following 
services:
A.  Case management to manage services to help the MaineCare member develop 
problem-solving skills and manage medication;
B.  Family support to give the family of the MaineCare member information and skills 
to support the member receiving treatment and recovery services;
C.  Psychotherapy services that teach resiliency, managing the psychotic disorder, 
promoting wellness and developing coping skills;
D.  Medication management to determine the most effective medication and the lowest 
dosage to be effective;
E.  Support services to help the MaineCare member continue education or employment 
or return to education or employment; and
F.  Peer support services to connect the MaineCare member with others who have 
similar experiences.
3.  Bundled reimbursement rate.  The department, in cooperation with the 
Department of Education and the Department of Labor, shall establish a bundled 
reimbursement rate for any services identified in subsection 2, paragraphs A to F that are 
not otherwise covered under the MaineCare program.  In establishing the bundled 
reimbursement rate, the department shall consider various structures of a bundled 
reimbursement rate model, including, but not limited to, a daily rate or a monthly rate.
4.  Funds.  The department may review, develop or apply for any source of funds that 
may be available to implement reimbursement for services under this section that are not 
otherwise covered under the MaineCare program.
5.  Evaluation assessment.  The department shall ensure that an organization 
providing coordinated specialty care provides program evaluation assessments to the 
department, including external ratings of fidelity to the coordinated specialty care model 
and reports of clinical and functional outcomes.
6.  Rules.  The department may adopt rules to implement this section. Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A.
Sec. 2.  State plan amendment or waiver.  By June 30, 2021, the Department of 
Health and Human Services shall submit a state plan amendment or waiver under Section 
1135 of the United States Social Security Act, Title XI to the United States Department of 
Health and Human Services, Centers for Medicare and Medicaid Services to implement the 
coordinated specialty care services under the Maine Revised Statutes, Title 22, section 
3174-FFF.
Upon approval from the United States Department of Health and Human Services, 
Centers for Medicare and Medicaid Services, and no later than January 1, 2022, the 
Department of Health and Human Services, in cooperation with the Department of 
Education and the Department of Labor, shall establish a bundled reimbursement rate for 
coordinated specialty care services that are not otherwise covered under the MaineCare 
program for the treatment of MaineCare members within the first 3 years of onset of a 
psychotic disorder.  In establishing the bundled reimbursement rate, the department shall 
consider various structures of a bundled reimbursement rate model, including, but not 
limited to, a daily rate or a monthly rate.
Services provided as part of coordinated specialty care include, but are not limited to, 
the following:
1.  Case management to manage services to help a MaineCare member develop 
problem-solving skills and manage medication;
2.  Family support to give the family of the MaineCare member information and skills 
to support the member receiving treatment and recovery services;
3.  Psychotherapy services that teach resiliency, managing the psychotic disorder, 
promoting wellness and developing coping skills;
4.  Medication management to determine the most effective medication and the lowest 
dosage to be effective;
5.  Support services to help the MaineCare member continue education or employment 
or return to education or employment; and
6.  Peer support services to connect the MaineCare member with others who have 
similar experiences.
Sec. 3.  Community mental health services block grant.  The Department of 
Health and Human Services shall seek federal funding from the United States Department 
of Health and Human Services, Substance Abuse and Mental Health Services 
Administration through the community mental health services block grant to cover services 
provided pursuant to the Maine Revised Statutes, Title 22, section 3174-FFF that are not 
otherwise covered by the MaineCare program.  The community mental health services 
block grant funding may be used in any other manner allowable under federal law to 
establish and support coordinated specialty care services.
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 a 
reimbursement rate for a coordinated specialty care model to treat individuals showing 
early signs of psychotic disorder.  Services must be evidence based and treat both the 
individual and the family.  The department is directed, in cooperation with the Department 
of Education and the Department of Labor and no later than July 1, 2021, to establish a 
bundled rate to reimburse for services provided under the coordinated specialty care model 
that are not otherwise covered under the MaineCare program.  The bill directs the 
department to apply to the United States Department of Health and Human Services, 
Centers for Medicare and Medicaid Services for a waiver or state plan amendment to 
cooperate with the Department of Education and the Department of Labor to establish a 
bundled reimbursement rate and to seek federal funding under the community mental 
health services block grant.