An Act To Expand Access to Mental Health and Crisis Care for Individuals in Jails and Individuals Experiencing Homelessness
Maine Legislature, Session 130, LD 1968
Committee Amendment CA_A_H947 (House)
Amends: 15 MRSA §101-D

CO:MJVIITTEE AMENDMENT"#'' to H.P. 1463, L.D. 1968, "An Act To Expand 
Access to Mental Health and Crisis Care for Individuals in Jails and Individuals 
Experiencing Homelessness" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'PART A 
Sec. A-1. 15 MRSA §101-D, sub-§10 is enacted to read: 
10. Appropriate placement. When a court commits the defendant to the custody of 
the Commissioner of Health and Human Services for placement in an appropriate 
institution for the care and treatment of persons with mental illness or in an appropriate 
residential program that provides care and treatment for persons who have intellectual 
disabilities or autism as set forth in subsection 4, the transfer of the defendant must take 
place within 30 days from the time the order is transmitted to the State Forensic Service. 
PARTB 
Sec. B-1. Maine State Housing Authority to develop program; target 
population defined. The Maine State Housing Authority shall develop a program to 
provide housing for a target population, defined for this Part as individuals who are 
homeless or at risk of homelessness and suffering from serious and persistent mental illness 
and who are frequent users of high-cost services, including law enforcement, jails and 
hospitals. 
Sec. B-2. Permanent supportive housing; financing. The Maine State Housing 
Authority shall provide financing for no fewer than 50 and up to 200 units of permanent 
supportive housing to the target population. The Maine State Housing Authority shall 
provide financing from any appropriate source, including the federal low-income housing 
tax credit under Section 42 of the federal Internal Revenue Code of 1986, the National 
Housing Trust Fund established by the federal Housing and Economic Recove1y Act of 
COMMITTEE AMENDMENT 
~os 1 
COMMITTEEAMENDMENT'ff.toH.P. 1463,L.D. 1968 
2008 and municipal tax increment financing, to develop the permanent supportive housing 
units. 
Sec. B-3. Service centers; geographic expansion. The Maine State Housing 
Authority shall facilitate the process for the development of no fewer than 50 units of 
permanent supportive housing by January 2027, locating housing in service centers with 
higher populations of the target population and encouraging geographic expansion of 
housing across the State. 
Sec. B-4. Affordability; services. The Department of Health and Human Services 
and the Maine State Housing Authority shall identify rental subsidies that are available to 
the target population to ensure affordability and ongoing residential stability to the 
maximum extent possible. The department shall ensure that each member of the target 
population receives ongoing housing navigation services and continuity in case 
management in order to access and remain successful in permanent supportive housing and 
receives ongoing behavioral health, substance use disorder and other medical services for 
which the member is eligible. 
PARTC 
Sec. C-1. Department of Health and Human Services to develop a 
comprehensive system of residential care to serve people with behavioral 
health needs. 
The Department of Health and Human Services shall develop a 
comprehensive system of residential can, for adults and children with high levels of 
behavioral health needs who are at increased risk of involvement with the criminal justice 
system or who, because of their behaviors, require high levels of staffing. For purposes of 
this Part, "behavioral health" includes a wide range of mental disorders and illnesses, 
substance use disorder, developmental disabilities and autism. 
Sec. C-2. System of residential care; participation. The Department of Health 
and Human Services shall develop a plan for and implement the comprehensive system of 
residential care for adults and children pursuant to this Part in collaboration with 
stakeholders including consumer groups, behavioral health service providers, public safety 
organizations, representatives of the education system, law enforcement organizations and 
hospitals. The plan must be developed over the course of a minimum of 5 stakeholder 
meetings and must align with the development of a strategic plan for behavioral health 
services as required by Resolve 2021, chapter 80. 
Sec. C-3. Elements of the system. In developing the comprehensive system of 
residential care for adults and children pursuant to this Part, the Depaitment of Health and 
Human Services shall incorporate the following elements as they relate to behavioral 
health: 
1. Needs study. A needs study to identify the current and predicted residential needs 
of individuals with behavioral health needs, based on current best practices and evidence, 
for the next 10 years; and 
2. Gaps analysis. A data-informed analysis that identifies the gaps between currently 
available residential services and those predicted needs identified through the needs study 
under subsection 1 and that includes, at a minimum, the following: 
A. Population information: 
COMMITTEE AMENDMENT 
?,,.OS 
COMMITTEE AMENDMENT ff• to H.P. 1463, L.D. 1968 
(1) Geography; 
(2) Insurance status; 
(3) Guardianship and family status; 
(4)Age; 
(5) Medical diagnoses; 
(6) Propensity for violent behaviors; 
(7) Special populations, including, but not limited to, pregnant persons and foster 
children; and 
(8) Other identified factors; 
B. Human and facility infrastructure and access information: 
(1) Availability of providers and community services; 
(2) Labor costs by geographic area; and 
(3) Barriers to access; 
C. Existing barriers that may inhibit access to or the development of needed services; 
D. Evidence-based review of social determinants; 
E. Existing strengths and weaknesses in the systems and support services; and 
F. Defined metrics and outcomes to measure success and progress. 
Sec, C-4. Report. No later than January 2, 2023, the Department of Health and 
Human Services shall submit a report to the joint standing committee of the Legislature 
having jurisdiction over health and human services matters regarding the status of the 
comprehensive system of residential care for adults and children pursuant to this Part, 
including the number of staffed community residential treatment beds for individuals with 
behavioral health needs, including children with behavioral health needs, in each 
geographic region of the State. The report must include the plan developed in collaboration 
with the stakeholders under section 2 and a timeline and metrics to achieve the 
comprehensive system of residential care identified by the analysis under section 3. The 
committee may report out legislation to implement the plan. 
PARTD 
Sec, D-1. Residential bed availability; report. The Department of Health and 
Human Services shall report biannually for a period of 5 years on the number of licensed 
psychiatric inpatient beds and licensed residential treatment beds in each geographic region 
of the State for adults with serious and persistent mental illness, substance use disorder, 
developmental disabilities and autism and for children with behavioral health diagnoses. 
The repmt must include data on occupied beds, total staffed beds, beds that are not available 
and barriers to making those beds available and the number of beds that have been closed. 
The department shall submit the first repmt to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters no later than 
January 2, 2023. The depaitment shall provide repo1ts in June and January of each year 
until the last report is submitted in June 2027. 
PARTE 
Sec. E-1. Appropriations and allocations. The following appropriations and 
allocations are made. 
COMMITTEE AMENDMENT 
ylOS 
COMMITTEE AMENDMENT 'ft" to H.P. 1463, L.D. 1968 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Mental Health Services - Community Z198 
Initiative: Provides funding to establish one Social Services Program Manager position for 
coordination, oversight of a report, reporting to the Legislature, developing policy changes 
and managing changes to a system of residential care following a needs study. 
GENERAL FUND 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
All Other 
GENERAL FUND TOTAL 
Mental Health Services - Community Z198 
2021-22 
0.000 
$0 
$0 
$0 
2022-23 
1.000 
$107,817 
$15,730 
$123,547 
Initiative: Provides one-time funding for a needs study to identify the cmTent and predicted 
residential needs of individuals with behavioral health diagnoses. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Mental Health Services - Community Z198 
2021-22 
$0 
$0 
2022-23 
$214,830 
$214,830 
Initiative: Provides funding to establish 10 Intensive Case Manager positions and one 
Social Services Program Manager position for case management and coordination of 
housing services, substance use services and mental health services. All Other funding is 
also provided for additional training, travel and office space costs. 
GENERAL FUND 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
All Other 
GENERAL FUND TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
DEPARTMENT TOTAL-ALL FUNDS 
2021-22 
0.000 
$0 
$0 
$0 
2021-22 
$0 
$0 
2022-23 
11.000 
$1,143,428 
$216,195 
$1,359,623 
2022-23 
$1,698,000 
$1,698,000 
Amend the bill by relettering or renumbering any nonconsecutive Patt letter or section 
number to read consecutively. 
COMMITTEE AMENDMENT 
iOS 
COMMITTEE AMENDMENT #,a H.P. 1463, L.D. 1968 
SUMMARY 
This amendment, which is the majority report of the committee, replaces the bill, which 
is a concept draft. 
Part A requires an appropriate placement in an institution for the care and treatment of 
persons with mental illness within 30 days from the time the court transmits an order to the 
State Forensic Service committing a defendant to the custody of the Commissioner of 
Health and Human Services. 
Part B requires the Maine State Housing Authority to implement the so-called frequent 
users systems engagement plan developed pursuant to Resolve 2021, chapter 23 by 
requiring the authority to develop at least 50 units, and up to 200 units, of permanent 
supportive housing for individuals who are homeless and suffering from serious and 
persistent mental illness and who have regular interaction with law enforcement or 
hospitals. The authority is directed to facilitate the development of 50 units by January 
2027. The Department of Health and Human Services is directed to provide housing 
navigation and case management services in addition to any behavioral health, substance 
use disorder and medical services for which the individual is eligible. 
Part C requires the Department of Health and Human Services to develop a 
comprehensive system of residential care for adults and children with high levels of 
behavioral health needs who are at risk of involvement with the criminal justice system or 
who, because of their behaviors, require high levels of staffing. The department shall 
submit a report to the joint standing committee of the Legislature having jurisdiction over 
health and human services matters no later than January 2, 2023. 
Part D requires the Department of Health and Human Services to report biannually for 
a period of 5 years to the joint standing committee of the Legislature having jurisdiction 
over health and human services matters on the number of licensed psychiatric inpatient 
beds and licensed residential treatment beds for adults with serious and persistent mental 
illness, substance use disorder, developmental disabilities and autism and for children with 
behavioral health diagnoses. 
Part E provides appropriations and allocations. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 04/01/22 feac:.. 
LD 1968 
LR2352(02) 
An Act To Expand Access to Mental Health and Crisis Care for Individuals in Jails and Individuals 
Experiencing Homelessness 
Fiscal Note for Bill as Amended by Committee Amendment #OJ~ C/'f1} 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY2021-22 
FY2022-23 
$0 
$1,698,000 
$0 
$1,698,000 
Projections 
FY2023-24 
$1,494,887 
$1,494,887 
Projections 
FY2024-25 
$1,527,974 
$1,527,974 
The bill includes General Fund appropriations to the Department of Health and Human Services of $1,698,000 in 
fiscal year 2022-23 to establish 10 Intensive Case Manager positions and one Social Services Program Manager 
position for case management, coordination of housing, substance use services and mental health services, a needs 
study to identify the current and predicted residential needs of individuals with behavioral health diagnoses and to 
establish one Social Services Program Manager position for coordination, oversight of a report, reporting to the 
legislature, developing policy changes and managing the system's changes following a needs study. 
This legislation requires the Maine State Housing Authority (MSHA) to implement the so-called Frequent Users 
Systems Engagement (FUSE) program by providing financing for no less than 50 and up to 200 units of permanent 
supportive housing to individuals who are homeless or at risk of homelessness and suffering from serious and 
persistent mental illness and are frequent users of high-cost services, including law enforcement, jails and hospitals. 
MSHA has indicated that it has the financing resources available to implement the requirements of this legislation and 
General Fund appropriations are not required. 
LR2352(02) - Fiscal Note - Page 1 of 1