An Act to Address the Shortage of Direct Care Workers for Children with Disabilities in Maine
Maine Legislature, Session 131, LD 0874
Committee: Health and Human Services
Sponsors: BALDACCI
Amends: 22 MRSA §3174-K

Legislative Document
No. 874
S.P. 371
In Senate, February 24, 2023
An Act to Address the Shortage of Direct Care Workers for 
Children with Disabilities in Maine
(EMERGENCY)
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator BALDACCI of Penobscot.
Emergency preamble.  Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, a shortage of direct care workers has resulted in individuals, including 
children, who are eligible for in-home personal care services but are not receiving critical 
services; and
Whereas, parents of children eligible for in-home personal care services are leaving 
paid employment to provide care in the absence of available direct care workers, resulting 
in economic hardship; and
Whereas, this legislation requires the Department of Health and Human Services to 
submit a request for the necessary state plan amendment or Medicaid waiver from the 
Federal Government as soon after enactment 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-KKK is enacted to read:
§3174-KKK.  In-home personal care services to minors
1.  Reimbursement for parent.  A parent of a child who is eligible for in-home 
personal care services under the MaineCare program may register as a personal care agency 
as defined in section 1717, subsection 1, paragraph C and determined in department rule 
and receive reimbursement for providing those services to the child if the following 
requirements are met:
A.  The parent has made reasonable efforts to obtain regular in-home personal care 
services; and
B.  The parent has satisfied the requirements of the applicable background check 
required for providers of in-home personal care services.
2.  Employer designation.  In order for a parent to be registered as a personal care 
agency under subsection 1, another individual who is not a parent of the child must be 
designated as the employer. The person designated as the employer must be approved by 
both the department and the parent to act in the child's interest.
3.  Rulemaking.  The department shall 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.  Department of Health and Human Services to seek federal 
approval.  The Department of Health and Human Services shall seek any necessary state 
plan amendments or waivers from the United States Department of Health and Human 
Services, Centers for Medicare and Medicaid Services to implement the Maine Revised 
Statutes, Title 22, section 3174-KKK. The department shall submit the requests for 
approval no later than 6 months after the effective date of this Act.
Sec. 3.  Rulemaking.  The Department of Health and Human Services shall adopt 
rules in accordance with the Maine Revised Statutes, Title 22, section 3174-KKK, 
subsection 3 no later than 6 months after receiving the necessary approvals from the United 
States Department of Health and Human Services, Centers for Medicare and Medicaid 
Services.
Sec. 4.  Contingent effective date. That section of this Act that enacts the Maine 
Revised Statutes, Title 22, section 3174-KKK takes effect only if the necessary approvals 
sought pursuant to section 2 of this Act are received. The Commissioner of Health and 
Human Services shall notify the Secretary of State, Secretary of the Senate, Clerk of the 
House of Representatives and Revisor of Statutes when approvals sought under section 2 
have been received.
Emergency clause.  In view of the emergency cited in the preamble, this legislation 
takes effect when approved.
SUMMARY
This bill allows for the reimbursement of a parent providing in-home personal care 
services to the parent's child by allowing the parent to register as a personal care agency if 
the parent has made reasonable efforts to obtain regular in-home personal care services and 
has passed a background check. The child must be eligible for the MaineCare program. An 
individual who is not a parent of the child must be designated as the employer and must be 
approved as the employer by both the parent and the Department of Health and Human 
Services. The department is required to request the necessary state plan amendments or 
waivers from the federal Department of Health and Human Services, Centers for Medicare 
and Medicaid Services and adopt routine technical rules upon federal approval.