Resolve, to Increase Access to Brain Injury Waiver Services
Maine Legislature, Session 131, LD 1617
Committee: Health and Human Services
Sponsors: LIBBY, GROHOSKI, HEPLER, LANDRY, PERRY, RANA, SARGENT, SKOLD, TERRY

Legislative Document
No. 1617
H.P. 1042
House of Representatives, April 11, 2023
Resolve, to Increase Access to Brain Injury Waiver Services
(EMERGENCY)
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative LIBBY of Auburn.
Cosponsored by Senator GROHOSKI of Hancock and
Representatives: HEPLER of Woolwich, LANDRY of Farmington, PERRY of Bangor, RANA 
of Bangor, SARGENT of York, SKOLD of Portland, TERRY of Gorham.
Emergency preamble.  Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, this legislation must take effect before the end of the 90-day period in order 
for the Department of Health and Human Services to submit a request to the United States 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
to request approval to amend the brain injury waiver 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
Sec. 1.  Department of Health and Human Services to increase MaineCare 
rates. Resolved: That, upon approval of a waiver amendment from the United States 
Department of Health and Human Services, Centers for Medicare and Medicaid Services, 
the Department of Health and Human Services shall amend its rules in Chapter 101: 
MaineCare Benefits Manual, Chapter III, Section 18, Allowances for Home and 
Community-Based Services for Adults with Brain Injury, to increase rates for Home 
Support (Residential Habilitation) Level I by an amount in the same proportion as the 
difference between the Chained Consumer Price Index on the date the rate was last adjusted 
and the Chained Consumer Price Index on the effective date of this resolve. The rules must 
specify that the increase in reimbursement rates must be applied to wages and benefits for 
direct support employees. For the purposes of this resolve, "direct support employees" 
means all employees who work directly with individuals on the waiver and receiving 
services in the home but does not include administrators and contract labor, and "Chained 
Consumer Price Index" has the same meaning as in Maine Revised Statutes, Title 36, 
section 5402, subsection 1. Rules adopted pursuant to this section are routine technical 
rules pursuant to Title 5, chapter 375, subchapter 2-A.
Sec. 2.  Care coordination services units. Resolved: That, by January 1, 2024, 
the Department of Health and Human Services shall amend its rules in Chapter 101: 
MaineCare Benefits Manual, Chapter II, Section 18, Home and Community-Based 
Services for Adults with Brain Injury, to allow for 400 units of care coordination in each 
year rather than limiting it to 200 units after one year. Rules adopted pursuant to this section 
are routine technical rules pursuant to the Maine Revised Statutes, Title 5, chapter 375, 
subchapter 2-A.
Sec. 3.  Department of Health and Human Services to explore telehealth 
opportunities. Resolved: That the Department of Health and Human Services shall 
explore opportunities to provide additional reimbursable services using telehealth to 
members currently receiving services under the brain injury waiver administered by the 
department's office of aging and disability services, including care coordination services, 
that could be provided by health care providers, including licensed medical personnel and 
nonlicensed personnel.
Sec. 4.  Department of Health and Human Services to submit waiver 
amendment. Resolved: That the Department of Health and Human Services shall 
submit a request to the United States Department of Health and Human Services, Centers 
for Medicare and Medicaid Services no later than October 1, 2023 to request approval to 
amend the brain injury waiver, rule Chapter 101: MaineCare Benefits Manual, Chapter III, 
Section 18, Allowances for Home and Community-Based Services for Adults with Brain 
Injury, to increase MaineCare reimbursement rates pursuant to section 1.
Sec. 5.  Increase to employee wages. Resolved: That, to qualify for the rate 
increase pursuant to section 1, an agency providing direct support employees must 
demonstrate, to the satisfaction of the Department of Health and Human Services, that an 
increase in wages and benefits for direct support employees has been granted that equals 
the amount of increase received as a result of the increased reimbursement. The increase 
must be granted or paid out retroactively from the date the department begins reimbursing 
at the increased rates.
Emergency clause.  In view of the emergency cited in the preamble, this legislation 
takes effect when approved.
SUMMARY
This resolve directs the Department of Health and Human Services to seek approval 
from the United States Department of Health and Human Services, Centers for Medicare 
and Medicaid Services to amend the brain injury waiver, rule Chapter 101: MaineCare 
Benefits Manual, Chapter III, Section 18, Allowances for Home and Community-Based 
Services for Adults with Brain Injury, to increase Home Support (Residential Habilitation) 
Level I rates for services provided to MaineCare members by an amount in the same 
proportion as the difference between the Chained Consumer Price Index on the date the 
rate was last adjusted and the Chained Consumer Price Index on the effective date of this 
resolve. It requires the increase in reimbursement to go to direct support employees. It also 
allows up to 400 units of care coordination each year rather than only in the first year of 
receiving services under the waiver. The Department of Health and Human Services is 
directed to explore opportunities to provide additional telehealth services, including care 
coordination services, provided by both licensed medical personnel and nonlicensed 
personnel.