An Act Regarding Children with Behavioral Health Needs Awaiting
Maine Legislature, Session 132, LD 0791
Sponsors: BALDACCI
Amends: 22 MRSA §3174-P, 34-B MRSA §15003

Legislative Document
No. 791
S.P. 354
In Senate, March 4, 2025
An Act Regarding Children with Behavioral Health Needs Awaiting 
Placement in Residential Care Facilities
(EMERGENCY)
Received by the Secretary of the Senate on February 27, 2025.  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 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, the Department of Health and Human Services is required to ensure the 
operation of a psychiatric residential treatment facility as soon as possible and prior to 90 
days after adjournment; 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-PPP is enacted to read:
§3174-PPP.  Reimbursement for hospitals other than critical access hospitals for days 
awaiting placement
Beginning January 1, 2026, the department shall provide reimbursement to hospitals, 
other than critical access hospitals, for each day that a MaineCare eligible individual under 
years of age is in the care of a hospital while awaiting placement in a children's 
residential care facility as defined in section 8101, subsection 4.  The department shall 
reimburse hospitals prospectively at the average daily rate for a MaineCare member at a 
children's residential care facility.  For the purposes of this section, "critical access hospital" 
has the same meaning as in section 7932, subsection 10.
Sec. 2.  34-B MRSA §15003, sub-§9-A is enacted to read:
9-A.  Monthly data report.  Beginning November 1, 2025, the department shall 
submit a monthly report to the joint standing committee of the Legislature having 
jurisdiction over health and human services matters with the total number of children in a 
hospital emergency room who stayed in that hospital emergency room longer than 48 hours 
after they no longer needed a hospital level of care.  The report must also provide the 
following data breakdown for the children in the report:
A.  The number of children under 12 years of age;
B.  The number of children who have entered the hospital emergency room directly 
from a residential setting, including, but not limited to, a children's home as defined in 
Title 22, section 8101, subsection 1, a children's residential care facility as defined in 
Title 22, section 8101, subsection 4 or another hospital;
C.  The number of children who are experiencing homelessness; and
D.  The services needed that are unavailable, causing the children to remain in the 
hospital emergency room.
Sec. 3.  Hospital reimbursement rules.  The Department of Health and Human 
Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, 
Section 45, Hospital Services to implement the Maine Revised Statutes, Title 22, section 
3174-PPP.  Rules adopted pursuant to this section are routine technical rules as defined in 
Title 5, chapter 375, subchapter 2-A.
Sec. 4.  Crisis centers.  No later than 270 days after adjournment of the First Regular 
Session of the 132nd Legislature or March 16, 2026, whichever is later, the Department of 
Health and Human Services shall issue a request for proposals to develop 3 crisis centers 
in the State to meet the needs of children and adolescents with high levels of behavioral 
health needs who are located in a hospital awaiting placement in an appropriate residential 
facility or community service.  At least 1/3 of the beds must be available for use by children 
with intellectual disabilities or autism spectrum disorder.  The request for proposals must 
include capital costs with a goal to adapt existing facilities in the State.  If no vendor has 
responded to the request for proposals by October 1, 2026, the department is authorized to 
issue a sole-source contract.  If the department fails to enter into an agreement with a vendor 
to develop one or more crisis centers by December 1, 2026, the department shall submit a 
report to the joint standing committee of the Legislature having jurisdiction over health and 
human services matters by March 1, 2027 with a plan for how the department will meet the 
crisis needs of children and adolescents with high levels of behavioral health needs.
Sec. 5.  Psychiatric residential treatment facilities.  The Department of Health 
and Human Services shall enter into an agreement with a vendor to provide one or more 
psychiatric residential treatment facilities no later than April 1, 2025.  If the department 
fails to enter into an agreement with a vendor by that date, the department is required to 
establish a facility that is owned and operated by the department and the facility must be 
operational by July 1, 2026.  The department shall submit a report no later than May 1, 
2025 to the Joint Standing Committee on Health and Human Services with its actions and 
plans with respect to establishing a psychiatric residential treatment facility either through 
a vendor or department operation.
Sec. 6.  Settlement data.  The Department of Health and Human Services shall 
provide to the joint standing committee of the Legislature having jurisdiction over health 
and human services matters copies of the de-identified data provided to the independent 
reviewer pursuant to the settlement agreement executed in response to the lawsuit United 
States of America v. State of Maine, United States District Court, District of Maine, Docket 
No. 1:24-cv-00315-SDN no later than 30 days after that data is provided to the independent 
reviewer.
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 reimburse hospitals 
for children who are eligible under the MaineCare program and who are in hospital 
emergency rooms awaiting placement in a children's residential care facility at the same 
rate as would be provided to a children's residential care facility.  The bill requires the 
department to develop 3 crisis centers for children and adolescents with high levels of 
behavioral health needs and awaiting placement in a residential facility or community 
service.  
The bill requires the department to enter into an agreement with a vendor to provide a 
psychiatric residential treatment facility by April 1, 2025 or develop a facility owned and 
operated directly by the department.  The bill requires the department to provide monthly 
data to the joint standing committee of the Legislature having jurisdiction over health and 
human services matters on the number of children who are in a hospital emergency room 
awaiting placement.  The report must also include the number of children under 12 years 
of age, the number of children who have come from another residential setting or hospital, 
the number of children who are experiencing homelessness and the services the children 
are waiting for.
The bill also requires the department to provide to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters the de-identified 
data provided to the independent reviewer to settle the lawsuit filed by the United States 
Department of Justice no later than 30 days after that data is provided to the reviewer.