An Act to Support
Maine Legislature, Session 132, LD 1932
Committee Amendment CA_A_H936 (House)

COMMITTEE AMENDMENT '/-T" to H.P. 1293, L.D, 1932, "An Act to Support
Essential Support Workers and Enhance Workforce Development"
Amend the bill by striking out all of sections 1 to 4.
Amend the bill by striking out all of sections 6 to 10 and inserting the following:
'See. 6. Maine Health Data Organization and Department of Health and
Human Services to develop care gap plan. The Maine Health Data Organization,
referred to in this section as "the organization," and the Department of Health and Human
Services, referred to in this section as "fhe department," shall develop a plan to measure the
State's care gap. For the purposes of this section, "care gap" means the difference between
the home and community-based services individuals are authorized to receive and the
services that they actually received. The organization and the department shaU do the
following:
1. Work with the department's appropriate vendors to create a supplemental file to
report on the care gap for services provided under the sections of MaineCare policy
provided under rule Chapter 101: MaineCare Benefits Manual, Chapter II, Sections 12,17,
18, 19, 20, 21, 28, 29, 40, 65, 92 and 96. This file must include the authorization data
elements needed for the organization to link this data with the claims and eligibility data
that the vendor currently submits to the organization on behalf of the Office of MaineCare
Services within the department. The organization must have access to the authorization,
claims and eligibility data necessary to calculate the care gap. Using the existing data
governance framework, the organization shall securely integrate multiple data streams,
manage and store the data and develop dashboards to display key data points over time;
2. Work with the department's appropriate vendors to create a uniform reporting system
for submitting key data elements to report on the care gap for services provided under the
department's Office of Aging and Disability Ser/ices, Part 1 rule Chapter 5, Office of
Aging and Disability Services Policy Manual, Sections 61, 63, 68 and 69. These data
elements that may need modification to allow for data collection include, but are not limited
COMMITTEE AMENDMENT
COMMTTTEE AMENDMENT " /+ " to H.P, 1293, L.D. 1932
to, the medical eligibility determination form, authorized care plan, invoiced payment data
and utilization reports; and
3. Determine if there is any data available to estimate the care gap for services provided
under the sections of MaineCare policy provided under rule Chapter 101: MaineCare
Benefits Manual, Chapter II, Sections 23 and 26 and those services provided under Section
65 that do not require prior authorization. If data is available, the organization and the
department shall estimate the care gap.
Following the modifications to contracts required in subsections 1 and 2, the
organization shall integrate multiple data streams, manage and store the data and develop
dashboards to display key data points over time. The organization may integrate any
available data for those MaineCare services that do not require prior authorization
described in subsection 3. The organization shall submit an annual report to the joint
standing committees of the Legislature having jurisdiction over health and human services
matters and over appropriations and financial affairs no later than November 15th of each
year beginning m 2027. This report must contain data on the care gap with a breakdown
by MaineCare Benefits Manual sections and Office of Aging and Disability Services Policy
Manual sections, including any changes in trends. The first report in 2027 must include
information on progress toward developing the care gap analysis, mcluding any options for
MaineCare services without prior authorization. The joint standing conunittee of the
Legislature having jurisdiction over health and human services matters is authorized to
report out legislation in response to the first report in 2027. As part of any proposed
legislation, the j oint standing committee of the Legislature having jurisdiction over health
and human services matters must consider the inclusion of the care gap data and the full
cost of providing the services identified in the care gap in one of the existing statutorily
required reports submitted by the department to the joint standing committee of the
Legislature having jurisdiction over health and human services matters.
Sec. 7. Cost-of-living adjustment for essential support workers; MaineCare
rates. Notwithstanding any provision of law to the contrary, the Department of Health
and Human Services shall submit a request to seek approval from the United States
Department of Health and Human Services, Centers for Medicare and Medicaid Services
to implement a cost-of-livmg adjustment of 3.07% for reimbursement rates subject to rule
Chapter 101: MaineCare Benefits Manual, Chapter II, Sections 13, 65 and 92 and mle
Chapter 101: MaineCare Benefits Manual, Chapter HI, Sections 2, 12,17,18,19,20, 21,
26, 29, 40, 67, 96 and 97 Appendix C effective January 1, 2027. The department shall
submit the request required to seek approval under this section to implement the cost-of-
living adjustment as soon as practicable.
Sec. 8. Cost-of-livmg adjustment for state-funded home and community-
based services. The Department of Health and Human Services shall increase
reimbursement for state-fimded home and community-based services by implementing a
cost-of-Uving increase of 3.07% for direct care services provided under the department's
Office of Aging and Disability Services, Part 1 mle Chapter 5, Office of Aging and
Disability Services Policy Manual, Sections 61, 63, 68 and 69 effective January 1, 2027 to
maintain parity with similar MaineCare programs.
See. 9. Appropriations and allocations. The followmg appropriations and
allocations are made.
Page2-132LRl742(02)
COMMITTEE AMENDMENT
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COMMnTEE AMENDMENT'^ "toH.P. 1293, L.D. 1932
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HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Developmental Services Waiver - MaineCare Z211
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-funded home and community-based services.
GENERAL FUND 2025-26 2026-27
All Other $0 $3,601,826
GENERAL FUND TOTAL $0 $3,601,826
Developmental Services Waiver - Supports Z212
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-funded home and community-based services.
GENERAL FUND 2025-26 2026-27
All Other $0 $295,468
GENERAL FUND TOTAL $0 $295,468
Long Term Care - Office of Aging and Disability Services 0420
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-funded home and community-based services.
GENERAL FUND 2025-26 2026-27
AllOfher $0 $253,130
2425 GENERAL FUND TOTAL $0 $253,130
Mfedicaid Services - Developmental Services Z210
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-funded home and community-based services.
GENERAL FUND 2025-26 2026-27
AU Other $0 $270,572
3233 GENERAL FUND TOTAL $0 $270,572
Medical Care - Payments to Providers 0147
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-ftmded home and community-based services.
GENERAL FUND 2025-26 2026-27
All Other $0 $2,954,257
GENERAL FUND TOTAL $0 $2,954,257
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COMMTTTEE AMENDMENT"/^ "toH.P. 1293, L.D. 1932
"A
FEDERAL EXPENDITURES FUND
All Ofher
FEDERAL EXPENDITURES FUND TOTAL
FEDERAL BLOCK GRANT FUND
All Other
FEDERAL BLOCK GRANT FUND TOTAL
Nursing Facilities 0148
2025-26
$0
$0
2025-26
$0
$0
2026-27
$11,488,930
$11,488,930
2026-27
$75,046
$75,046
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-funded home and community-based services.
GENERAL FUND
All O&er
GENERAL FUND TOTAL
FEDERAL EXPENDITURES FUND
All Other
FEDERAL EXPENDITURES FUND TOTAL
OTHER SPECIAL REVENUE FUNDS
All Other
OTHER SPECIAL REVENUE RJNDS TOTAL
Office of]VIaineCare Services 0129
2025-26
$0
$0
2025-26
$0
$0
2025-26
$0
$0
2026-27
$2,099,642
$2,099,642
2026-27
$3,843,337
$3,843,337
2026-27
$379,339
$379,339
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-funded home and community-based services.
GENERAL FUND
All Other
GENERAL FUND TOTAL
FEDERAL EXPENDITURES FUND
All Other
FEDERAL EXPENDITURES FUND TOTAL
2025-26
$0
$0
2025-26
$0
2026-27
$42,194
$42,194
2026-27
$130,538
1.538
Page4-132LR1742(02)
COMMITTEE AMENDMENT
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COMMHTEE AMENDMENT "/-)• "toH.P, 1293, L.D. 1932
•f{
PNMI Room and Board Z009
Initiative: Provides funding to the Department of Health and Human Services to implement
a cost-of-living adjustment for direct care services under several MaineCare policy sections
and state-funded home and community-based services,
GENERAL FUND 2025-26 2026-27
All Other $0 $534,775
GENERAL FUND TOTAL $0 $534,775
HEALTH AND HUMAN SERVICES,
DEPARTMENT OF
DEPARTMENT TOTALS 2025-26 2026-27
1314 GENERAL FUND $0 $10,051,864
FEDERAL EXPENDITURES FUND $0 $15,462,805
OTHER SPECIAL REVENUE FUNDS $0 $379,339
FEDERAL BLOCK GRANT FUND $0 $75,046
DEPARTMENT TOTAL - ALL FUNDS $0 $25,969,054
HEALTH DATA ORGANIZATION, MAINE
Maine Health Data Organization 0848
Initiative: Provides one-time funding to the Maine Health Data Organization for data
collection and initial implementation of a reporting dashboard to calculate the care gap for
Office of Aging and Disability Services services.
OTHER SPECIAL REVENUE FUNDS 2025-26 2026-27
AllOther $0 $133,768
OTHER SPECIAL REVENUE FUNDS TOTAL $0 $133,768
HEALTH DATA ORGANIZATION, MAINE
DEPARTMENT TOTALS 2025-26 2026-27
OTHER SPECIAL REVENUE FUNDS $0 $133,768
DEPARTMENT TOTAL - ALL FUNDS $0 $133,768
SECTION TOTALS 2025-26 2026-27
3839 GENERAL FUND $0 $10,051,864
FEDERAL EXPENDITURES FUND $0 $15,462,805
OTHER SPECIAL REVENUE FUNDS $0 $513,107
FEDERAL BLOCK GRANT FUND $0 $75,046
COMMITTEE AMENDMENT
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COMMTTTEE AMENDMENT 'f\ " to H.P. 1293, L.D. 1932
SECTION TOTAL-ALL FUNDS $0 $26,102,822
'
Amend the bill by reletteriag or renumbering any nonconsecutive Part letter or section
number to read consecutively.
SUMMARY
This amendment removes all sections of the bill except for the section that adds 2
members to the Essential Support Workforce Advisory Committee.
The amendment applies a one-time cost-of-living adjustment of 3.07% for direct care
services provided under certain sections of the MaineCare Benefits Manual and state-
funded home and conmn.mity-based services. The adjustment is applied beginning January
1,2027.
The amendment replaces the requirement for the Maine Health Data Organization to
develop a methodology to develop a care gap report with a requirement for fhe Maine
Health Data Organization and the department to work with the department's vendors to
allow for the Maine Health Data Organization to develop a plan to measure the care gap in
essential support worker services paid by the MaineCare program or a similar state-funded
program. "Care gap" is defined as the difference between the services individuals are
authorized to receive and the services that they actually received. This follows the
recommendations from the report submitted pursuant to Resolve 2025, chapter 113. The
amendment also requires the joint standing committee of the Legislature having jurisdiction
over health and human services matters to determine which existing reports required by
statute that are submitted by the department to the committee could be amended to include
the ongoing care gap funding requirements.
FISCAL NOTE REQmRED
(See attached)
COMMITTEE AMENDMENT
Revised: 03/27/26 t-Kt-
LD 1932 LR 1742(02)
An Act to Support Essential Support Workers and Enhance Workforce Development
Fiscal Note for Bill as Amended by Committee Amendment';
Committee: Health and Human Services
Fiscal Note Required: Yes
/ J
Fiscal Note
Projections Projections
FY 2025-26 FY 2026-27 FY 2027-28 FY 2028-29
$0 $10,051,864 $20,159,786 $20,159,786
Net Cost (Savings)
General Fund
Appropriations/Allocations
General Fund
Federal Expenditures Fund
Other Special Revenue Funds
Federal Block Grant Fund
Revenue
Federal Expenditures Fund
Other Special Revenue Funds
Federal Block Grant Fund
Fiscal Detail and Notes
The bill includes General Fund appropriations to the Department of Health and Human Services of $10,051,864 in
fiscal year 2026-27 for a cost-of-living adjustment for several sections within MaineCare policy, A Federal
Expenditures Fund allocation is also included in this bill for the FMAP match and an Other Special Revenue Fund
allocation for the Nursing Facility Tax,
An Other Special Revenue Funds allocation of $133,768 is also provided to the Maine Health Data Organization for
data collection and implementation of a reporting dashboard to calculate the care gap for OADS services.
$0
$0
$0
$0
$0
$0
$0
$10,051,864
$15,462,805
$513,107
$75,046
$15,462,805
$379,339
$75,046
$20,159,786
$30,632,605
$786,808
$149,840
$30,632,605
$758,678
$149,840
$20,159,786
$30,632,605
$786,808
$149,840
$30,632,605
$758,678
$149,840
LR1742(02) - Fiscal Note - Page 1 of 1