Resolve, to Direct the Department of Health and Human Services,
Maine Legislature, Session 132, LD 1540
Committee: Health and Human Services
Sponsors: BALDACCI

Legislative Document
No. 1540
S.P. 624
In Senate, April 10, 2025
Resolve, to Direct the Department of Health and Human Services, 
Office of MaineCare Services to Create the Complex Care Assistant 
Training Program
(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, families with children who need skilled care are unable to find an 
appropriate workforce to provide care resulting in parents providing services without 
sufficient medical skills; and
Whereas, the statewide working group that will develop the complex care assistant 
training program is required to meet within 30 days of the enactment of this legislation; 
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.  Establishment of a complex care assistant training program.  
Resolved:  That the Department of Health and Human Services shall convene a statewide 
working group known as the Complex Care Assistant Council, referred to in this resolve 
as "the council," within 30 days of enactment of this resolve, to develop a system of 
standards for a complex care assistant training program for providing care for children 
under 20 years of age who require complex medical care provided in the home.  
1.  The council consists of representatives from the department, including the Office of 
MaineCare Services, the State Board of Nursing, parents and guardians of children who 
require complex medical care, pediatricians, nurses, respiratory therapists and private duty 
nursing agencies.  
2.  The council shall develop a system of training and qualification criteria for a 
complex care assistant training program.  The training must include, but is not limited to, 
the following topics:  ambulation, positioning, feeding, personal care, catheter care, range 
of motion, vital signs, medication administration, tracheostomy care, enteral care and 
therapy, administering enteral feedings by specific types of tubes and respiratory care.
3.  The council shall work with private duty nursing agencies to establish an appropriate 
training schedule conducted by the agencies.
4.  The department and the State Board of Nursing have oversight over the training 
program, including credentialing, continuing education requirements, background checks, 
quality requirements and any other necessary aspects of oversight to ensure the appropriate 
care of children who require complex medical care.
5.  The council shall establish a requirement that complex care assistants work under 
the direction of a registered nurse visiting every 30 days.  The requirement must allow 
complex care assistants to be able to provide services to the children without disruption to 
services.
Sec. 2.  Department of Health and Human Services to establish MaineCare 
program to reimburse complex care assistants.  Resolved:  That the Department 
of Health and Human Services shall establish a MaineCare program to reimburse for the 
complex care assistant training program developed pursuant to section 1.  The program 
must allow for reimbursement to parents or guardians trained as complex care assistants to 
provide care, under the direction of a registered nurse, to children under 20 years of age for 
whom they are a parent or guardian and who qualify under the MaineCare program for 
complex medical services that would otherwise be reimbursed only under the department's 
rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 96.  
1.  The department shall identify families with children who require complex medical 
care and parents or guardians who may train as complex care assistants to provide care for 
children for whom they are a parent or guardian.  
2.  The department shall apply for any necessary waivers or state plan amendments 
from the United States Department of Health and Human Services, Centers for Medicare 
and Medicaid Services to allow for MaineCare reimbursement for parents or guardians who 
are trained as complex care assistants providing care for children who require complex 
medical care.
3.  The department and private duty nursing agencies shall develop a method of 
providing complex care assistant training to eligible parents and guardians at no cost to the 
parent or guardian.
4.  The department shall adopt rules for reimbursement for complex care assistants, 
including requirements for employment of complex care assistants by private duty nursing 
agencies, and requirements for private duty nursing agencies to pay certification costs for 
complex care assistants.  Rules adopted pursuant to this subsection are routine technical 
rules pursuant to the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A.
5.  The department shall regularly meet with the council when developing rules, 
waivers and state plan amendments to develop a system of reimbursement for complex care 
assistants.
Sec. 3.  Report to the Legislature.  Resolved:  That 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 no later than January 2, 2029 
with a description of the implementation of the program developed pursuant to sections 1 
and 2, the number of children requiring complex medical care served in the program and 
data showing the effectiveness of the complex care assistant training program and private 
duty nursing model under this resolve.  The joint standing committee of the Legislature 
having jurisdiction over health and human services matters may report out legislation 
related to the report to the 134th Legislature in 2029.
Emergency clause.  In view of the emergency cited in the preamble, this legislation 
takes effect when approved.
SUMMARY
This bill establishes the complex care assistant training program to allow parents and 
guardians of children requiring complex medical care who qualify under the MaineCare 
program for private duty nursing services.  The Department of Health and Human Services 
must establish the Complex Care Assistant Council to develop qualifications and training 
for complex care assistants.  The department must develop a MaineCare program and apply 
for any necessary waivers or state plan amendments for the complex care assistant training 
program.  The department is required to submit a report to the joint standing committee of 
the Legislature having jurisdiction over health and human services matters in 2029 
describing the implementation of the program, the number of participants and data showing 
the effectiveness of the program.