HP1164
LD 1676
Session - 128th Maine Legislature
C "A", Filing Number H-769, Sponsored by
LR 2500
Item 2
Bill Tracking, Additional Documents Chamber Status

Amend the bill by striking out the title and substituting the following:

‘An Act To Establish an Independent Oversight Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism’

Amend the bill by striking out everything after the enacting clause and before the summary and inserting the following:

Sec. 1. 5 MRSA §12004-J, sub-§18  is enacted to read:

18  
Intellectual Disability or Autism Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism Expenses for uncompensated members 34-B MRSA §1971

Sec. 2. 22 MRSA §1711-C, sub-§6, ¶T,  as amended by PL 2017, c. 203, §3, is further amended to read:

T. To a lay caregiver designated by an individual pursuant to section 1711-G; and

Sec. 3. 22 MRSA §1711-C, sub-§6, ¶U,  as enacted by PL 2017, c. 203, §4, is amended to read:

U. To a panel coordinator of the maternal, fetal and infant mortality review panel pursuant to section 261, subsection 4, paragraph B-1 for the purposes of reviewing health care information of a deceased person and a mother of a child who died within one year of birth, including fetal deaths after 28 weeks of gestation. For purposes of this paragraph, "panel coordinator" has the same meaning as in section 261, subsection 1, paragraph E and "deceased person" has the same meaning as in section 261, subsection 1, paragraph B . ; and

Sec. 4. 22 MRSA §1711-C, sub-§6, ¶V  is enacted to read:

V To the panel coordinator, appointed under Title 34-B, section 1972, subsection 1, of the Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism, established in Title 5, section 12004-J, subsection 18, for the purposes of reviewing health care information of a person with an intellectual disability or autism receiving adult developmental services as defined in Title 34-B, section 1001, subsection 1-A who has died or experienced a serious injury in the last 12 months.

Sec. 5. 22 MRSA §3474, sub-§3, ¶C,  as corrected by RR 1991, c. 2, §80, is amended to read:

C. A grand jury on its determination that access to those records is necessary in the conduct of its official business; and

Sec. 6. 22 MRSA §3474, sub-§3, ¶D,  as corrected by RR 1991, c. 2, §81, is amended to read:

D.  An advocacy agency conducting an investigation under chapter 961, United States Public Law 88-164, Title I, Part C or United States Public Law 99-319, regarding a developmentally disabled person or mentally ill person who is or who, within the last 90 days, was residing in a facility rendering care or treatment, when a complaint has been received by the agency or there is probable cause to believe that that individual has been subject to abuse or neglect, and that person does not have a legal guardian or the person is under public guardianship. The determination of which information and records are relevant to the investigation is made by agreement between the department and the agency . ; and

Sec. 7. 22 MRSA §3474, sub-§3, ¶E  is enacted to read:

E The panel coordinator, appointed under Title 34-B, section 1972, subsection 1, of the Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism, established in Title 5, section 12004-J, subsection 18.

Sec. 8. 34-B MRSA c. 1, sub-c. 9  is enacted to read:

SUBCHAPTER 9

PANEL TO REVIEW DEATHS OF AND SERIOUS INJURIES TO PERSONS WITH INTELLECTUAL DISABILITIES OR AUTISM

§ 1971 Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism

The Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism, referred to in this subchapter as "the panel," is established to conduct comprehensive, multidisciplinary reviews of cases of death of or serious injury to persons with intellectual disabilities or autism receiving adult developmental services in the State as described in this subchapter.

§ 1972 Panel membership; compensation; staffing

1 Membership.   The panel consists of 14 members as provided in this subsection.
A The commissioner shall appoint a member to the panel who is an employee of the Maine Center for Disease Control and Prevention within the department and who is a registered nurse. The member appointed pursuant to this paragraph is the panel coordinator.
B The Maine Developmental Services Oversight and Advisory Board, established in Title 5, section 12004-J, subsection 15, shall appoint a member to the panel. The board may appoint a new member to the panel annually or as the board determines necessary.
C The Governor shall appoint 4 members to the panel as follows:

(1) A representative of the judicial branch;

(2) A physician licensed under Title 32, chapter 36 or chapter 48 who is a primary care physician;

(3) A law enforcement officer; and

(4) A provider of community services to persons with intellectual disabilities or autism in the State.

D The President of the Senate shall appoint 4 members to the panel as follows:

(1) A nurse licensed in the State with expertise in intellectual disabilities or autism;

(2) A person licensed to practice law in the State working in the public sector;

(3) A person with expertise in forensic pathology; and

(4) A person with expertise in the field of community mental health.

E The Speaker of the House of Representatives shall appoint 4 members to the panel as follows:

(1) A person with expertise in the field of public health;

(2) A person licensed to practice law in the State working in the private sector;

(3) A person employed by a university or who is a doctoral candidate in a relevant area of study; and

(4) A provider of community services to persons with intellectual disabilities or autism in the State.

2 Terms.   The term of office of each member of the panel appointed under subsection 1, not including the panel coordinator and the member appointed pursuant to subsection 1, paragraph B, is 3 years. A member serves until a successor is appointed. A vacancy must be filled as soon as practicable by appointment for the unexpired term. Members may be reappointed.
3 Chair.   Every year, the panel shall elect a chair from among its members.
4 Compensation.   Members of the panel not otherwise compensated by their employers or other entities whom they represent are entitled to reimbursement of reasonable expenses incurred in serving on the panel.
5 Panel coordinator duties; staffing.   The panel coordinator shall act as staff to the panel. The panel coordinator may procure specialist expertise when the panel coordinator considers it necessary or when it is requested by the panel. The panel coordinator shall conduct an initial review as described in section 1973 of any death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services. The panel coordinator shall compile reports required pursuant to this subchapter.

§ 1973 Initial review by the panel coordinator

The panel coordinator shall conduct an initial review of any death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services to determine whether to refer a case to the panel for a review. The panel coordinator shall refer a case to the panel if the panel coordinator determines that any of the following circumstances exist:

1 Unexpected.   The death or serious injury was unexpected;
2 Preventable.   Facts and circumstances indicate that the death or serious injury could have been prevented;
3 System issues.   Issues with the system of care described in section 5003-A are implicated; or
4 Other issues.   Other issues related to the case indicate the case should be reviewed.

§ 1974 Access to information and records

1 Department records.   Notwithstanding any other provision of law, the panel coordinator may access information or records from the department determined by the panel coordinator to be necessary to carry out the panel coordinator's responsibilities. The department shall provide the panel coordinator with direct access to the information or records or provide information or records necessary and relevant as soon as practicable upon oral or written request of the panel coordinator. Records that must be provided include, but are not limited to, the following:
A Personal plans developed pursuant to section 5470-B;
B Service plans and agreements developed pursuant to section 5471;
C Documents from providers of residential services to persons with intellectual disabilities or autism pursuant to chapters 5 and 6 or caseworkers;
D Documents related to any adult protective case or investigation;
E Reports related to a person with an intellectual disability or autism who was receiving adult developmental services of incidents that occurred in the 12-month period prior to the person's death or serious injury;
F Death certificates;
G Health care information related to a person with an intellectual disability or autism who was receiving adult developmental services from the 12-month period prior to the person's death or serious injury. For the purposes of this paragraph, "health care information" has the same meaning as in Title 22, section 1711-C, subsection 1, paragraph E; and
H Records from any autopsy performed on a deceased person.
2 Duty to provide records.   A person that possesses medical records or information that is necessary and relevant to the review under section 1973 shall provide those medical records or information to the panel coordinator as soon as practicable. This subsection does not authorize the disclosure of a record generated by a hospital that is otherwise confidential, including, but not limited to, a sentinel event record, a root cause analysis and a professional competency review. As used in this subsection, "sentinel event" has the same meaning as in Title 22, section 8752, subsection 4-A and "root cause analysis" has the same meaning as in Title 22, section 8752, subsection 3-B.

§ 1975 Cases referred to the panel by others

A case of death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services may be referred to the panel by the commissioner, the agency designated as the protection and advocacy agency for persons with disabilities pursuant to Title 5, section 19502, a member of the panel or any other person who presents credible evidence, as determined by the panel coordinator, that a death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services warrants review by the panel.

§ 1976 Monthly report

The panel coordinator shall compile a monthly report that includes a list of all cases of death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services reviewed by the panel coordinator, a list of all cases the panel coordinator has referred for review to the panel and a list of all cases referred pursuant to section 1975. For each case referred for review, the report must include the name of the person receiving adult developmental services who has died or experienced serious injury, the name of the guardian, the status of guardianship and a short description of the circumstances of the death or serious injury that occurred. The panel coordinator shall provide the monthly report to the panel, the department and the Maine Developmental Services Oversight and Advisory Board, established in Title 5, section 12004-J, subsection 15. The monthly report compiled pursuant to this section is not a public record as defined in Title 1, section 402, subsection 3.

§ 1977 Review by the panel

1 Cases reviewed by the panel.   The panel shall review all cases of death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services that are referred by the panel coordinator or are referred pursuant to section 1975; all medical examiner cases pursuant to Title 22, section 3025, subsection 1, paragraph E that pertain to a person with an intellectual disability or autism who received adult developmental services; all cases from the last 12 months that are reported incidents pursuant to section 5604-A; and all cases of death or serious injury that are being reviewed by the Maine Developmental Services Oversight and Advisory Board, established in Title 5, section 12004-J, subsection 15. The panel may also choose to review any other case from the monthly report of the panel coordinator under section 1976.
2 Records provided to the panel.   The panel coordinator shall determine records as listed in section 1974 that must be made available to the panel for the purpose of reviewing cases of death of or serious injury to persons with intellectual disabilities or autism receiving adult developmental services. The panel coordinator shall maintain custody of all records.
3 Review.   A review of a case conducted by the panel is intended to be a thorough evaluation of circumstances surrounding the death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services, including the overall care of the person, quality of life issues, the death or serious injury event and medical care preceding the event. The review must also include any determination of whether the case is suspicious.
4 Investigations.   A review under this section is subject to and may not interfere with the authority and responsibility of the Attorney General to investigate and prosecute homicides pursuant to Title 5, section 200-A.

§ 1978 Report of findings

After a review of all materials related to a case of death of or serious injury to a person with an intellectual disability or autism receiving adult developmental services reviewed by the panel pursuant to section 1977, the panel shall make findings and recommendations and submit those findings and recommendations in a report to the commissioner and to the Maine Developmental Services Oversight and Advisory Board, established in Title 5, section 12004-J, subsection 15. The report must identify trends and patterns in deaths or serious injuries that indicate necessary systemic changes and reforms in the delivery of services to reduce adverse outcomes for persons with intellectual disabilities or autism receiving adult developmental services as well as recommendations for corrective actions. All personally identifying information must be removed from the report before it is submitted to the commissioner and the Maine Developmental Services Oversight and Advisory Board.

§ 1979 Legislative reports

1 Annual report.   The panel shall provide to the joint standing committee of the Legislature having jurisdiction over health and human services matters an annual report by January 30th with data regarding the number of deaths of and serious injuries to persons with intellectual disabilities or autism receiving adult developmental services, the number of cases reviewed by the panel, the number of cases determined suspicious, actions taken on recommendations submitted to the commissioner and the Maine Developmental Services Oversight and Advisory Board, established in Title 5, section 12004-J, subsection 15, and a summary of findings and recommendations.
2 Trend analyses.   The panel may provide to the joint standing committee of the Legislature having jurisdiction over health and human services matters a periodic report with trend analyses if the panel determines that such a report is necessary. Any periodic trend analysis report that is submitted must be developed in conjunction with the commissioner and the Maine Developmental Services Oversight and Advisory Board, established in Title 5, section 12004-J, subsection 15.

§ 1980 Confidentiality

Any information or record accessed by or provided to the panel coordinator or the panel pursuant to this subchapter that is designated confidential pursuant to state or federal law by the official, agency or other entity providing the information or record must be maintained as confidential by the panel coordinator and the panel.

Sec. 9. Initial appointments; staggered terms. Notwithstanding the Maine Revised Statutes, Title 34-B, section 1972, subsection 2, of the initial appointments to the Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism, the Governor shall appoint one member to serve an initial term of one year, 2 members to serve an initial term of 2 years and one member to serve an initial term of 3 years; the President of the Senate shall appoint 2 members to serve an initial term of one year, one member to serve an initial term of 2 years and one member to serve an initial term of 3 years; and the Speaker of the House of Representatives shall appoint one member to serve an initial term of one year, one member to serve an initial term of 2 years and 2 members to serve an initial term of 3 years.

Sec. 10. Appropriations and allocations. The following appropriations and allocations are made.

HEALTH AND HUMAN SERVICES, DEPARTMENT OF

Maine Center for Disease Control and Prevention 0143

Initiative: Provides funding for one Health Services Consultant position to be the panel coordinator for the Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism.

GENERAL FUND 2017-18 2018-19
POSITIONS - LEGISLATIVE COUNT
0.000 1.000
Personal Services
$0 $84,899
All Other
$0 $6,286
inline graphic sline.gif inline graphic sline.gif
GENERAL FUND TOTAL $0 $91,185

summary

This amendment, which is the majority report of the committee, replaces the bill. It establishes the Panel To Review Deaths of and Serious Injuries to Persons with Intellectual Disabilities or Autism. The panel consists of 14 members, including a panel coordinator who is an employee of the Department of Health and Human Services, Maine Center for Disease Control and Prevention and is a registered nurse and a member appointed by the Maine Developmental Services Oversight and Advisory Board. Other members of the panel are appointed by the Governor, the President of the Senate and the Speaker of the House of Representatives. Terms are for 3 years, and members receive expenses if they are not already compensated by their employers. The panel coordinator must review all cases of death of and serious injury to persons with intellectual disabilities or autism receiving adult developmental services and determine those that require further review by the panel. Other individuals may refer cases to the panel, and the panel may choose additional cases from the list of cases provided by the panel coordinator. The panel has access to records necessary for the review. The panel must provide reports to the Commissioner of Health and Human Services and the Maine Developmental Services Oversight and Advisory Board with findings and recommendations. The panel is required to provide reports to the Legislature on an annual basis and may provide trend analyses to the Legislature as necessary. Legislative reports are public documents.

The amendment also adds an appropriations and allocations section.

FISCAL NOTE REQUIRED
(See attached)


Top of Page