Resolve, To Develop a Plan To Improve Service Delivery to Individuals Receiving Medicaid Home and Community-based Services

Preamble. Whereas,  the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services adopted home and community-based settings rules in 2014 that the State must comply with by March 17, 2022; and

Whereas,  the rules are intended to ensure that individuals receiving long-term services and supports through Medicaid home and community-based service programs have full access to the benefits of community living and the opportunity to receive services in the most integrated setting; and

Whereas,  the rules require the Department of Health and Human Services to develop, with stakeholder input and Centers for Medicare and Medicaid Services approval, a transition plan to bring the State into full compliance; and

Whereas,  the State submitted proposed transition plans in 2014 and 2016 but has not received approval from the Centers for Medicare and Medicaid Services; and

Whereas,  implementing the rules will be a complex process requiring significant changes to how services are delivered in the State; now, therefore, be it

Sec. 1. Stakeholder group for working plan created. Resolved: That the Department of Health and Human Services, referred to in this resolve as "the department," shall convene a stakeholder group to develop a working plan to implement the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services home and community-based settings rules in the State. The department shall provide staff support for the stakeholder group, including but not limited to a facilitator and administrative support.

Sec. 2. Membership. Resolved: That the membership of the stakeholder group under section 1 consists of the following:

1. Two members of the Senate, appointed by the President of the Senate;

2. Two members of the House of Representatives, appointed by the Speaker of the House; and

3. A member receiving services under each home and community-based waiver, including department rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Sections 18, 19, 20, 21 and 29.

The department shall also invite the participation of at least one representative from each of the following organizations: Developmental Disabilities Partners for Positive Change within Disability Rights Maine; the Maine Developmental Disabilities Council; the University of Maine Center for Community Inclusion and Disability Studies; Speaking Up For Us of Maine; the Acquired Brain Injury Advisory Council under the Maine Revised Statutes, Title 34-B, section 19001; the Maine Long-Term Care Ombudsman Program; and the Maine Association for Community Service Providers.

Sec. 3. Duties. Resolved: That the stakeholder group under section 1 shall investigate and develop a plan for the department to fully comply with the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services home and community-based settings rules and bring best practices to the State by:

1. Reviewing information about home and community-based settings best practices in other states;

2. Reviewing the State's most recently submitted transition plan and making recommendations on how to revise the plan for resubmission to the Centers for Medicare and Medicaid Services; and

3. Reviewing and making specific recommendations regarding:

Sec. 4. Report. Resolved: That the department shall submit a report on the findings and recommendations of the stakeholder group under section 1, including any recommended legislation, to the Joint Standing Committee on Health and Human Services by January 15, 2020. The committee may submit a bill related to the report to the Second Regular Session of the 129th Legislature.

summary

This resolve directs the Department of Health and Human Services to convene a stakeholder group to review the Medicaid home and community-based settings rules, review past efforts by the State to come into compliance with those rules and make recommendations about how to bring the State into compliance and recommendations on necessary statutory and regulatory changes. The department is required to submit a report by January 15, 2020 to the Joint Standing Committee on Health and Human Services, which may submit a bill to the Second Regular Session of the 129th Legislature.