Sec. BB-1. 22 MRSA §§5107-C to 5107-F, as enacted by PL 1997, c. 734, §2, are repealed.
Sec. BB-2. 22 MRSA §5107-G, as enacted by PL 1999, c. 401, Pt. SSS, §1, is repealed.
Sec. BB-3. 22 MRSA §5107-H, as enacted by PL 1999, c. 615, §1 and affected by §2, is repealed.
Sec. BB-4. 26 MRSA §1412-G is enacted to read:
§1412-G. Program of consumer-directed personal care assistance services
The Bureau of Rehabilitation Services, referred to in this section as the "bureau," is the lead agency for administering a program of consumer-directed personal care assistance services, referred to in this section as the "program." The bureau shall administer state-funded and Medicaid-funded, consumer-directed personal care assistance services for adults with disabilities and shall ensure that services are delivered in the most comprehensive manner possible.
1. Eligibility. An adult with long-term care needs is eligible for personal care assistance services under the program if the bureau or its designee determines that the adult:
A. Has a severe disability;
B. Needs personal care assistance services or an attendant at night or both to prevent or remove the adult from inappropriate placement in an institutional setting; and
C. Has no or insufficient personal income or other support from public services, family members or neighbors.
2. Consumer cost sharing. Consumer cost sharing is subject to the requirements of this subsection.
A. Within the state-funded program, a sliding scale for consumer cost sharing must be established for services provided under the program. The sliding scale must be based on the net income of the adult who receives subsidies under the program and may take assets into consideration. The expenses associated with each adult's disabilities must be factored into the calculation of net income for the adult.
B. Within the Medicaid physical disability waiver and Medicaid programs, the cost sharing required must be stated in rules adopted by the Department of Human Services.
3. Evaluation teams. The commissioner shall designate evaluation teams in the State to assist the department with evaluations of adults with long-term care needs who apply for personal care assistance services under the program.
A. Each evaluation team must include at least one registered nurse or registered occupational therapist and the adult with long-term care needs.
B. For each adult with long-term care needs evaluated by an evaluation team, the team shall assist the bureau to:
(1) Determine the eligibility of the adult for personal care assistance services;
(2) Determine the capability of the adult, at the time of evaluation or after skills training provided pursuant to paragraph C, to hire and direct a personal care assistant;
(3) Reevaluate the adult periodically to determine the adult's continuing need for the services; and
(4) Consult when possible with the adult's attending physician.
C. The commissioner may authorize an evaluation team to arrange for skills training for an adult with long-term care needs who applies for services under the program. Skills training may be provided in the following areas by the following individuals:
(1) Personal health management skills to maximize personal well-being in relation to the adult's disability, provided by a registered nurse or other qualified person experienced in the rehabilitation of the severely disabled, including all aspects of prevention, maintenance and treatment techniques;
(2) Personal care assistant management skills, provided by a registered nurse or other qualified person experienced in the rehabilitation of the severely disabled, including training in recruiting, hiring and managing a personal care assistant, scheduling and potential problems; and
(3) Functional skills required to maximize the adult's abilities in activities of daily living, provided by a registered occupational therapist or other qualified person experienced in the rehabilitation of the severely disabled.
4. Reimbursement of spouses. Within the state-funded program, the department shall reimburse providers who are spouses of adults who are eligible for services under the program. Within the Medicaid physical disability waiver and Medicaid programs, the Department of Human Services shall provide for the reimbursement of certain family members employed as personal care assistants to the extent permitted by federal regulation.
5. Review of reimbursement rates. By January 1, 2005 and every 2 years thereafter, the commissioner shall review the rates of reimbursement under the program. As part of the review, the following provisions apply.
A. The commissioner shall:
(1) Ensure the input of consumers of those services. The commissioner may seek input through one or more public hearings or by other means determined reasonable by the commissioner; and
(2) Seek advice and input from the Long-term Care Steering Committee established in Title 22, section 5107-B to determine whether the rates of reimbursement are sufficient for consumers to recruit, hire and retain personal care assistants.
B. If the commissioner determines that an increase in one or more of the reimbursement rates is necessary after the review required in this subsection, the commissioner shall:
(1) As to non-Medicaid rates, adopt rules to accomplish the required rate increase; and
(2) As to Medicaid rates, forward a recommendation for the required rate increase to the Department of Human Services, Bureau of Medical Services for consideration by the Bureau of Medical Services.
6. Rulemaking. The following provisions apply to rules necessary to implement the program under this section.
A. The bureau shall adopt rules to implement this section, except for rules that pertain to the federal Medicaid program under the United States Social Security Act, Title XIX or its successors.
B. The Department of Human Services, Bureau of Medical Services shall adopt rules regarding the federal Medicaid program.
C. In adopting rules regarding the program, the bureau and the Department of Human Services, Bureau of Medical Services shall strive to maximize the participation of persons with disabilities and to coordinate rules between the 2 departments.
D. Rules adopted pursuant to this section are routine technical rules as defined by Title 5, chapter 375, subchapter II-A, except that rules regarding consumer cost sharing under subsection 2 are major substantive rules as defined by that subchapter.
Sec. BB-5. Transition. During the transition of the consumer-directed personal care assistance services program from the Department of Human Services, Bureau of Medical Services to the Department of Labor, Bureau of Rehabilitation Services, all rules and procedures pertaining to the program that were in effect on April 1, 2002 remain in effect until rules regarding the program are adopted by the Bureau of Rehabilitation Services.
Sec. BB-6. Appropriations and allocations. The following appropriations and allocations are made.
HUMAN SERVICES, DEPARTMENT OF
Long-term Care - Human Services 0420
Initiative: Transfers the Long-term Care program for the handicapped to the Department of Labor.
General Fund 2001-02 2002-03
All Other $0 ($3,033,592)
Medical Care - Payments to Providers 0147
Initiative: Transfers the state share of Medicaid for consumer-directed attendant services and the physical disability waiver to the Department of Labor.
General Fund 2001-02 2002-03
All Other 0 (4,061,501)
HUMAN SERVICES, DEPARTMENT OF
DEPARTMENT TOTALS 2001-02 2002-03
GENERAL FUND 0 (7,095,093)
DEPARTMENT TOTAL -
ALL FUNDS 0 (7,095,093)
LABOR, DEPARTMENT OF
Rehabilitation Services 0799
Initiative: Provides for the transfer of funds from the Department of Human Services to the Department of Labor for the home-based care program for adults with physical disabilities and additional funds for a contractual occupational therapist position to oversee the home-based care program and Medicaid Seed and Waiver program.
General Fund 2001-02 2002-03
All Other 0 3,042,592
Rehabilitation Services - Medicaid
Initiative: Provides for the transfer of funds from the Department of Human Services for the state share of Medicaid for consumer-directed attendant services and the physical disability waiver.
General Fund 2001-02 2002-03
All Other 0 4,061,501
Administration - Labor 0030
Initiative: Provides for the allocation of funds for one Management Analyst I position to provide fiscal support for the programs being transferred from the Department of Human Services and for increasing support for other existing programs.
Federal Expenditures Fund 2001-02 2002-03
Positions - Legislative Count (1.000) (1.000)
Personal Services 7,620 47,110
All Other 2,500 0
____________ ____________
Total 10,120 47,110
LABOR, DEPARTMENT OF
DEPARTMENT TOTALS 2001-02 2002-03
GENERAL FUND 0 7,104,093
FEDERAL EXPENDITURES
FUND 10,120 47,110
DEPARTMENT TOTAL -
ALL FUNDS 10,120 7,151,203
SECTION TOTALS 2001-02 2002-03
GENERAL FUND 0 9,000
FEDERAL EXPENDITURES
FUND 10,120 47,110
SECTION TOTAL -
ALL FUNDS $10,120 $56,110
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