Chapter 240
H.P. 383 - L.D. 499
PART AAAA
Sec. AAAA-1. Administrative burden reduction. The Department of Health and Human Services shall convene the Administrative Burdens Work Group, referred to in this section as "the work group," no later than July 1, 2007. The charge of the work group is to identify potential savings of provider operating expenses in fiscal year 2009 through a reduction of administrative burdens arising from requirements imposed by the department upon contracting mental health agencies. The work group shall also develop a plan to be implemented in fiscal year 2009 for consolidating administrative functions and reducing overhead costs within each of the department's community service network areas. The work group consists of 3 representatives of mental health service providers, 2 designated by the Maine Association of Mental Health Services and one designated by the department; 3 representatives of the interests of consumers of adult and children's mental health services identified by the department; and representatives of the department designated by the Commissioner of Health and Human Services. The department shall provide the information and staff support necessary for the work group to fulfill its responsibilities.
1. The work group shall review and evaluate the department's current reporting, billing, record-keeping, auditing, operational and other administrative requirements applicable to mental health agencies for the purpose of identifying opportunities to reduce provider costs by reducing the burdens imposed by these requirements. The requirements and costs to be reviewed include, without limitation, the department's rules, practices, expectations and forms in the areas of contracted services, licensing, MaineCare services and other department relationships with providers.
2. Based on its review and evaluation, the work group shall develop recommendations that detail:
Sec. AAAA-2. System redesign. The Department of Health and Human Services shall convene the Systems Redesign Work Group, referred to in this section as "the work group," no later than July 1, 2007. The charge of the work group is to identify potential savings in General Fund expenditures for mental health care services in fiscal year 2009 to be achieved by redesigning certain elements of the community mental health system as provided in this section. The work group consists of 3 representatives of mental health service providers, 2 designated by the Maine Association of Mental Health Services and one designated by the department; 3 representatives of the interests of consumers of mental health services and their families designated by the department; a representative of the contractor selected by the department for implementation of behavioral health managed care services, once such a selection has been made; and representatives of the department designated by the Commissioner of Health and Human Services. The department shall provide the information and staff support necessary for the work group to fulfill its responsibilities.
1. The work group shall review the continuum of core services in child and adult mental health; consider whether refinements or modifications of the continuum are appropriate, consistent with the requirements of applicable court orders, consent decrees and other legal authorities; identify current system inefficiencies and service redundancies that can be corrected within a reasonable time; and recommend models for expanding flexibility for certain core service areas and other models of service delivery that support quality, access, choice and economy in community-based services.
2. Based on its development of redesign elements as described in subsection 1, the work group shall develop recommendations that detail:
Sec. AAAA-3. Rate standardization. The Department of Health and Human Services shall convene the Rate Standardization Work Group, referred to in this section as "the work group," no later than July 1, 2007. The charge of the work group is to create a regulatory framework for the development of standard rates for all behavioral health services for which payment is now made on the basis of provider-specific rates and any additional services affected by system redesign pursuant to section 2. The work group consists of 4 representatives of mental health service providers, 2 designated by the Maine Association of Mental Health Services and 2 designated by the department, and representatives of the department designated by the Commissioner of Health and Human Services. The department shall provide the information and staff support necessary for the work group to fulfill its responsibilities. The department shall establish by rule a methodology for setting standard rates in a manner consistent with those recommendations and section 4. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.
1. The work group shall develop a rate-setting methodology that relies on objective benchmarking tools to identify the key cost components, including productivity, of core services, consistent with the administrative savings achievable pursuant to section 1 and the service descriptions developed pursuant to section 2. The methodology recommended by the work group must be designed to produce rates that are adequate to cover the costs incurred by efficiently and economically operated service providers to deliver services consistent with the descriptions developed pursuant to section 2.
2. The work group shall develop recommendations concerning:
3. The work group shall provide its recommendations in draft form to representatives of the interests of consumers of mental health services and their families, designated by the department, and to the court master in the Augusta Mental Health Institute consent decree proceedings. The comments of these representatives must be considered in developing final recommendations.
Sec. AAAA-4. Implementation of rate and system changes. The Department of Health and Human Services shall report and implement the agreed-upon recommendations of the work groups established in this Part in accordance with this section.
1. Beginning in July 2007, the department shall report monthly to the Joint Standing Committee on Health and Human Services on the progress of the work groups established in this Part.
2. No later than October 31, 2007, the Commissioner of Health and Human Services shall present to the Joint Standing Committee on Health and Human Services and the Joint Standing Committee on Appropriations and Financial Affairs the department's proposals for actions to be taken and savings to be realized on the basis of the recommendations of the work groups established in sections 1 and 2. No later than January 7, 2008, the commissioner shall present to those committees the department's proposals for actions to be taken and potential savings to be realized on the basis of the recommendations of the work group established in section 3.
3. The department, with the concurrence of the work groups established in this Part, shall prepare and provide to the Joint Standing Committee on Health and Human Services, no later than January 7, 2008, drafts of all regulatory, licensing, contractual or other language changes required to accomplish the proposals presented pursuant to subsection 2, including any implementing legislation.
4. The Joint Standing Committee on Health and Human Services is authorized to introduce any legislation necessary to implement the changes recommended by the commissioner pursuant to this section.
5. No later than March 31, 2008, the department shall give notice pursuant to the Maine Revised Statutes, Title 5, section 8053 of any amendment or adoption of rules that may be necessary to implement the changes identified pursuant to this Part. The timetable provided in such notice or notices must provide for the necessary rules to take effect no later than June 30, 2008. To the extent that all parties concur, the department shall implement identified changes that do not require legislation as promptly as practicable.
Sec. AAAA-5. Net rate standardization target. If the savings described in section 6 are not achieved through the actions taken pursuant to sections 1, 2 and 4, the department may not achieve the savings by further reducing rates or expanding rate standardization beyond the amounts recommended pursuant to section 3 and reflected in section 7 without first reporting its recommendations to the Joint Standing Committee on Health and Human Services and the Joint Standing Committee on Appropriations and Financial Affairs pursuant to section 4, subsection 2 and providing adequate opportunity for public comment on these recommendations to those joint standing committees.
Sec. AAAA-6. Calculation and transfer; General Fund savings from adjusting rates and redesigning behavioral health services; Department of Health and Human Services. Notwithstanding any other provision of law, the State Budget Officer shall calculate the amount of savings in section 7 in the Department of Health and Human Services resulting from adjusting rates, including adjustments resulting from reducing administrative burdens, and resulting from redesigning services and from other measures described in this Part that applies to each applicable General Fund account in the department and shall transfer the amounts by financial order upon approval of the Governor. These transfers are considered adjustments to appropriations in fiscal year 2007-08 and fiscal year 2008-09.
Sec. AAAA-7. Appropriations and allocations. The following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS)
Departmentwide 0019
Initiative: Reduces funding from savings achieved by adjusting rates, including adjustments resulting from reducing administrative burden, and by redesigning services and other measures that the department may take within its existing authority pursuant to this Part. The corresponding federal match reductions are reflected in the Medical Care - Payments to Providers program.
| GENERAL FUND | 2007-08 | 2008-09 |
|
All Other
|
($5,000,000) | ($14,000,000) |
 |
|
|
| GENERAL FUND TOTAL | ($5,000,000) | ($14,000,000) |
| HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS) | ||
| DEPARTMENT TOTALS | 2007-08 | 2008-09 |
|
GENERAL FUND
|
($5,000,000) | ($14,000,000) |
|
|
|
| DEPARTMENT TOTAL - ALL FUNDS | ($5,000,000) | ($14,000,000) |
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)
Medical Care - Payments to Providers 0147
Initiative: Reduces funding from savings achieved by adjusting rates, including adjustments resulting from reducing administrative burden, and by redesigning services and other measures that the department may take within its existing authority pursuant to this Part. The corresponding state funding reductions are reflected in the Departmentwide program in the former Department of Behavioral and Developmental Services.
| FEDERAL EXPENDITURES FUND | 2007-08 | 2008-09 |
|
All Other
|
($8,623,978) | ($24,157,536) |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | ($8,623,978) | ($24,157,536) |
| HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) | ||
| DEPARTMENT TOTALS | 2007-08 | 2008-09 |
|
FEDERAL EXPENDITURES FUND
|
($8,623,978) | ($24,157,536) |
|
|
|
| DEPARTMENT TOTAL - ALL FUNDS | ($8,623,978) | ($24,157,536) |
| SECTION TOTALS | 2007-08 | 2008-09 |
|
GENERAL FUND
|
($5,000,000) | ($14,000,000) |
|
FEDERAL EXPENDITURES FUND
|
($8,623,978) | ($24,157,536) |
|
|
|
| SECTION TOTAL - ALL FUNDS | ($13,623,978) | ($38,157,536) |