An Act to Address the Shortage of Direct Care Workers for Children with Disabilities in Maine

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132nd MAINE LEGISLATURE
FIRST REGULAR SESSION-2025
Legislative Document No. 279
S.P. 129 In Senate, January 28, 2025
An Act to Address the Shortage of Direct Care Workers for
Children with Disabilities in Maine
(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.
Cosponsored by Senators: GROHOSKI of Hancock, INGWERSEN of York, RAFFERTY of
York.

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1Emergency preamble. Whereas, acts and resolves of the Legislature do not
2 become effective until 90 days after adjournment unless enacted as emergencies; and
3Whereas, a shortage of direct care workers has resulted in individuals, including
4 children, who are eligible for in-home personal care services but are not receiving critical
5 services; and
6Whereas, parents of children eligible for in-home personal care services are leaving
7 paid employment to provide care in the absence of available direct care workers, resulting
8 in economic hardship; and
9Whereas, this legislation requires the Department of Health and Human Services to
10 submit a request for the necessary state plan amendment or Medicaid waiver from the
11 Federal Government as soon after enactment as possible; and
12Whereas, in the judgment of the Legislature, these facts create an emergency within
13 the meaning of the Constitution of Maine and require the following legislation as
14 immediately necessary for the preservation of the public peace, health and safety; now,
15 therefore,
16Be it enacted by the People of the State of Maine as follows:
17Sec. 1. 22 MRSA §1717, sub-§2-A, as enacted by PL 2023, c. 309, §5, is amended
18 to read:
192-A. Licensing of personal care agencies. Beginning July 1, 2024, an entity may not
20 provide home care services without a personal care agency license issued by the department
21 in accordance with this section. Beginning November 1, 2025, a parent who is registered
22 pursuant to section 3174-PPP may provide in-home personal care services in accordance
23 with section 3174-PPP. All application fees for a license under this section are
24 nonrefundable and are due upon submission of the application.
25 A. A personal care agency that holds an unexpired registration issued in accordance
26 with subsection 2 may continue to provide home care services until the registration
27 expires.
28 This paragraph is repealed July 1, 2025.
29 B. A personal care agency holding an unexpired registration issued in accordance with
30 subsection 2 is not required to obtain a license until the registration expires.
31 This paragraph is repealed July 1, 2025.
32Sec. 2. 22 MRSA §3174-PPP is enacted to read:
33§3174-PPP. In-home personal care services to children
341. Reimbursement for parent. A parent of a child who is eligible for in-home
35 personal care services under the MaineCare program may register as a personal care
36 agency, as defined in section 1717, subsection 1, paragraph C and determined in department
37 rule, and receive reimbursement for providing those services to the child if the following
38 requirements are met:
39 A. The parent has made reasonable but unsuccessful efforts to obtain regular in-home
40 personal care services; and
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1 B. The parent has satisfied the requirements of the applicable background check
2 required for providers of in-home personal care services.
32. Employer designation. In order for a parent to be registered as a personal care
4 agency under subsection 1, another individual who is not a parent of the child must be
5 designated as the employer. The person designated as the employer must be approved by
6 both the department and the parent to act in the child's interest.
73. Rulemaking. The department shall adopt rules to implement this section. Rules
8 adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter
9 375, subchapter 2-A.
10Sec. 3. Department of Health and Human Services to seek federal
11approval. The Department of Health and Human Services shall seek any necessary state
12 plan amendments or waivers from the United States Department of Health and Human
13 Services, Centers for Medicare and Medicaid Services to implement the Maine Revised
14 Statutes, Title 22, section 3174-PPP. The department shall submit the requests for approval
15 no later than 6 months after the effective date of this Act.
16Sec. 4. Rulemaking. The Department of Health and Human Services shall adopt
17 rules in accordance with the Maine Revised Statutes, Title 22, section 3174-PPP,
18 subsection 3 no later than 6 months after receiving the necessary approvals from the United
19 States Department of Health and Human Services, Centers for Medicare and Medicaid
20 Services under section 3.
21Sec. 5. Contingent effective date. That section of this Act that amends the Maine
22 Revised Statutes, Title 22, section 1717, subsection 2-A and enacts Title 22, section
23 3174-PPP take effect only if the necessary approvals sought pursuant to section 3 of this
24 Act are received. The Commissioner of Health and Human Services shall notify the
25 Secretary of State, Secretary of the Senate, Clerk of the House of Representatives and
26 Revisor of Statutes when approvals sought under section 3 have been received.
27Emergency clause. In view of the emergency cited in the preamble, this legislation
28 takes effect when approved.
29SUMMARY
30 This bill allows for the reimbursement of a parent providing in-home personal care
31 services to the parent's child by allowing the parent to register as a personal care agency if
32 the parent has made reasonable but unsuccessful efforts to obtain regular in-home personal
33 care services and has passed a background check. The child must be eligible for the
34 MaineCare program. An individual who is not a parent of the child must be designated as
35 the employer and must be approved as the employer by both the parent and the Department
36 of Health and Human Services. The department is required to request the necessary state
37 plan amendments or waivers from the federal Department of Health and Human Services,
38 Centers for Medicare and Medicaid Services and adopt routine technical rules within 6
39 months of federal approval.
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