HP1504, LD 2109, item 1, An Act To Implement the Recommendations of the Commission To Study Long-term Care Workforce Issues

An Act To Implement the Recommendations of the Commission To Study Long-term Care Workforce Issues

Be it enacted by the People of the State of Maine as follows:

PART A

Sec. A-1. 22 MRSA c. 1476 is enacted to read:

CHAPTER 1476

DIRECT CARE WORKER WAGES

§ 5319. Definitions

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings.

1. Activities of daily living. "Activities of daily living" means tasks routinely performed by a person to maintain bodily functions, including bed mobility, transfers, locomotion, dressing, eating, toileting, bathing and personal hygiene.

2. Direct access. "Direct access" means, with respect to an individual who is receiving services from a direct care worker in an institutional setting or in a home or community setting, access to the individual's property, personally identifiable information, financial information or resources or physical access to the individual.

3. Direct care worker. "Direct care worker" means an individual who by virtue of employment generally provides to individuals direct contact assistance with activities of daily living or instrumental activities of daily living or has direct access to provide care and services to clients, patients or residents regardless of the setting.

4. Home and community-based support services. "Home and community-based support services" means health and social services and other assistance required to enable adults with long-term care needs to remain in their places of residence or group homes. These services include, but are not limited to, self-directed care services; home health aide services; personal care assistance services; companion and attendant services; homemaker services; respite care; and other appropriate and necessary social services.

5. Home or community setting. "Home or community setting" means a place of residence or group home where adults with long-term care needs receive home and community-based support services.

6. Institutional setting. "Institutional setting" means residential care facilities licensed pursuant to chapter 1664, intermediate care and skilled nursing facilities and units and hospitals licensed pursuant to chapter 405 and state institutions for individuals who have intellectual disabilities or autism or other related conditions.

7. Instrumental activities of daily living. "Instrumental activities of daily living" includes, but is not limited to, preparing or receiving of a main meal, taking medication, using the telephone, handling finances, banking, shopping, routine housework, laundry and getting to appointments.

8. Self-directed care services. "Self-directed care services" means services procured and directed by the person receiving services or the person's surrogate that allow the person to reenter or remain in the community and to maximize independent living opportunities. "Self-directed care services" includes the hiring, firing, training and supervision of direct care workers to assist with activities of daily living and instrumental activities of daily living.

§ 5320. Direct care worker minimum wage

Starting January 1, 2021, the minimum hourly wage paid to a direct care worker must be no less than 125% of the minimum wage established in Title 26, section 664, subsection 1. Increases to the minimum wage for direct care workers must begin on January 1st of each year at the same time as any increase in the minimum wage takes place.

§ 5320-A. Rulemaking

The department shall adopt rules providing reimbursement rates under this chapter that take into account the costs of providing the direct care worker minimum wage required in section 5320. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

Sec. A-2. Department of Health and Human Services to adopt rules to provide reimbursement rates sufficient for structural costs. The Department of Health and Human Services shall adopt rules to increase reimbursement rates under Chapter 101: MaineCare Benefits Manual and any state-funded programs to take into account costs of providing care and services in conformity with applicable state and federal laws, rules, regulations, training requirements and quality and safety standards, including, but not limited to: costs of increases in wages for direct care workers pursuant to the Maine Revised Statutes, Title 22, chapter 1476; increases in minimum wages for any other workers pursuant to Title 26, section 664, subsection 1; earned paid leave pursuant to Title 26, section 637; background checks required pursuant to Title 22, chapter 1691; and electronic visit verification required under the federal 21st Century Cures Act, Public Law 114-255, Section 12006. The department shall consult with providers and other stakeholders that the department determines appropriate to determine appropriate reimbursement levels for services. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A except for rules that amend Chapter 101: MaineCare Benefits Manual, Chapter III, Section 97, which are major substantive rules.

PART B

Sec. B-1. 5 MRSA §12004-I, sub-§47-J is enacted to read:

47-J.

Human Services

Long-term care workforce oversight advisory committee

Not Authorized

22 MRSA §5307

Sec. B-2. 22 MRSA §5307 is enacted to read:

§ 5307. Long-term care workforce oversight advisory committee

The long-term care workforce oversight advisory committee, as established in Title 5, section 12004-I, subsection 47-J and referred to in this section as "the oversight committee," is established to provide advice and oversight to the department and the joint standing committee of the Legislature having jurisdiction over health and human services matters regarding long-term care workforce issues.

1. Membership. The oversight committee consists of 10 members as follows:

A. Eight members, appointed by the commissioner, who are employers and providers of services in the long-term care industry and employ direct care workers who provide assistance with activities of daily living or instrumental activities of daily living to clients, patients or residents, in institutional and home or community settings;

B. One member, appointed by the commissioner, who is a recipient of self-directed care services as defined in section 5319, subsection 8; and

C. The long-term care ombudsman as described in section 5107-A.

For the purposes of this subsection, "direct care worker" has the same meaning as in section 5319, subsection 3.

2. Terms; vacancy. Members of the oversight committee are appointed to staggered 2-year terms so that the terms of 4 members representing providers expire on July 1st of each year. If the commissioner fails to make an appointment prior to the expiration of a member's term, that member continues to serve until the commissioner makes an appointment for the remainder of that term. If a vacancy occurs prior to the expiration of a specified term, the commissioner shall appoint a person to serve the remainder of that term.

3. Duties. The oversight committee has the following duties:

A. Collect data from the department relating to the number of hours of services provided by direct care workers, the number of approved hours for which staffing cannot be provided due to staffing shortages, vacancies for direct care worker positions and the number of unfilled beds in residential care facilities licensed under chapter 1664 and nursing facilities licensed under chapter 405;

B. Compile data available from the Department of Labor relating to current and future needs for direct care workers;

C. Review progress by the department in implementing recommendations provided to the department and the joint standing committee of the Legislature having jurisdiction over health and human services matters relating to long-term care workforce issues and address barriers to implementing those recommendations; and

D. Make recommendations to the department and the joint standing committee of the Legislature having jurisdiction over health and human services matters on proposals to increase the long-term care workforce and address shortages in services.

4. Meetings; report. The oversight committee shall meet at least quarterly and submit an annual report no later than January 2nd to the joint standing committee of the Legislature having jurisdiction over health and human services matters describing the oversight committee's activities and recommendations.

summary

This bill implements the recommendations of the Commission To Study Long-term Care Workforce Issues, which was established by Public Law 2019, chapter 343, Part BBBBB, section 1. The bill does the following.

1. It requires direct care workers across the long-term care spectrum to be paid no less than 125% of the minimum wage. It requires the Department of Health and Human Services to adopt rules that take into account the cost of this increased wage in its reimbursement rates.

2. It requires the Department of Health and Human Services to adopt rules to increase reimbursement rates under Chapter 101: MaineCare Benefits Manual and any state-funded programs to take into account costs of providing care and services in conformity with applicable state and federal laws, rules, regulations, training requirements and quality and safety standards, including, but not limited to, increases in the minimum wage, earned paid leave, electronic visit verification, background checks and other costs that are not provided for in the current reimbursement rates.

3. It establishes a long-term care workforce oversight advisory committee to collect and compile data related to workforce shortages and services provided to clients, review progress by the Department of Health and Human Services regarding recommendations provided to the department and the joint standing committee of the Legislature having jurisdiction over health and human services matters, including the recommendations of the Commission To Study Long-term Care Workforce Issues, identify barriers to implementing recommendations and make recommendations on proposals to address long-term care workforce shortages. The oversight committee must submit an annual report to the joint standing committee of the Legislature having jurisdiction over health and human services matters.

HP1504 LD 2109	Session - 129th Maine Legislature		LR 3212 Item 1
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