Resolve, Regarding Home Care Service Rates for Serving Persons with Complex Medical Needs

Sec. 1. Department of Health and Human Services; enhanced rates for home care services. Resolved: That, beginning October 15, 2016, the Department of Health and Human Services' office of aging and disability services shall implement a demonstration project to provide enhanced rates for home care services, with participation limited to patients with complex medical needs who are enrolled in the Maine "Homeward Bound" program, which is funded by the federal Centers for Medicaid and Medicare Services. The demonstration project must allow for enhanced rates that will provide additional reimbursement for services provided by personal support specialists to patients with complex medical needs, as well as on-site training of personal support specialist staff before services are provided, in order to promote quality of care and retention of staff serving patient populations with complex medical needs. The Department of Health and Human Services' office of aging and disability services shall submit a report to the joint standing committee of the Legislature having jurisdiction over health and human services matters no later than January 15, 2018 on its findings and recommendations regarding the provision of enhanced rates for home care services under this section. The joint standing committee of the Legislature having jurisdiction over health and human services matters is authorized to report out legislation relating to the demonstration project to the Second Regular Session of the 128th Legislature; and be it further

Sec. 2. Department of Health and Human Services; home care services review. Resolved: That the Department of Health and Human Services' quality assurance review committee, as established in the Maine Revised Statutes, Title 22, section 5107-I shall conduct a review of the adequacy of home care services provided to individuals with complex needs under Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities. The review must include, at a minimum, consideration of quality of care, emergency department visits and hospital admissions of individuals receiving services under Section 19. In conducting the review, the quality assurance review committee shall request input from, at a minimum, consumers, care coordination agencies, patient advocacy organizations and home care agencies. The Department of Health and Human Services shall submit a report, no later than January 15, 2017, to the joint standing committee of the Legislature having jurisdiction over health and human services matters detailing the quality assurance review committee's findings and any recommendations for legislation regarding the adequacy of home care services provided under Section 19. After reviewing the report, the joint standing committee of the Legislature having jurisdiction over health and human services matters may report out legislation relating to the report to the First Regular Session of the 128th Legislature.

summary

This resolve includes recommendations of the Commission to Study Difficult-to-place Patients. It requires the Department of Health and Human Services' office of aging and disability services to implement a demonstration project that will provide enhanced rates for home care services, with participation limited to patients with complex medical needs who are enrolled in the Maine "Homeward Bound" program, which is funded by the federal Centers for Medicaid and Medicare Services. The Department of Health and Human Services' office of aging and disability services is directed to submit a report, no later than January 15, 2018, to the joint standing committee of the Legislature having jurisdiction over health and human services matters detailing its findings and any recommendations regarding the provision of enhanced rates for home care services.

The resolve also requires the Department of Health and Human Services' quality assurance review committee to conduct a review of the adequacy of home care services provided to individuals with complex needs under Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities. The Department of Health and Human Services is directed to submit a report, no later than January 15, 2017, to the joint standing committee of the Legislature having jurisdiction over health and human services matters detailing the quality assurance review committee's findings and any recommendations for legislation regarding the adequacy of home care services provided under Section 19.

The joint standing committee of the legislature having jurisdiction over health and human services matters is authorized to report out legislation pursuant to both of the reports submitted pursuant to this legislation.