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Home > Weekly Newspaper Notices > August 12, 2009

August 12, 2009

As posted in 5 daily Maine newspapers

NOTICE OF STATE RULE-MAKING
Public Input for Proposed and Adopted Rules

Notices are published each Wednesday to alert the public regarding state agency rule-making. You may obtain a copy of any rule by notifying the agency contact person. You may also comment on the rule, and/or attend the public hearing. If no hearing is scheduled, you may request one -- the agency may then schedule a hearing, and must do so if 5 or more persons request it. If you are disabled or need special services to attend a hearing, please notify the agency contact person at least 7 days prior to it. Petitions: you can petition an agency to adopt, amend, or repeal any rule; the agency must provide you with petition forms, and must respond to your petition within 60 days. The agency must enter rule-making if the petition is signed by 150 or more registered voters, and may begin rule-making if there are fewer. You can also petition the Legislature to review a rule; the Executive Director of the Legislative Council (115 State House Station, Augusta, ME 04333, phone (207)287-1615) will provide you with the necessary petition forms. The appropriate legislative committee will review a rule upon receipt of a petition from 100 or more registered voters, or from "...any person who may be directly, substantially and adversely affected by the application of a rule..." (Title 5 Section 11112). World-Wide Web: Copies of the weekly notices and the full texts of adopted rule chapters may be found on the internet at: http://www.maine.gov/sos/cec/rules.



PROPOSALS


AGENCY:  10-144 – Department of Health and Human Services, Office of MaineCare Services
RULE TITLE OR SUBJECT:  MaineCare Benefits Manual, Chapter VI, Primary Care Case Management
PROPOSED RULE NUMBER: 2009-P212
CONCISE SUMMARY:  The Department of Health and Human Services is proposing changes to Chapter VI, Primary Care Case Management (PCCM) to add a new level of services, Patient Center Medical Home. Patient Centered Medical Home services will assure effective, efficient and accessible health care services for eligible MaineCare members.  Provider requirements are included in the proposed rule. Providers who are approved to deliver this service will receive $3.50 per member per month to deliver patient centered medical home services. This management fee is in addition to the $3.50 they have received for providing PCCM services for a total of $7.00 per member per month.  Providers will be required to deliver additional integration of patient services, and participate in on-going educational and evaluation activities. The Department also added language to clarify what groups may not be required to participate in PCCM or PCMH services to be in compliance with federal guidelines and updated sections that have been revised or consolidated in the MaineCare Benefits Manual.  The rulemaking will not yield any new administrative burdens or compliance-related costs that could fiscally impact municipal or county governments. The rulemaking has no adverse impact on small business. See:  http://www.maine.gov/bms/rules/provider_rules_policies.htm for rules and related rulemaking documents.
THIS RULE WILL NOT HAVE A FISCAL IMPACT ON MUNICIPALITIES.
STATUTORY AUTHORITY:  22 MRSA §42, §3173, PL 2009, ch. 213, Part A
PUBLIC HEARING:  September 1, 2009 at 1:00 pm, Conference Room 1B, Department of Health and Human Services, MaineCare Services, 442 Civic Center Drive, Augusta, Maine
Any interested party requiring special arrangements to attend the hearing must contact the agency person listed below before August 27, 2009.
DEADLINE FOR COMMENTS:  Comments must be received by midnight September 13, 2009
AGENCY CONTACT PERSON:  Patricia Dushuttle, Manager, Division of Policy and Performance, Office of MaineCare Services, 442 Civic Center Drive, 11 State House Station, Augusta, Maine  04333-0011
TELEPHONE:  (207) 287-9362, FAX:  (207) 287-9369, TTY:  (800) 423-4331 or (207) 287-1828 (Deaf or Hard of Hearing)
E-MAIL:  patricia.dushuttle@maine.gov


AGENCY:  19-100 – Department of Economic and Community Development
RULE TITLE OR SUBJECT:  Rules for the Maine Technology Centers
PROPOSED RULE NUMBER:  2009-P213
CONCISE SUMMARY:  Repeals existing Chapter 450 and replaces it with a new rule which defines the policies under which the Technology Centers will operate, and establishes the process and criteria under which annual grants will be awarded by the Office of Innovation.  Technology Centers are established to support the early-stage development of technology-based businesses and will provide on-on-one technical assistance, peer networks, classroom or other training on technology and commercialization and the management of high-growth enterprises, mentorship programs and other networking opportunities.
THIS RULE WILL NOT HAVE A FISCAL IMPACT ON MUNICIPALITIES.
STATUTORY AUTHORITY:  PL 2009, Ch. 90
PUBLIC HEARING:  None
DEADLINE FOR COMMENTS:  September 10, 2009
AGENCY CONTACT PERSON FOR IMFORMATION ON THIS RULE, INCLUDING A STATEMENT OF IMPACT ON SMALL BUSINESS IF RELEVANT:  Catherine S. Renault, Department of Economic and Community Development, Office of Innovation, 59 State House Station, Augusta, ME  04333-0059
TELEPHONE:  (207) 624-9801, FAX:  (207) 287-8461
E-MAIL:  catherine.s.renault@maine.gov



ADOPTIONS


AGENCY: 10-144 – Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE:  Ch. 101, MaineCare Benefits Manual, Chapter III, Section 97, and Appendix D and E, Private Non-Medical Institutions
ADOPTED RULE NUMBER:  2009-398
CONCISE SUMMARY:  The Department has determined that the immediate adoption of these rules is necessary to assure that initiatives directed by the Maine State Legislature are immediately implemented to achieve required savings in the approved budget.  The Legislature, in Public Law chapter 213, authorizes emergency rulemaking on or before 12/31/09 for provisions over which the Department has subject matter jurisdiction without demonstrating that emergency rule implementation of this rule is necessary to avoid a threat to public health, safety or general welfare.  These emergency rules specifically address budget initiatives for children’s Private Non-Medical Institution (PNMI) services and for adults with mental illness.
In this rulemaking, the Department is setting standard rates for children’s PNMI services and is removing language about cost settlement for facilities reimbursed under Appendix D, as the Department will no longer cost settle these services.  The Department has also made changes to Appendix E, Community Residences for Persons with Mental Illness to clarify that “scattered site” services are no longer reimbursed under this Section.  Those services will still be provided to members in their apartments, but instead will be reimbursed through Community Support Services under Section 17 of the MaineCare Benefits Manual.   The Department has sent a notice to those affected members to inform them of this change in services.  Prior authorization will be required for all behavioral health PNMI services for children and adults to assure that required savings are met and that services are medically necessary.   All child care providers will need to bill new codes for reimbursement.
The Maine State Legislature has directed the Department to achieve $6.8 million savings per State fiscal year in this rulemaking for children’s services.  Another $1.7 million of savings is expected through the scattered site housing changes. Because these rules are major substantive, the emergency rules will remain in effect for one year or until the legislature approves them. The Department will propose rules through the regular Administrative Procedures Act (APA) process to provisionally adopt these rules. A public hearing will be held as part of that process. 
See http://www.maine.gov/bms/rules/provider_rules_policies.htm for rules and related rulemaking documents.
EFFECTIVE DATE:  August 1, 2009
AGENCY CONTACT PERSON:  Patricia Dushuttle, Office of MaineCare Services, 442 Civic Center Drive, 11 State House Station, Augusta, Maine  04333-0011
TELEPHONE:  (207) 287-9362; FAX:  (207) 287-9369; TTY:  (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
E-MAIL:  patricia.dushuttle@maine.gov


AGENCY:  10-144 – Department of Health and Human Services, Office of MaineCare Services
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual, Chapters II & III, Section 13, Targeted Case Management Services (EMERGENCY RULE)
ADOPTED RULE NUMBER:  2009-399
CONCISE SUMMARY:  The Department is repealing and replacing Targeted Case Management rules in this Emergency rulemaking. Services in the former rule will no longer be available upon implementation of these rules. Target groups have been consolidated and redefined.  Several target groups are being deleted, including Pregnant and Postpartum women, Adults with Diabetes and Asthma and Members who are receiving Healthy Futures Services.  The Department is adding language detailing eligibility criteria for Children and Adults to include Case Management Services for Children with Developmental Disabilities and Behavioral Health Disorders as well as Case Management Services for Adults with Developmental Disabilities, Behavioral Health Disorders, Substance Abuse Disorders, HIV, Long Term Care Needs and Members Experiencing Homelessness. Children’s targeted case management services require prior authorization. This rule also reduces funding for children’s targeted case management by limiting services to two (2) months for children with scores between fifty (50) and seventy (70) on the Child and Adolescent Functional Assessment Scale. The assessment tool score may not be the sole criterion for determining medical necessity, needs and/or eligibility.
This rulemaking contains changes to the TCM service and delivery required by federal Medicaid regulation.  42 C.F.R. §§ 440.169 and 441.18.  For example, this rule clarifies that MaineCare will not cover multiple case management services; and sets forth the eligibility process, and the requirement of transitioning to one comprehensive case manager for children and adult members. Chapter III establishes new billing procedure codes based on HIPAA compliant HCPCS coding. Chapter III also implements a change in reimbursement to some Providers/Case Management Agencies through the requirement of billing in fifteen (15) minute increments.  Record-keeping requirements for TCM providers have been added to the rule.
On June 1, 2009, the Department mailed a notice to TCM recipients notifying them of changes to the TCM service.  On June 31, 2009, the Department published a Notice of Change in Medicaid Reimbursement Methodology to notify TCM providers of rate changes. 
The Department anticipates achieving a cost savings in the General Fund of $ 4,138,665 per State fiscal year 2010/2011. The Department expects an annual decrease in annual aggregate (state and federal) expenditures of $11,744,223.00 per State fiscal year 2010/2011.  
Other than providers of these specific services, this rule is not expected to fiscally impact or create new recording burdens for other small businesses and is not expected to yield new costs for municipal or county governments.
See:  http://www.maine.gov/dhhs/oms/rules/provider_rules_policies.html for rules and related rulemaking documents.
EFFECTIVE DATE:  August 1, 2009
AGENCY CONTACT PERSON:  Melanie Miller, Health Planner, Division of Policy and Performance, 442 Civic Center Drive, 11 State House Station, Augusta, Maine 04333-0011
TELEPHONE:  (207) 287-4459 FAX: (207) 287-9369; TTY:  (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
E-MAIL:  melanie.miller@maine.gov


AGENCY:  10-144 – Department of Health and Human Services, Office of MaineCare Services
CHAPTER NUMBER AND TITLE:  Ch. 101, MaineCare Benefits Manual, Chapter III, Section 17, Community Support Services
ADOPTED RULE NUMBER: 2009-400
CONCISE SUMMARY:  The Emergency rule specifies a correction in the rate for Day Treatment.
See:  http://www.maine.gov/dhhs/oms/rules/provider_rules_policies.html for rules and related rulemaking documents.
EFFECTIVE DATE:  July 30, 2009
AGENCY CONTACT PERSON:  Ginger Roberts-Scott, Comprehensive Health Planner, Division of Policy and Performance Services, 442 Civic Center Drive, 11 State House Station, Augusta, Maine 04333-0011
TELEPHONE:  (207) 287-9365 FAX:  (207) 287-9369; TTY:  (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
E-MAIL:  ginger.roberts-scott@maine.gov


AGENCY: 10-144 – Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE:  Ch. 101, MaineCare Benefits Manual, Chapter II, Section 97, Private Non-Medical Institutions
ADOPTED RULE NUMBER:  2009-401
CONCISE SUMMARY:  The Department has determined that the immediate adoption of these rules is necessary to assure targeted budget savings are met.  In this rulemaking, the Department is adding language detailing eligibility criteria and requiring prior authorization for children’s PNMI services.   These changes are necessary to assure that PNMI services are medically necessary and that more cost effective community based services are used to the fullest extent possible.  In this Section, the Department is also defining models of PNMI services for which standard rates are being set in a separate rulemaking pertaining to reimbursement of PNMI services in Chapter III, Section 97.
These rules will remain in effect for 90 days while the Department permanently adopts these changes in a proposed rulemaking. A public hearing will be held as part of that separate rulemaking.  This rule has no impact on small businesses, counties or municipalities, other than those providers with twenty or fewer employees.  These rule changes are expected to result in total savings of $8,538,368.  The changes for children’s PNMI services will result in cost savings per State Fiscal year of $6,838,368, $2,091,857 from general funds, $4,404,593 from federal funds and $341,819 from other special revenue.  The changes for adult PNMI services are expected to result in an additional $1.7 million savings per State Fiscal year, $1,615,000 from general funds and $85,000 from other special revenue. 
See http://www.maine.gov/bms/rules/provider_rules_policies.htm for rules and related rulemaking documents.
EFFECTIVE DATE:  August 1, 2009
AGENCY CONTACT PERSON:  Patricia Dushuttle, Office of MaineCare Services, 442 Civic Center Drive, 11 State House Station, Augusta, Maine  04333-0011
TELEPHONE:  (207) 287-9362; FAX:  (207) 287-9369; TTY:  (800) 423-4331 or (207) 287-1828 (Deaf/Hard of Hearing)
E-MAIL:  patricia.dushuttle@maine.gov


AGENCY:  02-373 – Board of Licensure in Medicine
CHAPTER NUMBER AND TITLE:  Ch. 4, Rules for the Issuance of Citations
ADOPTED RULE NUMBER: 2009-402
CONCISE SUMMARY:  Chapter 4 lists the violations for which a citation and administrative fine may be issued, describes the licensee’s right to request a hearing, and describes the time and manner in which the fine must be paid.
EFFECTIVE DATE:  August 9, 2009
AGENCY CONTACT PERSON:  Jean M. Greenwood, Administrative Assistant, Board of Licensure in Medicine, 137 State House Station, August, ME 04333-0137
TELEPHONE:  (207) 287-3603
E-MAIL:  jean.m.greenwood@maine.gov


AGENCY:  16-163 -  Bureau of Emergency Medical Services
CHAPTER NUMBER AND TITLE:  Ch. 1, Missions and Goals of the Maine EMS System; Ch. 2, Definitions; Ch. 3, Ground Ambulance Service and Non-Transporting Service Licenses; Ch. 3-A, Emergency Medical Dispatch Service Certification; Ch. 4, Air Ambulance Services Licenses; Ch. 5, Personnel Licenses; Ch. 5-A, Emergency Medical Dispatcher Certification; Ch. 6, Advanced Life Support Drugs and Medications; Ch. 7, State Licensure Examinations; Ch. 8, Training Courses and Continuing Education Programs Used For Licensure; Ch. 9, Instructor/Coordinator Certification; Ch. 9-A, Emergency Medical Dispatch Training, Instructors and Continuing Education Programs; Ch. 10, Reciprocity; Ch. 11, Standards and Procedures for Refusing to issue or Renew a License, and for Modifying, Suspending, or Revoking a license; Ch. 12, Procedures For Licensing Actions and Board Actions; Ch. 13, Waiver of Rules; Ch. 14, Sexual Misconduct; Ch. 15, Maine EMS Regions and Regional Councils; Ch. 16, Death Benefits for Emergency Medical Services Persons Who Die in the Line of Duty; Ch. 17, Equipment Lists for Maine EMS Services and Regional EMS Radio Frequencies
ADOPTED RULE NUMBER:  2009-403 to 2009-422
CONCISE SUMMARY:  The proposed rules changes will: 1) Adopt or amend rules regarding definitions, licensing requirements, equipment requirements, and scopes of practice for EMS services and individual EMS providers to ensure consistency with Maine EMS law and EMS protocol; 2) Adopt definitions regarding Federal Aviation Administration (FAA), Federal Aviation Rules (FAR), Patient Care Report, Paramedic Interfacility Transfer (PIFT), PIFT Service, PIFT Provider, and Training Centers; 3) Amend rules regarding the types of EMS services that are licensed by the Board and the service licensing process; 4) Amend rules regarding air ambulance services, 5) Amend rules regarding scene response air ambulance services; 6) Amend rules for service level quality assurance and quality improvement, 7) Amend rules regarding the licensing of emergency medical services providers; 8) Amend rules regarding education and testing requirements for EMS licensees; 9) Amend rules regarding approval of EMS licensing courses; 10) Amend rules regarding licensing and training of EMD providers and centers; 11) Adopt rules regarding EMS education, training entities and instructor certification; and 12) Amend rules regarding sexual misconduct by EMS providers.
EFFECTIVE DATE: Ch. 1-16 October 1, 2009; Ch. 17 January 1, 2010
AGENCY CONTACT PERSON:  Alan P. Leo, Maine Emergency Medical Services, 152 State House Station, Augusta, ME  04333-0152
TELEPHONE:  (207) 626-3866
E-MAIL:  alan.p.leo@maine.gov


AGENCY:  18-389 – Department of Administrative & Financial Services, Bureau of Human Resources
CHAPTER NUMBER AND TITLE:  Ch. 11, Holidays, Leaves of Absence and Related Compensation Practices
ADOPTED RULE NUMBER:  2009-423
CONCISE SUMMARY:  Pursuant to 2009 Resolve Chapter 43 (signed May 15, 2009), this rule will allow seasonal employees of the Baxter State Park Authority to choose to be paid for unused vacation and overtime hours at the end of each season.  The rule also clarifies that such an option may not be construed as an interruption in state service if the employee returns to classified or unclassified state service within one year.
EFFECTIVE DATE:  August 11, 2009
AGENCY CONTACT PERSON:  J. Thaddeus Cotnoir, Bureau of Human Resources, 4 State House Station, Augusta, ME  04333-0004
TELEPHONE:  (207) 624-7799
E-MAIL:  thaddeus.cotnoir@maine.gov