November 18, 2015

WEEKLY NOTICES 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. There is also a list of rule-making liaisons, who are single points of contact for each agency.

PROPOSALS

AGENCY: 01-017 - Maine State Harness Racing Commission
CHAPTER NUMBER AND TITLE: Ch. 9, Sire Stakes: Section 5, Purse Structure, Subsection 2
PROPOSED RULE NUMBER: 2015-P209
BRIEF SUMMARY: The proposed amendment would update Ch. 9 to account for the additional revenue stream arising from the new casino in Oxford and allow a portion of the revenues designated to the Sire Stakes Fund to be used to promote the Sire Stakes Program.
PUBLIC HEARING: None.
COMMENT DEADLINE: 5:00 p.m. on December 18, 2015
CONTACT PERSON FOR THIS FILING / SMALL BUSINESS INFORMATION: Henry Jennings, Rule Contact, 28 State House Station, Augusta, ME 04333-0028. Telephone: (207) 287-7543. E-male: Henry.Jennings@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES (if any):
STATUTORY AUTHORITY FOR THIS RULE: 8 MRS  § § 263-A, 268, 279-A, 279-B, 281
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
AGRICULTURE RULE-MAKING LIAISON: Mari.Wells@Maine.gov .

AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office of MaineCare Services (OMS) - Division of Policy
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual: Ch. I Section 1, General Administrative Policies and Procedures
PROPOSED RULE NUMBER: 2015-P210
CONCISE SUMMARY: The Department of Health and Human Services (DHHS) is proposing to remove the Telehealth section from Ch. 101, MaineCare Benefits Manual, Ch. I Section 1, “General Administrative Policies and Procedures”, concurrent with the implementation of Ch. 101, MaineCare Benefits Manual, Ch. I Section 4, “Telehealth Services”.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
PUBLIC HEARING: December 7, 2015 - 9:00 a.m., Room 300, Burton Cross Building, 111 Sewall Street, Augusta, ME 04330. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before November 30, 2015.
DEADLINE FOR COMMENTS: Comments must be received by midnight December 17, 2015.
AGENCY CONTACT PERSON / SMALL BUSINESS INFORMATION: Thomas Leet, Comprehensive Health Planner II, MaineCare Services, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4068. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). E-mail: Thomas.Leet@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rule-making will not have any impact on municipalities or counties.
STATUTORY AUTHORITY FOR THIS RULE: 22 MRSA  § § 42, 3173
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .

AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office of MaineCare Services – Division of Policy
RULE TITLE OR SUBJECT: Ch. 101, MaineCare Benefits Manual: Ch. I Section 4, Telehealth Services
PROPOSED RULE NUMBER: 2015-P211
CONCISE SUMMARY: Current MaineCare policy in Ch. 1 Section 1.06-2, allows a limited group of providers to provide services remotely to patients through the use of telehealth, which is defined as “the use of electronic communication by a health care provider to deliver clinical services at a distance for the purpose of diagnosis, disease monitoring, or treatment.” Under the current telehealth rule, for each instance where telehealth is used, a provider is required to submit documentation showing that a physical, social or geographic limitation exists that prevents the provider from delivering a MaineCare covered service to a particular member in a face-to-face encounter, or to otherwise justify the use of telehealth as more appropriate, and to get the Department’s prior authorization before using telehealth services.
MaineCare staff and MaineCare providers have found the current telehealth policy to be too restrictive. Providers have found it difficult to obtain approval for telehealth in some cases, and staff has found it challenging to implement a consistent system of review.
In response to these challenges, the Legislature passed LD 1596 in 2014. This LD directed the Department to “convene a working group to review the MaineCare rules regarding the definition of telehealth and the technologies used for provider patient interaction involving MaineCare patients” and to make according changes to MaineCare policy.
MaineCare staff convened a workgroup consisting of providers, industry stakeholders, advocates, and lawmakers. The group met several times over late spring and summer 2014, and a draft policy was written based on the feedback provided by the group and upon extensive research conducted by MaineCare staff. The drafted policy combined stakeholder recommendations with industry best practices. A working draft of the policy was submitted to the stakeholder group for comments in fall 2014, and the comments were compiled in written form and responded to by MaineCare staff.
The proposed new telehealth policy is written as a standalone policy, as opposed to a subsection of Ch. I Section 1, as it was previously. The new rule will be effective upon the repeal of the current telehealth rule (Ch. I Section 1.06-2). The major components of the new telehealth rule are as follows:
1. Removes the prior approval process for use of telehealth;
2. Allows telehealth for all medically necessary services that can be delivered remotely at comparable quality;
3. Provides for an “originating site fee” to be paid to the site housing the patient, while the remote, or provider site, bills for the services rendered;
4. Provides for visual/audio, or, if video/audio is not available, the provision of telephonic services;
5. Requires providers to use secure, HIPAA compliant equipment; and;
6. Requires member choice, written informed consent, and member education.
In addition to Interactive Telehealth Services, the policy also provides for a new service known as “Telemonitoring.” Telemonitoring provides electronic communication between a member and healthcare provider whereby health-related data is collected, such as pulse and blood pressure readings that assist healthcare providers in monitoring and assessing the member’s medical conditions. Telemonitoring takes place in the home environment. Home Health agencies deliver Telemonitoring Services. In order to be eligible, a member must have had two or more hospitalizations or emergency department visits related to their diagnosis in the past calendar year, or have continuously received telemonitoring services during the past calendar year and have a continuing need for such services, as documented by an annual note from a licensed healthcare provider.
See http://www.maine.gov/dhhs/oms/rules/provider_rules_policies.html for rules and related rule-making documents.
PUBLIC HEARING: December 7, 2015 - 10 a.m., Room 300, Burton Cross Building, 111 Sewall Street, Augusta, Maine 04330. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before November 30, 2015.
DEADLINE FOR COMMENTS: Comments must be received by midnight December 17, 2015.
AGENCY CONTACT PERSON: Samuel Senft, Comprehensive Health Planner, MaineCare Services, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4053. Fax: (207) 287-1864. TTY: 711. E-mail: Samuel.Senft@Maine.gov .
THIS RULE WILL NOT HAVE A FISCAL IMPACT ON MUNICIPALITIES.
STATUTORY AUTHORITY: 22 MRSA  § § 42, 3173; LD 1596 ch. 105, “Resolve, Directing the Department of Health and Human Services to Amend MaineCare Rules as They Pertain to the Delivery of Covered Services via Telecommunications Technology”
WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .

AGENCY: 14-197 - Department of Health and Human Services (DHHS), Office of Aging and Disability Services (OADS)
CHAPTER NUMBER AND TITLE: Ch. 5, Regulations Governing Behavioral Support, Modification and Management for People with Intellectual Disabilities or Autism
PROPOSED RULE NUMBER: 2015-P212
BRIEF SUMMARY: The Department of Health and Human Services proposes to repeal 14-197 CMR Ch. 5, Regulations Governing Emergency Interventions and Behavioral Treatment for People with Intellectual Disabilities and/or Autism. This rule will be replaced by 14-197 CMR Ch. 5, Regulations Governing Behavioral Support, Modification and Management for People with Intellectual Disabilities or Autism.
This repeal and replace of Ch. 5 brings the behavior support, modification and management practices for persons with intellectual disabilities or autism in closer compliance with current best practice for such behavior support, modification and management. These changes provide enhanced guidance and direction on less restrictive alternatives which will decrease the number and severity of restraints used as behavioral support, modification and management. The proposed rule better defines prohibitions and expands prohibited practices. It requires Positive Supports as the first line of treatment. These proposed changes more closely align this rule with the right to dignity, privacy and humane treatment guaranteed persons with intellectual disabilities or autism under state law.
PUBLIC HEARING: December 8, 2015 – 9 a.m., 19 Union Street, Room 110, Augusta, ME
COMMENT DEADLINE: midnight, December 18, 2015
CONTACT PERSON FOR THIS FILING / SMALL BUSINESS INFORMATION: Lynne Caswell, OADS, 41 Anthony Avenue, 11 State House Station, Augusta, ME 04333. Telephone: (207) 287-9200. Fax: (207) 287-9229. E-mail: Lynne.Caswell@Maine.gov .
STATUTORY AUTHORITY FOR THIS RULE: 34-B MRSA  §5201(9),  §5604(4),  §5605
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED: no
WEBSITE: http://www.maine.gov/dhhs/oads/ .
E-MAIL FOR OVERALL AGENCY RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .

ADOPTIONS

AGENCY: 03-201 - Department of Corrections (DOC)
CHAPTER NUMBER AND TITLE: Ch. 10, Community Transition Program
ADOPTED RULE NUMBER: 2015-224 (Emergency)
CONCISE SUMMARY: The revisions to this rule will enable the Commissioner to allow prisoners classified minimum custody to participate in a work release program without meeting the ordinary eligibility and application requirements if the program is for a specified period of time necessary to complete a special work release project. All prisoners participating in the program must be under the supervision of Department staff while at the work release site.
This revision allows work release for prisoners who are not yet classified community custody, but who pose negligible risk in the community. Further, these prisoners will be under Department staff supervision while on work release. This revision is necessary to adopt on an emergency basis in order to provide a work force for a Maine employer needing extra employees for a seasonal business with a time sensitive production need.
EFFECTIVE DATE: November 12, 2015
AGENCY CONTACT PERSON / DOC RULE-MAKING LIAISON: Mary Lucia, Department of Corrections, 25 Tyson Drive, 111 State House Station, Augusta, ME 04333-0111. Telephone: (207) 287-4681. E-mail: Mary.A.Lucia@Maine.gov .
WEBSITE: http://www.maine.gov/sos/cec/rules/03/chaps03.htm .