March 13, 2019

WEEKLY NOTICES OF STATE RULEMAKING
Public Input for Proposed and Adopted Rules

Notices are published each Wednesday to alert the public regarding state agency rulemaking. 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 rulemaking if the petition is signed by 150 or more registered voters, and may begin rulemaking 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 rulemaking liaisons, who are single points of contact for each agency.

PROPOSALS

AGENCIES:
02-373 - Board of Licensure in Medicine
02-383 - Board of Osteopathic Licensure
CHAPTER NUMBER AND TITLE: Ch. 10, Sexual Misconduct
PROPOSED RULE NUMBERS: 2019-P032, P033
BRIEF SUMMARY: This is a consolidated rulemaking proceeding of the Board of Licensure in Medicine and the Board of Osteopathic Licensure to adopt a joint rule regarding sexual misconduct. The proposed rule repeals and replaces an existing joint rule regarding sexual misconduct. The proposed joint rule: defines terms, including the new term “key third parties”; defines sexual misconduct by physicians and physician assistants; sets forth the range of sanctions applicable to violations of the rule; and identifies the factors the Boards should consider in imposing sanctions.
PUBLIC HEARING: None planned. Request to hold a public hearing by any interested person may be submitted in writing to the identified agency contact person.
COMMENT DEADLINE: Friday, April 12, 2019 at 4:30 p.m.
CONTACT PERSONS FOR THIS FILING / SMALL BUSINESS IMPACT INFORMATION:
Dennis E. Smith, Executive Director, Board of Licensure in Medicine, 137 State House Station, Augusta, ME 04333-0137. Telephone: (207) 287-3605. Fax: (207) 287-6590. Email: Dennis.E.Smith@Maine.gov .
Susan E. Strout, Executive Secretary, Board of Osteopathic Licensure, 142 State House Station, Augusta, ME 04333-0142. Telephone: (207) 287-2480 Fax: (207) 536-5811. Email: Susan.E.Strout@Maine.gov  .
FINANCIAL IMPACT ON MUNICIPALITIES OR COUNTIES: none
STATUTORY AUTHORITY FOR THIS RULE: 32 MRS § 3269(3),(7) (Board of Licensure in Medicine); 32 MRS §2562 (Board of Osteopathic Licensure)
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
AGENCY WEBSITES:
www.maine.gov/md (Board of Licensure in Medicine)
www.maine.gov/osteo (Board of Osteopathic Licensure)
AGENCY RULEMAKING LIAISONS:
Maureen.S.Lathrop@Maine.gov (Board of Licensure in Medicine); Susan.E.Strout@Maine.gov (Board of Osteopathic Licensure)

AGENCIES:
02-373 - Board of Licensure in Medicine
02-380 – State Board of Nursing
02-383 - Board of Osteopathic Licensure
CHAPTER NUMBER AND TITLE: Ch. 12, Joint Rule Regarding Office Based Treatment of Opioid Use Disorder
PROPOSED RULE NUMBERS: 2019-P034, P035, P036
BRIEF SUMMARY: The Board of Licensure in Medicine, State Board of Nursing and Board of Osteopathic Licensure propose a joint rule to ensure safe and adequate treatment of opioid use disorder with approved medications in an outpatient medical setting. The proposed joint rule: defines terms; establishes minimum requirements for qualified clinicians to prescribe, and in limited circumstances, dispense approved medications to individuals requiring and seeking treatment for opioid use disorder; establishes requirements for prescriptions for approved medications; establishes principles for proper office based treatment for opioid use disorder; establishes requirements for clinical care and management; and establishes additional requirements for pregnant patients and adolescent patients.
PUBLIC HEARING: None planned. Request to hold a public hearing by any interested person may be submitted in writing to the identified agency contact person.
COMMENT DEADLINE: Friday, April 12, 2019 at 4:30 p.m.
CONTACT PERSONS FOR THIS FILING / SMALL BUSINESS IMPACT INFORMATION:
Dennis E. Smith, Executive Director, Board of Licensure in Medicine, 137 State House Station, Augusta, ME 04333-0137. Telephone: (207) 287-3605. Fax: (207) 287-6590. Email: Dennis.E.Smith@Maine.gov .
Kim Esquibel, Executive Director, State Board of Nursing, 158 State House Station, Augusta, ME 04333-0158. Telephone: (207) 287-1148 Fax: (207) 287-1149. Email:  Kim.Esquibel@Maine.gov .
Susan E. Strout, Executive Secretary, Board of Osteopathic Licensure, 142 State House Station, Augusta, ME 04333-0142. Telephone: (207) 287-2480 Fax: (207) 536-5811. Email: Susan.E.Strout@Maine.gov  .
FINANCIAL IMPACT ON MUNICIPALITIES OR COUNTIES: none
STATUTORY AUTHORITY FOR THIS RULE: 32 MRS §§ 3269(3),(7), 3300-F (Board of Licensure in Medicine); 32 MRS §§ 2102(2-A), 2153-A(1), 2210 (State Board of Nursing); 32 MRS §§ 2562, 2600-C (Board of Osteopathic Licensure)
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
AGENCY WEBSITES:
www.maine.gov/md (Board of Licensure in Medicine)
www.maine.gov/boardofnursing (State Board of Nursing)
www.maine.gov/osteo (Board of Osteopathic Licensure)
AGENCY RULEMAKING LIAISONS:
Maureen.S.Lathrop@Maine.gov (Board of Licensure in Medicine)
Virginia.E.deLorimier@Maine.gov (State Board of Nursing)
Susan.E.Strout@Maine.gov (Board of Osteopathic Licensure)

AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office for Family Independence (OFI)
CHAPTER NUMBER AND TITLE: Ch. 301, Food Supplement Program, Rule #206P – Simplified Reporting: Introduction; Section 666-6, Certified Households; Section 999-1, Appendix (Definitions)
PROPOSED RULE NUMBER: 2019-P037
BRIEF SUMMARY: The current change reporting rules require recipients to report numerous changes including; changes in employment if there is an associated change in income, changes of more than $50 in the amount of gross monthly unearned income, all changes in household composition, changes in residence and the resulting change in shelter costs, various changes in assets and changes in the legal obligation to pay child support. Under the proposed rule most households will only be required to report if their income exceeds 130% of the federal poverty level (FPL) between certification(s) and their six-month report. A six-month report is required between certifications for many simplified reporting households. Six-month reports require clients to update certain aspects of their case without requiring an interview.
See http://www.maine.gov/dhhs/ofi/rules/index.shtml for rules and related rulemaking documents.
PUBLIC HEARING: None scheduled.
COMMENT DEADLINE: April 12, 2019
CONTACT PERSON FOR THIS FILING: Jessica Drenning, Senior Planner, Department of Health & Human Services, Office for Family Independence, 19 Union Street – 11 State House Station, Augusta, ME 04333-0011. Telephone: (207) 624-Fax: (207) 287-3455. TT Users Call Maine Relay – 711. Email: Jessica.Drenning@Maine.gov .
FINANCIAL IMPACT ON MUNICIPALITIES OR COUNTIES: None anticipated.
STATUTORY AUTHORITY FOR THIS RULE: 22 MRS §42(1); 45 CFR 400.301
OFI WEBSITE: http://www.maine.gov/dhhs/ofi/rules/index.shtml. .
DHHS WEBSITE: http://www.maine.gov/dhhs/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .

ADOPTIONS

AGENCY: 13-188 - Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 8, Landings Program: 8.20, Harvester Reporting
ADOPTED RULE NUMBER: 2019-045
CONCISE SUMMARY: This rule updates reporting requirements for halibut, shrimp, and scallop harvesters to remove outdated references to Loran stations and bearings as options for reporting harvesting locations. It requires halibut harvesters to report landings numbers rather than license numbers, and would add a new component to the halibut harvester reporting requirements to include total number of hooks fished.
EFFECTIVE DATE: March 13, 2019
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing).
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 - Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 25, Lobster and Crab: 25.04, Lobster Trawl Limits
ADOPTED RULE NUMBER: 2019-046
CONCISE SUMMARY: In October 2018, a new trawl limit area was established at the request of the Zone B Council. DMR was aware that there was potential to refine the area described by the new trawl limit to better meet the needs of Zone B and Zone C fishermen fishing there. The Department held meetings with fishermen from Zone B and Zone C to determine what changes to the area were advisable. At their January 2019 meeting, the Zone B Council supported the Department’s proposal to amend this area in accordance with the changes proposed through the meetings that were held. The rule represents the amended area and eliminates the sunset on the original area.
EFFECTIVE DATE: March 13, 2019
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing).
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 - Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 32, Eels (Elver Quota System for the 2019 Season)
ADOPTED RULE NUMBER: 2019-047
CONCISE SUMMARY: This rule establishes the elver quota allocations for the 2019 season for individuals licensed under §§ 6505-A and 6302-A, and the method of calculating individual elver quota allocations for individuals licensed under 6505-A. 2019 allocations for individuals who held a license in 2018 will be the same as their 2018 allocations, plus any quota associated with licenses not renewed in 2018, or licenses suspended for the duration of the 2019 season, which will be distributed evenly to all license holders. This rule also prohibits more than one elver dealer from engaging in the licensed activities at the same physical address, and requires that transfers from vehicles to permanent facilities include all the contents of the vehicle. Finally, the rule establishes a process by which Maine Marine Patrol will monitor and seal the packing of elvers for export.
EFFECTIVE DATE: March 13, 2019
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing).
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 - Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 34, Groundfish Regulations: 34.07, Atlantic Halibut (Hippoglossus hippoglossus) (Atlantic Halibut Size Limit)
ADOPTED RULE NUMBER: 2019-048
CONCISE SUMMARY: This rule allows charter and party boat operators to fillet Atlantic halibut at sea. Possession for Atlantic halibut is limited to one fish per boat. This rule ensures the fish can be measured and is greater than the minimum size limit of 41 inches total length or 32 inches from the pectoral fin if the head is removed. This rule allows charter/party boat captains to fillet Atlantic halibut at sea if the halibut carcass (rack) remains in their possession until all customers have landed on shore. This rule allows a single Atlantic halibut to be shared with several fishing customers instead of one customer retaining the entire fish. Marine patrol officers will be able to measure Atlantic halibut carcasses (racks) to ensure fish of legal sizes are possessed.
EFFECTIVE DATE: March 13, 2019
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing).
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 - Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 36, Atlantic Herring (2019 Season)
ADOPTED RULE NUMBER: 2019-049
CONCISE SUMMARY: This rule clarifies the reporting requirement such that all directed herring trips must report daily using the herring.dmr@maine.gov landings email. Additionally, this regulation implements a weekly limit on state only permitted vessels directing on Atlantic herring of 25,000 pounds. State waters fishing may occur from Sunday at 6:00 p.m. to Thursday at 6:00 p.m. Fixed gear harvesting in state waters is exempt from the weekly harvest schedule, but is subject to a weekly landing limit of 25,000 pounds.
EFFECTIVE DATE: March 13, 2019
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing).
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 - Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 41, Menhaden (2019 Menhaden Fishery Program)
ADOPTED RULE NUMBER: 2019-050
CONCISE SUMMARY: This rulemaking clarifies the reporting requirements for all Atlantic menhaden fishery operations. Components of the fishery that are quota managed (state and episodic) require daily reporting, while the incidental/small scale fishery requires monthly reporting.
This rulemaking updates the management framework for the Atlantic menhaden fishery in territorial waters, including the state allocated fishery, the episodic event fishery, and an incidental catch/small scale fishery by separating out the restrictions placed on the fixed gear sector. Fixed gear harvesting may occur seven days a week in both the state allocated fishery and the episodic event fishery; however, the fixed gear fishery will maintain the same daily and weekly landing limits as previously set for the mobile fishery.
Finally, the rule reinstates a personal use regulation for hook and line harvest. Recreational harvest by hook and line for 25 fish per day is permitted seven days a week.
EFFECTIVE DATE: March 13, 2019
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing).
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 - Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 115, Vibrio parahaemolyticus Control Plan
ADOPTED RULE NUMBER: 2019-051
CONCISE SUMMARY: This rule incorporates the Sheepscot River, north of Route 1, into the existing Vibrio parahaemolyticus (Vp) control plan. The addition of the Sheepscot River is intended to reduce the likelihood that American and European oysters (Crassostrea virginica andOstrea edulis) and hard clams (Mercenaria mercenaria) harvested from the Sheepscot River will cause Vp infections in consumers. In 2018, DMR received an illness report of a laboratory confirmed case of Vp that implicated oysters from the Sheepscot River as the sole source. The Maine Department of Marine Resources recognizes that the portion of the Sheepscot River north of Route 1 has the environmental characteristics (primarily water and air temperature and salinity) that potentially pose a threat to public health with regard to Vp infections. Research indicates that the most reliable way to minimize potential Vp illnesses is to utilize time and temperature controls.
EFFECTIVE DATE: March 13, 2019
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing).
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@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 (MBM): Ch. II & III Section 93, Opioid Health Home Services
ADOPTED RULE NUMBER: 2019-052
CONCISE SUMMARY: The Department of Health and Human Services (“Department”) adopts changes to Ch. II and III Section 93, “Opioid Health Home Services”, of the MaineCare Benefits Manual pursuant to PL 2017 ch. 460 part G, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (emergency, effective July 9, 2018) (the “Act”) and in response to the ongoing opioid crisis.
Part G of the Act amends the Maine Substance Abuse and Treatment Act, 5 MRS §§ 20001-20078-A, by implementing new definitions and creating a “hub-and-spoke” model of treatment. The Department’s current service delivery model for Opioid Health Homes (OHH) under Section 93 largely abides by the hub-and-spoke model. However, to more closely align with the Legislature’s directive, the Department is adopting the following rule changes: added a definition of Integrated Medication Assisted Treatment (IMAT) to describe OHH service expectations; added urine drug screening as an integral part of IMAT services; established levels of care (intensive, intermediate/ stabilization, and maintenance) that correspond to the member’s needs; and created a tiered reimbursement rate structure corresponding to these levels of care.
In addition, the Department is adopting other changes to improve the Section 93 rules by making it easier for current and new providers to deliver IMAT services through the OHH model. These changes included: altering the current staffing requirements and adding a new patient navigator to the OHH team to ensure flexibility for provider organizations and expertise to meet members’ needs; creating an allowance for members who meet eligibility for MaineCare Benefits Manual, Section 92, “Behavioral Health Home Services”, Section 91, “Health Home Services”, certain Section 13, “Targeted Case Management Services”, or Section 17, “Community Support Services”, to receive these services in coordination with OHH services; easing requirements regarding the Electronic Health Record to allow provider flexibility in meeting OHH program requirements; providing clarification to covered services; and making minor and technical changes to the operation of OHH.
With these changes, the reimbursement of OHH services at a Per Member Per Month (PMPM) rate will now be based on the level of care of services provided to the member and whether the OHH provides coordinated case management to the member. Urine drug screening will be part of the OHH bundled reimbursement. Medication costs will be excluded from the PMPM bundle and billed separately.
This rule adoption follows emergency rulemaking which adopted the aforementioned changes effective November 27, 2018. With this rulemaking, the Department is permanently adopting the above changes with the exception of a few additional changes following public comment on the rule proposal. This includes removing the preference on substance use licensing for the OHH, easing the parameters for the Nurse Care Manager, expanding who can serve as the Patient Navigator, altering counseling requirements, removing interpretive language on the Prescription Monitoring Program rules, adding the requirement that member’s must consent to and sign their treatment plans, and clarifying minimum requirements for OHH reimbursement.
The rule changes are contingent upon approval from the Centers for Medicare and Medicaid Services which the Department is currently seeking through a State Plan Amendment.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
EFFECTIVE DATE: March 16, 2019
OMS CONTACT PERSON: Anne E. Labonte, Comprehensive Health Planner II, Division of Policy, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207)-624-4082. Fax: (207) 287-1864. TTY users call Maine relay 711. Email: Anne.Labonte@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS WEBSITE: http://www.maine.gov/dhhs/ .
DHHS RULEMAKING LIAISON: Kevin.Wells@Maine.gov .