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131st MAINE LEGISLATURE
FIRST REGULAR SESSION-2023
Legislative Document No. 475H.P. 292House of Representatives, February 7, 2023
An Act to Simplify and Clarify the Licensing of Assisted Housing
Facilities
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204.
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative MEYER of Eliot. Page 1 - 131LR0309(01)
1
2 as repealed and replaced by PL 2021, c. 570,
3 §4, is amended to read:
4
5 Residents of certain nursing homes, residential care facilities and assisted living programs
6 facilities may cast absentee ballots under the provisions of this subsection. This subsection
7 applies to a licensed nursing home subject to the provisions of Title 22, chapter 405; a
8 licensed level IV residential care facility subject to the provisions of Title 22, chapter 1664;
9 and a licensed assisted living program facility with more than 6 beds subject to the
10 provisions of Title 22, chapter 1664. As used in this subsection, "level IV residential care
11 facility" means a residential care facility as defined by Title 22, section 7852, subsection
12 14 that has a licensed capacity of more than 6 residents.
13 A. The municipal clerk shall designate one time during the 30-day period prior to an
14 election during which the municipal clerk shall be present in each facility to which this
15 subsection applies in the municipality for the purpose of conducting absentee voting
16 by residents of these facilities. The clerk shall designate which areas in these facilities
17 constitute the voting place, the voting booth and the guardrail enclosure. The clerk shall
18 post a notice in the municipal office that absentee voting will be conducted as
19 prescribed in this subsection. The clerk shall provide a notice to each facility of the
20 date and time when absentee voting will be conducted. The notice must state that the
21 facility is required to notify the contact person or persons, if any, for each resident that
22 absentee voting will be conducted. Each facility shall provide notice, which may be in
23 the form of an e-mail or an electronic newsletter, to the contact person or persons, if
24 any, for each resident of the date and time when absentee voting will be conducted at
25 the facility. Sections 681 and 682 apply to voting in these facilities within the areas
26 designated by the clerk.
27 B. To protect public health, the Secretary of State may designate procedures for
28 conducting absentee voting for the residents of a facility to which this subsection
29 applies that differ from the procedures described in paragraph A if:
30 (1) The Department of Health and Human Services declares a health emergency
31 under Title 22, section 802, subsection 2;
32 (2) The Governor declares an extreme public health emergency under Title 22,
33 section 802, subsection 2‑A;
34 (3) The Department of Health and Human Services determines that a public health
35 threat, as defined in Title 22, section 801, subsection 10, threatens the health,
36 welfare or safety of the municipal clerk or the residents of a facility described in
37 this subsection; or
38 (4) A facility described in this subsection prohibits the municipal clerk from
39 entering the facility.
40 Procedures designated under this paragraph remain in effect for the duration of the
41 health emergency, extreme public health emergency or public health threat or for as
42 long as the municipal clerk remains prohibited from entering the facility, as the case
43 may be. Page 2 - 131LR0309(01)
1 as amended by PL 2003, c. 416, §2, is
2 further amended to read:
3
4 shared with facilities licensed to provide assisted living housing services as long as there is
5 a clear, documented audit trail and the staffing in the nursing facilities remains adequate to
6 meet the needs of residents. Staffing to be shared may be based on the average number of
7 hours used per week or month within the assisted living program housing facility. In a
8 facility licensed to provide assisted living housing services under section 7801 in which 2
9 or more staff are required to be awake and on duty during a night shift, one of the staff may
10 be shared with a nursing facility located in the same building without prior approval from
11 the department, subject to the following provisions.
12 A. Prior notice must be given to the department.
13 B. The assisted living program housing facility shall maintain its state minimum
14 staffing ratio, and the nursing facility shall maintain its state minimum staffing ratio
15 and its federal licensed nurse staffing requirement.
16 C. The assisted housing program facility and the nursing facility shall each post a
17 notice informing the public that, although staffing is shared on the night shift,
18 compliance with the minimum staffing requirements is maintained.
19 D. The department may suspend the facility's ability to share staffing under this
20 subsection if the most recent survey for either level of care indicates deficiencies that
21 are related to resident care and that arise from the sharing of staff.
22
23 amended to read:
24
25 structure, used, maintained or advertised as a place where sleeping accommodations are
26 furnished that offers stays that are temporary in nature and consist of fewer than 183 days
27 in the aggregate per year. "Lodging place" includes accommodations in the entertainment,
28 hospitality, recreation and tourism industries, including, but not limited to, hotels, motels,
29 bed and breakfasts, inns and properties under common management at the same location
30 where 4 or more rooms, cottages or condominium units are available. "Lodging place"
31 does not include vacation rentals, youth camps, dormitories of charitable, educational or
32 philanthropic institutions, fraternity or sorority houses affiliated with educational
33 institutions, permanent residences, or rental properties with tenant and landlord
34 relationships as described under Title 14, chapters 709 to 710‑D, nursing facilities as
35 defined in section 1812‑A, assisted living programs facilities as defined in section 7852,
36 subsection 4 4-A or residential care facilities as defined in section 7852, subsection 14.
37 as corrected by RR 2001, c. 2, Pt. A, §36,
38 is amended to read:
39 A-1. In accordance with subparagraphs (1) and (2), an assisted housing program
40 facility either directly or by contract providing to its residents any of the following
41 services: personal care assistance, the administration of medication or nursing services.
42 (1) An assisted housing program facility may directly provide to its residents
43 meals, housekeeping and chore assistance, case management and personal care Page 3 - 131LR0309(01)
44 assistance delivered on the site of congregate housing without obtaining a separate
45 license to do so.
3 (2) An assisted housing program facility licensee may hold at any one time only
4 one license under this subsection. A qualified assisted housing program facility
5 may obtain a license for a different category under this subsection, upon
6 application and surrender of the previous license;
7 as amended by PL 2021, c. 35, §14, is further
8 amended to read:
9 B. The terms of full licenses or approvals are as follows.
10 (1) Except as provided in subparagraphs (2) to (7) (8), the term of all full licenses
11 and approvals issued pursuant to this chapter is for one year or the remaining period
12 of a conditional or provisional license that has been issued for less than one year.
13 (2) The term of a children's residential care facility license is for 2 years.
14 (3) The term of a drug treatment center license is for 2 years.
15 (4) The term of a family foster home or specialized foster home license is for 2
16 years.
17 (5) The term of a child care facility license issued under section 8301‑A,
18 subsection 2 is for 2 years.
19 (6) The term of a family child care provider license issued under section 8301‑A,
20 subsection 3 is for 2 years.
21 (7) The term of an adult day care program license pursuant to chapter 1679 is for
22 either one or 2 years at the discretion of the department.
23 (8) The term of an assisted housing facility license issued under section 7853 is
24 for 2 years.
25 headnote is amended to read:
26
27 FACILITIES
28 as amended by PL 2015, c. 494, Pt. A, §25, is further
29 amended to read:
30 facilities
31 Assisted housing programs facilities are authorized under this chapter in the following
32 settings and subject to the following standards and licensure requirements.
33 facilities further the independence of the
34 resident and respect the privacy and personal choices of the resident, including the choice
35 to continue to reside at home for so long as the assisted housing program facility, as it is
36 fundamentally designed, is able to meet the needs of the resident. Assisted housing
37 programs facilities provided to residents must be consumer oriented and meet professional
38 standards of quality.
1
2 Page 4 - 131LR0309(01)
1 facilities consist of the
2 following settings:
3 A. Independent housing with services programs, as defined in section 7852, subsection
4 6;
5 B. Assisted living programs facilities, as defined in section 7852, subsection 4 4-A; or
6 C. Residential care facilities, as defined in section 7852, subsection 14.
7
8 subject to licensure. Licensure of assisted living programs facilities is governed by section
9 7801, subsection 1. Licensure of residential care facilities is governed by section 7801,
10 subsections 1 and 3.
11
12 housing program facility shall conduct a comprehensive background check for direct access
13 personnel, as defined in section 1717, subsection 1, paragraph A2, in accordance with state
14 law and rules adopted by the department and is subject to the employment restrictions set
15 out in section 1812‑G and other applicable federal and state laws when hiring, employing
16 or placing direct access personnel, including a certified nursing assistant or a direct care
17 worker.
18 The department may adopt rules necessary to implement this subsection. Rules adopted
19 pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375,
20 subchapter 2‑A.
21 as enacted by PL 2001, c. 596, Pt. A, §1 and
22 affected by Pt. B, §25, is repealed.
23 is enacted to read:
24
25 facility or a residential care facility.
26 as enacted by PL 2001, c. 596, Pt. A, §1 and
27 affected by Pt. B, §25, is amended to read:
28
29 assisted housing program of housing, assistance with activities of daily living and
30 instrumental activities of daily living, personal supervision, protection from environmental
31 hazards, meals, diet care, care management and, diversional or motivational activities,
32 medication administration and nursing services.
33 as enacted by PL 2001, c. 596, Pt. A, §1 and
34 affected by Pt. B, §25, is repealed.
35 is enacted to read:
36
37 that, for consideration, is maintained wholly or in part for the purpose of providing assisted
38 living services to residents in private apartments in buildings that include a common dining
39 area, either directly by the provider or indirectly through contracts with persons, entities or
40 agencies. Page 5 - 131LR0309(01)
1 as amended by PL 2003, c. 688, Pt. C, §12, is
2 further amended to read:
3
4 housing services by an assisted housing program, either directly by the provider or
5 indirectly through contracts with persons, entities or agencies, of assisted housing services,
6 assisted housing services with the addition of medication administration or assisted housing
7 services with the addition of medication administration and nursing services facility.
8 as enacted by PL 2001, c. 596, Pt. A, §1 and
9 affected by Pt. B, §25, is repealed.
10 as enacted by PL 2001, c. 596, Pt. A, §1 and
11 affected by Pt. B, §25, is repealed.
12 is enacted to read:
13
14 residential care facility and a nursing facility that are colocated on the same premises.
15 as enacted by PL 2001, c. 596, Pt. A, §1 and
16 affected by Pt. B, §25, is amended to read:
17
18 nurses defined in Title 32, section 2102, subsection 2. "Nursing services" includes
19 coordination and oversight of resident care services provided by unlicensed health care
20 assistive personnel in assisted living programs housing facilities.
21 as enacted by PL 2001, c. 596, Pt. A, §1 and
22 affected by Pt. B, §25 and amended by PL 2003, c. 689, Pt. B, §6, is further amended to
23 read:
24
25 that, for consideration, is maintained wholly or partly for the purpose of providing residents
26 with assisted living services. Residential care facilities provide housing and services to
27 residents in private or semi-private bedrooms in buildings with common living areas and
28 dining areas. "Residential care facility" does not include a licensed nursing home, a mental
29 health residential program licensed under Title 34-B, section 1203-A, a substance use
30 treatment facility licensed under chapter 1667, a residential program for individuals with
31 intellectual disabilities licensed under Title 34-B, section 1203-A or a supported shared
32 living arrangement certified by the department.
33 as amended by PL 2003, c. 673, Pt. V, §2 and
34 affected by §29, is further amended to read:
35 The commissioner shall adopt rules for licensed assisted housing programs facilities.
36 Rules adopted pursuant to this section are major substantive rules as defined in Title 5,
37 chapter 375, subchapter 2‑A, except that rules to establish categories of licensed assisted
38 housing programs facilities, including private nonmedical institutions, are routine technical
39 rules as defined in Title 5, chapter 375, subchapter 2‑A.
40 as enacted by PL 2001, c. 596, Pt. A, §1 and
41 affected by Pt. B, §25, is amended to read: Page 6 - 131LR0309(01)
1
2 ombudsman program established pursuant to section 5106, subsection 11‑C, consumer
3 representatives and providers of in the type of assisted housing program facility to which
4 the rules will apply.
5 as enacted by PL 2001, c. 596, Pt. A, §1 and
6 affected by Pt. B, §25, is amended to read:
7
8 medication, the commissioner shall consider, among other factors, the general health of the
9 persons likely to receive medication and the numbers of persons served and employed by
10 the assisted housing program facility. The department may require unlicensed personnel
11 to have successfully completed a program of training and instruction, approved by the
12 department for the administration of medication, that is not limited to in-service training.
13 as amended by PL 2003, c. 449, §3, is further
14 amended to read:
15 housing facility rules. The commissioner shall adopt
16 rules for assisted living programs housing facilities. In addition to the subject matter of
17 rules listed in subsection 2, the rules must recognize and promote the efficiencies inherent
18 in providing services in the applicable setting with respect to staffing and other
19 responsibilities, while ensuring quality of care and safety. The rules must set requirements
20 and standards for services rendered in the applicable settings that recognize the differences
21 between those settings and private homes served pursuant to chapter 419. The rules must
22 permit staff in assisted living programs housing facilities to be shared in accordance with
23 section 1812‑C, subsection 6‑A and section 7914 7860.
24 as amended by PL 2003, c. 449, §3, is further
25 amended to read:
26
27 pertaining to residents' rights are applicable to licensed assisted housing programs facilities.
28 as enacted by PL 2003, c. 449, §4, is amended
29 to read:
30
31 department shall give due consideration to and shall avoid conflicts with the requirements
32 of the federal Internal Revenue Code of 1986 and regulations promulgated under the federal
33 Internal Revenue Code of 1986 and any other requirements imposed by the federal Internal
34 Revenue Service when financing based on low-income housing tax credits is utilized for
35 the housing component of assisted living programs housing facilities.
36 as enacted by PL 2001, c. 596, Pt. A, §1 and affected by
37 Pt. B, §25, is amended to read:
38
39 The department shall charge annual fees for licensure of residential care facilities and
40 assisted living programs facilities as follows:
41
42 care facility; and Page 7 - 131LR0309(01)
1 facilities. Two hundred dollars for an assisted
2 living program facility.
3 as amended by PL 2019, c. 338, §1, is further amended
4 to read:
5 facilities
6 In accordance with this section, the department shall adopt rules pursuant to Title 5,
7 chapter 375 for the inspection of assisted living programs facilities as defined in section
8 7852, subsection 4, 4-A by the Commissioner of Public Safety or the commissioner's
9 designee and the fees for that inspection. Rules regarding fees adopted pursuant to this
10 section are major substantive rules as defined in Title 5, chapter 375, subchapter II‑A 2-A.
11
12 facilities require a construction permit from the Commissioner of Public Safety. Prior to
13 licensure all assisted living programs facilities must be inspected by the Commissioner of
14 Public Safety or the commissioner's designee at the request of the department. All assisted
15 living programs facilities must be inspected upon performing renovations and must be
16 reinspected every 2 years.
17
18 certificate of compliance with the provisions of this section to the department.
19 facilities must be inspected using the
20 chapter pertaining to the applicable building type of the National Fire Protection
21 Association Life Safety Code adopted by the Department of Public Safety, Office of the
22 State Fire Marshal and must be protected throughout by a supervised, automatic sprinkler
23 system approved by the Commissioner of Public Safety.
24 as enacted by PL 2001, c. 596, Pt. A, §1 and
25 affected by Pt. B, §25, is amended to read:
26
27 program facility may not manage, hold or deposit in a financial institution the personal
28 funds of a resident of the facility unless the operator or agent has received written
29 permission from:
30 A. The resident if the resident does not have a guardian, trustee or conservator;
31 B. The resident's guardian, trustee or conservator if that person exists and can be
32 reached; or
33 C. The department if a guardian, trustee or conservator exists but can not cannot be
34 reached.
35 as enacted by PL 2001, c. 596, Pt. A, §1 and
36 affected by Pt. B, §25, is amended to read:
37 facility
38 who, after receiving written permission pursuant to subsection 1, manages or holds the
39 personal funds of a resident shall maintain an account for these funds, which must include
40 for each resident a separate, itemized accounting for the use of that resident's personal funds
41 with supporting documentation for every expenditure in excess of $2. Page 8 - 131LR0309(01)
1 as enacted by PL 2001, c. 596, Pt. A, §1 and
2 affected by Pt. B, §25, is amended to read:
3
4 an assisted housing program facility to deposit in a financial institution the personal funds
5 of a resident if the resident has a guardian, trustee or conservator who can not cannot be
6 reached.
7 as enacted by PL 2001, c. 596, Pt. A, §1 and
8 affected by Pt. B, §25, is amended to read:
9
10 operator or agent of an assisted housing program facility use the personal funds of a resident
11 for the operating costs of the facility or for services or items that are reimbursed by a 3rd
12 party. The personal funds of a resident may not be commingled with the business funds of
13 the facility or with the personal funds or accounts of the owner, a member of the owner's
14 family or an employee of the facility.
15 as enacted by PL 2001, c. 596, Pt. A, §1 and affected by
16 Pt. B, §25, is amended to read:
17
18 The department shall permit shared staffing between residential care facilities and other
19 levels of assisted housing on the same premises within multi-level health care facilities as
20 long as there is a clear, documented audit trail and the staffing in the residential care
21 facilities remains adequate to meet the needs of residents. Staffing to be shared may be
22 based on the average number of hours used per week or month within the assisted housing
23 program facility. For the purposes of this section, "shared staffing" means the use of
24 licensed and unlicensed personnel who are employed, directly or under a contract, by a
25 long-term care multi-level health care facility in more than one level of care provided by a
26 single entity on the same premises.
27 as amended by PL 2013, c. 582, §§2 and 3, is further
28 amended to read:
29 facilities funded by the State;
30
31 The Department of Health and Human Services, with advice from the Maine State
32 Housing Authority, the United States Department of Agriculture, Rural Housing Services
33 Service or any other housing agency financing assisted housing programs facilities, shall
34 administer state-funded assisted housing programs facilities. Administration must include,
35 but is not limited to:
36 facilities. Adopting rules
37 governing the services to be provided under assisted housing programs facilities paid for
38 with state funds. Rules adopted pursuant to this subsection are routine technical rules as
39 defined in Title 5, chapter 375, subchapter II‑A 2-A;
40
41 assisted housing programs facilities with standards and guidelines established for the
42 programs facilities; Page 9 - 131LR0309(01)
1
2 subsidize the cost of assisted housing programs facilities for eligible clients.
3 For the purposes of this subsection, "eligible clients" means adults who have been
4 determined through an approved assessment by the department to be functionally or
5 cognitively impaired and in need of financial assistance to access assisted housing
6 programs facilities; and
7
8 residential care facility, as defined in section 7852, subsection 14, that is reimbursed by the
9 department under the rules of reimbursement for room and board costs, including
10 depreciation, when the facility is sold on or after July 1, 2013, using a methodology that
11 provides percentage credits for buildings, fixed equipment and moveable equipment based
12 on the number of years of operation of the residential care facility by the owner that is
13 consistent with the following:
14 A. For the purposes of determining depreciation recapture for buildings and fixed
15 equipment, the methodology must determine the number of years of operation by
16 reference to the date on which the owner began operating with the original license;
17 B. For the purposes of determining depreciation recapture for moveable equipment,
18 the methodology must enable percentage credits to reach 100% after the first 6 years
19 of the assigned useful life; and
20 C. The methodology must treat as equivalent to the owner of the residential care
21 facility any person or entity that owns or controls the entity that owns the residential
22 care facility and any entity that is owned or controlled by the owner of the residential
23 care facility.
24 as amended by PL 2001, c. 596, Pt. B, §15 and
25 affected by §25, is further amended to read:
26
27 assisted housing program facility subject to licensure pursuant to chapters 1663 and 1664,
28 any nursing facility or unit subject to licensure pursuant to chapter 405 and any private
29 psychiatric hospital subject to licensure pursuant to chapter 405.
30 as amended by PL 2003, c. 634, §7, is further
31 amended to read:
32
33 program facility or residential care facility subject to licensure pursuant to chapters 1663
34 and 1664 and a nursing or intermediate care facility or unit subject to licensure pursuant to
35 chapter 405.
36 as amended by PL 2011, c. 542, Pt. A, §47, is
37 further amended to read:
38
39 governing the licensing and functioning of nursing facilities, intermediate care facilities for
40 persons with intellectual disabilities and assisted living programs facilities or residential
41 care facilities. Page 10 - 131LR0309(01)
1 as amended by PL 2011, c. 233, §1, is further
2 amended to read:
3
4 or not-for-profit entity or institution providing health services, including, but not limited
5 to, a radiological facility licensed under chapter 160, a health care facility licensed under
6 chapter 405, an independent radiological service center, a federally qualified health center
7 certified by the United States Department of Health and Human Services, Health Resources
8 and Services Administration, a rural health clinic or rehabilitation agency certified or
9 otherwise approved by the Division of Licensing and Regulatory Services within the
10 Department of Health and Human Services, a home health care provider licensed under
11 chapter 419, an assisted living program facility or a residential care facility licensed under
12 chapter 1663, a hospice provider licensed under chapter 1681, a state institution as defined
13 under Title 34‑B, chapter 1 and a mental health facility licensed under Title 34‑B, chapter
14 1. For the purposes of this chapter, "health care facility" does not include retail pharmacies.
15 as enacted by PL 2015, c. 299, §25, is amended
16 to read:
17 facility. "Assisted housing program facility" means a
18 program or facility licensed pursuant to chapter 1663.
19 as enacted by PL 2015, c. 299, §25, is
20 amended to read:
21 L. Assisted housing programs facilities;
22
23 This bill accomplishes the following.
24 1. It replaces the term "assisted housing program" with the term "assisted housing
25 facility."
26 2. It replaces the term "assisted living program" with the term "assisted living facility."
27 3. It amends the definition of "assisted housing services" to include medication
28 management and nursing services and removes those services from the definition of
29 "assisted living services."
30 4. It amends the definition of "residential care facility" to clarify which licensed
31 entities are excluded from the definition.
32 5. It provides that the term of the license for an assisted housing facility is 2 years.
23