Page 1 - 131LR0309(03)
STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-THREE
_____
H.P. 292 - L.D. 475
An Act to Simplify and Clarify the Licensing of Assisted Housing Facilities
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 21-A MRSA §753-B, sub-§5, as repealed and replaced by PL 2021, c. 570,
§4, is amended to read:
5. Alternate method of absentee voting by residents of certain licensed facilities.
Residents of certain nursing homes, residential care facilities and assisted living programs
facilities may cast absentee ballots under the provisions of this subsection. This subsection
applies to a licensed nursing home subject to the provisions of Title 22, chapter 405; a
licensed level IV residential care facility subject to the provisions of Title 22, chapter 1664;
and a licensed assisted living program facility with more than 6 beds subject to the
provisions of Title 22, chapter 1664. As used in this subsection, "level IV residential care
facility" means a residential care facility as defined by Title 22, section 7852, subsection
14 that has a licensed capacity of more than 6 residents.
A. The municipal clerk shall designate one time during the 30-day period prior to an
election during which the municipal clerk shall be present in each facility to which this
subsection applies in the municipality for the purpose of conducting absentee voting
by residents of these facilities. The clerk shall designate which areas in these facilities
constitute the voting place, the voting booth and the guardrail enclosure. The clerk shall
post a notice in the municipal office that absentee voting will be conducted as
prescribed in this subsection. The clerk shall provide a notice to each facility of the
date and time when absentee voting will be conducted. The notice must state that the
facility is required to notify the contact person or persons, if any, for each resident that
absentee voting will be conducted. Each facility shall provide notice, which may be in
the form of an e-mail or an electronic newsletter, to the contact person or persons, if
any, for each resident of the date and time when absentee voting will be conducted at
the facility. Sections 681 and 682 apply to voting in these facilities within the areas
designated by the clerk.
B. To protect public health, the Secretary of State may designate procedures for
conducting absentee voting for the residents of a facility to which this subsection
applies that differ from the procedures described in paragraph A if:
APPROVED
JUNE 15, 2023
BY GOVERNOR
CHAPTER
176
PUBLIC LAW Page 2 - 131LR0309(03)
(1) The Department of Health and Human Services declares a health emergency
under Title 22, section 802, subsection 2;
(2) The Governor declares an extreme public health emergency under Title 22,
section 802, subsection 2‑A;
(3) The Department of Health and Human Services determines that a public health
threat, as defined in Title 22, section 801, subsection 10, threatens the health,
welfare or safety of the municipal clerk or the residents of a facility described in
this subsection; or
(4) A facility described in this subsection prohibits the municipal clerk from
entering the facility.
Procedures designated under this paragraph remain in effect for the duration of the
health emergency, extreme public health emergency or public health threat or for as
long as the municipal clerk remains prohibited from entering the facility, as the case
may be.
Sec. 2. 22 MRSA §1812-C, sub-§6-A, as amended by PL 2003, c. 416, §2, is
further amended to read:
6-A. Shared staffing.
shared with facilities licensed to provide assisted living housing services as long as there is
a clear, documented audit trail and the staffing in the nursing facilities remains adequate to
meet the needs of residents. Staffing to be shared may be based on the average number of
hours used per week or month within the assisted living program housing facility. In a
facility licensed to provide assisted living housing services under section 7801 in which 2
or more staff are required to be awake and on duty during a night shift, one of the staff may
be shared with a nursing facility located in the same building without prior approval from
the department, subject to the following provisions.
A. Prior notice must be given to the department.
B. The assisted living program housing facility shall maintain its state minimum
staffing ratio, and the nursing facility shall maintain its state minimum staffing ratio
and its federal licensed nurse staffing requirement.
C. The assisted housing program facility and the nursing facility shall each post a
notice informing the public that, although staffing is shared on the night shift,
compliance with the minimum staffing requirements is maintained.
D. The department may suspend the facility's ability to share staffing under this
subsection if the most recent survey for either level of care indicates deficiencies that
are related to resident care and that arise from the sharing of staff.
Sec. 3. 22 MRSA §2491, sub-§7-F,
amended to read:
7-F. Lodging place.
structure, used, maintained or advertised as a place where sleeping accommodations are
furnished that offers stays that are temporary in nature and consist of fewer than 183 days
in the aggregate per year. "Lodging place" includes accommodations in the entertainment,
hospitality, recreation and tourism industries, including, but not limited to, hotels, motels,
bed and breakfasts, inns and properties under common management at the same location Page 3 - 131LR0309(03)
where 4 or more rooms, cottages or condominium units are available. "Lodging place"
does not include vacation rentals, youth camps, dormitories of charitable, educational or
philanthropic institutions, fraternity or sorority houses affiliated with educational
institutions, permanent residences, or rental properties with tenant and landlord
relationships as described under Title 14, chapters 709 to 710‑D, nursing facilities as
defined in section 1812‑A, assisted living programs facilities as defined in section 7852,
subsection 4 4-A or residential care facilities as defined in section 7852, subsection 14.
Sec. 4. 22 MRSA §7801, sub-§1, ¶A-1, as corrected by RR 2001, c. 2, Pt. A, §36,
is amended to read:
A-1. In accordance with subparagraphs (1) and (2), an assisted housing program
facility either directly or by contract providing to its residents any of the following
services: personal care assistance, the administration of medication or nursing services.
(1) An assisted housing program facility may directly provide to its residents
meals, housekeeping and chore assistance, case management and personal care
assistance delivered on the site of congregate housing without obtaining a separate
license to do so.
(2) An assisted housing program facility licensee may hold at any one time only
one license under this subsection. A qualified assisted housing program facility
may obtain a license for a different category under this subsection, upon
application and surrender of the previous license;
Sec. 5. 22 MRSA §7802, sub-§2, ¶B, as amended by PL 2021, c. 35, §14, is further
amended to read:
B. The terms of full licenses or approvals are as follows.
(1) Except as provided in subparagraphs (2) to (7) (8), the term of all full licenses
and approvals issued pursuant to this chapter is for one year or the remaining period
of a conditional or provisional license that has been issued for less than one year.
(2) The term of a children's residential care facility license is for 2 years.
(3) The term of a drug treatment center license is for 2 years.
(4) The term of a family foster home or specialized foster home license is for 2
years.
(5) The term of a child care facility license issued under section 8301‑A,
subsection 2 is for 2 years.
(6) The term of a family child care provider license issued under section 8301‑A,
subsection 3 is for 2 years.
(7) The term of an adult day care program license pursuant to chapter 1679 is for
either one or 2 years at the discretion of the department.
(8) The term of an assisted housing facility license issued under section 7853 is
for 2 years.
Sec. 6. 22 MRSA c. 1664, headnote is amended to read:
CHAPTER 1664 Page 4 - 131LR0309(03)
ASSISTED HOUSING PROGRAMS FACILITIES
Sec. 7. 22 MRSA §7851, as amended by PL 2015, c. 494, Pt. A, §25, is further
amended to read:
§7851. Assisted housing programs facilities
Assisted housing programs facilities are authorized under this chapter in the following
settings and subject to the following standards and licensure requirements.
1. Standards.
resident and respect the privacy and personal choices of the resident, including the choice
to continue to reside at home for so long as the assisted housing program facility, as it is
fundamentally designed, is able to meet the needs of the resident. Assisted housing
programs facilities provided to residents must be consumer oriented and meet professional
standards of quality.
2. Settings.
following settings:
A. Independent housing with services programs, as defined in section 7852, subsection
6;
B. Assisted living programs facilities, as defined in section 7852, subsection 4 4-A; or
C. Residential care facilities, as defined in section 7852, subsection 14.
3. Licensure requirements.
subject to licensure. Licensure of assisted living programs facilities is governed by
subsection 3-A and section 7801, subsection 1. Licensure of residential care facilities is
governed by subsection 3-A and section 7801, subsections 1 and 3.
3-A. Multiple licenses; limitations.
issuance of multiple licenses to assisted living facilities and residential care facilities.
A. Except as provided in paragraph B, beginning October 1, 2023, the department may
not issue more than one license at the same license level to an applicant for an assisted
living facility license or a residential care facility license for services offered in the
same location.
B. The department may issue more than one license at the same license level to an
applicant for an assisted living facility license or a residential care facility license that,
on October 1, 2023, held more than one license at the same license level for services
offered in the same location.
The department shall adopt rules to define license levels for assisted living facilities and
residential care facilities. Rules adopted pursuant to this subsection are routine technical
rules as defined in Title 5, chapter 375, subchapter 2-A.
4. Prohibited employment based on disqualifying offenses.
housing program facility shall conduct a comprehensive background check for direct access
personnel, as defined in section 1717, subsection 1, paragraph A‑2, in accordance with state
law and rules adopted by the department and is subject to the employment restrictions set
out in section 1812‑G and other applicable federal and state laws when hiring, employing Page 5 - 131LR0309(03)
or placing direct access personnel, including a certified nursing assistant or a direct care
worker.
The department may adopt rules necessary to implement this subsection. Rules adopted
pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375,
subchapter 2‑A.
Sec. 8. 22 MRSA §7852, sub-§2, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is repealed.
Sec. 9. 22 MRSA §7852, sub-§2-A is enacted to read:
2-A. Assisting housing facility.
facility, a residential care facility or an independent housing with services program.
Sec. 10. 22 MRSA §7852, sub-§3, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
3. Assisted housing services.
assisted housing program of housing, assistance with activities of daily living and
instrumental activities of daily living, personal supervision, protection from environmental
hazards, meals, diet care, care management and, diversional or motivational activities,
medication administration and nursing services.
Sec. 11. 22 MRSA §7852, sub-§4, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is repealed.
Sec. 12. 22 MRSA §7852, sub-§4-A is enacted to read:
4-A. Assisted living facility.
that, for consideration, is maintained wholly or in part for the purpose of providing assisted
living services to residents in private apartments in buildings that include a common dining
area, either directly by the provider or indirectly through contracts with persons, entities or
agencies.
Sec. 13. 22 MRSA §7852, sub-§5, as amended by PL 2003, c. 688, Pt. C, §12, is
further amended to read:
5. Assisted living services.
housing services by an assisted housing program, either directly by the provider or
indirectly through contracts with persons, entities or agencies, of assisted housing services,
assisted housing services with the addition of medication administration or assisted housing
services with the addition of medication administration and nursing services facility.
Sec. 14. 22 MRSA §7852, sub-§6, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
6. Independent housing with services program.
program" means a program of assisted housing supportive services provided to residents in
private apartments in buildings that include a common dining area, either directly by the
provider or indirectly through contracts with persons, entities or agencies who receive
funds through a written agreement with the department's office of aging and disability
services. Page 6 - 131LR0309(03)
Sec. 15. 22 MRSA §7852, sub-§9, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is repealed.
Sec. 16. 22 MRSA §7852, sub-§10-A is enacted to read:
10-A. Multi-level health care facility.
residential care facility and a nursing facility that are colocated on the same premises.
Sec. 17. 22 MRSA §7852, sub-§11, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
11. Nursing services.
nurses defined in Title 32, section 2102, subsection 2. "Nursing services" includes
coordination and oversight of resident care services provided by unlicensed health care
assistive personnel in assisted living programs housing facilities.
Sec. 18. 22 MRSA §7852, sub-§14, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25 and amended by PL 2003, c. 689, Pt. B, §6, is further amended to
read:
14. Residential care facility.
that, for consideration, is maintained wholly or partly for the purpose of providing residents
with assisted living services. Residential care facilities provide housing and services to
residents in private or semi-private bedrooms in buildings with common living areas and
dining areas. "Residential care facility" does not include a licensed nursing home, a mental
health residential program licensed under Title 34-B, section 1203-A, a substance use
treatment facility licensed under chapter 1667, a residential program for individuals with
intellectual disabilities licensed under Title 34-B, section 1203-A or a supported shared
living arrangement certified by the department.
Sec. 19. 22 MRSA §7853, first ¶, as amended by PL 2003, c. 673, Pt. V, §2 and
affected by §29, is further amended to read:
The commissioner shall adopt rules for licensed assisted housing programs facilities.
Rules adopted pursuant to this section are major substantive rules as defined in Title 5,
chapter 375, subchapter 2‑A, except that rules to establish categories of licensed assisted
housing programs facilities, including private nonmedical institutions, are routine technical
rules as defined in Title 5, chapter 375, subchapter 2‑A.
Sec. 20. 22 MRSA §7853, sub-§1, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
1. Consultation.
ombudsman program established pursuant to section 5106, subsection 11‑C, consumer
representatives and providers of in the type of assisted housing program facility to which
the rules will apply.
Sec. 21. 22 MRSA §7853, sub-§3, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
3. Administration of medication rules.
medication, the commissioner shall consider, among other factors, the general health of the
persons likely to receive medication and the numbers of persons served and employed by
the assisted housing program facility. The department may require unlicensed personnel Page 7 - 131LR0309(03)
to have successfully completed a program of training and instruction, approved by the
department for the administration of medication, that is not limited to in-service training.
Sec. 22. 22 MRSA §7853, sub-§5, as amended by PL 2003, c. 449, §3, is further
amended to read:
5. Assisted living program housing facility rules. The commissioner shall adopt
rules for assisted living programs housing facilities. In addition to the subject matter of
rules listed in subsection 2, the rules must recognize and promote the efficiencies inherent
in providing services in the applicable setting with respect to staffing and other
responsibilities, while ensuring quality of care and safety. The rules must set requirements
and standards for services rendered in the applicable settings that recognize the differences
between those settings and private homes served pursuant to chapter 419. The rules must
permit staff in assisted living programs housing facilities to be shared in accordance with
section 1812‑C, subsection 6‑A and section 7914 7860.
Sec. 23. 22 MRSA §7853, sub-§6, as amended by PL 2003, c. 449, §3, is further
amended to read:
6. Applicability of residents' rights rules.
pertaining to residents' rights are applicable to licensed assisted housing programs facilities.
Sec. 24. 22 MRSA §7853, sub-§7, as enacted by PL 2003, c. 449, §4, is amended
to read:
7. Relationship to tax credit financing.
department shall give due consideration to and shall avoid conflicts with the requirements
of the federal Internal Revenue Code of 1986 and regulations promulgated under the federal
Internal Revenue Code of 1986 and any other requirements imposed by the federal Internal
Revenue Service when financing based on low-income housing tax credits is utilized for
the housing component of assisted living programs housing facilities.
Sec. 25. 22 MRSA §7854, as enacted by PL 2001, c. 596, Pt. A, §1 and affected by
Pt. B, §25, is amended to read:
§7854. Fees for licensure
The department shall charge annual fees for licensure of residential care facilities and
assisted living programs facilities as follows:
1. Fees for residential care facility.
care facility; and
2. Fees for assisted living programs facilities. Two hundred dollars for an assisted
living program facility.
Sec. 26. 22 MRSA §7856, as amended by PL 2019, c. 338, §1, is further amended
to read:
§7856. Fire safety inspection for assisted living programs facilities
In accordance with this section, the department shall adopt rules pursuant to Title 5,
chapter 375 for the inspection of assisted living programs facilities as defined in section
7852, subsection 4, 4-A by the Commissioner of Public Safety or the commissioner's
designee and the fees for that inspection. Rules regarding fees adopted pursuant to this
section are major substantive rules as defined in Title 5, chapter 375, subchapter II‑A 2-A. Page 8 - 131LR0309(03)
1. Permits; inspection.
facilities require a construction permit from the Commissioner of Public Safety. Prior to
licensure all assisted living programs facilities must be inspected by the Commissioner of
Public Safety or the commissioner's designee at the request of the department. All assisted
living programs facilities must be inspected upon performing renovations and must be
reinspected every 2 years.
2. Certificate of compliance.
certificate of compliance with the provisions of this section to the department.
3. Requirements.
chapter pertaining to the applicable building type of the National Fire Protection
Association Life Safety Code adopted by the Department of Public Safety, Office of the
State Fire Marshal and must be protected throughout by a supervised, automatic sprinkler
system approved by the Commissioner of Public Safety.
Sec. 27. 22 MRSA §7857, sub-§1, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
1. Permission to manage personal funds.
program facility may not manage, hold or deposit in a financial institution the personal
funds of a resident of the facility unless the operator or agent has received written
permission from:
A. The resident if the resident does not have a guardian, trustee or conservator;
B. The resident's guardian, trustee or conservator if that person exists and can be
reached; or
C. The department if a guardian, trustee or conservator exists but can not cannot be
reached.
Sec. 28. 22 MRSA §7857, sub-§2, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
2. Itemized accounting.
who, after receiving written permission pursuant to subsection 1, manages or holds the
personal funds of a resident shall maintain an account for these funds, which must include
for each resident a separate, itemized accounting for the use of that resident's personal funds
with supporting documentation for every expenditure in excess of $2.
Sec. 29. 22 MRSA §7857, sub-§3, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
3. Depositing personal funds.
an assisted housing program facility to deposit in a financial institution the personal funds
of a resident if the resident has a guardian, trustee or conservator who can not cannot be
reached.
Sec. 30. 22 MRSA §7857, sub-§4, as enacted by PL 2001, c. 596, Pt. A, §1 and
affected by Pt. B, §25, is amended to read:
4. Use of personal funds by operator prohibited.
operator or agent of an assisted housing program facility use the personal funds of a resident
for the operating costs of the facility or for services or items that are reimbursed by a 3rd Page 9 - 131LR0309(03)
party. The personal funds of a resident may not be commingled with the business funds of
the facility or with the personal funds or accounts of the owner, a member of the owner's
family or an employee of the facility.
Sec. 31. 22 MRSA §7860, as enacted by PL 2001, c. 596, Pt. A, §1 and affected by
Pt. B, §25, is amended to read:
§7860. Shared staffing
The department shall permit shared staffing between residential care facilities and other
levels of assisted housing on the same premises within multi-level health care facilities as
long as there is a clear, documented audit trail and the staffing in the residential care
facilities remains adequate to meet the needs of residents. Staffing to be shared may be
based on the average number of hours used per week or month within the assisted housing
program facility. For the purposes of this section, "shared staffing" means the use of
licensed and unlicensed personnel who are employed, directly or under a contract, by a
long-term care multi-level health care facility in more than one level of care provided by a
single entity on the same premises.
Sec. 32. 22 MRSA §7861, as amended by PL 2013, c. 582, §§2 and 3, is further
amended to read:
§7861. Administration of assisted housing programs facilities funded by the State;
eligible clients
The Department of Health and Human Services, with advice from the Maine State
Housing Authority, the United States Department of Agriculture, Rural Housing Services
Service or any other housing agency financing assisted housing programs facilities, shall
administer state-funded assisted housing programs facilities. Administration must include,
but is not limited to:
1. Rules; payment for assisted housing programs facilities. Adopting rules
governing the services to be provided under assisted housing programs facilities paid for
with state funds. Rules adopted pursuant to this subsection are routine technical rules as
defined in Title 5, chapter 375, subchapter II‑A 2-A;
2. Compliance with standards and guidelines.
assisted housing programs facilities with standards and guidelines established for the
programs facilities;
3. Awarding of grants.
subsidize the cost of assisted housing programs facilities for eligible clients.
For the purposes of this subsection, "eligible clients" means adults who have been
determined through an approved assessment by the department to be functionally or
cognitively impaired and in need of financial assistance to access assisted housing
programs facilities; and
4. Residential care facility depreciation.
residential care facility, as defined in section 7852, subsection 14, that is reimbursed by the
department under the rules of reimbursement for room and board costs, including
depreciation, when the facility is sold on or after July 1, 2013, using a methodology that
provides percentage credits for buildings, fixed equipment and moveable equipment based Page 10 - 131LR0309(03)
on the number of years of operation of the residential care facility by the owner that is
consistent with the following:
A. For the purposes of determining depreciation recapture for buildings and fixed
equipment, the methodology must determine the number of years of operation by
reference to the date on which the owner began operating with the original license;
B. For the purposes of determining depreciation recapture for moveable equipment,
the methodology must enable percentage credits to reach 100% after the first 6 years
of the assigned useful life; and
C. The methodology must treat as equivalent to the owner of the residential care
facility any person or entity that owns or controls the entity that owns the residential
care facility and any entity that is owned or controlled by the owner of the residential
care facility.
Sec. 33. 22 MRSA §7932, sub-§2, as amended by PL 2001, c. 596, Pt. B, §15 and
affected by §25, is further amended to read:
2. Facility.
assisted housing program facility subject to licensure pursuant to chapters 1663 and 1664,
any nursing facility or unit subject to licensure pursuant to chapter 405 and any private
psychiatric hospital subject to licensure pursuant to chapter 405.
Sec. 34. 22 MRSA §7942, sub-§3, as amended by PL 2003, c. 634, §7, is further
amended to read:
3. Long-term care facility.
program facility or residential care facility subject to licensure pursuant to chapters 1663
and 1664 and a nursing or intermediate care facility or unit subject to licensure pursuant to
chapter 405.
Sec. 35. 22 MRSA §7942, sub-§7, as amended by PL 2011, c. 542, Pt. A, §47, is
further amended to read:
7. State licensing rules.
governing the licensing and functioning of nursing facilities, intermediate care facilities for
persons with intellectual disabilities and assisted living programs facilities or residential
care facilities.
Sec. 36. 22 MRSA §8702, sub-§4, as amended by PL 2011, c. 233, §1, is further
amended to read:
4. Health care facility.
or not-for-profit entity or institution providing health services, including, but not limited
to, a radiological facility licensed under chapter 160, a health care facility licensed under
chapter 405, an independent radiological service center, a federally qualified health center
certified by the United States Department of Health and Human Services, Health Resources
and Services Administration, a rural health clinic or rehabilitation agency certified or
otherwise approved by the Division of Licensing and Regulatory Services within the
Department of Health and Human Services, a home health care provider licensed under
chapter 419, an assisted living program facility or a residential care facility licensed under
chapter 1663, a hospice provider licensed under chapter 1681, a state institution as defined Page 11 - 131LR0309(03)
under Title 34‑B, chapter 1 and a mental health facility licensed under Title 34‑B, chapter
1. For the purposes of this chapter, "health care facility" does not include retail pharmacies.
Sec. 37. 22 MRSA §9053, sub-§2, as enacted by PL 2015, c. 299, §25, is amended
to read:
2. Assisted housing program facility. "Assisted housing program facility" means a
program or facility licensed pursuant to chapter 1663.
Sec. 38. 22 MRSA §9054, sub-§7, ¶L, as enacted by PL 2015, c. 299, §25, is
amended to read:
L. Assisted housing programs facilities;