An Act To Refine the Criteria for\~suing a Certificate of Need
Maine Legislature, Session 121, LD 0159
Committee Amendment CA_A_S363 (Senate)
Amends: 22 MRSA §335

COMMITTEE AMENDMENT "~,, to S.P. 82, L.D. 159, Bill, "An Act 
To Refine the Criteria for\~suing a Certificate of Need" 
Amend the bill by striking out everything after the title 
and before the summary and inserting in its place the following: 
. Emergency preamble. Whereas, Acts of the Legislature do not 
become effective until 90 days after adjournment unless enacted 
as emergencies; and 
Whereas, 
health 
care 
projects 
with 
applications 
for 
certificates of need currently pending with the Department of 
Human Services that are appropriate for action by the department 
at this time require action promptly in order to provide needed 
health care service improvements for residents of this State; and 
Whereas, in the judgment of the Legislature, these facts 
create an emergency wi thin the meaning of the Constitution of 
Maine 
and 
require 
the 
following 
legislation 
as 
immediately 
necessary for the preservation of the public peace, health and 
safety; now, therefore, 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA §335, sub-§7, as amended by PL 2003, 469, Pt. 
C. §§ll and 12, is further amended to read: 
7. 
Review; approval. 
Except as provided in section 336, 
the 
commissioner 
shall 
issue 
a 
certificate of 
need if the 
commissioner 
determines 
and 
makes 
specific 
written 
findings 
regarding that determination that: 
Page l-LR059l(2) 
COMMITTEE AMENDMENT 
, ~,~' 
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53b3 
COMMITTEE AMENDMENT "~' to S.P. 82, L.D. 159 
A. 
The applicant is fit, willing and able to provide the 
proposed 
services 
at 
the 
proper 
standard 
of 
care 
as 
demonstrated by, among other factors, 
whether the quality 
of any health care provided in the past by the applicant or 
a related party under the applicant's control meets industry 
standards; 
B. 
The economic feasibility of the proposed services is 
demonstrated in terms of the: 
(1) 
Capacity of the applicant to support the proj ect 
financially over its useful life, in light of the rates 
the applicant expects to be able to charge for the 
services to be provided by the project; and 
(2) 
Applicant's ability to establish 
project in accordance with existing 
anticipated future changes in federal, 
licensure 
and 
other 
applicable 
applicable rules; 
and operate the 
and 
reasonably 
state and local 
or 
potentially 
C. 
There is a public need for the proposed services as 
demonstrated by certain factors, including, but not limited 
to: 
(1) 
Whether, and the extent to which, the project will 
substantially 
address 
specific 
health 
problems 
as 
measured by health needs in the area to be served by 
the project; 
(2) 
Whether the project will have a positive impact on 
the health status indicators of the population to be 
served; 
(3) 
Whether the services affected by the project will 
be accessible to all residents of the area proposed to 
be served; and 
(4) 
Whether 
the project will provide 
demonstrable 
improvements in quality and outcome measures applicable 
to the services proposed in the project; 
D. 
The proposed services are consistent with 
and economic development of health facilities 
resources for the State as demonstrated by: 
the orderly 
and health 
(1) 
The impact of the project on total health care 
expenditures after taking into account, to the extent 
practical, both the costs and benefits of the project 
COMMITTEE AMENDMENT 
'" 
• \,-~i'-~' 
53G3 
COMMITTEE AMENDMENT ,,'\\, to S.P. 82, L.D. 159 
and the competing demands in the local service area and 
statewide for available resources for health care; 
(2) 
The availability of state funds 
to cover 
any 
increase in state costs associated with utilization of 
the project's services; and 
(3) 
The 
accessible 
methods of 
likelihood 
that 
more 
effective, 
more 
or less costly alternative technologies or 
service delivery may become available; and 
E. 
The project meets the criteria set forth in subsection 1. 
In making a determination under this subsection, the commissioner 
shall use data available in the state health plan under Title 2, 
section 
103, 
data 
from 
the 
Maine 
Health 
Data 
Organization 
established in chapter 1683 and other information available to 
the commissioner. 
Particular weight must be given to information 
that indicates that the proposed health services are innovations 
in high quality health care delivery, that the proposed health 
services are not reasonably available in the proposed area and 
that the facility proposing the new health services is designed 
to provide excellent quality health care. 
Sec. 2. Nursing facility projects. 
Notwithstanding the provisions 
of 
the 
Maine 
Revised Statutes, 
Title 
22, 
section 
334, 
the 
Department of 
Human 
Services 
may 
approve 
a 
nursing facility 
project if the applicant has been recommended for conditional 
approval from the department prior to February 15, 2004, complies 
with all other applicable state rules and federal regulations and 
demonstrates 
cost-neutrality using 
savings 
obtained 
from 
the 
purchase of beds 
from the Maine Health and Higher Education 
Facilities Authority and approved by the department. 
Sec. 3. Report on nursing facility projects. 
By February 15, 4004, 
the Department of Human 
Services' shall report to the joint 
standing committee of the Legislature having jurisdiction over 
health and human services matters regarding funding requirements 
under the Maine Revised Statutes, Title 22, 
section 334 
for 
nursing facility projects that use banked beds 
from 
nursing 
facilities and residential care facilities. 
The joint standing 
committee of the Legislature having jurisdiction over health and 
human services matters is authorized to report out legislation 
regarding this issue to the First Regular Session of the 122nd 
Legislature. 
Emergency clause. 
In view of the emergency cited in the 
preamble, this Act takes effect when approved.' 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ,~" to S.P. 82, L.D. 159 
SUMMARY 
S3~3 
This 
amendment 
retains the provisions of the bill that 
require 
applications 
for 
certificates of 
need 
be 
judged in 
reference to the state health plan, data from the Maine Health 
Data 
Organization 
and 
other 
information 
available 
to 
the 
Commissioner of Human Services. 
It also retains the provisions 
that require that particular weight be given to information that 
the proposed health care services are innovations in high quality 
health care delivery and that the facility proposing the new 
health services is designed to provide excellent quality health 
care. 
It updates the bill language to reflect amendments to the 
certificate of 
need 
law enacted in 2003. 
It adds 
language 
permitting the Department of Human Services to approve a nursing 
facility 
project 
if 
the 
project 
has 
been 
recommended 
for 
conditional approval prior to February 15, 
2004, 
the project 
complies with other state rules and federal regulations and the 
project demonstrates cost-neutrality using savings obtained from 
the purchase of beds from the Maine Health and Higher Education 
Facilities Authority and approved by the Department of Human 
Services. 
The amendment directs the Department of Human Services 
to report to the Joint Standing Committee on Health and Human 
Services regarding funding nursing facility projects under the 
Maine Revised Statutes, Title 22, section 334. 
The amendment 
adds an emergency preamble and an emergency clause. 
FISCAL :\OTE REQLlRED 
<~ee attached) 
COMMITTEE AMENDMENT 
Fiscal Detail and Notes 
Approved: 01123/04 ;t;vac:.. 
Office of Fiscal and Program Review 
LD159 
An Act To Refine the Criteria for Issuing a Certificate of Need 
LR 0591(02) 
Fiscal Note for Bill as Amended by Committee Amendment " " 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Minor cost increase - Other Special Revenue Funds 
Any additional cost to the Department of Human Services can be absorbed by the Department within existing budgeted 
resources. Any additional cost the Maine Health Data Organization in implementing this legislation can be absorbed by 
the agency utilizing existing resources. 
LR0591(2) - Fiscal Note - Page 1 of 1