An Act To Restore Funding for Certain Nursing Facilities and Residential Care Facilities
Maine Legislature, Session 121, LD 1791
Committee: Health and Human Services
Sponsors: RICHARDSON, MARTIN, CURLEY, EARLE, FISCHER, KANE, PATRICK, ROSEN, SA VIELLO, DAGGETT
Amends: 22 MRSA §1719, 22 MRSA §3187-A

12lst MAINE LEGISLATURE 
Legislative Document 
No. 1791 
H.P.1313 
House of Representatives, December 22,2003 
An Act To Restore Funding for Certain Nursing Facilities and 
Residential Care Facilities 
(EMERGENCY) 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203. 
Received by the Clerk of the House on December 17,2003. Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint 
Rule 401. 
Presented by Representative RICHARDSON of Brunswick. 
Cosponsored by Senator MARTIN of Aroostook and 
7r/~ 
/J1.11l1lC~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: CURLEY of Scarborough, EARLE of Damariscotta, FISCHER of Presque 
Isle, KANE of Saco, PATRICK of Rumford, ROSEN of Bucksport, SA VIELLO of Wilton, 
Senator: President DAGGETT of Kennebec. 
Printed on recycled paper 
Emergency preamble. Whereas, Acts of the Legislature do not 
become effective until 90 days after adjournment unless enacted 
as emergencies; and 
Whereas, 
this 
services provided 
facilities; and 
by 
legislation 
requires 
nursing facilities 
reimbursement 
and residential 
for 
ca:,e 
Whereas, without 
the 
reimbursement, 
the 
ability of 
the 
facilities 
to 
provide 
services 
to 
residents 
requiring 
these 
services will be sever'ely hampered; and 
Whereas, in the judgment of the Legislature, these facts 
create an emergency ,d thin the meaning of the Constitution 'Jf 
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 §1719 is enacted to read: 
§1719. 
Residential ca,re facility reimbursement 
The 
department 
shall 
reimbursement 
for 
services 
facilities an allowance for a 
invested in those facilities 
cost of living. 
include 
in 
its 
calculation 
of 
provided 
by 
residential 
care 
reasonable return on eguity capital 
and an annual adjustment for the 
Sec. 2. 22 MRS A §1815, as amended by PL 2003, c. 507, Pt. C, 
§l and affected by §4, is further amended to read: 
§1815. Fees 
Each 
application for 
a 
license 
to 
operate 
a 
hospital, 
convalescent 
home 
or nursing 
home 
must 
be 
accompanied 
by 
a 
nonrefundable 
fee. 
Hospi tals 
shall 
pay 
$40 
for 
each 
bed 
contained within the facility. 
Nursing and convalescent homes 
shall pay $69 .i.l.Q. for each bed contained wi thin the facili t.y. 
Each application for a license to operate an ambulatory surgical 
facility must 
be 
accompanied 
by 
the 
fee 
established by 
the 
department. 
The 
department 
shall establish the 
fee 
for 
an 
ambulatory surgical facility, not to exceed $500, on the basis of 
a sliding scale representing size, number of employees and scope 
of operations. All licenses issued must be renewed annually upon 
payment of a like fee. The State's share of all fees received by 
the 
department 
under 
this 
chapter must 
be deposited in the 
General 
Fund. 
A license granted 
may 
not 
be 
assignable 
or 
Page l-LR2419(1) 
transferable. 
State hospitals are not required to pay licensing 
fees. 
Sec. 3. 22 MRSA §3187-A is enacted to read: 
§3187-A. 
Intermediate care facility efficiency incentive 
An 
intermediate 
care 
facility 
for 
persons 
with 
mental 
retardation that limits its variable costs during the fiscal year 
to less than the amounts paid through the variable cost component 
of the final prospective rate is entitled to retain an incentive 
payment equal to 75% of the savings represented by the difference 
between the department's appropriate share of the intermediate 
care facility's allowable expenses and the amount paid by the 
department. 
The amount of the incentive payment is determined 
upon final audit and is calculated in the determination of any 
overpayments made by the department. 
Sec. 4. PL 2003, c. 20, Pt. K, §17 is amended to read: 
Sec. 5. Suspension of inflation and return on equity payments to 
nursing facilities. 
Notwithstanding any other provisions of law, the 
Department of Human Services may not include in its reimbursement 
of nursing facilities under the MaineCare program any amounts 
designed to provide for inflation adjustments or a 
return on 
equity capital for state fiscal yeatS year 2003-04 aaa-dQQ4-Q§. 
Sec. 
6. 
Appropriations 
and 
allocations. 
The 
following 
appropriations and allocations are made. 
HUMAN SERVICES, DEPARTMENT OF 
Medical Care -
Payments to Providers 
0147 
Initiative: 
Restores MaineCare reimbursement reduced by Public 
Law 2003, chapter 20, Part B, section 1 for private nonmedical 
institution bed-hold days. 
Reimbursement for bed-hold days will 
be restored to 100% from 75% of a facility's per diem rate. 
This 
change 
would 
apply 
only 
to 
those 
facilities 
categorized 
as 
medical and remedial. 
General Fund 
2003-04 
2004-05 
All Other 
$0 
$200,000 
General Fund Total 
$0 
$200,000 
Federal Expenditures Fund 
2003-04 
2004-05 
All Other 
$0 
$388,408 
Federal Expenditures Fund Total 
$0 
$388,408 
Nursing Facilities 
01'18 
Initiative: 
Restores the cost-of-living adjustment for nursing 
facili ties 
removed 
by Public 
Law 
2003, 
chapter 
20, 
Part 
B, 
section 1. 
The annual cost-of-living adjustment has historically 
been approximately 3%. 
General Fund 
2003-04 
2004-05 
All Other 
$0 
$1, 600,000 
General Fund Total 
$0 
$1, 600,000 
Federal Expenditures F'llD.d 
2003-04 
2004-05 
All Other 
$0 
$3,114,202 
Federal Expenditures Fund Total 
$0 
$3,114,202 
Nursing Facilities 
01,118 
Initiative: 
Restores the return on equity for both nonprofit a~d 
for-profit nursing facilities reduced by Public Law 2003, chapter 
20, Part B, section 1. 
General Fund 
All Other 
General Fund Total 
Federal Expenditures Fund 
All Other 
Federal Expenditures Fund Total 
Nursing Facilities 
0148 
2003-04 
$0 
$0 
2003-04 
$0 
$0 
2004-105 
$450,000 
$450,000 
2004-05 
$873,919 
$873,919 
Ini tiative: 
Restores 
funding 
to 
permit 
intermediate 
care 
facilities for persons with mental retardation to retain 75% of 
savings following audit. 
General Fund 
2003-04 
2004-05 
All Other 
$0 
$100,000 
General Fund Total 
$0 
$100,000 
Federal Expenditures F'und 
2003-04 
2004-05 
All Other 
$0 
$200,000 
Federal Expenditures Fund Total 
$0 
$200,000 
Medical Care -
Payments to Providers 
0147 
Initiative: 
Provides for the appropriation of funds necessary to 
restore the return on equity adjustment to certain residential 
care facilities reduced by Public Law 2003, chapter 20, Part B, 
section 1. 
General Fund 
All Other 
General Fund Total 
Federal Expenditures Fund 
A11 Other 
Federal Expenditures Fund Total 
Medical Care -
Payments to Providers 
0147 
2003-04 
$0 
$0 
2003-04 
$0 
$0 
2004-05 
$350,000 
$350,000 
2004-05 
$350,000 
$350,000 
Initiative: 
Provides for the appropriation of funds necessary to 
restore 
the 
cost-of-living 
adjustment 
for 
residential 
care 
facilities 
removed 
by Public 
Law 
2003, 
chapter 
20, 
Part 
B, 
section 1. 
The annual cost-of-living adjustment has historically 
been approximately 3%. 
General Fund 
A11 Other 
General Fund Total 
Federal Expenditures Fund 
A11 Other 
Federal Expenditures Fund Total 
HUMAN SERVICES, DEPARTMENT OF 
DEPARTMENT 'I'OTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
DEPARTMENT 'I'OTAL -
ALL FUNDS 
2003-04 
$0 
$0 
2003-04 
$0 
$0 
2003-04 
$0 
o 
$0 
2004-05 
$800,000 
$800,000 
2004-05 
$800,000 
$800,000 
2004-05 
$3,500,000 
5,726,529 
$9,226,529 
Emergency clause. 
In view of the emergency cited in the 
preamble, this Act takes effect July 1, 2004. 
SUMMARY 
This bill requires 
the 
Department 
of 
Human 
Services 
to 
include in its calculation of reimbursement for services provided 
by residential care facilities an allowance for 
a 
reasonable 
return on equity capital invested in those facilities and an 
annual adjustment for the cost of living. 
This bill also allows 
an intermediate care facility for persons with mental retardation 
to retain an incentive payment for savings equal to 75'l-o of the 
Department 
of 
Human 
Services' 
estimate 
of 
the 
facility' s 
allowable expenses and the amount actually paid by the department 
for those expenses. 
This bill also repeals language suspending the inflation and 
return on equity payments to nursing facilities for fiscal year 
2004-05. 
This bill also repeals the increase in licensing fees 
for nursing and convalescent homes. 
Finally, this bill restores for fiscal year 2004-05 various 
appropriations 
to 
nursing 
facilities 
and 
residential 
care 
facilities 
that 
were 
cut 
by 
Public 
Law 
2003, 
chapter 
20, 
including the restoration of reimbursement for bed-hold days for 
residential care facilities; 
the cost-of-living adjustment 
to 
nursing facilities; the return on equity for nursing facilities; 
the 
return an equity adjustment 
to certain residential 
care 
facilities; 
and 
the 
cost-af-living 
increase 
for 
certain 
residential care facilities.