Resolve, To Create the Coomission To Study the Recruitment, Training and Retention of Physicians for Rural cu:.d ~-iE.:i..i..::u.:..ly Underserved Areas of Maine Further amend the bill by striking out everything after the ti tIe and before the summary and inserting in its place the following: , Emergency preamble. Whereas, Acts and Legislature do not become effective until adjournment unless enacted as emergencies; and resolves of the days after Whereas, it has been reported that many hospitals and towns in rural areas of the State are unable to attract enough physicians and must rely on programs that supply physicians on a temporary or transient basis: and Whereas, many of the graduates of the Access to Medical Education PTogram do not return or stay to practice in the State of Maine; and Whereas, Maine people deserve a system that provides a stable and reliable physician workforce, and difficulty in accessing physician services constitutes an immedio.te hard.::;l".ip for many Maine residents; and Page 1-LR0783(2) COMMITTEE AMENDMENT
Maine Legislature, Session 121, LD 0595
Committee Amendment CA_A_S549 (Senate)
Committee: Education and Cul

COMMITTEE AMENDMENT 
.. A" to S.P. 204, L.D. 595, Bill, "An 
Act To Appropriate Funds for a Study To Determine the Feasibility 
of a Medical School in Maine" 
Amend the bill by striking out the title and substituting 
the following: 
'Resolve, 
To Create the Coomission To Study the Recruitment, 
Training and Retention of Physicians for Rural 
cu:.d 
~-iE.:i..i..::u.:..ly 
Underserved Areas of Maine' 
Further amend the bill by striking out everything after the 
ti tIe and before the summary and inserting in its place the 
following: 
, Emergency preamble. Whereas, Acts 
and 
Legislature 
do 
not 
become 
effective 
until 
adjournment unless enacted as emergencies; and 
resolves 
of 
the 
days 
after 
Whereas, it has been reported that many hospitals and towns 
in rural areas 
of 
the State 
are 
unable 
to attract enough 
physicians and must rely on programs that supply physicians on a 
temporary or transient basis: and 
Whereas, many of the graduates of the Access to Medical 
Education PTogram do not return or stay to practice in the State 
of Maine; and 
Whereas, Maine people deserve 
a 
system that provides 
a 
stable 
and 
reliable 
physician 
workforce, 
and 
difficulty 
in 
accessing physician services constitutes an immedio.te hard.::;l".ip 
for many Maine residents; and 
COMMITTEE AMENDMENT 
,.. 
~~ 
. 
'" 
1'0 
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COMMITTEE AMENDMENT "A, to S.P. 204, L.D. 595 
Whereas, in the judgment of the Legislature, these facts 
create an emergency within 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 
Sec. 1. Commission established. Resolved: 
That the Commission 
to Study the Recruitment, Training and Retention of Physicians 
for Rural and Medically Underserved Areas of Maine, referred to 
in this resolve as "the commission," is established; and be it 
further 
Sec. 2. Commission membership. Resolved: 
That the commission 
consists of the following members: 
1. 
Two members of the House of Representatives appointed by 
the Speaker of the House as follows: 
A. 
One member of the House who is a member of the Joint 
Standing Committee on Health and Human Services; and 
B. 
One member of the House who is a member of the Joint 
Standing Committee on Education and Cultural Affairs; 
2. 
Two members of the Senate appointed by the President of 
the Senate as follows: 
A. 
One member of the Senate who is a member of the Joint 
Standing Committee on Health and Human Services; and 
B. 
One member of the Senate who is a member of the Joint 
Standing Committee on Insurance and Financial Services; 
3. 
One 
member 
from 
the 
Maine 
Osteopathic 
Association 
appointed by the Speaker of the House; 
4. 
One member from the Maine Medical Association appointed 
by the Speaker of the House; 
5. 
One member representing rural hospitals from the Maine 
Hospital Association appointed by the Speaker of the House; 
6. 
Three 
members, 
one 
member 
representing each medical 
school participating in the Access to Medical Education Program, 
appointed by the President of the Senate; 
7. 
The Chief Executive Officer of the Finance Authority of 
Maine, or that officer's designee; 
COMMITTEE AMENDMENT 
~. 
" 
COMMITTEE AMENDMENT .. A to S.P. 204, L.D. 595 
8. 
The Director of the Governor's Office of Health Policy 
and Finance, or the director's designee; 
9. 
The Commissioner of Education, 
or the commissioner's 
designee; 
10. 
The President of the Maine Hospital Association, or the 
president's designee: 
11. 
The 
Executive Director 
of 
the 
Maine 
Primary 
Care 
Association, or the director's designee; 
12. 
A representative of the University of Maine System 
designated by the chancellor; 
13. 
Four members, one appointed by each member of the Maine 
Congressional Delegation; and 
14. 
The Director of the Maine Recruitment Center, or the 
director's designee; and be it further 
Sec. 3. Chairs. Resolved: 
That the first named Senate member 
is the Senate chair of the commission and the first named House 
of Representatives member is the House chair of the commission; 
and be it further 
Sec. 4. Appointments; convening of commission. Resolved: 
That 
all appointments must be made no later than 30 days following the 
effective date of this resolve. 
All appointing authorities must 
notify the Executive Director of the Legislative Council once the 
selections have been made. 
Within 30 days after appointments of 
all 
members 
and 
the 
requirements 
of 
section 
have 
been 
satisfied, the chairs shall call and convene the first meeting of 
the commission; and be it further 
Sec. 5. Duties. Resolved: 
That the commission shall study the 
State's current policies regarding the recruitment, training, and 
retention of physicians and how these policies could be changed 
to improve the recruitment, training and retention of physicians 
for the rural and medically underserved areas of the State. 
1. 
In conducting the study, the commission shall: 
A. 
Develop recommendations to encourage the aspirations of 
Maine students to seek careers as physicians and to attend 
medical 
schools participating in the 
Access 
to Medical 
Education Program; 
COMMITTEE AMENDMENT 
~~. 
~~ 
COMl-1ITTEE AMENDMENT ·A to S.P. 204, L.D. 595 
B. 
Develop 
recommendations to encourage medical 
schools 
participating in the Access to Medical Education Program to 
accept more Maine students or to expand the progra~ to other 
schools or to accomplish both goals; 
C. 
Develop 
recommendations 
to 
expand 
and 
improve 
experiential training in rural and underserved areas in the 
State 
for 
students 
in the 
Access 
to 
Medical 
Education 
Program; 
D. 
Develop recommendations to expand and improve intern and 
residency training at existing and new sites in rural and 
underserved areas for allopathic and osteopathic graduates: 
E. 
Develop recommendations to reduce the indebtedness of 
Maine students pursuing medical education; and 
F. 
Develop 
recommendations 
to 
address 
any 
current 
and 
future physician shortages and distribution issues. 
2. 
In examining these questions, the commission may: 
A. 
Hold hearings throughout the State; 
B. 
Conduct, summarize and analyze the results of literature 
searches 
and 
studies 
on 
the 
recruitment, 
~ra~n~ng and 
retention of physicians and study why physicians who are 
educated or trained or are both educated and trained in the 
State leave to practice elsewhere; 
C. 
Conduct, tabulate and analyze the results of a survey of 
the public or affected persons and groups; 
D. 
Procure and analyze relevant data to establish the most 
cost-effective and efficient way to attract more physicians 
to the State to establish practices in rural and underserved 
areas. 
If such an analysis is performed, the commission 
shall examine the issue of physician reimbursement; and be 
it further 
Sec. 6. Staff assistance. Resolved: 
That the commission must be 
staffed and supported by the Area Health Education Center at the 
University of New England; and be it further 
Sec. 7. Funding. Resolved: 
That the commission may seek and 
accept other sources of funds to advance its work. 
Prompt notice 
of solicitation and acceptance of funds must be sent to the 
Legislative Council. 
All funds accepted are administered through 
the 
Area Health Education Center at the University of 
New 
England. 
An 
accounting 
record that 
includes 
the 
amount 
of 
COMMITTEE A MfNDMENT 
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COMMITTEE AMENDMENT "A· to S.P. 204, L.D. 595 
funds, the date the funds were received, from whom the funds were 
received and the purpose and any limitation on the use of the 
funds 
must 
be 
forwarded 
to 
the 
Executive 
Director 
of 
the 
Legislative 
Council. 
A 
portion 
of 
these 
funds 
must 
be 
transferred to the Office of 
the Executive Director of the 
Legislative Council to satisfy the requirements of section 8 of 
this 
resolve. 
If sufficient 
outside 
funding 
has 
not 
been 
received by August 15, 
2004 to fully fund all costs of the 
commission, meetings are not authorized and expenses may not be 
incurred or reimbursed. 
Contributions to support the work of the 
commission may not be accepted frum any party having a pecuniary 
or other vested interest in the outcome of the matters being 
studied. 
Any person, other than a state agency, desiring to make 
a 
financial 
or 
in-kind 
contribution 
must 
certify 
to 
the 
Legislative Council that it has no pecuniary or other vested 
interest in the outcome of the study. 
The certification must be 
made in the manner prescribed by the Legislative Council. 
All 
contributions 
are 
subject 
to 
approval 
by 
the 
Legislative 
Council. 
An 
accounting 
record 
of 
all 
funds 
accepted 
that 
includes the amount of funds, the date the funds were received, 
from whom the funds were received and the purpose of and any 
lim:l.tation on the use of those funds must be forwarded to the 
Executive Director of the Legislative Council. 
The executive 
director administers any funds received by the commission for the 
payment of per diem and expenses for legislative n:embers. 
The 
executive director shall notify the chairs of the commission when 
sufficient funding has been received and all appointments have 
been made pursuant to section 4; and be it further 
Sec. 8. Compensation of !~gisI2tive members. Resolv~d: 
That the 
legislative 
members 
of 
the 
co~~ission are 
entitled to 
the 
legislative per diem, as defined in the Maine Revised Statutes, 
Title 3, 
section 2, 
and 
reimbursement for travel and other 
necessary expenses related to their attendance at authorized 
meetings 
of 
the 
commission. 
The 
compensation 
must 
be 
administered through the Office of the Executive Director of the 
Legislative Council. 
Public members of the commission who are 
not otherwise compensated by their employers or other entities 
that they represent are entitled to receive reimbursement of 
necessary expenses and, upon demonstration of financial hardship, 
a per diem equal to the legislative per diem for their attendance 
at authorized meetings of the cqmmission. 
Such compensation must 
be administered through the Area Health Education Center at the 
University of New England; and be it further 
Sec. 9. Report. Resolved: 
That, 
no later than November 1, 
2004, 
the commission shall submit a report that includes its 
findings and recommendations, including any suggested legislation 
to implement its recommendations, for presentation to the First 
Regular Session of the 122nd Legislature; and be it further 
COMMITTEE AMENDMENT 
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.. 
~:s 
COMMITTEE AMENDMENT ,~, to S.P. 204, L.D. 595 
Sec. 10. Extension. Resolved: 
That, if the commission requires 
a limited extension of time to complete its study and make its 
report, it may apply to the Legislative Council and the Area 
Health Education Center at the University of New England, which 
together may grant an extension; and be it further 
Sec. 11. Commission budget. Resolved: 
That the chairs of the 
commission, 
with assistance 
from the commission staff, 
shall 
administer the commission's budget. 
Within 10 days after its 
first meeting, 
the commission shall present 
a 
work plan and 
proposed budget to the Area Health Education Center at the 
University of New 
England and 
a 
copy to the Office of the 
Executive 
Director 
of 
the 
Legislative 
Council, 
for 
their 
approval. 
The 
commission may not incur expenses 
that would 
result in the commission's exceeding its approved budget. 
Upon 
request from the commission, the Area Health Education Center at 
the 
University 
of 
New 
England 
shall 
promptly 
provide 
the 
commission 
chairs 
and 
staff 
with 
a 
status 
report 
on 
the 
commission budget, expenditures incurred and paid and available 
funds; and be it further 
Sec. 12. Appropriations and allocations. Resolved: 
following appropriations and allocations are made. 
LEGISLA'l'ORE 
That the 
CO.llllllission to Study the Recruitment, Traininq and Retention of 
Physicians for Rural and Medically Underserved Areas of Maine 
Initiative: 
Allocates funds, transferred from the Area Health 
Education Center at the University of New England, to authorize 
the per diem and expenditures of the legislative members of the 
Commission to Study the Recruitment, Training and Retention of 
Physicians for Rural and Medically Underserved Areas of Maine. 
The 
cost 
reflects 
the 
legislative 
members' 
attending 
authorized meetings of the commission. 
If more than 4 meetings 
are authorized, additional resources will have to be transferred 
from the Area Health Education Center at the University of New 
England and allotted via Financial Order. 
Other Special Revenue Funds 
Personal Services 
All Other 
Other Special Revenue Funds Total 
2003-04 
$0 
o 
$0 
2004-05 
$880 
$1,680 
Emergency clause. 
In view of the emergency cited in the 
preamble, this resolve takes effect when approved.' 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ,~, to S.P. 204, L.D. 595 
SUMMARY 
This amendment changes the bill into a resolve creating the 
Commission to Study the Recruitment, Training and Retention of 
Physicians for Rural and Medically Underserved Areas of Maine. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Legislative Study 
Approved: 04/15104 .::tvae. 
12lst Maine Legislature 
Office of Fiscal and Program Review 
LD595 
An Act to Ap~ropriate Funds for a Study To Determine the Feasibility of 
a Medical School in Maine 
LR0783(02) 
Fiscal Note for Bill as Amended by Committee Amendment 'R 
Committee: Appropriations and Financial Affairs n 
Fiscal Note Required: Yes 
Fiscal Note 
CUrrent Costs - Legislative Study 
The projected costs to fund the per diem and expenses of legislative members of the proposed study is estimated to be 
$1,680 in fiscal year 2004-05. This legislation proposes to allocate funds transferred from the Maine Area Health 
Education Center (AHEC) at the University of New England as other special revenue to the Legislature to pay for thl 
above mentioned legislative costs. This legislation further stipulates that if sufficient outside funding has not been 
received by August 15, 2004 to fully fund all costs of the commission, no meetings are authorized and no expenses of 
any kind may be incurred or reimbursed. 
LR0783(2) - Fiscal Note - Page 1 of 1