An Act To Further Coordinate the Laws Regarding Certificate of Need, the State Health Plan and the Capital Investment Fund
Maine Legislature, Session 122, LD 1401
Committee: Health and Human Services
Sponsors: BRENNAN, MILLETT, DAMON, MARTIN, MAYO, SNOWE-MELLO, STRIMLING, NUTTING, PERRY
Amends: 2 MRSA §101, 2 MRSA §103, 22 MRSA §335

Legislative Document 
No. 1401 
S.P.490 
In Senate, March 22, 2005 
An Act To Further Coordinate the Laws Regarding Certificate of 
Need, the State Health Plan and the Capital Investment Fund 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Senator BRENNAN of Cumberland. 
Cosponsored by Representative MILLETT of Waterford and 
JOY J. O'BRIEN 
Secretary of the Senate 
Senators: DAMON of Hancock, MARTIN of Aroostook, MAYO of Sag ada hoc, SNOWE-
MELLO of Androscoggin, STRIMLING of Cumberland, Representatives: NUTTING of 
Oakland, PERRY of Calais. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 2 MRSA §101, sub-§l, ,D, as enacted by PL 2003, c. 
469, Pt. B, §l, is amended to read: 
D. 
Establish a limit for allocating resources Ull'Qer the 
certificate of need program described in Title 22. chapter 
l03-A, called the capital investm'e-nt fund, fo'·:r; each year of 
the plan pursuant to section 102. 
Sec. 2. 2 MRSA §103, sub-§2, as enacted by PL 
20'C)'3" 
c. 469, 
Pt. B, §l, is amended to read: 
2. 
Input. 
In developing the plan, the Governor shall, at a 
minimum, review the procek. for the development of the plan with 
tb' 
jaint 
standing 
cammittl' 
af 
tbl 
Legislature 
baving 
jurisdiction oyer health and human services matters and seek 
input from the Advisory Council on Health Systems Development, 
pursuant to section 104; the Maine Quality Forum and the Maine 
Quality Forum Advisory Council, pursuant to Title 24-A, chapter 
87, 
subchapter 2; 
a statewide health performance council; 
and 
other agencies and organizations. 
Sec. 3. 2 MRSA §103, sub-§3, ,A, as enacted by PL 2003, c. 
469, Pt. B, §l, is amended to read: 
A. 
Assess health care cost, quality and access in the State 
based on demographic, health care service and health care 
cost data; 
Sec. 4. 2 MRSA §103, sub-§3, "E and F, as enacted by PL 2003, 
c. 469, Pt. B, §l, are amended to read: 
E. 
Outline strategies to: 
(1) 
Promote health systems change; 
(2) 
Address the factors influencing health care cost 
increases; and 
(3) 
Address the major threats to public health and 
safety in the State, including, but not limited to, 
lung disease, diabetes, cancer and heart disease; aBe 
F. 
Provide recommendations to help purchasers and providers 
make 
decisions that 
improve public health 
and build an 
affordable, high-quality health care systemTj and 
Sec. 5. 2 MRSA §103, sub-§3"G is enacted to read: 
Page l-LR1946(1) 
• 
G. 
Be consistent with the requirements of the certificate 
of need program described in Title 22. chapter 103-A. 
Sec. 6. 2 MRSA §103, sub-§3-A is enacted to read: 
A. 
Review. 
The 
plan must 
be 
reviewed by the 
joint 
standing committee of the Legislature having jurisdiction over 
health and human services matters prior to being finalized and 
issued by the Governor. 
Sec. 7. 2 MRS A §103, sub-§4, as enacted by PL 2003, c. 469, 
Pt. B, §1, is amended to read: 
4. 
Uses of plan. 
The plan must be used in determining the 
capital investment fund amount pursuant to section 102 
aRQ-Rl~6~ 
~~iQe-~Re-466~a~€e-~-~~~~~€~~~-~~-&h&-S~a~e-aRQ. The 
plan must be considered by the Commissioner of Health and Human 
Services 
in making 
determinations 
regarding applications 
for 
certificates of need under Title 22. chapter 103-A and must serve 
as a guide for the health care lending decisions of the Maine 
Health and Higher Education Facilities Authority. -~~~~i~iea6e 
e~-Reea-e~-~~9~ie Public financing that affects health care costs 
may not be provided unless it meets goals and budgets explicitly 
outlined in the plan. 
Sec. 8. 22 MRSA §335, sub-§l, 1[8, as enacted by PL 2003, c. 
469, Pt. C, §8, is amended to read: 
B. 
Is--eeRsis~eR~--wi~R Furthers the goals of the State 
Health Plan; 
Sec. 9. 22 MRS A §335, sub-§7, as amended by PL 2003, c. 514, 
§l, 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: 
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 propos,ed 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 the orderly 
and economic development of health facilities and health 
resources for the State as demonstrated by: 
(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 
and the competing demands in the local service area and 
statewide for available resources for health care; 
(2) 
The 
availability of state 
increase in state costs associated 
the project's services; and 
funds 
to 
cover 
any 
with utilization of 
(3) 
The 
accessible 
methods of 
likelihood 
that 
more 
effective, 
more 
or less costly alternative technologies or 
service delivery may become available; aBa 
• 
E. 
The project meets the criteria set forth in subsection 
... L.Qllii 
F. 
The project protects the public health and safety. 
In making a determination under this subsection, the commissioner 
shall use data available in the st;at;e--h&aJ..t-h--plaa State Health 
Plan under Title 2, section 103, including demographic, health 
care service and health care cost data, 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 
ai~a--~~alit;y 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. 
In 
making 
all 
determinations 
under 
this 
subsection, 
the 
commissioner shall consider the State Health Plan as described in 
Title 2, section 103. 
SUMMARY 
This bill provides coordination among the State Health Plan 
and the capital investment fund, adopted by the Governor under 
the 
Maine 
Revised 
Statutes, 
Title 
2, 
chapter 
5, 
and 
the 
certificate of need process under Title 22, 
chapter 103-A as 
follows. 
1. 
It clarifies that the capital investment fund serves as 
a limit for allocating resources under the certificate of need 
program. 
2. 
It specifies that demographic, health care service and 
health care cost data must be used by the Governor in drafting 
the State Health Plan. 
It requires that the State Health Plan be 
consistent with the 
requirements 
of 
the certificate of 
need 
program. 
It requires review of the process for the development 
of the State Health Plan and the plan itself by 
the 
joint 
standing committee of the Legislature having jurisdiction over 
health and human services matters prior to its being finalized 
and issued by the Governor. 
3. 
It specifies that demographic, health care service and 
health care cost data must be used by the Commissioner of Health 
and Human Services in making determinations regarding issuance of 
certificates of need. 
It requires certificate of need decisions 
to further the goals of the State Health Plan. 
It adds to the 
certificate of need standards protection of the public health and 
safety. 
It 
requires 
the 
Commissioner 
of 
Health 
and 
Human 
Services in making decisions regarding certificate of need to 
consider the State Health Plan.