An Act To Implement the Recommendations of the Commission To Study Public Health
Maine Legislature, Session 122, LD 0134
Committee Amendment CA_A_H480 (House)

the Clerk of 
COMMITTEE AMENDMENT "A" to H.P. 112, L.D. 134, Bill, "An 
Act To Implement the Recommendations of the Commission To Study 
Public Health" 
Amend the bill by striking out all of section 1. 
Further amend the bill in section 2 by inserting at the end 
the following: 
'If outside funding is not received to fully fund 
all costs of the commission, no meetings are authorized and no 
expenses of any kind may be incurred or reimbursed.' 
Further amend the bill by striking out all of sections 3 and 
and inserting in their place the following: 
'Sec. 3. Dirigo Health study and report. 
The Board of Directors 
of Dirigo Health, 
established pursuant to 
the Maine 
Revised 
Statutes, 
Title 
24-A, 
chapter 
87, 
shall 
consider 
the 
recommendations of the Commission to Study Public Health related 
to 
providing incentives 
to 
individuals 
using certain public 
benefit 
programs 
when 
it 
reviews 
the 
"Healthy 
ME 
Rewards" 
incentive program of the Dirigo Health plan. 
In response to the 
recommendations included in the final report of the Commission to 
Study Public Health, 
the Board of Directors of Dirigo Health 
shall conduct a study that includes the following: 
1. 
An 
analysis of the extent to which the "Healthy 
ME 
Rewards" incentive program, 
or any quality assurance, 
disease 
prevention, 
disease 
management 
or 
cost-containment 
programs 
included as part of the Dirigo Health plan in accordance with 
Title 24-A, section 6910, contains incentives that encourage the 
purchase of healthy and nutritious food by individuals enrolled 
in the health plan and their dependents; and 
Page l-LR0159(2) 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT 
H.P. 112, L.D. 134 
2. An analysis of the extent to which the consumer education 
campaign developed and conducted by the Maine Quality Forum in 
accordance with Title 24-A, section 6951, subsection 5 to help 
health care 
consumers 
make 
informed decisions 
and engage in 
healthy lifestyles includes information regarding the consumption 
of healthy and nutritious food by individuals enrolled in the 
Dirigo Health plan, as well as individuals who are receiving 
public benefits through the food stamp program. 
The 
Board of Directors of Dirigo Health shall submit 
a 
report 
that 
includes 
findings 
and 
recommendations 
from 
the 
analyses of issues identified in this section as part of the 
annual report required by November 3, 2006 in accordance with 
Title 24-A, section 6908, subsection 6. 
Sec. 4. 
Comprehensive employee health program addressing 
obesity. 
The Department of Administrative and Financial Services, 
Bureau of 
Human 
Resources, 
Division of 
Employee 
Health 
and 
Benefits 
shall 
implement 
a 
comprehensive, 
population-based 
approach to addressing obesity-related risk factors and disease 
management, including nutrition counseling and physical activity 
and health risk identification and management. 
Implementation 
should include: 
1. Offering to 
bargaining for all 
employee health; 
negotiate flex-time 
state employees 
to 
options in collective 
encourage 
and support 
2. Conducting an inventory of the availability of fitness 
centers in locations of heavy concentrations of state employees; 
3. Creating performance management objectives through which 
supervisors and managers support and encourage healthy lifestyles 
among employees they supervise; and 
4. 
Dedicating at least 0.5% of annual health insurance 
premiums for all state employees to support employee health and 
wellness .• 
Further amend the bill by striking out all of section 6 and 
inserting in its place the following: 
· Sec. 6. Healthy food and beverage options at state cafeterias, snack 
bars and vending machines. 
The Department of Labor, 
Bureau of 
Rehabilitation Services, 
Division of 
the 
Blind 
and Visually 
Impaired shall: 
1. 
Implement recommendations of food choice committees to 
include heal thy food and beverage options at cafeterias, snack 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 112, L.D. 134 
bars and vending machines under the division's purview. 
These 
food choice committees shall consider providing price incentives 
for purchase of healthy foods and beverages; 
2. 
Include in the food choice committee for any executive 
department 
that 
uses 
a 
cafeteria 
or 
snack 
bar 
under 
the 
division's purview a wellness coordinator from that department; 
and 
3. 
Analyze the costs associated with: 
A. 
Developing 
a 
system for 
tracking food purchases at 
cafeterias and snack bars and in vending machines under the 
division's purview; and 
B. 
Performing nutritional analysis on all major-selling 
food items and posting caloric and nutritional information 
at cafeterias and snack bars under the division's purview. 
The Department of Labor, Bureau of Rehabilitation Services, 
Division of the Blind and Visually Impaired shall report back to 
the Joint Standing Committee on Health and Human Services by 
December 1, 2005.' 
Further amend the bill by inserting at the end before the 
summary the following: 
, Sec. 
9. 
Appropriations 
and 
allocations. 
appropriations and allocations are made. 
LEGISLATURE 
Miscellaneous Studies 
The 
following 
Initiative: 
Allocates per diem and general operating expenses 
for the Commission to Study Public Health should outside sources 
of funding be received for this purpose. 
OTHER SPECIAL REVENUE FUNDS 
2005-06 
2006-07 
Personal Services 
$880 
$880 
All Other 
$5,650 
$6,400 
OTHER SPECIAL REVENUE FUNDS TOTAL 
$6,530 
$7,280 
LEGISLATURE 
DEPARTMENT TOTALS 
2005-06 
2006-07 
OTHER SPECIAL REVENUE FUNDS 
$6,530 
$7,280 
DEPARTMENT TOTAL -
ALL FUNDS 
$6,530 
$7,280 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ·A .. to H.P. 112, L.D. 134 
ADMINISTRATIVE AND FINANCIAL SERVICES, 
DEPARTMENT OF 
Salary Plan 
Initiative: 
Appropriates and allocates funds for the additional 
costs 
of 
health 
insurance 
to 
the 
State 
resulting 
from 
the 
requirement that 0.5% of annual health insurance premiums be used 
to support employee health and wellness 
GENERAL FOND 
Personal Services 
GENERAL FUND TOTAL 
HIGHWAY FOND 
Personal Services 
HIGHWAY FUND TOTAL 
ADMINISTRATIVE AND FINANCIAL SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
HIGlDfAY FUND 
DEPAR"l'MENT TOTAL - ALL FUNDS 
SECTION TOTALS 
GENERAL FUND 
HIGlDfAY FUND 
OTHER SPECIAL REVENUE FUNDS 
SECTION TOTAL - ALL FUNDS 
programs. 
2005-06 
2006-07 
$63,780 
$261,321 
$63,780 
$261,321 
2005-06 
2006-07 
$27,033 
$114,514 
$27,033 
$114,514 
2005-06 
2006-07 
$63,780 
$261,321 
$27,033 
$114,514 
$90,813 
$375,835 
2005-06 
2006-07 
$63,780 
$261,321 
$27,033 
$114,514 
$6,530 
$7,280 
$97,343 
$383,115' 
Further amend the bill by 
nonconsecutive 
Part 
letter 
consecutively. 
relettering 
or 
section 
or renumbering any 
number 
to 
read 
SUMMARY 
This amendment is the minority report of the committee. 
It 
strikes from the bill the Maine Obesity Prevention Fund. 
It adds 
a prohibition on expenditures in the absence of obtaining outside 
funding for the Commission to Study Public Health. It strikes 
reference to information gathered from the food stamp program 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A" to H.P. 112, L.D. 134 
with regard to consumer buying habits. 
It strikes a provision 
that would have added at least one position to develop a health 
improvement 
infrastructure. 
The 
amendment 
removes 
the 
requirement 
of 
tracking 
purchases 
and 
analyzing nutritional 
content of foods sold through the Department of Labor, Bureau of 
Rehabilitation Services, 
Division of 
the 
Blind 
and Visually 
Impaired. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 04/26/05 ,;:'!vac:.. 
LD 134 
LR 0159(02) 
An Act To Implement the Recommendations of the Commission To Study Public Health 
Fiscal Note for Bill as Amended by Committee Amendment 'A" 
. 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Highway Fund 
Appropriations/Allocations 
General Fund 
Highway Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
Current Costs - Legislative Study 
2005-06 
$63,780 
$27,033 
$63,780 
$27,033 
$6,530 
2006-07 
. $261,321 
$114,514 
$261,321 
$114,514 
$7,280 
Projections 
2007-08 
$267,854 
$117,377 
$267,854 
$117,377 
$0 
Projections 
2008-09 
$274,5 r 
$120,31. 
$274,550 
$120,311 
$0 
The bill's requirement that 0.5% of annual health insurance premiums for state employees be dedicated to support 
employee health and wellness programs would result in additional costs to the state employee health program. While 
some of the current expenses of the state employee health program may be "countable" toward this requirement, it is 
assumed meeting this requirement as well as existing program obligations could not be accomplished within existing 
resources and would require a rate increase to keep the state employee health program adequately funded. Such a rate 
incr~ase would result in additional costs to the General Fund, Highway Fund, and all other funds with allocated costs 
of the state employee health program. 
General Fund appropriations of $63,780 for 2005-06 and $261,321 for 2006-07 and Highway Fund allocations of 
$27,033 for 2005-06 and $114,514 for 2006-07 are incl~ded in the bill for the salary plan reserve accounts to fund the 
increases for General Fund and Highway Fund active employee health insurance costs. The costs for employees paid 
by other funds, including a small amount for the Fund for a Healthy Maine, may require increased allotments as 
recommended by the State Budget Officer and approved by the Governor. It is further assumed this requirement 
would apply to the contract year beginning April 1, 2006. 
LR0159(2) - Fiscal Note - Page 1 of2 
Any additional costs to the Dirigo Health program in implementing Section 3 of the bill can be absorbed by the Dirigo 
Health program utilizing existing budgetary resources. 
Additional costs to the Department of Labor, Division of Blind and Visually Impaired can be absorbed within existing 
budgeted resources. 
Legislative Study 
Extending the Commission to Study Public Health will require the Commission to seek funds from other sources to 
fully fund all costs of the commission. Consistent with provisions of Resolve 2003, Chapter 95, before meetings are 
authorized and expenses can be incurred or reimbursed, sufficient outside funding must be received. All contributions 
are subject to approval of the Legislative Council. 
An allocation of Other Special Revenue funds in the amount of$6,530 in fiscal year 2005-06 and $7,280 in fiscal year 
2006-07 is needed to fund all costs of the commission from this dedicated account should outside sources of funding 
be received. If sufficient funds are not received, no meeting can be held or costs incurred. 
The Commission to Study Public Health received contributions in the amount of$7,280 as a result of Resolve 2003, 
chapter 95. Expenditures for the previous work ofthe commission were $4,220.31. There currently is an unexpended 
balance of$3,059.69 which would be available to fund a portion of the costs of the commission, if the commission is 
extended. 
LR0159(2) - Fiscal Note - Page 2 of2