Resolve, To Establish the Work Group To Review and Recommend Improvements for the Certificate of Need Program
Maine Legislature, Session 123, LD 1535
Committee: Health and Human Services
Sponsors: MILLER, BRANNIGAN, CRAVEN, PERRY, PINGREE

Legislative Document 
No. 1535 
H.P.1060 
House of Representatives, March 20, 2007 
Resolve, To Establish the Work Group To Review and Recommend 
Improvements for the Certificate of Need Program 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative MILLER of Somerville. 
Cosponsored by Senator BRANNIGAN of Cumberland and 
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MILLICENT M. MacFARLAND 
Clerk 
Representatives: CRAVEN of Lewiston, PERRY of Calais, PINGREE of North Haven. 
Primed on recyded paper 
Sec. 1. Work group established. Resolved: That the Work Group to Review 
and Recommend Improvements for the Certificate of Need Program, referred to in this 
resolve as "the work group," is established; and be it further 
Sec. 2. Work group membership. Resolved: That the work group consists of 
members appointed as follows. 
1. The President ofthe Senate and the Speaker of the House shall appoint 6 members 
to the work group as follows: 
A. The President of the Senate shall appoint one member of the Senate who serves 
on the Joint Standing Committee on Health and Human Services and 2 
representatives from businesses, unions, advocacy organizations or public health 
groups; and 
B. 
The Speaker of the House shall appoint one member of the House of 
Representatives who serves on the Joint Standing Committee on Health and Human 
Services and 2 representatives from businesses, unions, advocacy organizations or 
public health groups. 
The Senate and House appointees must represent the 2 major political parties. Businesses, 
unions, advocacy organizations and public health groups must each be represented when 
the appointments of the President of the Senate and the Speaker of the House are 
combined. 
2. 
The Governor shall appoint 4 medical representatives: 2 representatives of 
hospitals, nominated by the Maine Hospital Association; one representative of a statewide 
association of physicians, nominated jointly by the Maine Medical Association and the 
Maine Osteopathic Association; and one representative of the ambulatory surgical 
centers; and 
3. 
The Director of the Governor's Office of Health Policy and Finance, or the 
director's designee, and the Director of Licensing and Regulatory Services within the 
Department of Health and Human Services shall serve as nonvoting ex officio members; 
and be it further 
Sec. 3. 
Chairs. 
Resolved: 
That the Senate member and the House of 
Representatives member of the work group shall serve as cochairs of the work group; and 
be it further 
Sec. 4. 
AppoiBtments; convening of work group. Resolved: 
That all 
appointments must be made no later than 30 days following the effective date of this 
resolve. The appointing authorities shall notify the Executive Director of the Legislative 
Council once all appointments have been completed. 
Within 15 days after the 
appointment of all members, the chairs shall call and convene the first meeting of the 
work group; and be it further 
Sec. 5. 
Duties. Resolved: That the work group may hold up to 4 meetings to 
prioritize and examine some or all of the following issues. Based on findings from the 
examination of the prioritized issues, the work group shall identify improvements and 
Page I -123LR0791(Ol)-1 
make recommendations for changes in law or rule. The work group may examine the 
following issues: 
1. Recent changes made by law or rule to the certificate of need program and the 
need for any modifications to the law or rule; 
2. 
The current dollar amount threshold used in determining whether a project 
requires review and, if inadequate, a potential process for identifying projects that fall 
below the threshold; 
3. The current statutory authority of and methods used by the Department of Health 
and Human Services to determine whether review is needed. This should include the 
definition of "reviewable project" and clarification of the term "new service"; 
II 
4. The current statutory authority of and methods used by the Department of Health 
and Human Services to define community need for new services or facilities; 
5. The relationship between the State Health Plan, the certificate of need process and 
the capital investment fund; 
6. The roles of the Maine Quality Forum; the Department of Health and Human 
Services, Maine Center for Disease Control and Prevention; and the Department of 
Professional and Financial Regulation, Bureau of Insurance in the certificate of need 
review process; 
7. The criteria used by the Department of Health and Human Services for evaluating 
a certificate of need application along with procedures for public hearings and the use of 
review panels; 
8. Historical review of revenues and expenditures in the certificate of need unit to 
identify and determine the amount of resources that are adequate to have a highly 
functioning unit; 
9. Historical review of the certificate of need application process including number 
of submissions, approvals, disapprovals and withdrawn applications and associated 
timelines to determine any improvements needed; 
10. Review of the most recent studies on the impact that the competitive market 
versus regulation has on health care costs and access; and 
11. 
Additional topics determined by unanimous agreement of the work group 
members; and be it further 
Sec. 6. Staff assistance. Resolved: That the Legislative Council shall provide 
necessary staffing services to the work group; and be it further 
Sec. 7. Compensation. Resolved: That the legislative members of the work 
group are entitled to receive 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 work group. Public members not 
otherwise compensated by their employers or other entities that they represent are entitled 
to receive reimbursement of necessary expenses and, upon a demonstration of financial 
hardship, a per diem equal to the legislative per diem for their attendance at authorized 
meetings of the work group; and be it further 
Sec. 8. Department background report on certificate of need. Resolved: 
That, no later than 45 days after the effective date of this resolve, the Department of 
Health and Human Services shall provide a written report to the work group that provides 
information on revenues, expenditures, staffing levels, staffing needs and review cycles, 
including submissions, approvals, disapprovals and withdrawals of certificate of need 
applications for the last 5 years of the certificate of need program; and be it further 
Sec. 9. Report. Resolved: That, no later than December 1, 2007 the work group 
shall submit a report that includes its findings and recommendations, including suggested 
legislation, for presentation to the Second Regular Session of the 123 rd Legislature. The 
work group is authorized to introduce legislation related to its report to the Second 
Regular Session of the 123rd Legislature at the time of submission of its report; and be it 
further 
Sec. 10. 
Extension. Resolved: 
That, if the work group requires a limited 
extension of time to complete its study and make its report, it may apply to the 
Legislative Council, which may grant an extension; and be it further 
Sec. 11. Work group budget. Resolved: That the chairs of the work group, 
with assistance from the work group staff, shall administer the work group's budget. 
Within 10 days after its first meeting, the work group shall present a work plan and 
proposed budget to the Legislative Council for its approval. The work group may not 
incur expenses that would result in the work group's exceeding its approved budget. 
Upon request from the work group, the Executive Director of the Legislative Council 
shall promptly provide the work group chairs and staff with a status report on the work 
group budget, expenditures incurred and paid and available funds. 
SUMMARY 
This resolve creates the 12-member Work Group to Review and Recommend 
Improvements for the Certificate of Need Program, which includes 6 members appointed 
by the President of the Senate and the Speaker of the House, 4 members appointed by the 
Governor, a nonvoting ex officio member from the Governor's Office of Health Policy 
and Finance and a nonvoting ex officio member from the Department of Health and 
Human Services. The work group may hold up to 4 meetings to prioritize and examine 
some or all of 11 issues that are listed in the resolve and then, based on findings from the 
examination of the prioritized issues, identify improvements and make recommendations 
for changes in law or rule. The resolve requires the Department of Health and Human 
Services to provide a certificate of need background report to the work group no later 
than 45 days after the effective date of this resolve. The resolve also requires the work 
group to submit a report that includes its findings and recommendations, including 
suggested legislation, for presentation to the Second Regular Session of the 123rd 
Legislature by December 1, 2007 and authorizes the work group to introduce legislation 
related to its report.