An Act To Prevent Inappropriate Transfers of Residents of Nursing Facilities
Maine Legislature, Session 123, LD 0339
Committee Amendment CA_A_S117 (Senate)

COMMITTEE AMENDMENT "A" to S.P. 112, L.D. 339, Bill, "An Act To 
Prevent Inappropriate Transfers of Residents of Nursing Facilities" 
Amend the bill by striking out the title and substituting the following: 
'Resolve, To Ensure Proper Levels of Care for the Elderly and the Disabled' 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, certain disabled persons are living in inappropriate institutional settings, 
often at significant emotional costs to them and their families and at significant financial 
cost to the State; and 
Whereas, the Legislature believes that suitable alternative living arrangements are 
available or can be made reasonably available within existing resources; and 
Whereas, the Legislature believes that other individuals who could be maintained in 
their current living arrangements if appropriate supports and education were provided are 
unnecessarily transferred to more restrictive settings; and 
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. Assessment process. Resolved: That, within available resources, the 
Department of Health and Human Services shall establish an ongoing process to assess 
31. 
the medically necessary physical, cognitive and behavioral needs of adult MaineCare 
members living in out-of-state facilities or living in state nursing or hospital facilities, 
including psychiatric hospitals and units, who could benefit from a less restrictive level of 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT 'i4 .. to S.P. 112, L.D. 339 
care but who have been unable to locate appropriate services because they have complex 
medical needs such as ventilator care or complex behavioral health needs; and be it 
further 
Sec. 2. 
Planning for services. Resolved: That the Department of Health and 
Human Services shall plan for appropriate and medically necessary physical, cognitive 
and behavioral services within available resources, including residential and supportive 
services, so that individuals who are inappropriately placed, if they choose, may live in 
the least restrictive setting that meets their medical, physical, cognitive and behavioral 
needs. This planning must include a process for individualized planning that includes the 
hospital patient or nursing home resident, a guardian or other representative, 
representatives of the hospital or nursing facility, the assigned case manager and an 
appropriate representative of the Department of Health and Human Services; and be it 
further 
Sec. 3. 
Positive behavioral support training. 
Resolved: 
That the 
Department of Health and Human Services shall work with interested parties to determine 
specific additions to the curriculum for positive behavioral support training for all long-
term care settings as developed by the department and the Joint Advisory Committee on 
Select Services for Older Persons and to determine how this training can be delivered 
within available resources; and be it further 
Sec. 4. Discussions among stakeholders. Resolved: That the Department of 
Health and Human Services shall facilitate discussions among the stakeholders with the 
following goals: 
1. Creating useable procedures for transferring individuals between hospitals and 
nonhospital settings; 
2. Developing an improved process for mutual clinical assistance and support when 
necessary; and 
3. Reviewing and modifying, if necessary, the rules regarding the written notices 
provided to residents to ensure that they are adequately informed about the reasons for 
transfer, discharge or denial of admission or readmission; and be it further 
Sec. 5. Process. Resolved: That the Department of Health and Human Services 
shall establish or collaborate with an appropriate working group that includes advocates 
and providers to ensure that the activities in sections 1 to 4 take place in a timely manner. 
The Department of Health and Human Services shall share with the working group data 
and information that is not personally identifiable collected through the planning process. 
The Department of Health and Human Services shall complete the assessment and 
planning process for individuals who currently meet the criteria in section 1 no later than 
October 1,2007; and be it further 
Sec. 6. Report. Resolved: That, by November 1, 2007, the Department of Health 
and Human Services shall report to the Joint Standing Committee on Health and Human 
Services on the progress made to implement this resolve. This report must recount the 
activities to date and identify any needs to be addressed. The joint standing committee is 
authorized to submit legislation that it determines necessary to further the intent of this 
resolve to the Second Regular Session of the l23rd Legislature. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ':4 "to S.P. 112, L.D. 339 
Emergency clause. 
In view of the emergency cited In the preamble, this 
legislation takes effect when approved.' 
SUMMARY 
This amendment replaces the bill with a resolve. It establishes a process to assess 
and plan for the medically necessary physical, cognitive and behavioral needs of adult 
MaineCare members and to implement a training program in positive behavioral support 
health. It establishes a process for stakeholder involvement and collaboration. It requires 
the sharing of data, sets a timetable and requires a report to the Joint Standing Committee 
on Health and Human Services, which is authorized to submit legislation. 
FISCAL :\"OTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/11107 .::b?ac:.. 
LD339 
LR 2072(02) 
An Act To Prevent Inappropriate Transfers of Residents of Nursing Facilities 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment "/I " 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Any additional costs incurred by the Department of Health and Human Services in implementing this bill can be 
absorbed by the department italicizing existing budget resources. 
LR2072(02) - Fiscal Note - Page 1 of 1