Resolve, To Improve the Continuity of Care for Individuals with Behavioral Issues in Long-term Care
Maine Legislature, Session 124, LD 1245
Committee Amendment CA_A_H460 (House)

. COMMITTEE AMENDMENT 'A "to H.P. 864,1.0. 1245, "Resolve, To Improve 
the Continuity of Care for Individuals with Behavioral Issues in Long-term Care" 
Amend the resolve in section I in the 3rd line (page I, line 17 in 1.0.) by inserting' 
after the following: "shall" the following: 'continue its efforts to' 
Amend the resolve in section I in the 5th line (page I, line 19 in L.O.) by inserting 
after the following: 
"61." the following: 
'The department shall report to the Joint 
Standing Committee on Health and Human Services by February I, 2010 on the 
department's progress.' 
Amend the resolve in section I in subsection 3 in the first line (page I, line 25 in 
1.0.) by striking .out the following: "nursing" and inserting the following: 'long-term 
care' 
Amend the resolve in section 1 in subsection 6 in the first line (page I, line 33 in 
1.0.) by striking Ollt the following: 
"nursing facilities" and inserting the following: 
'long-term care facility staff 
Amend the resolve in section 2 in the first line (page 2, line 1 in 1.0.) by striking out 
the 
following: 
"Case 
mix 
reimbursement." 
and 
inserting 
the following: 
'Reimbursement.' 
Amend the resolve in section 2 iii the 2nd line (page 2, line 2 in 1.0.) by striking out 
the following: "case mix" 
Amend the resolve by striking out all of section 3 (page 2, lines 8 to 15 in 1.0.) and 
inserting the following: 
'Sec. 3. 
Standardized transfer protocol; improved discharge planning. 
Resolved: That the department shall work with representatives of the long-term care 
ombudsman program established pursuant to the Maine Revised Statutes, Title 22, 
section 5106, subsection II-C, hospitals, nursing facilities and residential care facilities to 
improve the transparency and coordination of services between hospital discharge 
planning and long-term care facility admission to provide patients and their families with' 
Page I - 124LRI403(02)-1 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ·A,. to H.P. 864, L.D. 1245 
a more coordinated, efficient and patient-friendly process that meets the specific needs of 
individual patients, including behavioral health needs. The department shall develop and 
implement a standardized transfer protocol, including improving the support offered to a 
long-term care facility when a hospital has determined that an individual is ready to be 
discharged back to the long-term care facility, and consider the following: 
I. The hospital discharge planning process and methods to provide at the outset all 
patients with a summary of patients' rights during the discharge process, including the 
right to await transition out of hospital care until satisfactory placement can be found at a 
nursing facility, residential care facility or other long-term care facility or with a home 
health care provider, based on the patient's medical needs; 
2. Methods for providing patients in the hospital discharge planning process with a 
comprehensive list of patient resources and contact information for guidance and support 
during the discharge process, including contact information for the long-term care 
ombudsman program and the Department of Health and Human Services, Bureau of 
Elder and Adult Services, as well as a copy of the most recent report from the federal 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
on the federal ranking system for nursing facilities providing care for Me'dicare and 
Medicaid recipients in those areas where the patient resides or wishes to' reside; and 
3. A hospital discharge planning process in cases where the patient has behavioral 
health issues that ensures the involvement or consultation with representatives from. the 
Department of Health and Human Services, Bureau of Elder and Adult Services, and 
Office of Adult Mental Health Services to improve the coordination, planning and 
efficiency of the discharge process for the patient. 
The department shall report on implementation of the protocol, as well as provide 
proposed recommendations for changes that would improve the hospital discharge 
planning process, to the Joint Standing Committee on Health and Human Services by 
February I, 2010. The Joint Standing Committee on Health and Human Services is 
authorized to submit legislation related to the report to the Second Regular Session oTthe 
I 24th Legislature; and be it further' 
. 
Amend the resolve in section 4 in the 2nd line (page 2, line 17 in L.D.) by striking out 
the following: "psychiatric" 
Amend the resolve in section 4 in the 3rd line (page 2, line 18 in L.D.) by striking out 
the following: "psychiatric" 
Amend the resolve in section 5 in the 5th line (page 2, line 27 in L.D.) by striking out 
the following: "geropsychiatric" 
Amend the resolve in section 5 in the last line (page 2, line 29 in L.D.) by striking out 
the following: "2010." and inserting the following: '2010; and be it further' 
Amend the resolve by inserting after section 5 the foJlowing: 
'Sec. 6. Coordination. Resolved: That the department shall conduct the work 
required by this resolve within existing resources and to the extent possible shall 
coordinate it with similar work addressing similar issues for any other population group. 
The department shall facilitate the exchange of information and communication among 
workgroups with the goal of maximizing department workload and fiscal efficiencies as 
COMMITTEE AMENDMENT 
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COMMITIEE AMENDMENT ·An to H.P. 864, L.D. 1245 
well as the impact and effectiveness of approaches or solutions proposed or developed 
within the work process. A description of coordination efforts must be included in any 
report required by this resolve.' 
SUMMARY 
This amendment changes the resolve by clarifying language, removing certain terms 
and adding reporting requirements for the Department of Health and Human Services. It 
specifies the groups to be included in the department's work on the standardized transfer 
protocol and improved discharge planning. It also requires this work to include a review 
of specific discharge planning processes and methods, patients' rights and resources and 
contact information and provides specific guidance 011 areas of review related to patient 
behavioral health issues. 
It authorizes the Joint Standing Committee on Health and 
Human Services to submit legislation related to the standardized transfer protocol and 
improved discharge planning to the Second Regular Session of the 124th Legislature. It 
requires the department to conduct the work within existing resources and to coordinate it 
with similar work addressing similar issues. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/24/09 Mac:;.. 
LD 1245 
LR 1403(02) 
Resolve, To Improve the Continuity of Care for Individuals with Behavioral Issues in Long-term Care 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment 4, 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
The additional costs to the Department of Health and Human Services to implement the recommendations concerning 
long-term care services for individuals with behavioral issues can be absorbed utilizing existing budgeted resources. 
LRI403(02) - Fiscal Note - Page 1 of I 
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