An Act To
Maine Legislature, Session 124, LD 1164
Committee Amendment CA_A_H534 (House)
Amends: 22 MRSA §329, 22 MRSA §334-A

COMMITTEE AMENDMENT "A" to H.P. 803, L.D. 1164, Bill, "An Act To 
Amend the Maine Cel1ificate of Need Act of 2002 To Change Nursing Facilities Review 
Thresholds for Energy Efficiency Projects and for Replacement Equipment" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inseliing the following: 
'Sec. 1. 22 MRSA §329, sub-§6, as enacted by PL 2001, c. 664, §2, is repealed 
and the following enacted in its place: 
6. Nursing facilities. The obligation by a nursing facility, when related to nursing 
services provided by the nursing facility, of any capital expenditures of $51 0,000 or more 
and, beginning JanuaIY 1, 2010, the obligation by a nursing facility, when related to 
nursing services provided by the nursing facility, of any capital expenditures of 
$1,000,000 or more. 
A celiificate of need is not required for the following: 
A. A nursing facility converting beds used for the provision of nursing services to 
beds to be used for the provision of residential care services. If such a conversion 
occurs, MaineCare and other public funds may not be obligated for payment of 
services provided in the converted beds unless approved by the department pursuant 
to the provisions of sections 333-A and 334-A; 
B. Capital expenditures in the case of a natural disaster, major accident or equipment 
failure; 
. 
C. 
Replacement equipment, other than major medical equipment as defined III 
section 328, subsection 16; 
D. Information systems, communication systems, parking lots and garages; and 
E. Cel1ain energy-efficient improvements, as described in section 334-A, subsection 
4. 
Page I - 124LRlSll(02)-1 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT -A " 
to I-J.P. 803, L.D. 1164 
Sec. 2. 22 MRSA §334-A, sub-§3, «;fA, as enacted by PL 2007, c. 440, § 13, is 
amended to read: 
A. Allow gross square footage per licensed bed of not less than 500 square feet 
unless the applicant specifies a smaller allowance for the project; aH4 
Sec. 3. 22 MRSA §334-A, sub-§3, ~, as enacted by PL 2007, c. 440, § 13, is 
amended to read: 
B. 
Exclude the projected incremental cost associated with replacement of 
equipment~; and 
Sec. 4. 22 MRSA §334-A, sub-§3, C[C is enacted to read: 
C. Exclude the incremental cost of energy-efficient improvements as defined in the 
rules governing MaineCare reimbursement for nursing facilities. 
Sec. 5. 22 MRSA §334-A, sub-§4 is enacted to read: 
4. Cost associated with energy-efficient improvements. The cost associated with 
energy-efficient improvements in nursing facilities, as set fOl1h in rules governing special 
reimbursement provisions for energy-efficient improvements adopted by the department, 
must be excluded from the cost of a project in determining whether the project is subject 
to review. 
Sec. 6. Cost associated with energy-efficient improvements. For purposes 
of the Maine Revised Statutes, Title 22, section 334-A, subsection 4, the rules governing 
special reimbursement provisions for energy-efficient improvements are set forth in the 
Department of Health and Human Services MaineCare Benefits Manual, Chapter Ill, 
Section 67, subsection 44.2.4. The rules must be amended and take effect no later than 
January 1, 2010. The rules must require that the department provide a response to 
provider requests for prior approval of energy-efficient improvements within 30 days 
following the receipt of a request supported by sufficient information. Rules adopted 
pursuant to this section are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A.' 
SUMMARY 
This amendment replaces the bill. Beginning January 1, 2010, it increases the 
threshold amount for nursing facility projects to $1,000,000. It exempts from the full 
cel1ificate of need approval cel1ain nursing facility projects including capital expenditures 
under limited circumstances, nonmedical replacement equipment, information systems, 
communication systems, parking lots, garages and projects that implement cel1ain 
energy-efficient improvements. It requires the costs associated with energy-efficient 
projects to be excluded from the total cost of a project in determining whether the project 
is subject to review. It requires the depal1ment to amend the rules governing special' 
reimbursement provisions for energy-efficient improvements and to include requirements 
that the Department of Health and Human Services respond to provider requests for prior 
approval of energy-efficient improvements within 30 days following the receipt of a 
request suppOl1ed by sufficient information. 
FISCAL 7'OTE REQuIRED 
(See attached) 
COMMITTEE AMENDMENT 
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Approved: 06/03/09 
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LD 1164 
LR 1511(02) 
An Act To Amend the lVlaine Certificate of Need Act of 2002 To Change Nursing Facilities Review 
Thresholds for Energy Efficiency Projects and for Replacement Equipment 
Fiscal Note for Bill as Amended by Committee Amendment A" 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Potential CUlTent biennium cost increase - General Fund 
Fiscal Detail and Notes 
The bill's provisions increasing the certificate of need tlu-eshold for nursing facility projects and increasing the nursing 
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facility projects and capital expenditures that are exempt from certificate of need could increase MaineCare nursing 
. 
facility costs because additional costs would not be subject to the certificate of need MaineCare cost neutrality 
requirements, The number and costs of the additional projects and expenditures cannot be detennined at this time, 
PL 2.009, c, 213 (the 2010-2011 Biennial Budget) de appropriated $300,000 in each of 2009-1 0 and 2010-11 in 
baseline funding that would have been available in the nursing facility MaineCare funding pool intended for the 
development of new beds or other improvements requiring certificate of need. 
LR1S 11 (02) - Fiscal Note - Page 1 of 1