Resolve, To Define High-risk Populations for the Purposes of Hospital Surveillance for Methicillin-resistant Staphylococcus Aureus and To Implement Public Law 2009, chapter 346
Maine Legislature, Session 124, LD 1687
Committee Amendment CA_A_H810 (House)

. 
COMMITTEE AMENDMENT"~ "to H.P. 1188, L.D. 1687, "Resolve, To Define 
High-risk Populations for the Purposes of Hospital Surveillance for Methicillin-resistant 
Staphylococcus Aureus and To Implement Public Law 2009, chapter 346" 
Amend the resolve by striking out all of sections I and 2 and inserting the following: 
'Sec. 1. Implementation of law. Resolved: That, in order to implement the 
Maine Revised Statutes, Title 22, section 8761, the Maine Quality Forum shall by July I, 
2010: 
I. 
Define high-risk populations for the purposes of surveillance for methicillin-
resistant Staphylococcus aureus in all hospitals in this State as persons who: 
A. Are all critical care patients in all specialties, categorized by level of care rather 
than location of care, immunocompromised patients, dialysis patients and all surgical 
patients who have or are getting implants; 
B. Have had antibiotic therapy either repeatedly or within the recent past; 
C. Have 'had frequent and repeated health care contacts within the last year; 
D. 
Are long-term care patients, rehabilitation facility patients or nursing facility 
patients; 
E. 
Have previously had methicillin-resistant Staphylococcus aureus or have been 
caregivers for such persons; 
F. Have any open wound or lesion that appears to be infectious; 
G. 
Have an indwelling catheter or other foreign body such as a feeding tube or 
central line; 
H. Are transferred from a prison or jail; 
I. Are homeless; or 
J. Take drugs intravenously; and 
Page I - 124LR2198(02)-J 
COMMITTEE AMENDMENT 
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COMMIITEE AMENDMENT" A" to H.P. II 88, L.D. 1687 
.. Require screening by hospitals for all high-risk populations up to 10 days prior to 
elective admission, upon admission or within 12 hours after admission and, for those 
persons screened negative upon admission, require repeat screening: 
A. One week after admission and weekly after that; 
B. Upon transfer to a different critical care setting; and 
C. Prior to discharge; and be it further 
Sec. 2. Rulemaking. Resolved: That, by July 1, 2010, the Maine Health Data 
Organization shaIl adopt rules pursuant to the Maine Revised Statutes, Title 22, section 
8708-A and Resolve 2009, chapter 82 to· require the reporting of the results of screening 
and all other clinical cultures for methicillin-resistant Staphylococcus aureus by all 
hospitals in the State. 
I .. The rules must require that hospitals report to the Maine Quality Forum working 
group on multidrug-resistant organisms, the Maine Health Data Organization and the 
Department of Health and Human Services, Maine Center for Disease Control and 
Prevention all positive tests for methicillin-resistant Staphylococcus aureus, including a 
designation of the infection as acquired in the community or hospital, based on a brief 
patient interview and the timing of acquisition onhe infection. 
2. The rules must require reported infection data to be made available to the public 
through a publicly accessible website. 
3. The rules must enable reported test results to form the foundation for evaluating 
the progress of screening of high-risk populations and a new policy for the prevention of 
epidemiologically significant organisms, inc Iud ing methicillin-resistant Staphylococcus 
aureus. 
4. Rules adopted pursuant to this section are routine technical rules as defined in 
Title 5, chapter 375, subchapter 2-A; and be it further 
Sec. 3. 
Appropriations and allocations. 
Resolved: 
That the following 
appropriations and allocations are made. 
CORRECTIONS, DEPARTMENT OF 
Correctional Medical Services Fund 0286 
Initiative: Provides funds for testing costs. 
GENERAL FUND 
AIl Other 
GENERAL FUND TOTAL 
CORRECTIONS, DEPARTMENT OF 
DEPARTMENT TOTALS 
2009-10 
$0 
$0 
2009-10 
COMMITTEE AMENDMENT 
2010-11 
$2,219 
$2,219 
2010-11 
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COM M ITTEE AMENDMENT ,A" Ie >J.P. 1188, L. D. 1687 
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GENERAL FUND 
$0 
$2,219 
DEPARTMENT TOTAL - ALL FUNDS 
$0 
$2,219 
CORRECTIONS, STATE BOARD OF 
State BoaI'd of Co .... ections Investment Fund Z087 
Initiative: Provides funds for testing costs. 
GENERAL FUND 
2009-10 
2010-11 
All Other 
$0 
$2,219 
GENERAL FUND TOTAL 
$0 
$2,219 
CORRECTIONS, STATE BOARD OF 
DEPARTMENT TOTALS 
2009-10 
2010-11 
GENERAL FUND 
$0 
$2,219 
,/". 
DEPARTMENT TOTAL - ALL FUNDS 
$0 
$2,219 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS) 
Dorothea Dix Psychiatric Cente .. 0120 
Initiative: Provides allocation for testing costs. 
OTHER SPECIAL REVENUE FUNDS 
2009-10 
2010-11 
All Other 
$0 
$25,650 
OTHER SPECIAL REVENUE FUNDS TOTAL 
$0 
$25,650 
Riven'iew Psychiatric Center 0105 
Initiative: Provides allocation for testing costs. 
OTHER SPECIAL REVENUE FUNDS 
2009-10 
2010-11 
All Other 
$0 
$107,577 
OTHER SPECIAL REVENUE FUNDS TOTAL 
$0 
$107,577 
COMMITTEE AMENDMENT 
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COMMIITEE AMENDMENT"R .. t, H.P. 1188. L.D. 1687 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY BDS) 
DEPARTMENT TOTALS 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL - ALL FUNDS 
SECTION TOTALS 
GENERAL FUND 
OTHER SPECIAL REVENUE FUNDS 
SECTION TOTAL - ALL FUNDS 
SUMMARY 
2009-10 
$0 
$0 
2009-10 
$0 
$0 
$0 
2010-11 
$133,227 
$133,227 
2010-11 
$4,438 
$133,227 
$137,665 
This amendment is the minority report of the committee. It requires the Maine 
Quality Forum to define high-risk populations for the purposes of surveillance for 
methicillin-resistant Staphylococcus aureus and provides the definition. 
It directs the 
Maine Quality Forum to require screening of all high-risk populations, with some 
rescreening. ' It requires the Maine Health Data Organization to adopt routine technical 
rules requiring that hospitals report the results of all screening and clinical cultures for 
methicillin-resistant Staphylococcus aureus. 
It specifies what additional information 
must be repOlted by the hospitals. The amendment also adds an appropriations and 
allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
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Approved: 03/30/1 0 Mac. 
LD 1687 
LR 2198(02) 
Resolve, To Define High-risk Populations for the Purposes of Hospital Surveillance for MethiciIlin-
resistant Staphylococcus Aureus and To Implement Public Law 2009, chapter 346 
Fiscal Note for Bill as A~ended by Committee Amendment "!},, 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
2009-10 
2010-11 
Projections 
2011-12 
Projections 
2012-13 
Net Cost (Savings) 
General Fund 
$0 
$4,438 
$4,438 
$4,438 
( .... > 
.. fAil 
. 
'-'-._ . .:ppropnatlOns 
ocatlOns 
General Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
$0 
$0 
$4,438 
$133,227 
$4,438 
$133,227 
$4,438 
$133,227 
This bill includes a General Fund appropriation of $2,219 in fiscal year 20 10-11 for the Department of Corrections 
and $2,219 for the State Board of Corrections to suppOli the additional cost to test certain prisoners. This bill also 
includes' Other Special Revenue Funds allocaticms of $25,650 for Dorothea Dix Psychiatric Center and $107,577 for 
Riverview Psychiatric Center for the additional.testing costs at the 2 state hospitals. The accounts receiving allocation 
already have sufficient funds to cover the allocations. 'Any additional costs to the Maine Health Data Organization 
and the Maine Quality Fomm in the Dirigo Health Agency can be absorbed utilizing existing budgeted resources. 
LR2198(02) - Fiscal Note- Page I of I