An Act To Amend the Maine Certificate of Need Act of 2002 To Change Nursing Facilities Review Thresholds for Energy Efficiency Projects and for Replacement Equipment ,
Maine Legislature, Session 124, LD 1164
Committee: Health and Human Services
Sponsors: MILLER, FLOOD, LEWIN, MARTIN, ROSEN
Amends: 22 MRSA §329, 22 MRSA §334-A

FIRST REGULARSESSION-2009 
Legislative Document 
No. 1164 
H.P.803 
House of Representatives, March 25, 2009 
An Act To Amend the Maine Certificate of Need Act of 2002 To 
Change Nursing Facilities Review Thresholds for Energy Efficiency 
Projects and for Replacement Equipment 
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Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative MILLER of Somerville. 
'I7l~ /h.11l1f£~{ 
MILLICENT M. MacFARLAND 
Clerk 
Cosponsored by Representatives: FLOOD of Winthrop, LEWIN of Eliot, MARTIN of Eagle 
Lake,Senator: ROSEN of Hancock. 
PrilllcJ UII I'l!cydctl pilpr:r 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 22 MRSA §329, sub-§3, as amended by PL 2007, c. 681, §3, is further 
amended to read: 
3. Capital expenditures. Except as provided in subsection 6, the obligation byor 
on behalf of a health care facility of any capital expenditure of $2,400,000 or more. 
Capital expenditures in the case of a natural disaster, major accident or equipment failure 
or for replacement equipment or fef parking lots and garages, for information and 
communications systems and for physician office space do not require a certificate of 
need. Beginning September 30, 2004 and annually thereafter through 2007, the threshold 
amount for review must be updated by the commissioner to reflect the change in the 
Consumer Price Index medical index. 
Beginning· January i, 2009 and annually 
thereafter, the threshold amount for review must be updated. by the commissioner to 
reflect the change in the Consumer Price Index medical index, with an ~ffective date of 
January 1 st each year; 
Sec. 2.22 MRS A §329, sub~§6, as enacted by PL 2001, c. 664, §2, is amended to 
read: 
6. Nursing facilities. The obligation by a nursing facility, when related to nursing 
services provided by the nursing facility, of any capital expenditures of $510,000 
$1,000,000 or more. Capital expenditures in the case of a natural disaster, major accident 
or equipmentfailtireor for replacement equipment or parking lots and garages, for 
information and communications systems and for physician office space do not require a 
certificate of need. Beginning January· 1, 2010 and annually thereafter, the threshold 
amount for review must be updated by the commissioner to reflect the change in the 
Consumer Price Index medical index, with an effective date of January 1 st each year. 
A certificate of need is not required for a nursiIig facility to convert 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, public funds are not obligated, for payment of 
services provided in the conveiied bedst.:. 
A certificate of need is not required for certain energy-efficient improvements, as 
described in section 334-A, subsection 4, paragraph A. A simplified approval of the 
improvements may be obtained from the department's audit division under procedures set 
forth in department rules; 
Sec. 3. 22 MRSA §334-A, sub-§4 is enacted to read: 
4. Simplified ,approval of projects to implement energy-efficient improvements. 
Nursing facility projects that implement energy-efficient improvements are not subject to 
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certificate of rieed approval. . A simplified approval 'of the improvements may be obtained 
from the department's audit division under procedures set forth in department rules. 
A. The eligible energy~efficient improvements are: 
(1) Insulation, including, but not limited to, fiberglass and cellulose; 
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(2) Energy-efficient windows or doors for the' outside of the facility, including 
insulating shades and shutters; 
(3) Caulking or weather stripping for windows or doors for the outside of the 
facility; 
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(4) Fans specially designed for circulation of heat inside the facility; 
(5) Wood- and coal-burning furnaces or boilers; 
(6) Furnace replacement burners that reduce the amount of fuel used; 
(7) Dampers, or other deviCes connected to furnaces to control heat usage; 
(8) 
A device or capital expenditure for modifying an existing furnace that 
reduces the consumption of fuel; 
(9) Solar active systems for water and space heating; 
(10) Retrofitting structures for the purpose of creating or enhancing passive solar 
gain. 
Prior approval must be obtained by the department's audit division regardless of 
amount of expenditure. A request for prior approval must be evaluated by the 
department's audit division on the basis of whether energy costs would be 
decreased to such an extent as to render the expenditure reasonable. The age and 
condition of the facility requesting approval must be also considered; and 
(11 ) Any energy-saving devices that might qualify as energy efficient other than 
,those listed in this 'paragraph having prior approval of the department. The 
department's audit division must evaluate a request for' prior approval under 
recommendations from the division that oversees energy programs on what items 
qualify as energy-efficient devices and determine that the eiIergy-saving device is 
a reliable product and the device would decrease the energy costs of the facility, 
rrialdng the expenditure reasonable in nature. 
B. MaineCare shall amend its niles to establish guidelines for reimbursement to a 
nursing facility for the energy-efficient improvements described in paragraph A. 
Rules adopted pursuant to this paragraph are routine technical rules as defined in 
Title 5, chapter 375, subchapter 2-A. 
Sec. 4. Rules. Rules adopted pursuant to the Maine Revised Statutes, Title 22, 
seCtion 334-A, subsection 4, paragraph B must take effect no later than January 1, 2010 
and must require that the minimum depreciation periods of between 3 and 7 years set 
forth in the niles are determined based on the value and efficiency of the assets and the 
depreciation periods are not extended to mirror the terms of the financing. 
SUMMARY 
This bill amends the Maine Certificate of Need Act of2002 in the following ways. 
1. 
It .increases the capital expenditure threshold for nursing facility projects to 
$1,000,000. ' It also clarifies that nursing facility projects involving replacement, 
equipment are not subject to review. 
2. 
It amends generic capital expenditure provisions· to clarify that any type of 
replacement equipment is not subject to review. 
3. It exempts from the full certificate of need approval nursing facility projects that 
implement certain energy~efficient improvements. 
4. It requires a simplified approval process for these nursing facility energy-efficient 
improvements, administered by the audit division· of the Department of Health and 
Human Services, consistent with department rules. 
.. It requires amendments to these rules to be effective on or before January 1, 2010 
and to require that the minimum depreciation periods between 3 and 7 years are 
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determined based on the value and efficiency of the assets and,the depreciation periods 
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are not .extended to mirror the terms of the financin:g. 
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