An Act To Support Nursing Facilities and Home Care for Seniors and Create a Tax Credit for Primary Care Professionals Practicing in Underserved Areas
Maine Legislature, Session 126, LD 1864
Committee: Health and Human Services
Sponsors: HAMPER
Amends: 36 MRSA §5219-L

Legislative Document 
No. 1864 
S.P. 758 
In Senate, May 1, 2014 
An Act To Support Nursing Facilities and Home Care for Seniors 
and Create a Tax Credit for Primary Care Professionals Practicing 
in Underserved Areas 
(EMERGENCY) 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
DAREK M. GRANT 
Secretary of the Senate 
Presented by Senator HAMPER of Oxford.  (GOVERNOR'S BILL) 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, many nursing facilities are under imminent threat of closure as a result of 
chronic underfunding; and 
Whereas, additional funding provided as soon as possible could prevent the closure 
of nursing homes, many of which are in rural locations; and 
Whereas, additional funding provided as soon as possible could assist seniors to age 
in place without their needing to transfer to nursing facilities; and 
Whereas, nursing facilities and adult day services are essential parts of the 
continuum of health care; 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 enacted by the People of the State of Maine as follows: 
Sec. 1.  36 MRSA §5219-LL is enacted to read: 
§5219-LL.  Primary care access credit 
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.  
A.  "Eligible primary care professional" means a person licensed under Title 32, 
chapter 31, subchapter 3 or subchapter 4; Title 32, chapter 36, subchapter 4; or Title 
32, chapter 48, subchapter 2 and who, on or after January 1, 2013:  
(1)  First begins practicing primary care medicine in the State by joining an 
existing health care practice in an underserved area or establishing a new health 
care practice or purchasing an existing health care practice in an underserved 
area; 
(2)  Agrees to practice full time for at least 5 years in an underserved area;  
(3)  Is certified under subsection 3 to be eligible by the Department of Health and 
Human Services; and 
(4)  Has an unpaid student loan owed to an institution for course work directly 
related to that person's training in primary care medicine. 
B.  "Underserved area" means an area in the State that is a health professional 
shortage area or medically underserved area or that contains a medically underserved 
population as defined by the federal Department of Health and Human Services, 
Health Resources and Services Administration.  
2.  Credit.  For tax years beginning on or after January 1, 2014 but before January 1, 
2019, an eligible primary care professional is allowed a credit against the taxes due under 
this Part as follows. 
A.  The credit may be claimed in the first year that the eligible primary care 
professional meets the conditions of eligibility for at least 6 months and each of the 4 
subsequent years or until the student loan of the eligible primary care professional is 
paid in full, whichever comes first. 
B.  The credit may be claimed in an amount equal to the annual payments made on 
the student loan not to exceed $6,000 in the first year, $9,000 in the 2nd year, 
$12,000 in the 3rd year, $15,000 in the 4th year and $18,000 in the 5th year. 
C.  The credit may not reduce the tax due under this Part to less than zero. 
3.  Eligibility limitation; certification.  The Department of Health and Human 
Services shall certify up to 5 eligible primary care professionals each year.  The 
Department of Health and Human Services shall monitor certified primary care 
professionals to ensure that they continue to be eligible for the credit under this section 
and shall decertify any primary care professional who ceases to meet the conditions of 
eligibility.  The Department of Health and Human Services shall notify the bureau 
whenever a primary care professional is certified or decertified.  A decertified primary 
care professional ceases to be eligible for the credit under this section beginning with the 
tax year during which the primary care professional is decertified.  
4.  Rules.  The Department of Health and Human Services may adopt rules to 
implement this section. Rules adopted pursuant to this subsection are routine technical 
rules as defined in Title 5, chapter 375, subchapter 2-A. 
5.  Annual report.  By January 15, 2016 and annually thereafter, the Department of 
Health and Human Services and the bureau shall submit a report to the joint standing 
committee of the Legislature having jurisdiction over taxation matters.  The report must 
indicate the number of eligible primary care professionals certified and decertified each 
year by the Department of Health and Human Services pursuant to this section and the 
total annual loss of revenue attributable to the credit under subsection 2. 
Sec. 2.  Transfer; Fund for a Healthy Maine; General Fund.  
Notwithstanding any other provision of law, the State Controller shall transfer $4,547,371 
from the Fund for a Healthy Maine to the unappropriated surplus of the General Fund no 
later than June 30, 2015. 
Sec. 3.  Department of Health and Human Services directed to increase 
reimbursement rates for adult day services.  The Department of Health and 
Human Services shall adopt rules on an emergency basis to increase reimbursement rates 
for adult day services programs in Chapter 101:  MaineCare Benefits Manual, Chapter II, 
Sections 19 and 26 and Chapter 5:  Office of Elder Services Policy Manual, Sections 61 
and 63 to $12 per hour beginning July 1, 2014.  Following adoption of the emergency 
rules, the department shall complete nonemergency rulemaking to implement this section.  
Rules adopted pursuant to this section are routine technical rules as described in the 
Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A. 
Sec. 4.  Appropriations and allocations.  The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
Long Term Care - Office of Aging and Disability Services 0420 
Initiative: Appropriates funds for an increase in the reimbursement rate for adult day 
services to $12 per hour. 
Low-cost Drugs To Maine's Elderly 0202 
Initiative: Allocates funds on a one-time basis for access to transitional assistance for 
Medicare Savings Program members who are losing state assistance with Medicare Part 
D plan selection. 
Medical Care - Payments to Providers 0147 
Initiative: Appropriates and allocates funds for an increase in the reimbursement rate for 
adult day services to $12 per hour. 
Nursing Facilities 0148 
Initiative: Provides one-time funding for increased reimbursements under the MaineCare 
program for nursing facilities. 
GENERAL FUND 
2013-14
2014-15
All Other 
$0
$57,095
GENERAL FUND TOTAL 
$0
$57,095
FUND FOR A HEALTHY MAINE 
2013-14
2014-15
All Other 
$0
$275,000
FUND FOR A HEALTHY MAINE TOTAL 
$0
$275,000
GENERAL FUND 
2013-14
2014-15
All Other 
$0
$46,416
GENERAL FUND TOTAL 
$0
$46,416
FEDERAL EXPENDITURES FUND 
2013-14
2014-15
All Other 
$0
$75,109
FEDERAL EXPENDITURES FUND TOTAL 
$0
$75,109
Nursing Facilities 0148 
Initiative: Provides one-time funds for increased nursing home costs. 
Nursing Facilities 0148 
Initiative: Adjusts funds to reflect additional nursing home provider tax revenue. 
Office of Aging and Disability Services Central Office 0140 
Initiative: Appropriates funds for an increase in the reimbursement rate for adult day 
services to $12 per hour. 
GENERAL FUND 
2013-14
2014-15
All Other 
$0
$4,915,699
GENERAL FUND TOTAL 
$0
$4,915,699
FEDERAL EXPENDITURES FUND 
2013-14
2014-15
All Other 
$0
$7,951,780
FEDERAL EXPENDITURES FUND TOTAL 
$0
$7,951,780
GENERAL FUND 
2013-14
2014-15
All Other 
$0
$206,459
GENERAL FUND TOTAL 
$0
$206,459
FEDERAL EXPENDITURES FUND 
2013-14
2014-15
All Other 
$0
$333,975
FEDERAL EXPENDITURES FUND TOTAL 
$0
$333,975
GENERAL FUND 
2013-14
2014-15
All Other 
$0
($772,049)
GENERAL FUND TOTAL 
$0
($772,049)
OTHER SPECIAL REVENUE FUNDS 
2013-14
2014-15
All Other 
$0
$772,049
OTHER SPECIAL REVENUE FUNDS TOTAL 
$0
$772,049
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill provides a primary care access tax credit to up to 5 eligible primary care 
professionals each year who practice in an underserved area in the State.  It creates a 
graduated schedule for claiming the credit allowing an eligible primary care professional 
to claim an amount equal to the annual payments made on the professional's student loan 
not to exceed $6,000 in the first year, $9,000 in the 2nd year, $12,000 in the 3rd year, 
$15,000 in the 4th year and $18,000 in the 5th year. 
This bill also provides that the primary care access credit is available for tax years 
beginning on or after January 1, 2014 but before January 1, 2019. It requires the 
Department of Health and Human Services and the Department of Administrative and 
Financial Services, Maine Revenue Services to submit an annual report to the joint 
standing committee of the Legislature having jurisdiction over taxation matters beginning 
on January 15, 2016 indicating the number of eligible primary care professionals certified 
and decertified each year by the Department of Health and Human Services and the total 
annual loss of revenue attributable to the primary care access credit. 
This bill uses one-time tobacco settlement funds from the Fund for a Healthy Maine 
to support health services for the elderly, including nursing home funding, transitional 
assistance with Medicare Part D plan selection and an increase for adult day services 
reimbursement.  This bill also uses one-time tobacco settlement funds from the Fund for a 
Healthy Maine for the primary care access tax credit. 
GENERAL FUND 
2013-14
2014-15
All Other 
$0
$71,521
GENERAL FUND TOTAL 
$0
$71,521
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY DHS) 
DEPARTMENT TOTALS 
2013-14
2014-15
GENERAL FUND 
$0
$4,525,141
FEDERAL EXPENDITURES FUND 
$0
$8,360,864
FUND FOR A HEALTHY MAINE 
$0
$275,000
OTHER SPECIAL REVENUE FUNDS 
$0
$772,049
DEPARTMENT TOTAL - ALL FUNDS 
$0
$13,933,054