Resolve, To Establish the Commission To Study Long-tenn Care Facilities
Maine Legislature, Session 126, LD 0986
Committee Amendment CA_A_S201 (Senate)

FDtST REGULAR SESSION 
COMMITTEE AMENDMENT" A" to S.P. 331, L.D. 986, "Resolve, To Establish' 
the Commission To Study Long-tenn Care Facilities" 
Amend the resolve by striking out everything after the title and before the summary 
and inserting the following: 
'Sec. 1. 
Commission To Study Long-term Care Facilities established. 
Resolved: That the Commission To Study Long-tenn Care Facilities, referred to in this 
resolve as "the cOlmnission," is established; and be it further 
Sec. 2. Commission membership. Resolved: That the commission consists of 
l3 members appointed as follows: 
1. Three members of the Senate appointed by the President of the Senate, including 
members from each of the 2 parties holding the largest number of seats in the Legislature; 
2. Four members of the House of Representatives appointed by the Speaker of the 
House, including members from each of the 2 parties holding the largest number of seats 
in the Legislature; and 
3. Six members appointed by the Governor who possess expertise in the subj ect 
matter of the study, as follows: 
A. The director of a long-tt~nn care ombudsman program described under the Maine 
Revised Statutes, Title 22, section 5106, subsection l1-C; 
B. The director of a statewide association representing long-term care facilities and 
one representative of a 2nd association of owners oflong-tenn care facilities; 
C. A person who serves as a city manager of a municipality in the State; 
D. A person who serves as a director or who is an owner or administrator of a nursing 
facility in the State; and 
E. A representative of the Governor's office or the Governor's administration; and be 
it further 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT::A "to S.P. 33 J, L.D. 986 
Sec. 3. 
Chairs; subcommittees. 
Resolved: 
That the first-named Senate 
member is the Senate chair and the first-named House of Representatives member is the 
House chair of the commission. The chairs of the commission are authorized to establish 
subcommittees to work on the duties listed in section 5 and to assist the commission. The 
subcommittees must be composed of members of the commission and interested persons 
who are not members of the commission and who volunteer to serve on the 
subcommittees without reimbursement. Interested persons may include representatives of 
nursing facilities with a high percentage of residents whose care is reimbursed through 
the MaineCare program,- individuals with specialized knowledge in implementing an 
acuity-based staffing system, individuals with expertise in acuity-based reimbursement 
systems, a representative of an agency that provides services to the elderly and any other 
persons with experience in nursing facility care; and be it further 
Sec. 4. 
Appointments; convening of commission. Resolved: 
That all 
appointments must be made no later than 30 days following the effective date of this 
resolve. The appointing authorities shall notify the Executive Director of the Legislative 
Council once all appointments have been completed. After appointment of all members, 
the chairs shall call and convene the first meeting of the commission. If 30 days or more 
after the effective date of this resolve a majority of but not all appointments have been 
made, the chairs may request authority and the Legislative Council may grant authority 
for the commission to meet and conduct its business; and be it further 
Sec. 5. Duties. Resolved: That the commission shall study the following issues 
and the feasibility of making policy changes to the long-tenn care system: 
1. Funding for long-tenn care facilities, including the development of an acuity-
based reimbursement system as proposed in Legislative Document 1245 of the l26th 
Legislature, "Resolve, Directing the Department of Health and Human Services To 
Create a More Equitable, Transparent Resource Allocation System for Nursing Facilities 
Based on Residents' Needs," and the development of a pay-for-perfonnance program to 
encourage and reward strong perfonnance by nursing facilities as proposed in Legislative 
Document 928 of the l26th Legislature, "An Act To Improve MaineCare Nursing Home 
Reimbursement To Preserve Access and Promote Quality"; 
2. 
Staffing and regulatory requirements, including the development of minimum 
staffmg requirements based on a 24-hour time period as proposed in Legislative 
Document 1246 of the 126th Legislature, "An Act To Promote Greater Staffing 
Flexibility without Compromising Safety or Quality in Nursing Facilities"; 
3. Collaborative agreements with critical access hospitals for the purpose of sharing 
resources; 
4. 
Reimbursement mechanisms to reimburse facilities for which the MaineCare 
program is the payor for a high percentage of the residents as proposed in Legislative 
Document 928 of the l26th Legislature, "An Act To Improve MaineCare Nursing Home 
Reimbursement To Preserve Access and Promote Quality"; 
5. The viability of privately owned facilities in rural communities; and 
6. The impact on rural populations of nursing home closures. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT 'A" to S.P. 331, L.D. 986 
In performing the study the commission shall review the final report of the 
Commission to Examine Rate Setting and the Financing of Maine's Long-term Care 
Facilities established by Resolve 1997, chapter 81; and be it further 
Sec. 6. Staff assistance. Resolved: That the Legislative Council shall provide 
necessary staffing services to the commission; and be it further 
Sec. 7. Information and assistance. Resolved: That the Commissioner of 
Health and Human Services, the State Auditor and the State Budget Officer shall provide 
information and assistance to the commission as required for its duties; and be it further 
Sec. 8. Report. Resolved: That, no later than December 4, 2013, the commission 
shall submit a report that includes its findings and recommendations, including suggested 
legislation, for presentation to the Second Regular Session of the 126th Legislature.' 
SUMMARY 
The resolve establishes the Commission To Study Long-tenn Care Facilities. This 
amendment changes the membership of the commission so that it consists of 7 
Legislators, one representative of a nursing facility, 2 representatives of long-tenn care 
facilities, one director of a long-term care ombudsman program, one person representing 
a municipality and one person representing the Govemor's office or the Govemor's 
administration. This amendment adds to the duties of the cOlmnission duties derived 
from 3 bills that were before: the Joint Standing COlmnittee on Health and Human 
Services, Legislative Document 928, Legislative Document 1245 and Legislative 
Document 1246. The amendment authorizes 'the chairs of the commission to establish 
subcOlmnittees composed of interested persons, including representatives of nursing 
facilities with a high percentage of residents whose care is reimbursed through the 
MaineCare program, individual.s with specialized knowledge in implementing an acuity-
based staffmg system, individuals with expertise in acuity-based reimbursement systems, 
a representative of an agency that provides services to the elderly and any other persons 
with experience or interest in nursing facility care. 
The amendment directs the 
commission to submit a report with findings and recommendations to the 126th 
Legislature by December 4,20]3. 
FISCAL \On: REQURED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/31113 .:tYac.. 
LD986 
LR49(02) 
Resolve, To Establish the Commission To Study Long-term Care Facilities 
Legislative Cost/Study 
Fiscal Note for Bill as Amended by Committee Amendment 'If.'61.D I) 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Legislative Cost/Study 
The general operating expenses of this study commission are projected to be $4,000 in fiscal year 2013-14. The 
Legislature's proposed budget includes $10,000 in fiscal year 2013-14 and $10,000 in fiscal year 2014-15 for 
legislative studies. Whether the amounts are sufficient to fund all studies will depend on the number of studies 
authorized by the Legislative Council and the Legislature. The additional costs of providing staff assistance to the 
study commission can be absorbed by the Legislature utilizing existing budgeted resources. 
Fiscal Detail and Notes 
Additional costs to the Department of Health and Human Services are expected to be minor and can be absorbed 
within existing budgeted resources.