An Act To Expand Housing Opportunities for Patients with Complex Medical Conditions
Maine Legislature, Session 127, LD 0155
Committee Amendment CA_A_H249 (House)

COMMITTEE AMENDMENT "ft" to H.P. 113, L.D. 155, Bill, "An Act To 
Expand Housing Opportunities for Patients with Complex Medical Conditions" 
Amend the bill by striking out the title and substituting the following: 
'Resolve, To Establish the Commission To Study Difficult-to-place Patients' 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective unti190 days after adjournment unless enacted as emergencies; and 
Whereas, this resolve establishes the Commission To Study Difficult-to-place 
Patients to study certain issues related to difficult-to-place patients with complex medical 
conditions and the feasibility of making policy changes to the long-term care system for 
those patients; and 
Whereas, immediate enactment of this resolve is necessary to provide the 
commission adequate time to complete its work; 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, 
Sec. 1. Commission established. Resolved: That, notwithstanding Joint Rule 
353, the Commission To Study Difficult-to-place Patients, referred to in this resolve as 
"the commission," is established; and be it further 
Sec. 2. Commission membership. Resolved: That the commission consists of 
members appointed as follows: 
1. Two 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; 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" A" to H.P. 113, L.D. 155 
2. Three 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; 
3. The Commissioner of Health and Human Services or the commissioner's designee; 
and 
4. Seven members appointed by the Governor who possess expertise in the subject 
matter of the study, as follows: 
A. The director of the long-term care ombudsman program described under the 
Maine Revised Statutes, Title 22, section 5106, subsection ll-C; 
B. An individual representing a statewide association oflong-term care facilities; 
C. An individual representing a statewide association of hospitals; 
D. An individual representing an organization that represents people with disabilities; 
E. An individual representing a statewide organization advocating for people with 
mental illness; 
F. An individual representing an organization promoting independent living for 
individuals with disabilities; and 
G. An individual or a family member of an individual with a complex medical 
condition; and be it further 
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. Any 
subcommittees established by the chairs 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 individuals with expertise in placing individuals with complex medical conditions 
in long-term care placements, individuals who provide long-term care to individuals with 
complex medical conditions, individuals affected by neurodegenerative diseases and 
individuals affected by mental illness; 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 
and after adjournment of the First Regular Session of the 127th Legislature, 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-term care system for patients 
with complex medical conditions: 
COMMITTEE AMENDMENT 
~O\ 
~ 
COMMITTEE AMENDMENT"~ "to H.P. 113, L.D. 155 
1. Identification of categories of patients with complex medical and mental health 
conditions who are unable to be discharged from hospitals because there are no facilities 
or providers who are able to care for them or to accept them for care; 
2. A description of how patients with complex medical and mental health conditions 
are placed currently, including the involvement of staff from the Department of Health 
and Human Services; 
3. Identification of primary barriers to placement of patients with complex medical 
and mental health conditions currently; 
4. A description of facilities in which patients with complex medical and mental 
health conditions are currently placed, including whether the facilities are in-state and the 
costs associated with the patients· care; 
5. Options for increasing availability of residential care and long-term care facilities, 
including conversion of existing facilities such as hospitals, nursing homes and the 
Dorothea Dix Psychiatric Center to long-term care facilities for specialized populations 
that are difficult to place for care, such as ventilator-dependent patients, geropsychiatric 
patients and bariatric patients; 
6. Rates of reimbursement necessary to operate facilities to manage patients with 
complex medical conditions, including psychiatric conditions and neurodegenerative 
diseases; and 
7. Any other issue identified by the commission; and be it further 
Sec. 6. Staff assistance. Resolved: That the Legislative Council shall provide 
necessary staffmg services to the commission; and be it further 
Sec. 7. Information and assistance. Resolved: That the Commissioner of 
Health and Human Services 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 2,2015, the commission 
shall submit a report that includes its fmdings and recommendations, including suggested 
legislation, for presentation to the Joint Standing Committee on Health and Human 
Services. 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.· 
SUMMARY 
This amendment replaces the bill, changes it into a resolve and adds an emergency 
preamble and emergency clause. The amendment establishes the Commission To Study 
Difficult-to-place Patients in order to study certain issues related to difficult-to-place 
patients with complex medical conditions and the feasibility of making policy changes to 
the long-term care system for those patients. The commission comprises 13 members, 
including 5 Legislators; the Commissioner of Health and Human Services; the director of 
the long-term care ombudsman program; representatives of organizations representing 
people with disabilities, people with mental illness, the promotion of independent living 
for individuals with disabilities, long-term care facilities and hospitals; and a patient or 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" A 
.. to H.P. 113, L.D. 155 
family member of a patient with complex medical needs. The amendment requires the 
commission to report to the Joint Standing Committee on Health and Human Services by 
December 2,2015. 
FISCAL NOTE REQL'IRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: OS/28/15 
;:!WaC"... 
LD 155 
LR 961(02) 
An Act To Expand Housing Opportunities for Patients with Complex Medical Conditions 
Fiscal Note for Bill as Amended by Committee Amendment 'k [f} -d Ljq \ 
Committee: Health and Human Services 
') 
Fiscal Note Required: Yes 
Fiscal Note 
Legislative Cost/Study 
Legislative Cost/Study 
The general operating expenses of this study are projected to be $2,750 in fiscal year 2015-16. The Legislature's 
proposed budget includes $10,000 in fiscal year 2015-16 for legislative studies. Whether this amount is 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 staffing assistance to the study during the interim can be absorbed utilizing existing 
budgeted staff resources. If more than 4 meetings are held during the interim the estimated cost for each additional 
meeting is projected to be $625 for legislative per diem and expenses. 
Fiscal Detail and Notes 
Any additional costs to the Department of Health and Human Services from the provisions in this bill are expected to 
be minor and can be absorbed within existing budgeted resources. 
LR0961(02) - Fiscal Note - Page 1 of 1