Resolve, To Improve Access to Bariatric Care
Maine Legislature, Session 129, LD 0177
Committee Amendment CA_A_H472 (House)

COMMITTEE AMENDMENT "/1" to H.P. 140, L.D. 177, "Resolve, To Improve 
Access to Bariatric Care" 
Amend the resolve by striking out everything after the title and inserting the 
following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, this resolve requires the Department of Health and Human Services to 
develop a plan to provide up to 16 bariatric care beds in the State; and 
Whereas, in developing the plan, the Department of Health and Human Services 
must begin the process of issuing a request for information before the 90-day period 
expires; 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. Department of Health and Human Services to develop a plan for 
specialized bariatric care beds. Resolved: That the Department of Health and 
Human Services, referred to in this resolve as "the department," shall develop a plan, by 
September 1, 2020, to provide up to 16 bariatric care beds in the State to serve individuals 
who are eligible for long-term care and need bariatric care. In developing the plan, the 
department shall do the following. 
1. 
No later than August 31, 2019, the department shall issue a request for 
information to determine potential providers of nursing facility bariatric care beds. 
Potential providers must include behavioral health technology partners to provide 
appropriate behavioral health services to residents occupying bariatric care beds. 
2. No later than October 31, 2019, the department shall review the responses to the 
request for information to inform the proposed amendment to rule Chapter 101: 
COMMITTEE AMENDMENT 
/ L:, 
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COMMITTEE AMENDMENT ,A "to H.P. 140, L.D. 177 
MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for 
Nursing Facilities with respect to bariatric care beds. 
3. No later than December 31, 2019, the department shall adopt rules with rate 
changes that build upon the resource utilization group system designed to capture the 
clinical intensity needs ofresidents occupying bariatric care beds. The rules must include 
appropriate body mass index requirements, an enhanced rate of reimbursement to nursing 
facilities for residents occupying bariatric care beds and up to 30 bed hold days for 
bariatric care residents experiencing hospitalization. The rules must also include direct 
billing to the department by providers of durable medical equipment, transportation and 
behavioral health services. Rules adopted pursuant to this section are routine technical 
rules as defined in the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A. 
4. No later than March 30, 2020, the department shall issue a request for proposals to 
award contracts to provide bariatric care beds. 
5. No later than June 30, 2020, the department shall award contracts under the 
request for proposals. Providers who are awarded contracts must offer bariatric care beds 
to appropriate residents no later than September 1, 2020 and receive enhanced 
reimbursement pursuant to rules adopted pursuant to subsections 2 and 3. 
The department shall submit a report on progress, including any necessary legislation 
to establish the bariatric care beds and any required funding, to the Joint Standing 
Committee on Health and Human Services no later than January 1, 2020. 
Emergency clause. 
In view of the emergency cited in the preamble, this 
legislation takes effect when approved.' 
SUMMARY 
This amendment replaces the resolve. It requires the Department of Health and 
Human Services to develop a plan to provide up to 16 new specialized bariatric care 
nursing facility beds by September 1, 2020. The amendment also adds an emergency 
preamble and emergency clause. 
FISCAL NOTE REQUIRED 
(Ste attaehtd) 
COMMITTEE AMENDMENT 
Fiscal Detail and Notes 
Approved: 06/01/19 .wac:.. 
LD177 
LR 1004(02) 
Resolve, To Improve Access to Bariatric Care 
Fiscal Note for Bill as Amended by Committee Amendment ,{J,( /-/ Af 7~ 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Cunent biennium cost increase - General Fund 
Current biennium cost increase - Federal Expenditures Fund 
The bill requires the Department of Health and Human Services to develop a plan and provide 16 new specialized 
bariatric care nursing facility beds by September 1, 2020. The deparhnent must issue a Request for Information (RFI) 
to detennine potential providers of the service, adopt rnles with rate changes for the service, issue a Request for 
Proposals (RFP) and award contracts based on the RFP's received. Plior to the RFI process and rate development, 
which would take into account issues such as: the individual's specific needs, the staffing required and specialized 
equipment needs, the department would not know which facilities will be available for the beds and what the final 
rates might be for the service. It is anticipated that this will create a significant fiscal impact. However, the amount of 
the that impact cannot be determined at this time. 
LR1004(02) - Fiscal Note - Page 1 of 1