Resolve, To Restore the MaineCare Nursing Facility COVID-19 Temporary Rate Increase
Maine Legislature, Session 130, LD 0949
Committee Amendment CA_A_S205 (Senate)

COMMITTEE AMENDMENT" f} "to S.P. 301, L.D. 949, "Resolve, To Restore the 
MaineCare Nursing Facility COVID-19 Temporary Rate Increase" 
Amend the resolve by striking out the title and substituting the following: 
'Resolve, To Provide Additional Funding to Nursing Facilities and Private 
Nonmedical Institutions for Costs Related to COVID-19' 
Amend the resolve by striking out the emergency preamble and substituting 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, nursing facilities and private nonmedical institution Appendix C facilities 
face a shortfall of approximately $180 million in operating funds in the cunent biennium; 
and 
Whereas, nursing facilities and private nonmedical institution Appendix C facilities 
are facing historically low occupancy rates due to COVID-19 pandemic restrictions, fatigue 
and staffing concerns; and 
Whereas, despite tireless and heroic efforts of workers, the workforce shmiage for 
nursing facilities and private nonmedical institution Appendix C facilities has been 
exacerbated due to the COVID-19 pandemic; and 
Whereas, nursing facilities and private nonmedical institution Appendix C facilities 
face insolvency within weeks if immediate action is not taken before July 1, 2021; 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' 
Amend the resolve by striking out everything after the emergency preamble and before 
the emergency clause and insetting the following: 
Page I - 130LR1294(02) 
COMMITTEE AMENDMENT 
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' , 
COMMITTEE AMENDMENT" ff" to S.P. 301, L.D. 949 (5-2,DS°) 
'Sec. 1. Department of Health and Human Services to appropriate funding 
for emergency rate relief. Resolved: That the Department of Health and Human 
Services, referred to in this resolve as "the department," shall appropriate $20 million in 
general funds for emergency rate relief for nursing facilities to provide funding to account 
for increased costs related to coronavirus disease 2019, referred to in this resolve as 
"COVID-19." The department shall amend its rule Chapter l O l: MaineCare Benefits 
Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities, to 
increase reimbursement rates by the combined amount of $20 million in state funds 
together with allowable federal matching Medicaid funds. The department shall implement 
the same accountability and transparency requirements, requirements regarding the 
appropriate use of funds, bonus payments for job perfo1mance and cost settlement 
requirements that applied to the use of temporary rate increases that were in effect from 
March 1, 2020 to May 31, 2020. The increased rates under this section must remain in 
effect until December 31, 2021 or until the state of emergency due to COVID-19 has ended 
as declared by the Governor, whichever is later. The department shall allocate the funds 
through a process modeled after the rate relief that was in effect from March 1, 2020 to 
May 31, 2020 and that targets lower-occupancy facilities beginning immediately and 
through December 31, 2021 but that applies to costs retroactive to the most recent quarter 
pennissible under federal law. 
Sec. 2. Department of Health and Human Services to allocate certain 
federal funds for grants to nursing facilities and private nonmedical institution 
Appendix C facilities to provide relief and avoid closures. Resolved: That the 
department shall allocate $12.5 million in remaining available federal funding from the 
federal Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, for facility 
grants to nursing facilities and to private nonmedical institution Appendix C facilities for 
COVID-19 related expenses. Seventy percent of this amount must be allocated to nursing 
facilities and 30% must be allocated to private nonmedical institution Appendix C facilities. 
These grants must be disbursed by July 1, 2021 to provide immediate relief and avoid 
facility closures. 
The Depaiiment of Economic and Community Development shall 
allocate the disbursement using the same or similar guidelines used by the federal 
Department of Health and Human Services in its disbursement of CARES Act federal relief 
funding directed to facilities in the last 12 months. 
Sec. 3. Department of Health and Human Services to waive certain audit 
cost settlement rules. Resolved: That the department shall amend its rules and 
practices so that the grant funds provided pursuant to section 2 are not cost settled under 
the depaiiment's nursing facility audit processes but are retained by nursing facilities. The 
department shall waive any reduction or adjustment to allowable MaineCare costs on filed 
or audited cost reports under department rule Chapter 101: MaineCare Benefits Manual, 
Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities, that would 
otherwise result from the receipt of the rate relief from the grant funds. 
Sec. 4. Department of Health and Human Services; Nursing Facilities 
account; lapsed balances. Resolved: That, notwithstanding any provision of law to 
the contrary, $20 million of unencumbered balance forward from the Department of Health 
and Human Services, Nursing Facilities, General Fund can-ying account, All Other line 
catego1-y lapses to the unappropriated surplus of the General Fund no later than December 
31,2021. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" A "to S.P. 301, L.D. 949 {'::)-v:£) 
Sec. 5. Stimulus funding. Resolved: That, to the extent resources are available 
from federal funding allocated to the State in any federal law enacted after December 15, 
2020 that provides stimulus funds due to the ongoing pandemic related to COVID-19, the 
department shall designate a portion of this funding to nursing facilities for the purposes of 
this resolve instead of using state general funds. 
Sec. 6. 
Appropriations and allocations. Resolved: That the following 
appropriations and allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Nursing Facilities 0148 
Initiative: Provides one-time funding for emergency rate relief for nursing facilities to 
provide funding to account for increased costs related to COVID-19. 
GENERAL FUND 
2021-22 
2022-23 
All Other 
$20,000,000 
$0 
GENERAL FUND TOTAL 
$20,000,000 
$0 
FEDERAL EXPENDITURES FUND 
2021-22 
2022-23 
All Other 
$58,480,484 
$0 
FEDERAL EXPENDITURES FUND TOTAL 
$58,480,484 
$0 
OTHER SPECIAL REVENUE FUNDS 
· 2021-22 
2022-23 
All Other 
$5,009,393 
$0 
OTHER SPECIAL REVENUE FUNDS TOT AL 
$5,009,393 
$0 
Nursing Facilities 0148 
Initiative: Provides one-time allocation of available federal funding from the federal 
Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, for facility grants to 
nursing facilities for COVID-19 related expenses. 
FEDERAL EXPENDITURES FUND 
2021-22 
2022-23 
All Other 
$8,750,000 
$0 
FEDERAL EXPENDITURES FUND TOT AL 
$8,750,000 
$0 
OTHER SPECIAL REVENUE FUNDS 
2021-22 
2022-23 
All Other 
$525,000 
$0 
OTHER SPECIAL REVENUE FUNDS TOTAL 
$525,000 
$0 
Nursing Facilities 0148 
COMMITTEE AMENDMENT 
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~ 
COMMITTEE AMENDMENT" /4, "to S.P. 301, L.D. 949 ( $~1.,.oC;') 
Initiative: Provides one-time allocation of available federal funding from the federal 
Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, for facility grants to 
private nonmedical institution Appendix C facilities for COVID-19 related expenses. 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
2021-22 
$3,750,000 
$3,750,000 
2021-22 
$225,000 
$225,000 
2021-22 
$20,000,000 
$70,980,484 
$5,759,393 
$96,739,877 
2022-23 
$0 
$0 
2022-23 
$0 
$0 
2022-23 
$0 
$0 
$0 
$0 
Amend the resolve by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment replaces the resolve. It does the following. 
1. It requires the Depa1iment of Health and Human Services to appropriate $20 million 
in state general funds, along with allowable federal matching funds, to nursing facilities in 
increased rates. The increased rates must remain in place until December 31, 2021 or the 
end of the state of emergency related to COVID-J 9, whichever is later. 
2. It requires the Department of Health and Human Services to allocate $12.5 million 
in available funding from the federal Coronavirus Aid, Relief, and Economic Security Act 
to nursing facilities and private nonmedical institution Appendix C facilities. Seventy 
percent of this funding must be allocated to nursing facilities and 30% must be allocated to 
private nonmedical institution Appendix C facilities. 
3. It requires the Department of Health and Human Services to waive any reduction or 
adjustment to allowable MaineCare costs on filed or audited cost reports that would result 
from receipt of grant funds. 
4. It lapses $20 million of unexpended funds in the Depaiiment of Health and Human 
Services, Nursing Facilities, General Fund carrying account no later than December 31, 
2021. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" J1t "to S.P. 301, L.D. 949 (~ -2,t,S) 
5. It requires any federal stimulus funds related to the COVID-19 pandemic to be used 
instead of state general funds for the purposes of this resolve. 
6. It adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 06/05/21 .#/ae! 
LD949 
LR 1294(02) 
Resolve, To Restore the MaineCare Nursing Facility COVID-19 Temporary Rate Increase 
Fiscal Note for Bill as Amended by Committee Amendment '}f"Cs-2.os') 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
FY2021-22 
FY 2022-23 
Projections 
FY2023-24 
Projections 
FY2024-25 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Other Special Revenue Funds 
Revenue 
Federal Expenditures Fund 
Other Special Revenue Funds 
Transfers 
General Fund 
Fiscal Detail and Notes 
$0 
$20,000,000 
$70,980,484 
$5,759,393 
$70,980,484 
$5,759,393 
$20,000,000 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
The bill includes a one-time General Fund appropriation to the Department of Health and Human Services of 
$20,000,000 in fiscal year 2021-22 for emergency rate relief for nursing facilities to provide funding to account for 
increased costs related to COVID-19. Federal Expenditures Fund allocations are also included for the FMAP match 
and Other Special Revenue Funds allocations for the Health Care Provider Tax. 
The bill also includes a one-time Federal Expenditures Fund allocation to the Department of Health and Human 
Services of $12,500,000 in fiscal year 2021-22 for available federal funding from the Coronavirus Aid, Relief and 
Economic Security Act, or CARES Act, for facility grants to nursing facilities and private non-medical institutions, 
Appendix C fa<;ilities for COVID-19 related expenses. Other Special Revenue Funds allocations are also included for 
the Health Care Provider Tax and the Service Provider Tax. 
Additionally, the bill requires $20,000,000 of unencumbered balance forward from the Department of Health and 
Human Services, Nursing Facilities, General Fund carrying account, All Other line category to lapse to the 
unappropriated surplus of the General Fund no later than December 31, 2021.