An Act To Establish the Trust for a Healthy Maine
Maine Legislature, Session 130, LD 1523
Committee Amendment CA_A_H945 (House)

COMMITTEE AMENDMENT ,ff,, to H.P. 1127, L.D. 1523, "An Act To Establish 
the Trust for a Healthy Maine" 
Amend the bill in section 1 in the first line (page 1, line 2 in L.D.) by striking out the 
following: "sub-§14-J" and inserting the following: 'sub-§14-K' 
Amend the bill in section 1 in subsection 14-J in the first line (page 1, line 3 in L.D.) 
by striking out the following: 
1114-J.
and inserting the following: '14-K.' 
Amend the bill in section 4 in sub-c. 2 in § 1514 in subsection 2 in the last line (page 2, 
line 2 in L.D.) by striking out the following: "14-J" and inserting the following: '14-K' 
Amend the bill in section 4 in sub-c. 2 in § 1514 in subsection 7 in the 2nd line (page 
2, line 17 in L.D.) by inserting after the following: "funds" the following: 'and other funds 
in the trnst' 
Amend the bill in section 4 in sub-c. 2 in § 1514 by inserting after subsection 7 the 
following: 
'8. Extraordinary receipts. "Extraordinary receipts" means funds received by the 
trust pursuant to section 1516, subsection 1, paragraph B or C.' 
Amend the bill in section 4 in sub-c. 2 in § 1514 in subsection 9 in the 2nd line (page 
2, line 23 in L.D.) by striking out the following: "prescription drug" and inserting the 
following: 'elderly low-cost drug' 
Amend the bill in section 4 in sub-c. 2 in § 1514 by renumbering the subsections to read 
consecutively. 
Amend the bill in section 4 in sub-c. 2 in § 1515 in subsection 3 in paragraph B by 
striking out all of subparagraph (2) (page 4, lines 1 and 2 in L.D.) and inserting the 
following: 
'(2) A person who has experience recruiting, employing, developing and retaining 
a healthy workforce; and' 
COMMITTEE AMENDMENT 
~O~· 
COMMITTEE AMENDMENT ,,,to H.P. 1127, L.D. 1523 
Amend the bill in section 4 in sub-c. 2 in § 1515 in subsection 3 in paragraph C in the 
first 2 lines (page 4, lines 7 and 8 in L.D.) by striking out the following: "trustees from 
nominations made in accordance with this paragraph" and inserting the following: 'one 
trustee from nominations made under each of the divisions described below' 
Amend the bill in section 4 in sub-c. 2 in §1515 in subsection 3 in paragraph C in 
subparagraph (1) in division (b) in the 2nd line (page 4, line 18 in L.D.) by striking out the 
following: "care," and insetting the following: 'care or rural oral health care,' 
Amend the bill in section 4 in sub-c. 2 in §1515 in subsection 6 in the 4th line (page 5, 
line 29 in L.D.) by striking out the following: "chapter 13, subchapter 1. Notwithstanding 
any provision of law" and inserting the following: 'section 403-B. Notwithstanding any 
provision of that section' 
Amend the bill in section 4 in sub-c. 2 in § 1515 in subsection 11 in the 2nd line (page 
6, line 2 in L.D.) by striking out the following: "14-J" and inserting the following: '14-K' 
Amend the bill in section 4 in sub-c. 2 in § 1517 by striking out all of subsection 3 (page 
7, lines 19 to 27 in L.D.) and inserting the following: 
'3. Funding disbursement plans. A funding disbursement plan approved by the board 
may not disburse funds for the purpose of providing medical care except as provided in 
subsection 7. When approving elements of the funding disbursement plans, the board shall 
consider funding levels in the most recent fiscal year and disburse funding in amounts that 
minimize disruption of existing programs and ensure smooth and efficient transitions to the 
funding levels required under subsection 4.' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph A in 
subparagraph (1) in the first line (page 7, line 35 in L.D.) by striking out the following: 
"Beginning in" and inserting the following: 'In' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph B in the 
2nd line (page 8, line 2 in L.D.) by striking out the following: "Department" and inserting 
the following: 'Office' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph B in 
subparagraph (1) in the first line (page 8, line 3 in L.D.) by striking out the following: 
"Beginning in fiscal year 2023-24, an amount equal to 0.005" and inserting the following: 
'In fiscal year 2023-24, an amount equal to 0.006' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph B in 
subparagraph (2) in the 2nd line (page 8, line 6 in L.D.) by striking out the following: 
"Department" and inserting the following: 'Office' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph B in 
subparagraph (2) in the last line (page 8, line 8 in L.D.) by inserting after the following: 
"5402" the following: 'except that the date the State Tax Assessor determines the cost-of-
living adjustment is on or about September 15th of each year, beginning in 2024, and "cost-
of-living adjustment" means the Chained Consumer Price Index for the 12-month period 
ending June 30th of the preceding calendar year divided by the Chained Consumer Price 
Index for the 12-month period ending June 30, 2024. The State Tax Assessor shall calculate 
the cost-of-living adjustment under this subparagraph' 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "A:to H.P. 1127, L.D. 1523 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph C by 
striking out all of subparagraph (1) (page 8, line 12 in L.D.) and inserting the following: 
'(1) In fiscal year 2023-24, an amount equal to 0.006 of the settlement funds; and' 
•
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Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph C in 
.. .,. •• •15 
subparagraph (2) in the last line (page 8, line 15 in L.D.) by inserting after the following: 
"5402" the following: 'except that the date the State Tax Assessor determines the cost-of-
living adjustment is on or about September 15th of each year. beginning in 2024, and "cost-
of-living adjustment" means the Chained Consumer Price Index for the 12-month period 
ending June 30th of the preceding calendar year divided by the Chained Consumer Price 
Index for the 12-month period ending June 3 O. 2024. The State Tax Assessor shall calculate 
the cost-of-living adjustment under this subparagraph' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in paragraph D in the 
last line (page 8, line 17 in L.D.) by inserting after the following: "year" the following: ' .. 
plus any extraordina:ty receipts,' 
Amend the bill in section 4 in sub-c. 2 in §1517 in subsection 4 in paragraph Fin the 
first line (page 8, line 20 in L.D.) by inserting after the following: "remaining" the 
following: ', including any remaining extraordinary receipts,' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 4 in the last blocked 
paragraph in the first line (page 8, line 23 in L.D.) by striking out the following: "The" and 
inserting the following: 'Except as provided in subsection 7 for the first funding 
disbursement plan, the' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 5 in paragraph A in 
subparagraph (4) in the first line (page 9, line 5 in L.D.) by inserting after the following: 
"Supporting the" the following: 'development,' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 7 in the 7th line (page 9, 
line 38 in L.D.) by inserting after the following: "needs." the following: 'If the biennial or 
supplemental budget enacted for fiscal year 2022-23 appropriates less than $2,400,000 
from the General Fund to the elderly low-cost drug program established under section 
254-D, the board shall disburse in its first funding disbursement plan an amount from the 
internal flexible account to the elderly low-cost drug program established under section 
254-D that when added to the General Fund appropriation to that program for that fiscal 
year totals $2,400,000. The internal flexible account may not otherwise be used to fund 
medical care.' 
Amend the bill in section 4 in sub-c. 2 in § 1517 in subsection 9 in the 5th and 6th lines 
(page 10, lines 7 and 8 in L.D.) by striking out the following: "from the trust's investments 
pursuant to" and inserting the following: 'regarding the fund described in' 
Amend the bill in section 4 in sub-c. 2 in §1519 in subsection 2 in the 5th line (page 
10, line 43 in L.D.) by striking out the following: "sector," and inserting the following: 
'sector or' 
Amend the bill by inserting after section 6 the following: 
'Sec. 7. Transfer; Fund for a Healthy Maine; General Fund. Notwithstanding 
any provision of law to the contrary, the State Controller shall transfer $36,604,210 from 
COMMITTEE AMENDMENT 
" 
COMMITTEE AMENDMENT ,;!f.:;;~.P. 1127, L.D. 1523 
the Fund for a Healthy Maine to the General Fund unappropriated surplus no later than 
June 30, 2023.' 
OQ?l 3 
,~... 
Amend the bill by inserting after section 7 the following: 
'Sec. 8. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Head Start 0545 
Initiative: Provides an ongoing deallocation of Fund for a Healthy Maine funds from the 
Head Start program. 
FUND FOR A HEALTHY MAINE 
All Other 
FUND FOR A HEAL THY MAINE TOTAL 
Head Start 0545 
2021-22 
$0 
2022-23 
($1,354,580) 
$0 
($1,354,580) 
Initiative: Provides an ongoing appropriation to retain state funding for the Head Start 
program. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2021-22 
$0 
$0 
2022-23 
$1,354,580 
$1,354,580 
Low-cost Drugs To Maine's Elderly 0202 
Initiative: Provides an ongoing deallocation of Fund for a Healthy Maine funds from the 
Low-cost Drugs To Maine's Elderly program. 
FUND FOR A HEALTHY MAINE 
All Other 
FUND FOR A HEALTHY MAINE TOTAL 
Low-cost Drugs To Maine's Elderly 0202 
2021-22 
$0 
$0 
2022-23 
($2,413,057) 
($2,413,057) 
Initiative: Provides an ongoing appropriation to retain state funding for the Low-cost Drugs 
To Maine's Elderly program. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Medical Care-Payments to Providers 0147 
2021-22 
$0 
$0 
2022-23 
$2,413,057 
$2,413,057 
Initiative: Provides an ongoing deallocation of Fund for a Healthy Maine funds from the 
Medical Care - Payments to Providers program. 
FUND FOR A HEALTHY MAINE 
All Other 
2021-22 
2022-23 
$0 
($30,865,455) 
COMMITTEE AMENDMENT 
B9?J 4 
COMMITTEE AMENDMENT./: to H.P. 1127, L.D. 1523 
FUND FOR A HEALTHY MAINE TOTAL 
Medical Care-Payments to Providers 0147 
$0 
($30,865,455) 
Initiative: Provides an ongoing appropriation to retain state funding for the Medical Care -
Payments to Providers program. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Purchased Social Services 0228 
2021-22 
$0 
$0 
2022-23 
$30,865,455 
$30,865,455 
Initiative: Provides an ongoing deallocation of Fund for a Healthy Maine funds from the 
Purchased Social Services program. 
FUND FOR A HEALTHY MAINE 
All Other 
FUND FORA HEALTHY MAINE TOTAL 
Purchased Social Services 0228 
2021-22 
$0 
$0 
2022-23 
($1,971,118) 
($1,971,118) 
Initiative: Provides an ongoing appropriation to retain state funding for the Purchased 
Social Services program. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
HEALTH AND IDJMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
FUND FORA HEALTHY MAINE 
DEPARTMENT TOTAL - ALL FUNDS 
2021-22 
$0 
$0 
2021-22 
2022-23 
$1,971,118 
$1,971,118 
2022-23 
$0 
$36,604,210 
$0 
($36,604,210) 
$0 
$0 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment: 
1. Adds a definition of "extraordinary receipts"; 
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2. Removes the requirement that one of the board members be an employer and 
replaces it with a requirement that the member have experience recruiting, employing, 
developing and retaining a healthy workforce; 
COMMITTEE AMENDMENT 
.J 
COMMITTEE AMENDMENT •t::o H.P. 1127, L.D. 1523 
3. Adds experience in rural oral health care to the allowable background requirements 
for one of the board members; 
4. Increases the amount of funds dedicated to the Office of the Attorney General in the 
first year of operation of the trust fund from 0.005 to 0.006 of settlement funds; 
5. Increases the amount of funds dedicated to administration in the first year of 
operation of the trust fund from 0.003 to 0.006 of settlement funds; 
6. Changes references to the Department of the Attorney General to the Office of the 
Attorney General; 
7. Adds development of the public health workforce to the allowable uses of the funds 
in the health equity and health improvement account; 
8. Adds language stating that if the Legislature enacts a biennial or supplemental 
budget for fiscal year 2022-23 in which it appropriates less than $2,400,000 from the 
General Fund to the elderly low-cost drug program established under the Maine Revised 
Statutes, Title 22, section 254-D, the Trust for a Healthy Maine Board is required to 
disburse an amount from the internal flexible account to the elderly low-cost drug program 
that when added to the General Fund appropriation to that program for that fiscal year totals 
$2,400,000; and 
9. Deallocates funding for the Head Start, Low-cost Drugs To Maine's Elderly, Medical 
Care - Payments to Providers and Purchased Social Services programs within the 
Department of Health and Human Services from the Fund for a Healthy Maine and adds 
ongoing appropriations from the General Fund to maintain these programs. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/19/22 ~ae 
LD 1523 
LR 1388(02) 
An Act To Establish the Trust for a Healthy Maine 
Fiscal Note for Bill as Amended by Committee Amendment#,{/f-ftf.~) 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Fund for a Healthy Maine 
Appropriations/ Allocations 
General Fund 
Fund for a Healthy Maine 
Transfers 
General Fund 
Fund for a Healthy Maine 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2021-22 
$0 
$0 
$0 
$0 
$0 
$0 
FY 2022-23 
$0 
$0 
$36,604,210 
($36,604,210) 
$36,604,210 
($36,604,210) 
Projections 
FY2023-24 
$36,604,210 
($50,774,084) 
$36,604,210 
($50,774,084) 
$0 
$0 
Projections 
FY2024-25 
$36,604,210 
($50,796,179) 
$36,604,210 
($50,796,179) 
$0 
$0 
This bill establishes the Trust for a Healthy Maine to receive money paid to the State pursuant to the tobacco 
settlement and from other sources to fund tobacco use prevention and control, ensure adequate resources for other 
disease prevention efforts, promote public health, plan and deliver public health and prevention programs and 
services, support accreditation of the Department of Health and Human Services, Maine Center for Disease Control 
and Prevention and support public health workforce development. The trust is governed by a 15-member board of 
trustees composed of the Director of the Maine Center for Disease Control and Prevention and 14 members appointed 
by the Governor. 
The bill includes General Fund appropriations to the Department of Health and Human Services of $36,604,210 
beginning in fiscal year 2022-23 to continue funding services in multiple DHHS accounts that were previously funded 
through Fund for a Healthy Maine Funds. The bill also includes corresponding deallocations of $36,604,210 
beginning in fiscal year 2022-23. Finally, there is a transfer of $36,604,210 from the Fund for a Healthy Maine to the 
unappropriated surplus of the General Fund by June 30, 2023. 
The bill also requires the allocation of tobacco settlement payment funds to be determined by the Trust for a Healthy 
Maine board and this new allocation process could lead to funding decreases in some areas currently funded by the 
Fund for a Healthy Maine. The full impact of these changes cannot be determined at this time and will only become 
known when future decisions of the new board are made. 
Any additional costs to the Department of Administrative and Financial Services can be absorbed within existing 
budgeted resources available to manage the current program. The Department of the Attorney General would receive 
an allocation percentage of Fund for a Healthy Maine funds beginning in fiscal year 2023-24. The impact on the 
department will depend on future settlement payments and could affect the department's ability to adequately enfom 
escrow statute in future years. 
T ,R 1388(02) - Fiscal Note - Pal!:e 2 of 2