Resolve, to Improve Long-term Care for the People of Maine
Maine Legislature, Session 131, LD 1972
Committee: Health and Human Services
Sponsors: JACKSON

Legislative Document
No. 1972
S.P. 806
In Senate, May 18, 2023
Resolve, to Improve Long-term Care for the People of Maine
(EMERGENCY)
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by President JACKSON of Aroostook.
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 legislation requires changes to certain MaineCare reimbursement rates 
and requires these changes to take effect July 1, 2023; 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 rebase 
reimbursement rates.  Resolved:  That, notwithstanding any provision of law to the 
contrary, the Department of Health and Human Services shall rebase reimbursement rates, 
effective July 1, 2023, to reflect the increased costs experienced by nursing facilities, 
including, but not limited to, the cost of labor.
Sec. 2. Department of Health and Human Services to establish enhanced 
reimbursement rate. Resolved:  That the Department of Health and Human Services 
shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67, 
Principles of Reimbursement for Nursing Facilities, Section 22.3.3.4 to provide that, 
effective July 1, 2023, the upper limit on the base year case mix and regionally adjusted 
cost per day is the median multiplied by 130%.
Sec. 3.  Department of Health and Human Services to amend its rules 
regarding occupancy adjustments for nursing facilities.  Resolved: That the 
Department of Health and Human Services shall amend its rules in Chapter 101: MaineCare 
Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing 
Facilities to provide, for the state fiscal year beginning July 1, 2023, that the reduction in 
allowable cost per day in the fixed costs component based on minimal occupancy standards 
applies only for an annual level of occupancy less than 50%.
Sec. 4.  Department of Health and Human Services to amend its rules 
regarding occupancy adjustments for certain residential care facilities.  
Resolved: That the Department of Health and Human Services shall amend its rules in 
Chapter 101: MaineCare Benefits Manual, Chapter III, Section 97, Appendix C, Principles 
of Reimbursement for Medical and Remedial Service Facilities and Chapter 115: Principles 
of Reimbursement for Residential Care Facilities - Room and Board Costs to provide, for 
the state fiscal year beginning July 1, 2023, that the reduction in allowable cost per day in 
the fixed costs component based on minimal occupancy standards applies only for an 
annual level of occupancy less than 50%.
Sec. 5.  Department of Health and Human Services to establish an add-on 
rate for nursing facilities.  Resolved:  That the Department of Health and Human 
Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, 
Section 67, Principles of Reimbursement for Nursing Facilities to establish, beginning July 
1, 2023, an add-on rate of $24.59 per resident day to be added to the direct care rate.  The 
add-on rate provided in this section is in effect until rebasing occurs under the Maine 
Revised Statutes, Title 22, section 1708, subsection 3, paragraph F and all allowable costs 
are included.
Sec. 6.  Department of Health and Human Services to establish an add-on 
rate for certain residential care facilities.  Resolved:  That the Department of Health 
and Human Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, 
Chapter III, Section 97, Appendix C, Principles of Reimbursement for Medical and 
Remedial Service Facilities and Chapter 115: Principles of Reimbursement for Residential 
Care Facilities - Room and Board Costs to establish, beginning July 1, 2023, an add-on rate 
of $36.16 per resident day to be added to the direct care rate.  The add-on rate provided in 
this section is in effect until rebasing occurs and all allowable costs are included.
Sec. 7.  Department of Health and Human Services to disburse funding for 
add-on rates.  Resolved: That the Department of Health and Human Services shall fully 
fund the add-on rates required by sections 5 and 6 from existing resources available due to 
low occupancy of long-term care facilities that resulted in the department's not fully using 
the total funds appropriated and allocated for long-term care facilities.  If existing resources 
are not sufficient to fully fund the add-on rates required by sections 5 and 6, the department 
shall complete a rebasing before the next statutorily required rebasing.
Sec. 8.  Appropriations and allocations.  Resolved:  That the following 
appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers 0147
Initiative: Provides ongoing funding for a high MaineCare utilization add-on payment to 
private nonmedical institutions that care for residents who are older or disabled, or 
PNMI-Cs.
GENERAL FUND
2023-24
2024-25
All Other
$2,427,500
$2,427,500
__________
__________
GENERAL FUND TOTAL
$2,427,500
$2,427,500
OTHER SPECIAL REVENUE FUNDS
2023-24
2024-25
All Other
$319,149
$319,149
__________
__________
OTHER SPECIAL REVENUE FUNDS TOTAL
$319,149
$319,149
Emergency clause.  In view of the emergency cited in the preamble, this legislation 
takes effect when approved.
SUMMARY
This resolve directs the Department of Health and Human Services to amend its rules 
to provide:
1. For the state fiscal year beginning July 1, 2023, that the reduction in allowable cost 
for low occupancy applies only for an annual level of occupancy less than 50% in nursing 
facilities and so-called Appendix C private nonmedical institutions;
2. Beginning July 1, 2023, add-on rates to the direct care rates for nursing homes and 
so-called Appendix C private nonmedical institutions; and
3. Effective July 1, 2023, the upper limit on the base year case mix and regionally 
adjusted cost per day is the median multiplied by 130%.
The resolve requires the Department of Health and Human Services to rebase 
reimbursement rates, effective July 1, 2023, to reflect the increased costs experienced by 
nursing facilities.
The resolve also provides ongoing funding for a high MaineCare utilization add-on 
payment to private nonmedical institutions that care for residents who are older or disabled, 
or PNMI-Cs.