An Act to Prevent Closures and Ensure Sustainability of Nursing Facilities, Private Nonmedical Institutions and Residential Care Facilities by Removing So-called Budget Neutrality
Maine Legislature, Session 131, LD 1827
Committee Amendment CA_A_S521 (Senate)

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COMMITTEE AMENDMENT " f\ " to S.P. 743, L.D. 1827, "An Act to Prevent
Closures and Ensure Sustainability of Nursing Facilities, Private Nonmedical Institutions
and Residential Care Facilities by Removing So-called Budget Neutrality"
Amend the bill by striking out the title and substituting the following:
'Resolve, to Establish the Blue Ribbon Commission to MEake Recommendations on the
Continuum of Long-term Care Options'
Amend the bill 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, the State's system of care that serves individuals who need residential
supports or long-term care is failing to meet the needs of the State's population, resulting
in hospitalized patients using inpatient beds when they need lower levels of care; and
Whereas, nursing facilities, assisted living facilities and other licensed residential
options that are intended to meet the needs of individuals who can no longer live safely at
home are unable to provide adequate access as a result of the closure of facilities and
reduced bed capacity due to financial and labor market pressures; and
Whereas, the State's laws governing residential supports have not been reviewed in
over a decade; and
Whereas, immediate review of the laws governing residential supports is necessary
in order to prevent more facility closures and bed capacity reduction; 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 necessaiy for the preservation of the public peace, health and safety; now,
therefore, be it
COMMITTEE AMENDMENT
<?,0"
•^ " to S.P. 743, L.D. 1827 C<5 •5' ^ I
COMMITTEE AMENDMENT "^ " to S.P. 743, L.D. 1827
Sec. 1. Commission established. Resolved: That the Blue Ribbon Commission
to Make Recommendations on the Continuum of Long-term Care Options, referred to in
this resolve as "the commission," is established.
Sec. 2. Commission membership. Resolved: That, notwithstanding Joint Rule
353, the commission consists of 13 members as follows:
1. One member of the Senate appointed by the President of the Senate who serves on
the Joint Standing Committee on Health and Human Services;
2. One member of the House of Representatives appointed by the Speaker of the House
of Representatives who serves on the Joint Standing Committee on Health and Human
Services;
3. Two members appointed by the President of the Senate who represent nursing
facilities;
4. One member appointed by the President of the Senate who represents assisted living
providers;
5. One member appointed by the President of the Senate who represents families with
experience with the continuum of long-term care in the State;
6. Two members appointed by the Speaker of the House of Representatives who
represent an organization that represents hospitals;
7. One member appointed by the Speaker of the House of Representatives who
represents an organization that advocates for issues regarding aging;
8. One member appointed by the Speaker of the House of Representatives who is
associated with a veterans' organization;
9. The executive director of the long-term care ombudsman program as established in
the Maine Revised Statutes, Title 22, section 5106, subsection 11-C or the executive
director's designee;
10. One member appointed by the Governor who represents the executive branch; and
11. One member appointed by the Governor who is a physician and who represents
medical directors of long-term care facilities.
Sec. 3. Chairs. Resolved: That the Senate member appointed by the President of
the Senate and the House member appointed by the Speaker of the House of
Representatives serve as chairs of the commission.
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,
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
8 made, the chairs may request authority and the Legislative Council may grant authority for
the commission to meet and conduct its business,
Sec. 5. Duties. Resolved: That the commission shall review the laws governing
residential options for individuals in need of residential supports, including but not limited
COMMITTEE AMENDMENT
^jp COMMITTEE AMENDMENT " ^ " to S.P. 743, L.D. 1827
to long-term care, assisted living facilities and other licensed residential options, and make
recommendations to the Legislature on changes to the State's laws in order to reflect the
State's changing demographics and labor market conditions and to ensure that the State has
the capacity to meet the current and future needs of individuals needing residential
supports. The commission shall review:
1. The demographics of the State and projected need for different levels of residential
supports, including but not limited to bed capacity at each level of support within a hospital
service area over the next 10 years;
2. The needs of the State's population needing residential supports and the barriers to
accessing appropriate levels of care;
3. Labor market conditions for residential supports, including projections over the next
10 years;
4. Laws governing clinical assessments and admission requirements for different levels
of residential supports;
5. Laws governing MaineCare coverage and payment;
6, Laws governing the growth of long-term care facilities, including but not limited to
certificate of need requirements and so-called budget neutrality;
7, Laws governing home care and hospice services to ensure that the State is
maximizing the use of those services; and
8. The role of technology to support the continuum of long-term care options for
elderly individuals and recommendations for the reimbursement of providers for expenses
for technology and innovation.
Sec. 6. Staff assistance. Resolved: That, notwithstanding Joint Rule 353, the
Legislative Council shall provide necessary staffing services to the commission, except that
Legislative Council staff support is not authorized when the Legislature is in regular or
special session.
Sec. 7. Report; Resolved: That, no later than November 6, 2024, the commission
shall submit a report that includes its fmdings and recommendations, including suggested
legislation, to the Joint Standing Committee on Health and Human Services. After receipt
and review of the report, thejoint standing committee of the Legislature havingjurisdiction
over health and human services matters may submit legislation relating to the subject matter
of the report to the 132nd Legislature in 2025 ,
Emergency clause. In view of the emergency cited in the preamble, this legislation
takes effect when approved.
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section
number to read consecutively.
. SUMMARY
8 This amendment replaces the bill with a resolve. The amendment establishes the Blue
Ribbon Commission to Make Recommendations on the Continuum of Long-term Care
Options to review the laws governing residential options for individuals in need of
residential supports, including but not limited to long-term care, assisted living facilities
COMMITTEE AMENDMENT
^
COMMITTEE AMENDMENT "/\ " to S.P. 743, L.D. 1827 (^ '<)2> I
and other licensed residential options, and to make recommendations to the Legislature on
changes to the State's laws in order to reflect the State's changing demographics and labor
market conditions and to ensure that the State has the capacity to meet the current and
future needs of individuals needing residential supports.
FISCAL NOTE REQUIRED
(See attached)
COMMITTEE AMENDMENT
Approved: 01/31/24 .^K?^
LD 1827 LR 945(02)
An Act to Prevent Closures and Ensure Sustain ability of Nursing Facilities, Private Nonmedical
Institutions and Residential Care Facilities by Removing So-called Budget Neutrality
Fiscal Note for Bill as Amended by Committee Amendment '^"/ <^- 57/1
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 $700 in fiscal year 2023-24 and $950 in fiscal year
2024-25. The Legislature's budget for the 2024-2025 biennium includes $14,500 in each of fiscal years 2023-24 and
2024-25 for the costs of legislative studies, as well as $38,909 of balances carried over from prior years for this
purpose, Whether these amounts are 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.
LR0945(02) - Fiscal Note - Page 1 of 1