Resolve, Regarding
Maine Legislature, Session 132, LD 0979
Committee Amendment CA_A_H743 (House)

FmST SPECIAL SESSION
T <<^-"
): Assist
COMMITTEE AMENDMENT <(/^" to H.P. 639, L.D. 979, "Resolve, Regarding
Legislative Review of Chapter 113: Assisted Housing Programs Licensing Rule, a Late-
filed Major Substantive Rule of the Department of Health and Human Services"
Amend the resolve by striking out everything after the emergency preamble and before
the emergency clause and inserting the followmg;
'See. 1. Adoption. Resolved: That final adoption of Chapter 113; Assisted
Housing Programs Licensing Rule, a provisionally adopted major substantive rule of the
Department of Health and Human Services that has been submitted to the Legislature for
review pursuant to the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A outside
the legislative rule acceptance period, is authorized only if:
1. In the rule in Part B: Residential Care Facilities, in Section 7,A, a new Section
7.A.3 is added that requires a facility s administrator to ensure that the following data is
submitted to the division of licensing and certification, no less frequently than on a
quarterly basis, beginning no later than 60 days after the written notice by the Department
of Health and Human Services that a reporting system has been developed and is ready for
facility data submission:
A, The facility's daily number of staff for each shift who were present and working
each day providing du-ect care to residents during each shift;
B. The facility's number of staff who are working as temporary staff and were hired
through a temporary nurse agency or other temporary staffing agency or Internet-based
system, and the name of the agency;
C. The facility's staff timover rate for each quarter; and
D. The facility's resident census for each day.
The Department of Health and Human Services shall submit an annual report, beginning
January 2,2027, to the joint standing committee of the Legislature having jurisdiction over
health and human services matters, with the monthly average of data collected under
COMMITTEE AMENDMENT
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COMMITTEE AMENDMENT "M " to H,P. 639, L.D. 979
COMMITTEE AMENDMENT "H'
Section 7.A, The report due January 2, 2027 must include a method to provide the data to
the public on the department's publicly accessible website;
2. The requirement in the rule in Part B : Residential Care Facilities for mmimum direct
residential care staff to occupied bed ratios in Section 14.B.1 that would be required after
one year and 2 years of fmal adoption of the rule is removed and only the current ratios
remain; and
3. The requirement in the rule in Part B: Residential Care Facilities for staffmg
requirements for memory care units in Section 17.1.2 and Section 17.1.3 that would be
required after one year and 2 years of fmal adoption of the rule is removed.
Sec. 2. Stakeholder group to examine residential facility staffing. Resolved:
That the long-term care ombudsman under the Maine Revised Statutes, Title 22, section
5107-A shall convene a stakeholder group to examine residential care facility staffing
issues, referred to in this resolve as "the stakeholder group."
1. Mfembership. The stakeholder group must include, but is not limited to, the
followmg;
A. A representative from the office of aging and disability services within the
Department of Health and Human Services;
B. A representative from the division of licensing and certification within the
Department of Health and Human Services;
C. A representative of a statewide organization representmg residential care facilities;
D. A representative of a residential care facility with a memoiy care unit;
E. A representative of a residential care facility without a memoiy care unit;
F. A representative of an assisted living provider;
G. A representative from Legal Services for Maine Elders;
H, A representative from a statewide association advocating on behalf of issues related
to Alzheimer's disease;
I. A representative from a statewide association advocating on behalf of the elderly;
J, A representative who has a family with a member in residential care;
K. Two employees with direct care experience working in residential care facilities
0 who are not m facility management; and
L. Additional representatives from the long-term care ombudsman program within the
Department of Health and Human Services,
2. Duties. The stakeholder group shall examine issues of staffing in residential care
facilities as governed by Department of Health and Human Services rule Chapter 113;
Assisted Housing Programs Licensing Rule, The stakeholder group shall:
A. Examine appropriate staffing levels, including at different times of the day;
B. Examine staffing ratios required to ensure residential care at different times of the
day;
C. Examine staffing levels and ratios sufficient to meet resident needs, includmg
medical and other needs;
COMMITTEE AMENDMENT
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COMMITTEE AMENDMENT "H " to H,P, 639, L,D, 979
D. Ensure that there is objective mformation about the unpact of staffing ratios on
access to care, includmg reimbursement and financial information; and
E. Examme the connections between facility reimbursement and staffing and the
transparency of those connections.
3. Outside expertise; data. The stakeholder group may consult with national experts
withm existing resources. The stakeholder group shall consider the following information;
A, Survey and certification results from the United States Department of Health and
Human Services, Centers for Medicare and Medicaid Services and the division of
licensing and certification withm the Department of Health and Human Services;
B, The minimum data set tool from the United States Department of Health and Human
Services, Centers for Medicare and Medicaid Services used by long-term care
providers;
C. Current reported staffmg levels, including quarterly reporting on direct care staffing,
submitted by providers to the Department of Health and Human Services;
D. Surveys of direct care staff;
E. Surveys submitted by residential care providers;
F. Complaints received by the long-term care ombudsman program within the
Department of Health and Human Services and by the Department of Health and
Human Services;
G, Steps taken by facilities to address workforce shortages;
H, Projected workforce needs and staffing availability; and
I. Current reimbursement rates for staffing,
4. Meeting and reports. The stakeholder group shall begm meetmg no later than
September 30, 2025. The stakeholder group shall submit a preliminary report no later than
January 30, 2026 and a final report no later than January 2, 2027 to the joint standing
committee of the Legislature having jurisdiction over health and human services matters,
The committee is authorized to report out legislation related to the final report to the 133rd
Legislature in 2027.'
Amend the resolve by relettering or renumbering any nonconsecutive Part letter or
section number to read consecutively,
SUMMARY
This amendment replaces the resolve and authorizes the Department of Health and
Human Services to adopt its major substantive mle Chapter 113: Assisted Housing
Programs Licensing Rule, as long as the staffing increases for residential care facilities and
memory care units are removed and the current staffing levels are retained, It requires the
6 rule to include provisions for staffing data to be reported at least quarterly to the department
from residential care facilities upon notification by the department that a reporting system
has been developed and is ready for data submission, The department shall provide an
annual report to the joint standing committee of the Legislature having jurisdiction over
health and human services matters with monthly averages for the data. The amendment
also requires the long-term care ombudsman program within the department to convene a
COMMITTEE AMENDMENT
^
COMMITTEE AMENDMENT "M" to H.P, 639, L.D, 979
stakeholder group to examine staffmg issues at residential care facilities and report its
findings in a preliminary and final report to the joint standing committee of the Legislature
having jurisdiction over health and human services matters.
FISCAL NOTE REQUIRED
(See attached)
Page4-132LR2424(02)
COMMITTEE AMENDMENT
Approved; 06/04/25 t-KL- .
LD 979 LR 2424(02)
Resolve, Regarding Legislative Review of Chapter 113: Assisted Housing Programs Licensing Rule, a
Late-filed Major Substantive Rule of the Department of Health and Human Services
Fiscal Note for Bill as Amended by Committee Amendment 7f' ( ^[-^
Committee: Health and Human Services
Fiscal Note Required: Yes
Fiscal Note
Minor cost increase - General Fund
Fiscal Detail and Notes
Any additional costs to the Department of Health and Human Services from the provisions of this bill are expected to
be minor and can be absorbed within existing budgeted resources.
LR2424(02) - Fiscal Note - Page 1 of 1