An Act to Preserve and
Maine Legislature, Session 132, LD 2131
Committee Amendment CA_A_S598 (Senate)

COMMITTEE AMENDMENT H^ " to S.P. 824, L.D. 2131, "An Act to Preserve and
Improve Access to Nursing Facility Services in the State"
Amend the bill by striking out the title and substituting the following:
'Resolve, Regarding the Nursing Facility Reform Transition Fund'
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, since 2014, 29 nursing facilities have closed across the State, and these
closures have been driven in large part by MaineCare reimbursement rates and a workforce
crisis that threatens the stability of long-term care services; and
Whereas, Maine has the oldest population in the nation, and the demand for long-
term care services continues to rise even as access to such care rapidly declines, placing
vulnerable older and disabled adults at immediate risk; and
Whereas, severe workforce shortages within nursing facilities have created ongoing
instability in the sector, and timely adjustments to MaineCare reimbursement rates for
nursing facilities are essential to support the recruitment and retention of qualified staff
necessary to ensure the safety and well-being of residents; and
Wh ereas, the Legislature established the Nursing Facility Reform Transition Fund to
assist facilities m moving toward fully implemented MaineCare rate reforms by calendar
year 2028, and all facilities should receive cost-of-living increases in their reimbursement
rates during this transition; and
Whereas, unappropriated General Fund surplus amounts were transferred to the
Department of Health and Human Services, Nursing Facilities program, Other Special
Revenue Funds account, including by Part SSS of Public Law 2023, chapter 643, to provide
the financial support necessary for facilities to implement new nursing facility rates
beguming January 1, 2025; and
COMMITTEE AMENDMENT
•y4 "to8.P.824,L.D,213l(S'-'
COMMITTEE AMENDMENT "/( " lo 8.P. 824, L.D, 2131
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 amend its rules to
provide cost-of-Uving adjustments. Resolved; That, as soon as practicable, the
Department of Health and Human Services shall amend its rule Chapter 101; MaineCare
Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing
Facilities, to remove the prohibition on adjusting the guardrails for inflation and require
that the guardrails used in the 3-year transition period to the new reimbursement
methodology are adjusted for inflation. The cost-of-living adjustment applied to rates for
certain MaineCare services under Public Law 2025, chapter 388, Part GGG on January 1,
2026 must be applied to the guardrails and retroactively applied to January 1,2026. The
guardrails must be adjusted for any subsequently implemented cost-of-living adjustment
until the end of the rate reform transition period or until guardrails are no longer applied,
whichever is later.
Sec. 2. Nursing Facility Reform Transition Fund stakeholder group.
Resolved: That the Department of Health and Human Services shall convene a
stakeholder group to examine the use of the Nursing Facility Reform Transition Fund. The
stakeholder group must include, but is not limited to, representatives from the department,
representatives of a statewide organization that represents nursing facilities, operators of
nursing facilities and the long-term care ombudsman described under the Maine Revised
Statutes, Title 22, section 5107-A. The department shall ensure that meetings are open to
the public and interested parties are provided with notice of meetings. The stakeholder
group shall examine the following issues related to the Nursing Facility Reform Transition
Fund established in Public Law 2023, chapter 643, Part SSS:
1. The uses for funding that has been spent from the fund;
2. The plan for the expendihire of the remaining funds in the fund;
3. The planned cycle for rebasing reimbursement rates; and
4. The use of the fund to pay for cost-of-living increases for staff pay compared to the
use of other funding sources for other cost-of-living increases for direct care services.
The stakeholder group shall submit a report, no later than January 15,2027, 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 report to the
133rd Legislature in 2027.
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
This amendment replaces the bill, which is a concept draft, with a resolve. It requires
the Department of Health and Human Services to amend its rule Chapter 101: MaineCare
Page2-132LR2932(02)
COMMITTEE AMENDMENT
COMMm-EE AMENDMENT"/} "toS.P, 824, L.D. 2131 l^'^
Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing
Facilities, as soon as practicable to require that the guardrails that are used in the 3-year
transition to new reimbursement rates be adjusted for inflation, The amendment also
requires the Department of Health and Human Services to convene a stakeholder group to
examine issues related to the Nursing Facility Reform Transition Fund. The stakeholder
group must submit a report, no later than January 15,2027, 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 report. The amendment also
adds an emergency preamble and emergency clause,
FISCAL NOTE REQUIRED
(See attached)
COMMITTEE AMENDMENT
Revised; 03/25/26 1-KI^
LD 2131 LR 2932(02)
An Act to Preserve and Improve Access to Nursing Facility Services in the State
Fiscal Note for Bill as Amended by Committee Amendment '^'/
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 to adopt the changes in this bill are expected to
be minor and can be absorbed within existing budgeted resources.
LR2932(02) - Fiscal Note - Page 1 of 1