Resolve, To Implement the Recommendations of the Commission To Continue the Study of Long-term Care Facilities

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 people of the State need and deserve a variety of well-planned and financially stable long-term care services in home-based and community-based care settings and in nursing facilities in their communities; and

Whereas,  recent closures of nursing facilities, in particular in rural and underserved areas of the State, have had a significant impact on Maine families and communities; and

Whereas,  in order to provide high-quality care to Maine's elderly and disabled persons and to maintain access to services across the State, the Legislature must take immediate action to continue a thoughtful and thorough planning process; 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. Amendment of Principles of Reimbursement for Nursing Facilities. Resolved: That the Department of Health and Human Services shall amend Rule Chapter 101, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities as follows.

1. Occupancy adjustment. The rule must be amended to decrease the occupancy percentage threshold required for a nursing facility with more than 60 beds from 90% to 80% and for a nursing facility with 60 beds or fewer from 85% to 75%.

2. Continuing education for direct care staff. The rule must be amended so that the cost of continuing education for direct care staff is included as a direct care cost component rather than a routine cost component.

3. Crossover payments. The rule must be amended to restore crossover payments to nursing facilities related to the nondual Qualified Medicare Beneficiary program population of the Medicare Savings Program for whom coverage was eliminated in Public Law 2013, chapter 368.

4. Critical access nursing facility designation. The rule must be amended to create a critical access nursing facility designation using criteria that are sensitive to the unique access challenges in remote areas of the State. The rule must also be amended to provide that a critical access nursing facility designation qualifies as an allowable exception to MaineCare budget neutrality. The department shall seek the approval of the federal Department of Health and Human Services, Centers for Medicare and Medicaid Services for the new designation and implement it by April 15, 2015.

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 Rule Chapter 101, MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities to:

1. Decrease the occupancy percentage threshold required for a nursing facility with more than 60 beds from 90% to 80% and for a nursing facility with 60 beds or fewer from 85% to 75%;

2. Provide that the cost of continuing education for direct care staff is included as a direct care cost component rather than a routine cost component;

3. Restore crossover payments to nursing facilities related to the nondual Qualified Medicare Beneficiary program population of the Medicare Savings Program for whom coverage was eliminated in Public Law 2013, chapter 368; and

4. Create a critical access nursing facility designation using criteria that are sensitive to the unique access challenges in remote areas of the State and provide that a critical access nursing facility designation qualifies as an allowable exception to MaineCare budget neutrality.