128th MAINE LEGISLATURE
		LD 517		LR 975(04)
	An Act To Amend Principles of Reimbursement for Nursing Facilities and for Residential Care Facilities
	Fiscal Note for Senate Amendment " " to Committee Amendment "A"
	Sponsor: Sen. Hamper of Oxford
	Fiscal Note Required: Yes
Fiscal Note
			FY 2017-18	FY 2018-19	Projections  FY 2019-20	Projections  FY 2020-21
Net Cost (Savings)
	General Fund		($26,448)	($28,862)	($28,862)	($28,862)
Appropriations/Allocations
	General Fund		($26,448)	($28,862)	($28,862)	($28,862)
	Federal Expenditures Fund		($57,401)	($62,609)	($62,609)	($62,609)
	Other Special Revenue Funds		($5,352)	($5,839)	($5,839)	($5,839)
Revenue
	Federal Expenditures Fund		($57,401)	($62,609)	($62,609)	($62,609)
	Other Special Revenue Funds		($5,352)	($5,839)	($5,839)	($5,839)
Fiscal Detail and Notes
	This amendment removes section 1 of the bill which allowed for nursing facilites to increase the cap on the cost of a medical director from $10,000 to $22,000. Removing this section eliminates all appropriations and allocations from the bill. As amended, this bill would still require the Department of Health and Human Services to permit capital expenditures by residential care facilities (RCF) that are less than $500,000 without prior approval and to provide an extraordinary circumstance allowance in permitted reimbursement to RCF's. As outlined in the original fiscal note, the costs incurred by an RCF to comply with federal or state laws, regulations and rules shall be considered reasonable and necessary costs. These additional changes to the Residential Care Facilities will increase costs that will largely be necessitated by decisions of the RCFs that cannot be projected by the department. Since new construction, acquisitions, and renovations apply to room and board and not direct care, which cannot be reimbursed with federal funds per 42 CFR 440.182, it is also expected that these costs would be reimbursed entirely by the General Fund.