128th MAINE LEGISLATURE
		LD 1466		LR 1387(06)
	An Act To Address Severe and Ongoing Shortfalls in the Funding of Direct Care Workers in Long-term Care Settings and To Establish the Commission To Study Long-term Care Workforce Issues
	Fiscal Note for House Amendment " " to Committee Amendment "A"
	Sponsor: Rep. Hymanson of York
	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		($14,852,104)	($11,661,404)	($11,663,216)	($11,661,404)
Appropriations/Allocations
	General Fund		($14,852,104)	($11,661,404)	($11,663,216)	($11,661,404)
	Federal Expenditures Fund		$2,997,129	$11,661,404	$11,663,216	$11,661,404
	Other Special Revenue Funds		($608,681)	$0	$0	$0
Revenue
	Federal Expenditures Fund		$2,997,129	$11,661,404	$11,663,216	$11,661,404
	Other Special Revenue Funds		($608,681)	$0	$0	$0
Fiscal Detail and Notes
	The amendment reduces the General Fund appropriations to the Department of Health and Human Services by $8,014,461 in fiscal year 2017-18 and $11,661,404 in fiscal year 2018-19 due to a requirement that the rate increases in this bill are limited, as necessary, to ensure that aggregate payments for nursing facility services do not exceed the upper payment limit established in federal regulations, 42 CFR. §447.272. If the rate increase does not exceed the Upper Payment Limit (UPL), the payments will receive the full federal match. The original bill assumed that a large portion of the rate increase for Nursing Facilities would be funded 100% by General Fund dollars, as it was expected the increase would go well above the UPL. Federal Expenditures Fund allocations are increased by $8,014,461 in fiscal year 2017-18 and $11,661,404 in fiscal year 2018-19 for the increased FMAP match. Additionally, removing the emergency preamble and clause from the bill reduces the General Fund appropriations to the Department of Health and Human Services by $6,833,643 in fiscal year 2017-18. Federal Expenditures Fund allocations and Other Special Revenue Funds allocations are also reduced due to the new effective date.