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Amend the bill by striking out all of section 1 and inserting the following:
‘Sec. 1. 22 MRSA §1720, as enacted by PL 2005, c. 242, §1, is amended to read:
§ 1720.Nursing facility medical director reimbursement
The department shall include in its calculation of reimbursement for services provided by a nursing facility an allowance for the cost of a medical director in a base year amount not to exceed $10,000$22,000, with that amount being subject to an annual cost-of-living adjustment.’
Amend the bill in section 2 in §7863 in subsection 1 in the 3rd line (page 1, line 12 in L.D.) by striking out the following: "$2,000,000" and inserting the following: '$500,000'
Amend the bill in section 2 in §7863 in subsection 1 in the 6th line (page 1, line 15 in L.D.) by striking out the following: "$2,000,000" and inserting the following: '$500,000'
Amend the bill in section 2 in §7863 in subsection 1 in the last line (page 1, line 19 in L.D.) by striking out the following: "$2,000,000" and inserting the following: '$500,000'
Amend the bill in section 2 in §7863 in subsection 3 in the 2nd line (page 1, line 39 in L.D.) by inserting after the following: "rules" the following: 'or local ordinances'
Amend the bill by adding after section 2 the following:
‘Sec. 3. Appropriations and allocations. The following appropriations and allocations are made.
 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)
 
Nursing Facilities 0148
 
Initiative: Provides funding for nursing facilities to increase the cap on the allowance for the cost of a medical director from $10,000 to $22,000.

GENERAL FUND	2017-18	2018-19	
All Other	$26,448	$28,862	
			
GENERAL FUND TOTAL	$26,448	$28,862	

FEDERAL EXPENDITURES FUND	2017-18	2018-19	
All Other	$57,401	$62,609	
			
FEDERAL EXPENDITURES FUND TOTAL	$57,401	$62,609	

OTHER SPECIAL REVENUE FUNDS	2017-18	2018-19	
All Other	$5,352	$5,839	
			
OTHER SPECIAL REVENUE FUNDS TOTAL	$5,352	$5,839	
 
’
 
SUMMARY
This amendment changes the allowance for a nursing facility medical director from $10,000 to $22,000. The bill proposes to remove the allowance cap entirely. The amendment changes the amount above which a residential care facility would need Department of Health and Human Services approval for new construction, acquisitions and renovations to $500,000 rather than $2,000,000 as in the bill. It also clarifies that residential facilities may be reimbursed for costs to comply with changes in local ordinances in addition to federal or state laws. The amendment also adds an appropriations and allocations section.
FISCAL NOTE REQUIRED
(See attached)