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Amend the bill by striking out everything after the enacting clause and before the emergency clause and inserting the following:
‘Sec. 1.  PL 2017, c. 460, Pt. B, §3, sub-§1  is amended to read:
1. Special wage allowance for fiscal year 2018-19 and subsequent fiscal years. For the state fiscal year ending June 30, 2019, a special supplemental allowance must be made to provide for increases in wages and wage-related benefits in both the direct care cost component and routine care cost component as follows. An amount equal to 10% of allowable wages and associated benefits and taxes as reported on each facility's as-filed cost report for its fiscal year ending in calendar year 2016 must be added to the cost per resident day in calculating each facility's prospective rate, notwithstanding any otherwise applicable caps or limits on reimbursement. This supplemental allowance must also be allowed and paid at final audit to the full extent that it does not cause reimbursement to exceed the facility's allowable costs in that fiscal year. The supplemental allowance for the state fiscal year ending June 30, 2019 provided pursuant to this subsection must continue in each successive fiscal year until the fiscal year in which the rebasing under the Maine Revised Statutes, Title 22, section 1708, subsection 3, paragraph F is based on 2019 as-filed cost report data and has incorporated the costs of wages and allowable benefits and taxes of a facility.
Sec. 2.  PL 2017, c. 460, Pt. B, §3, sub-§§1-A and 1-B  are enacted to read:
1-A. Additional special wage allowance for fiscal year 2019-20 and subsequent fiscal years.   For the state fiscal year ending June 30, 2020, an additional special supplemental allowance must be made to provide for increases in contract labor, wages and allowable benefits and taxes in both the direct care component and routine care component as follows. An amount equal to 10% of allowable contract labor, wages and allowable benefits and taxes as reported on each facility's as-filed cost report for its fiscal year ending in calendar year 2017 must be added to the cost per resident day in calculating each facility's prospective rate, notwithstanding any otherwise applicable caps or limits on reimbursement to the contrary. This additional supplemental allowance must be allowed and paid at final audit to the full extent that it does not cause reimbursement to exceed the facility's allowable costs in that fiscal year. The additional supplemental allowance for fiscal years ending in calendar year 2020 must be paid in each successive state fiscal year until the fiscal year in which a rebasing under the Maine Revised Statutes, Title 22, section 1708, subsection 3, paragraph F is based on 2020 as-filed cost report data and has incorporated the costs of contract labor, wages and allowable benefits and taxes of a facility. For the purposes of this subsection, "contract labor" includes nursing, housekeeping, dietary, laundry and related services.
1-B. No limitation.   The increases in reimbursement rates that result from implementation of this Act are not limited to only wage and wage-related costs.
Sec. 3.  PL 2017, c. 460, Pt. B, §4, sub-§1  is amended to read:
1. Special wage allowance for fiscal year 2018-19 and subsequent fiscal years. For the state fiscal year ending June 30, 2019, a special supplemental allowance must be made to provide for increases in wages and wage-related benefits in the direct care, personal care services and routine cost components as follows. An amount equal to 10% of wages and associated benefits and taxes as reported on each facility's as-filed cost report for its fiscal year ending in calendar year 2016 must be added to the cost per resident day in calculating each facility's prospective rate, notwithstanding any otherwise applicable caps or limits on reimbursement. This supplemental allowance must also be allowed and paid at final audit to the full extent that it does not cause reimbursement to exceed the facility's allowable costs in each component that is cost settled in that fiscal year. The supplemental allowance for the state fiscal year ending in June 30, 2019 provided pursuant to this subsection must continue in each successive fiscal year until the fiscal year in which the rebased rates have incorporated the costs of wages and allowable benefits and taxes that were reported on each facility's as-filed cost report for its fiscal year ending in calendar year 2019.
Sec. 4.  PL 2017, c. 460, Pt. B, §4, sub-§§1-A and 1-B  are enacted to read:
1-A. Additional special wage allowance for fiscal year 2019-20 and subsequent fiscal years.   For the state fiscal year ending June 30, 2020, an additional special supplemental allowance must be made to provide for increases in contract labor, wages and allowable benefits and taxes in the direct care, personal care services and routine care cost components as follows. An amount equal to 10% of allowable contract labor, wages and allowable benefits and taxes as reported on each facility's as-filed cost report for its fiscal year ending in calendar year 2017 must be added to the cost per resident day in calculating each facility's prospective rate, notwithstanding any otherwise applicable caps or limits on reimbursement to the contrary. The additional supplemental allowance must be allowed and paid at final audit to the full extent that it does not cause reimbursement to exceed the facility's allowable costs in that fiscal year. The supplemental allowance must be paid in each fiscal year after state fiscal year 2019-20 until the fiscal year in which rates have been rebased using 2020 or a later calendar year as a base year and the rebased rates have incorporated the costs of contract labor, wages and allowable benefits and taxes that were reported on each facility's as-filed cost report for its fiscal year ending in calendar year 2020. For purposes of this subsection, "contract labor" includes nursing, housekeeping, dietary, laundry and related services.
1-B. No limitation.   The increases in reimbursement rates that result from implementation of this Act are not limited to only wage and wage-related costs.
Sec. 5. Appropriations and allocations. The following appropriations and allocations are made.
 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
 
Medical Care - Payments to Providers 0147
 
Initiative: Provides appropriations and allocations for residential care facility wage allowances.

GENERAL FUND	2019-20	2020-21	
All Other	$4,105,583	$4,130,636	
			
GENERAL FUND TOTAL	$4,105,583	$4,130,636	

FEDERAL EXPENDITURES FUND	2019-20	2020-21	
All Other	$8,904,769	$8,879,717	
			
FEDERAL EXPENDITURES FUND TOTAL	$8,904,769	$8,879,717	

OTHER SPECIAL REVENUE FUNDS	2019-20	2020-21	
All Other	$907,699	$907,699	
			
OTHER SPECIAL REVENUE FUNDS TOTAL	$907,699	$907,699	

Nursing Facilities 0148
 
Initiative: Provides appropriations and allocations for nursing facility wage allowances.

GENERAL FUND	2019-20	2020-21	
All Other	$10,967,325	$7,399,924	
			
GENERAL FUND TOTAL	$10,967,325	$7,399,924	

FEDERAL EXPENDITURES FUND	2019-20	2020-21	
All Other	$23,374,065	$15,632,951	
			
FEDERAL EXPENDITURES FUND TOTAL	$23,374,065	$15,632,951	

OTHER SPECIAL REVENUE FUNDS	2019-20	2020-21	
All Other	$2,192,004	$1,470,183	
			
OTHER SPECIAL REVENUE FUNDS TOTAL	$2,192,004	$1,470,183	

PNMI Room and Board Z009
 
Initiative: Provides appropriations and allocations for residential care facility wage allowances.

GENERAL FUND	2019-20	2020-21	
All Other	$1,210,265	$1,210,265	
			
GENERAL FUND TOTAL	$1,210,265	$1,210,265	

HEALTH AND HUMAN SERVICES, DEPARTMENT OF			
DEPARTMENT TOTALS	2019-20	2020-21	
			
GENERAL FUND	$16,283,173	$12,740,825	
FEDERAL EXPENDITURES FUND	$32,278,834	$24,512,668	
OTHER SPECIAL REVENUE FUNDS	$3,099,703	$2,377,882	
			
DEPARTMENT TOTAL - ALL FUNDS	$51,661,710	$39,631,375	
 
’
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section number to read consecutively.
 
SUMMARY
This amendment removes the sections of the bill that require additional cost-of-living adjustments to nursing facilities and residential care facilities and supplemental allowances for facilities with a high proportion of MaineCare residents and facilities with specialty beds. It retains the requirements for the 10% one-time supplemental payment provided in Public Law 2017, chapter 460, Part B to nursing facilities and residential care facilities to continue in successive years until rebasing incorporates the increase, but the amendment removes the retroactive requirement to include contract labor. It retains the requirement to grant an additional 10% increase that is carried forward until rebasing incorporates the increase, but it removes the language relating to requiring increases to go to routine care cost components of the rates. It removes the specific prohibition upon the Department of Health and Human Services to require a nursing facility or residential care facility to demonstrate how increased reimbursement is applied to wages and benefits to direct care workers but specifies that the increased reimbursement is not limited to only wages and wage-related costs. It removes the retroactivity section of the bill but retains the emergency provision of the bill. It adds an appropriations and allocations section.
FISCAL NOTE REQUIRED
(See attached)