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Page 1 - 132LR2932(03)
STATE OF MAINE
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IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-SIX
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S.P. 824 - L.D. 2131
Resolve, Regarding the Nursing Facility Reform Transition Fund
Emergency preamble. Whereas, acts and resolves of the Legislature do not
become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, since 2014, 29 nursing facilities have closed across the State, and these
closures have been driven in large part by MaineCare reimbursement rates and a workforce
crisis that threatens the stability of long-term care services; and
Whereas, Maine has the oldest population in the nation, and the demand for long-
term care services continues to rise even as access to such care rapidly declines, placing
vulnerable older and disabled adults at immediate risk; and
Whereas, severe workforce shortages within nursing facilities have created ongoing
instability in the sector, and timely adjustments to MaineCare reimbursement rates for
nursing facilities are essential to support the recruitment and retention of qualified staff
necessary to ensure the safety and well-being of residents; and
Whereas, the Legislature established the Nursing Facility Reform Transition Fund to
assist facilities in moving toward fully implemented MaineCare rate reforms by calendar
year 2028, and all facilities should receive cost-of-living increases in their reimbursement
rates during this transition; and
Whereas, unappropriated General Fund surplus amounts were transferred to the
Department of Health and Human Services, Nursing Facilities program, Other Special
Revenue Funds account, including by Part SSS of Public Law 2023, chapter 643, to provide
the financial support necessary for facilities to implement new nursing facility rates
beginning January 1, 2025; 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. Department of Health and Human Services to amend its rules to
provide cost-of-living adjustments. Resolved: That, as soon as practicable, the
APPROVED
APRIL 13, 2026
BY GOVERNOR
CHAPTER
157
RESOLVES
Page 2 - 132LR2932(03)
Department of Health and Human Services shall amend its rule Chapter 101: MaineCare
Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing
Facilities, to remove the prohibition on adjusting the guardrails for inflation and require
that the guardrails used in the 3-year transition period to the new reimbursement
methodology are adjusted for inflation. The cost-of-living adjustment applied to rates for
certain MaineCare services under Public Law 2025, chapter 388, Part GGG on January 1,
2026 must be applied to the guardrails and retroactively applied to January 1, 2026. The
guardrails must be adjusted for any subsequently implemented cost-of-living adjustment
until the end of the rate reform transition period or until guardrails are no longer applied,
whichever is later.
Sec. 2. Nursing Facility Reform Transition Fund stakeholder group.
Resolved: That the Department of Health and Human Services shall convene a
stakeholder group to examine the use of the Nursing Facility Reform Transition Fund. The
stakeholder group must include, but is not limited to, representatives from the department,
representatives of a statewide organization that represents nursing facilities, operators of
nursing facilities and the long-term care ombudsman described under the Maine Revised
Statutes, Title 22, section 5107-A. The department shall ensure that meetings are open to
the public and interested parties are provided with notice of meetings. The stakeholder
group shall examine the following issues related to the Nursing Facility Reform Transition
Fund established in Public Law 2023, chapter 643, Part SSS:
1. The uses for funding that has been spent from the fund;
2. The plan for the expenditure of the remaining funds in the fund;
3. The planned cycle for rebasing reimbursement rates; and
4. The use of the fund to pay for cost-of-living increases for staff pay compared to the
use of other funding sources for other cost-of-living increases for direct care services.
The stakeholder group shall submit a report, no later than January 15, 2027, to the joint
standing committee of the Legislature having jurisdiction over health and human services
matters. The committee is authorized to report out legislation related to the report to the
133rd Legislature in 2027.
Emergency clause. In view of the emergency cited in the preamble, this legislation
takes effect when approved.