Code of Maine Rules
10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL
Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL)
Chapter II - Specific Policies By Service
Section 144-101-II-2 - Adult Family Care Services
Subsection 144-101-II-2.01 - DEFINITIONS

2.01-1 Activities of Daily Living (ADLs) include bed mobility, transfer, locomotion, dressing, eating, toilet use, bathing, personal hygiene, and walking.

2.01-2 Adult Family Care Home (AFCH ) means a residential style home for eight or fewer residents, which is licensed by the Department pursuant to the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level III Residential Care Facilities or Assisted Housing Programs: Level IV Residential Care Facilities and is primarily engaged in providing services to the elderly.

2.01-3 Adult Family Care (AFC) Services include personal care services such as: assistance with activities of daily living and instrumental activities of daily living, personal supervision, protection from environmental hazards, diversional and motivational activities, dietary services and care management, as further defined in the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level III Residential Care Facilities or Assisted Housing Programs: Level IV Residential Care Facilities.

2.01-4 Cueing means any spoken instruction or physical guidance that serves as a signal to do a specified activity. Cueing is typically used when caring for individuals who are cognitively impaired.

2.01-5 Department means the Maine Department of Health and Human Services (DHHS).

2.01-6 Individual Service Plan (ISP) means a written service plan developed with a resident based upon an assessment of the resident's needs and abilities, and including (as appropriate) habilitative or rehabilitative goals and objectives, program goals and objectives, and the resources and methods necessary to implement the plan.

2.01-7 Instrumental Activities of Daily Living (IADL) include main meal preparation; routine housework; grocery shopping and storage of purchased groceries; and laundry either within the residence or at an outside laundry facility.

2.01-8 MaineCare Weight is the resource group weight applied to each resource group to calculate the resource-adjusted price for each member residing in the adult family care home.

2.01-9 Member is an individual who is deemed eligible for MaineCare services.

2.01-10 Minimum Data Set- Assisted Living Services (MDS-ALS) is the assessment tool approved by the Department to provide a comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity. The Department utilizes this tool to divide members into resource groupings that determine the resource-adjusted price for each member.

2.01-11 Physician means an individual currently licensed by the Board of Licensure in Medicine to practice medicine or by the Board of Osteopathic Licensure to practice osteopathy in the State of Maine, or the State or Province in which services are provided.

2.01-12 Provider means the entity licensed by the Department, pursuant to the Regulations Governing the Licensing and Functioning of Assisted Housing Programs: Level III Residential Care Facilities . Provider, owner, licensee and operator are all synonymous terms.

2.01-13 Registered Nurse or "Registered Professional Nurse" means an individual who is currently licensed by the Maine State Board of Nursing to practice professional nursing.

2.01-14 Remote Island Facility means a facility located on an island not connected to the mainland by a bridge.

2.01-15 Resource Adjusted Price is the per diem rate the Department determines and pays to adult family care providers for the provision of services to a member. The Department determines this rate by considering the resources required to serve the needs of members based on assessment by the MDS-ALS assessment.

2.01-16 Unadjusted Price is the price calculated for payment prior to resource group adjustment. This represents the average reimbursement for the service.