Current through 2024-38, September 18, 2024
To provide services under this section a provider must be
a qualified vendor as approved by DHHS and enrolled by the MaineCare program.
Once a provider has been authorized to provide services, the provider cannot
terminate the member's services without written authorization from DHHS.
20.10-1
Assistive Technology
Services-In order to provide Assistive Technology Services, a provider
must be an OADS approved agency and employ:
A. A Licensed Occupational Therapist;
or
B. A Licensed Speech
Pathologist; or
C. A certified
Direct Support Professional (DSP) who is also certified as a Rehabilitation
Engineering Technologist (RET) or an Assistive Technology Professional
(ATP).
20.10-2
Care Coordination Services- In order to provide Care Coordination
Services, a provider must be an OADS-approved agency and employ:
A. A Registered Nurse; or
B. A Registered Occupational Therapist;
or
C. A Licensed Social Service or
health professional with four years of education in health or social services
field and one year of community experience in providing the direct service.
20.10-3
Career
Planning - In order to provide Career Planning Services, a provider must
be an OADS-approved Provider Agency and the individual providing the service
must meet one of the following training requirements and must have completed an
additional 12 hours of Career Planning and Discovery training provided through
Maine's Workforce Development System:
A.
Certificate as a Direct Support Professional (DSP) as detailed in 20.10-6;
or
B. Employment Specialist
National Certification approved by the Association of Community Rehabilitation
Educators (ACRE).
20.10-4
Communication Aids- In order to provide Communication Aids, an
independent (non-agency) provider must possess a Certificate of Clinical
Competence-Speech Pathology (CCC-SP) or be a Licensed Speech Language
Pathologist (SLP), or a Licensed Audiologist. An agency provider of
Communication Aids must be a licensed speech and hearing agency or licensed
Home Health Agency and the staff person must possess a Certificate of Clinical
Competence-Speech Pathology (CCC-SP).
20.10-5
Consultation Services-
In order to provide Consultation Services a provider must:
A. Possess a certificate of Clinical
Competence in Speech Pathology for Speech Consultation; or
B. Be a Licensed Occupational Therapist for
Occupational Therapy Consultation; or
C. Be a Physical Therapist for Physical
Therapy Consultation; or
D. Be a
Psychological Examiner or Be a Licensed Clinical Psychologist for Psychological
Consultation; or
E. Be a Licensed
Clinical Social Worker (LCSW) or Be a Licensed Clinical Professional Counselor
(LCPC) for Behavioral Consultation.
20.10-6
Community Support, Home
Support, Work Support Services- Community Support, Home Support, and
Work Support Services must be provided by a Direct Support Professional (DSP),
a Personal Support Specialist (PSS) or a Personal Care Assistant (PCA), and the
individual providing the services must:
A.
Meet one of the following training requirements:
i. Have successfully completed the
appropriate training as a Direct Support Professional curriculum as adopted by
DHHS, or
ii. Demonstrated
proficiency through DHHS's approved Assessment of Prior Learning, or
iii. Have successfully completed the
curriculum from the Maine College of Direct Support within 90 days of date of
hire and completed the following five modules from the College of Direct
Support prior to providing services to a member alone:
1. Safety at Home and in the Community
2. Personal Care.
3. Professionalism
4. Individual Rights and Choice
5. Maltreatment; or
iv. Hold a valid certificate of training as a
personal support specialist/personal care assistant issued as a result of
completing the Department approved personal support specialist training
curriculum and passing the competency-based examination of didactic and
demonstrated skills. The training course must include at least fifty (50) hours
of formal classroom instruction, demonstration, return demonstration, and
examination. Tasks covered under this section must be covered in the training;
or
v. Be a PCA or PSS who
successfully completed a Department-approved curriculum prior to September 1,
2003. Such individuals will be grandfathered as a qualified PCA or PSS; and
Documentation of completion must be retained in the personnel record.
B. Have a background
check consistent with Section 20.10-16;
C. Have a valid driver's license, if
transporting members;
D. Be at
least 18 years of age;
E. Have
graduated from high school or acquired a GED;
F. Have completed Reportable Events and
Behavior Regulations Training.
20.10-7
Employment Specialist
Services-In order to provide Employment Specialist Services, a provider
must:
A. Possess a national certification by
the Association of Community Rehabilitation Educators (ACRE); and
B. Pass a background check consistent with
Section 20.10-16; and
C. Possess a
valid driver's license, if transporting members; and
D. Be at least 18 years of age;
E. Possess a high school degree or GED;
and
F. Have one year of experience
working with people with disabilities in a work setting.
20.10-8
Home Accessibility
Adaptations- In order to provide Home Accessibility Adaptations, a
provider must be approved by the Office of Aging and Disability Services
(OADS).
20.10-9
Non
Traditional Communication Assessment and Consultation- In order to
provide Non Traditional Communication Assessment and Consultation, a provider
must;
A. Possess a Houston Certificate or
other training approved by DHHS; or
B. Be a Licensed Speech Language Pathologist.
20.10-10
Occupational Therapy (Maintenance)- In order to provide
Occupational Therapy (Maintenance) Services, a provider must be a Licensed
Occupational Therapist.
20.10-11
Personal Care-In order to provide Personal Care Services, a
provider must;
A. Possess a valid certificate
or training for nursing assistants and be listed on the Maine Registry of
Certified Nursing Assistants; or
B.
Hold a valid certificate of training, issued within the past three (3) years,
for nurse's aide or home health aide training that meets the standards of the
Maine State Board of Nursing nursing assistant training program; or
C. If a CNA's status on the Maine Registry of
Certified Nursing Assistants has lapsed, or an individual holds a valid
certificate of training meeting the standards of the Maine State Board of
Nursing nursing assistant program issued more than three (3) years ago, the
individual must have passed the competency-based examination of didactic and
demonstrated skills from the Department's approved personal support specialist
curriculum. A certificate of training as a personal care assistant/personal
support specialist is awarded upon passing this examination; or
D. Hold a valid certificate of training as a
PSS or PCA issued as a result of completing the Department approved personal
support specialist training curriculum and passing the competency-based
examination of didactic and demonstrated skills. The training course must
include at least fifty (50) hours of formal classroom instruction,
demonstration, return demonstration, and examination. Tasks covered under this
section must be covered in the training; or
E. Be a PCA or PSS who successfully completed
a Department-approved curriculum prior to September 1, 2003. Such individuals
will be grandfathered as a qualified personal care assistant/PSS; or
F. Be qualified as a DSP as described in
20.10-6.
20.10-12
Physical Therapy (Maintenance) Services-In order to provide
Physical Therapy (Maintenance) Services, a provider must be a Licensed Physical
Therapist.
20.10-13
Specialized Medical Equipment- In order to provide Specialized
Medical Equipment, a provider must be approved by the Office of Aging and
Disability Services (OADS).
20.10-14
Speech Therapy (Maintenance)
Services- In order to provide Speech Therapy (Maintenance) Services, a
provider must possess a Certificate of Clinical Competence in Speech Pathology
(CCC-SP).
20.10-15
Emergency
Intervention-Providers must meet training requirements on approved
behavioral interventions procedures (e.g.,Mandt) if applicable and indicated as
a need in the member's Care Plan.
20.10-16
Background Check
Criteria-Providers must conduct background checks on all prospective
employees, persons contracted or hired, consultants, volunteers, students, and
other persons who may provide services under this Section. Background checks on
persons professionally licensed by the State of Maine will include a
confirmation that the licensee is in good standing with the appropriate
licensing board or entity.
The provider shall not hire or retain in any capacity any
person who may directly provide services to a member under this section if that
person has a record of:
A. any
criminal conviction that involves abuse, neglect or exploitation;
B. any criminal conviction in connection to
intentional or knowing conduct that caused, threatened, solicited or created
the substantial risk of bodily injury to another person;
C. any criminal conviction resulting from a
sexual act, contact, touching or solicitation in connection with any victim;
or
D. any other criminal
conviction, classified as Class A, B or C or the equivalent of any of these, or
any criminal conviction based upon reckless conduct that caused, threatened,
solicited or created the substantial risk of bodily injury to another person
within the preceding two (2) years; or
E. any criminal conviction within Title 29-A,
chapter 23, subchapter 2, article 1, or Title 29-A, chapter 23, subchapter 5.
Employment of individuals with records of such convictions more than five (5)
years prior to the time of the background check is a matter within the
provider's discretion after consideration of the individual's criminal record
in relation to the nature of the position. The member receiving services must
approve the employment of such staff in writing if the provider decides to hire
a staff person with a conviction.
The provider shall contact child and adult protective
services (including the Office of Aging and Disability Services) units within
DHHS to obtain any record of substantiated allegations of abuse, neglect or
exploitation against an employment applicant before hiring the same. In the
case of a child or adult protective services investigation substantiating
abuse, neglect or exploitation by a prospective employee of the provider, it is
the provider's responsibility to decide what hiring action to take in response
to that substantiation, while acting in accordance with licensing standards.
20.10-17
Informed Consent Policy
Providers must put in place and implement an informed
consent policy approved by the Department. For the purposes of this
requirement, informed consent means consent obtained in writing from a member
or the member's legally authorized representative for a specific treatment,
intervention or service, following disclosure of information adequate to assist
the person in making the consent. Such information may include the diagnosis,
the nature and purpose of the procedure(s) or service(s) for which consent is
sought, all material risks and consequences of the procedure(s) or service(s),
an assessment of the likelihood that the procedure(s) or service(s) will
accomplish the desired objective(s), any reasonably feasible alternatives for
treatment, with the same supporting information as is required regarding the
proposed procedure(s) or service(s), and the prognosis if no treatment is
provided. At a minimum, a provider's informed consent policy must ensure that
members served by the provider (and their guardians, where applicable) are
informed of the risks and benefits of services and the right to refuse or
change services or providers.
20.10-18
Reportable Events
Providers shall comply with all terms and conditions of
the Department's Regulations Governing Reportable Events, Adult Protective
Investigations and Substantiation Hearings. All staff must receive
training in mandatory reporting/reportable events before they provide any
services under this waiver.
20.10-19
Requirements for Residential
Settings Owned or Controlled by a Provider
Where the member receives Home Support Services in a
residential setting owned or controlled by the provider, the provider must
ensure that the following requirements are met:
A. The member must occupy the residence
pursuant to a lease or other written, legally enforceable agreement providing
comparable protections, including eviction and appeal processes required under
Maine law;
B. The member must have
privacy in his or her unit, including doors lockable by the member, with only
appropriate staff having keys to such doors;
C. Where members share a unit, each member
must have choice of roommates;
D.
The member must have the freedom to furnish or decorate the unit;
E. The member must control his or her own
schedule and activities;
F. The
member must have access to food at any time;
G. The member must be allowed to receive
visitors of his or her choosing at any time; and
H. The setting must be physically accessible.
These requirements may only be modified where necessary
to respond to a specific assessed need. Modifications require clinical
documentation supporting the need, and must be identified and justified in the
Care Plan.
The following requirements must be documented in the
member's Care Plan in order to modify the Requirements for Residential Settings
Owned or Controlled by a Provider:
A.
Identify a specific and individualized assessed need;
B. Document the positive interventions and
supports used prior to any modifications to the Care Plan;
C. Document less intrusive methods of meeting
the need that have been tried but did not work;
D. Include a clear description of the
condition that is directly proportionate to the specific assessed
need;
E. Include a regular
collection and review of data to measure the ongoing effectiveness of the
modification;
F. Include
established time limits for periodic reviews to determine if the modification
is still necessary or can be terminated;
G. Include informed consent of the member;
and
H. Include an assurance that
the interventions and supports will cause no harm to the
member.
