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-45 - Hospital Services
Subsection 144-101-II-45.08 - ELIGIBILITY FOR HOME CARE FOR CHILDREN ELIGIBLE THROUGH THE KATIE BECKETT BENEFIT

A. Age and Disability

The child must be eighteen (18) years of age or younger and be determined disabled under Supplemental Security Income rules. The Medical Review Team (MRT) at the Office of Family Independence makes the disability determination as part of the application process.

B. Level of Care

The child must require a level of care that is typically provided in a hospital, although the child does not have to be admitted, relocated nor have a history of admissions to a hospital. If the child requires a level of care that can be provided in a nursing facility, eligibility for the Katie Beckett benefit must be assessed under Chapter II, Section 67 of this Manual.

C. Appropriateness of Community-Based Care

The child must be able to receive or currently be receiving appropriate care outside a hospital setting that provides that level of care.

D. Limits of Cost of Community-Based Care

The total annual cost to MaineCare for home care must be no greater than the amount MaineCare would pay for the child's care in an institution.