Section 21 and Section 29 Public Hearing Information:
Chapter II, Section 29 Proposed Rule Change and Chapter III, Section 29 Proposed Rule Change:
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
Chapter II, Section 21 Proposed Rule Change and Chapter III, Section 21 Proposed Rule Change:
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
More information on the proposed rule changes and how to submit written comments can be found below.
Chapter II, Section 29 Proposed Rule Change and Chapter III, Section 29 Proposed Rule Change:
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
Chapter II, Section 21 Proposed Rule Change and Chapter III, Section 21 Proposed Rule Change:
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
More information on the proposed rule changes and how to submit written comments can be found below.
There are two proposed rule changes regarding Section 21
1) Chapter II, Section 21 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter II, Section 21 Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full Proposed Rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for persons with Intellectual Disabilities and Autism Spectrum Disorder. The proposed rule includes language that will bring the Department into compliance with new requirements from the Centers for Medicare and Medicaid Services (CMS) Home and Community-Based Services (HCBS) Settings Rule released on January 16, 2014 (see 42 C.F.R. § 441.301(c)). The Department is seeking and anticipates receiving CMS approval for this section. Chapter II, Section 21 is a routine technical rule and does not require legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter II, Section 21 include:
Appendix V- Added Requirements for Section 21 Providers of Home Support Services, Community Support Services, and Employment Specialist Services.
In response to recent changes in HCBS rules, the state is working towards, creating greater emphasis on access to community settings and a more person driven focus in the Person Centered Planning process. No members will be affected through the proposal of this rule.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: [email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
2) Chapter III, Section 21 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter III, Section 21 Allowances for Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full Proposed Rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for Persons with Intellectual Disabilities and Autism Spectrum Disorder. Chapter III, Section 21 is a companion to Chapter II, Section 21, Home and Community-Based Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. Chapter III is a major substantive rule and requires legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter III, Section 21 includes;
The Department will adopt via emergency rulemaking an increase to the rates in Chapter III in accordance with L.D. 1638. The legislature passed L.D. 1638 to authorize an increase in the service provider tax. Chapter III, Section 21 lists the procedure codes, descriptions and reimbursement rates for covered services provided to members under its companion rule, Chapter II, Section 21 Home and Community Benefits for Adults with Intellectual Disabilities or Autistic Disorder.
The increased rates will be effective retroactive to April 15, 2016. The following services will have a 1% increase as a result of LD 1638:
Chapter III, Section 21 lists the procedure codes, descriptions and reimbursement rates for covered services provided to members under its companion rule, Chapter II, Section 21 Home and Community Benefits for Adults with Intellectual Disabilities or Autistic Disorder.
No members will be affected through this emergency rule. Providers of Section 21 services will be reimbursed at a higher rate for services.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: [email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
There are two proposed rule changes regarding Section 29
1) Chapter II, Section 29 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter II, Section 29 Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full proposed rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for persons with Intellectual Disabilities and Autism Spectrum Disorder. The proposed rule includes language that will bring the Department into compliance with new requirements from the Centers for Medicare and Medicaid Services (CMS) HCBS Settings Rule released on January 16, 2014 (see 42 C.F.R. § 441.301(c)). The Department is seeking and anticipates receiving CMS approval for this section. Chapter II, Section 29 is a routine technical rule and does not require legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter II, Section 29 include:
In response to recent changes in HCBS rules, the state is working toward creating greater emphasis on access to community settings and a more person driven focus in the Person Centered Planning process. No members will be affected through the proposal of this rule.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: [email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
2) Chapter III, Section 29 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29 Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full Proposed Rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for Persons with Intellectual Disabilities and Autism Spectrum Disorder. Chapter III, Section 29 is a companion to Chapter II, Section 29, Support Services for Members with Intellectual Disabilities or Autism Spectrum Disorder. Chapter III is a major substantive rule and requires legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter III, Section 29 include;
The Department will adopt via emergency rulemaking an increase to the rates in Chapter III in accordance with L.D. 1638. The legislature passed L.D. 1638, An Act to Increase Payments to MaineCare Providers That Are Subject to Maine’s Service Provider Tax, to authorize an increase in the service provider tax. Chapter III, Section 29 lists the procedure codes, descriptions and reimbursement rates for covered services provided to members under its companion rule, Chapter II, Section 29 Support Services for Adults with Intellectual Disabilities or Autistic Disorder.
The increased rates will be effective retroactive to April 15, 2016. The following services will have a 1% increase as a result of LD 1638:
In response to recent changes in HCBS rules, the State is working towards, creating greater emphasis on access to community settings and a more person driven focus in the Person Centered Planning process. No members will be affected through the proposal of this rule.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110, Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed above before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: andre[email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
1) Chapter II, Section 21 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter II, Section 21 Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full Proposed Rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for persons with Intellectual Disabilities and Autism Spectrum Disorder. The proposed rule includes language that will bring the Department into compliance with new requirements from the Centers for Medicare and Medicaid Services (CMS) Home and Community-Based Services (HCBS) Settings Rule released on January 16, 2014 (see 42 C.F.R. § 441.301(c)). The Department is seeking and anticipates receiving CMS approval for this section. Chapter II, Section 21 is a routine technical rule and does not require legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter II, Section 21 include:
- Renaming of the section from Home & Community Benefits for Members with Intellectual Disabilities or Autistic Disorder to Home & Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder.
- Throughout Section 21, replacement of the term “Mental Retardation” with “Intellectual Disabilities.”
- Updating references to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
- Added HCBS Settings Rule language to the Introduction.
- In the Definitions section:
- Addition of clarifying language to Administrative Oversight Agency.
- Updated definition for Autism Spectrum Disorder.
- Addition of Clinical Review Team.
- Addition of clarifying language to Medical Add On.
- Removal of Mental Retardation.
- Addition of clarifying language to Shared Living Provider.
- Under Personal Plan, the language was updated to ensure that the member is driving the process and that the process is more closely aligned with the CFR §441.301 and §441.303. Direct references to the CFR were included.
- In the Covered Services section:
- Under Career Planning addition of quality oriented language.
- Under Communication Aids, removed Facilitated communication and added Augmented communication.
- Addition of clarifying language to Community Support Services.
- In the Limits section:
- Addition of language which disallows duplicative services covered by other sections in the MaineCare Benefits Manual.
- Under Consultation Services added information regarding limits.
- Definition of annual limits for: Occupational Therapy (Maintenance).
- In the Duration of Care Section added requirements for Provider Termination of a Member’s Services.
- In Provider Qualifications and Requirements, added:
- Additional qualification for Direct Support Professionals.
- Provider qualifications necessary to perform an Assistive Technology Assessment.
- Residential Settings Owned or Controlled by a Provider.
- Shared Living (Foster Care, Adult).
- Clarification of Background Check Criteria.
- Clarification of Reportable Events & Behavioral Treatment.
Appendix V- Added Requirements for Section 21 Providers of Home Support Services, Community Support Services, and Employment Specialist Services.
In response to recent changes in HCBS rules, the state is working towards, creating greater emphasis on access to community settings and a more person driven focus in the Person Centered Planning process. No members will be affected through the proposal of this rule.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: [email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
2) Chapter III, Section 21 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter III, Section 21 Allowances for Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full Proposed Rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for Persons with Intellectual Disabilities and Autism Spectrum Disorder. Chapter III, Section 21 is a companion to Chapter II, Section 21, Home and Community-Based Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. Chapter III is a major substantive rule and requires legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter III, Section 21 includes;
- Renaming of the Section from “Allowances for Home and Community Benefits for Adults with Intellectual Disabilities or Autistic Disorder” to “Allowances for Home and Community Benefits for Adults with Intellectual Disabilities or Autism Spectrum Disorder.”
- Removal of Calculation of the Per Diem Rate for Agency Home Supports
- Clarification of the Average Billing Method (the Monthly Average Billing section has been removed).
- Removal of the Range in Appendix IIA and IIB.
The Department will adopt via emergency rulemaking an increase to the rates in Chapter III in accordance with L.D. 1638. The legislature passed L.D. 1638 to authorize an increase in the service provider tax. Chapter III, Section 21 lists the procedure codes, descriptions and reimbursement rates for covered services provided to members under its companion rule, Chapter II, Section 21 Home and Community Benefits for Adults with Intellectual Disabilities or Autistic Disorder.
The increased rates will be effective retroactive to April 15, 2016. The following services will have a 1% increase as a result of LD 1638:
- T2017, Home Support (habilitation, residential, waiver), from $6.27 to $6.33 per quarter hour.
- T2017 SC, Home Support (habilitation, residential, waiver)-with Medical Add On from $7.50 to $7.57 per quarter hour.
- T2017 QC, Home Support (habilitation, residential, waiver)-Remote Support-Monitor Only, from $1.62 to $1.63 per quarter hour.
- T2017 GT, Home Support (habilitation, residential, waiver)-Remote Support-Interactive Support, from $6.27 to $6.33 per quarter hour.
- T2016, Agency Home Support (habilitation, residential, waiver), from $22.43 to $22.64 per diem.
- T2016 SC, Agency Home Support (habilitation, residential, waiver) with Medical Add On, from $19.53 to $19.72 per diem
- T2016 SC, Agency Home Support (habilitation, residential, waiver), from $27.15 to $27.41 per diem.
- S5140, Shared Living (Foster Care, adult)-Shared Living Model-One member served, from $126.19 to $127.39 per diem.
- S5140 TG, Shared Living (Foster Care, adult)-Shared Living Model-One member served-increased level of support, from $183.52 to $185.27 per diem.
- S5140 UN, Shared Living (Foster Care, adult)-Shared Living Model-Two members served, from $63.10 to $63.71 per diem.
- S5140 UN TG, Shared Living (Foster Care, adult)-Shared Living Model-Two members served-Increased level of support, from $120.42 to $121.57 per diem.
- T2016 U5, Home Support (habilitation, residential, waiver)-Family Centered Support-One member served, from $104.17 to $105.16 per diem.
- T2016 TG U5, Home Support (habilitation, residential, waiver)-Family Centered Support-One member served-Increased level of support, from $216.96 to $219.03 per diem.
- T2016 UN U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Two members served, from $85.8 to $86.61 per diem.
- T2016 UN TG U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Two members served-Increased level of support, from $196.78 to $198.65 per diem.
- T2016 UP U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Three members served, from $73.15 to $73.85 per diem.
- T2016 UP TG U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Three members served-Increased level of support, from $178.40 to $180.09 per diem.
- T2016 UQ U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Four members served, from $61.99 to $62.58 per diem.
- T2016 UQ TG U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Four members served-Increased level of support, from $162.16 to $163.71 per diem.
- T2016 UR U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Five or members served, from $55.29 to $55.82 per diem.
- T2016 UR TG U5, Home Support (habilitation, residential, waiver)-Family Centered Support-Five or members served-Increased level of support, from $153.42 to $154.88 per diem.
- T2021, Community Support (day habilitation) from $5.28 to $5.33 per quarter hour.
- T2021 SC, Community Support (day habilitation) with Medical Add On from $6.51 to $6.57 per quarter hour.
- Replaced H023 HQ Work Support (supported employment) with the following modifiers below:
- H2023 UN Work Support (supported employment)-Group 2 members served, up to $3.46 per ¼ hour.
- H2023 UP Work Support (supported employment)-Group 3 members served, up to $2.30 per ¼ hour.
- H2023 UQ Work Support (supported employment)-Group 4 members served, up to $1.73 per ¼ hour.
- H2023 UR Work Support (supported employment)-Group 2 members served, up to $1.38 per ¼ hour.
- H2023 US Work Support (supported employment)-Group 2 members served, up to $1.15 per ¼ hour.
Chapter III, Section 21 lists the procedure codes, descriptions and reimbursement rates for covered services provided to members under its companion rule, Chapter II, Section 21 Home and Community Benefits for Adults with Intellectual Disabilities or Autistic Disorder.
No members will be affected through this emergency rule. Providers of Section 21 services will be reimbursed at a higher rate for services.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 1:00 PM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: [email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
There are two proposed rule changes regarding Section 29
1) Chapter II, Section 29 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter II, Section 29 Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full proposed rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for persons with Intellectual Disabilities and Autism Spectrum Disorder. The proposed rule includes language that will bring the Department into compliance with new requirements from the Centers for Medicare and Medicaid Services (CMS) HCBS Settings Rule released on January 16, 2014 (see 42 C.F.R. § 441.301(c)). The Department is seeking and anticipates receiving CMS approval for this section. Chapter II, Section 29 is a routine technical rule and does not require legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter II, Section 29 include:
- Renaming of the section from “Support Services for Members with Intellectual Disabilities or Autistic Disorder” to “Support Services for Members with Intellectual Disabilities or Autism Spectrum Disorder.”
- Throughout Section 21, replacement of the term “Mental Retardation” with “Intellectual Disabilities.”
- Updating references to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
- Added HCBS Settings Rule language to the Introduction.
- In the Definitions section:
- Updated definition of Autism Spectrum Disorder.
- Addition of Clinical Review Team
- Addition of Exploitation
- Addition of clarifying language to Medical Add On.
- Removal of Mental Retardation.
- Addition of clarifying language to On Behalf Of.
- Under Personal Plan, the language was updated to ensure that the member is driving the process and that the process is more closely aligned with the 42 CFR § 441.301 and 441.303. Direct references to the CFR were included.
- In the Covered Services section:
- Under Career Planning, addition of quality oriented language.
- Addition of clarifying language to Community Support Services.
- In the Limits section:
- Removed Assistive Technology and Career Planning from the annual limit of $23,771, for members who receive Home Support (remote or quarter hour).
- Under Consultation Services, added information regarding limits.
- Definition of annual limits for: Occupational Therapy (Maintenance).
- Increased the Home Accessibility Adaptions limit from $5,000.00 in a three year period to $10,000 in a three year period.
- Added limits for Out of State Services. (21.07-18 Out of State Services Authorizations for services to be provided out of state will not exceed sixty (60) days of service within a given fiscal year and not exceed sixty (60) days within any six (6) month period except as provided in 42 C.F.R. § 431.52 (b).)
- In the Duration of Care Section, added requirements for Provider Termination of a Member’s Services.
- In Provider Qualifications and Requirements, added:
- Additional qualification for Direct Support Professionals.
- Additional qualifications for Employment Specialist.
- Clarification of Background Check Criteria.
- Clarification of Reportable Events & Behavioral Treatment.
- Appendix IV- Added Requirements for Section 29 Providers of Home Support Services, Community Support Services, and Employment Specialist Services.
In response to recent changes in HCBS rules, the state is working toward creating greater emphasis on access to community settings and a more person driven focus in the Person Centered Planning process. No members will be affected through the proposal of this rule.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: [email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
2) Chapter III, Section 29 Proposed Rule Change:
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services, MaineCare Services
CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Proposed Rule: Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29 Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110,
Augusta ME 04333
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
CONCISE SUMMARY (Click here for the full Proposed Rule):
This waiver renewal proposes rule changes to the Comprehensive Home and Community-Based Services (HCBS) Waiver for Persons with Intellectual Disabilities and Autism Spectrum Disorder. Chapter III, Section 29 is a companion to Chapter II, Section 29, Support Services for Members with Intellectual Disabilities or Autism Spectrum Disorder. Chapter III is a major substantive rule and requires legislative approval prior to final adoption of the rule.
Significant Updates and Changes to Chapter III, Section 29 include;
- Renaming of the Section from “Allowances for Support Services for Adults with Intellectual Disabilities or Autistic Disorder” to “Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder.”
The Department will adopt via emergency rulemaking an increase to the rates in Chapter III in accordance with L.D. 1638. The legislature passed L.D. 1638, An Act to Increase Payments to MaineCare Providers That Are Subject to Maine’s Service Provider Tax, to authorize an increase in the service provider tax. Chapter III, Section 29 lists the procedure codes, descriptions and reimbursement rates for covered services provided to members under its companion rule, Chapter II, Section 29 Support Services for Adults with Intellectual Disabilities or Autistic Disorder.
The increased rates will be effective retroactive to April 15, 2016. The following services will have a 1% increase as a result of LD 1638:
- T2017, Home Support-Quarter Hour, from $6.27 to $6.33.
- T2017 QC, Home Support-Remote Support-Monitor Only, from $1.62 to $1.63 per quarter hour.
- T2017 GT, Home Support-Remote Support-Interactive Support, from $6.27 to $6.33 per quarter hour.
- T2021, Community Support (day habilitation) from $5.28 to $5.33 per quarter hour.
- T2021 SC, Community Support (day habilitation) with Medical Add On from $6.51 to $6.57 per quarter hour.
- Replaced H023 HQ Work Support (supported employment) with the following modifiers below:
- H2023 UN Work Support (supported employment-Group 2 members served, up to $3.46 per ¼ hour.
- H2023 UP Work Support (supported employment-Group 3 members served, up to $2.30 per ¼ hour.
- H2023 UQ Work Support (supported employment-Group 4 members served, up to $1.73 per ¼ hour.
- H2023 UR Work Support (supported employment-Group 2 members served, up to $1.38 per ¼ hour.
- H2023 US Work Support (supported employment-Group 2 members served, up to $1.15 per ¼ hour.
In response to recent changes in HCBS rules, the State is working towards, creating greater emphasis on access to community settings and a more person driven focus in the Person Centered Planning process. No members will be affected through the proposal of this rule.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173, L.D. 1638
PUBLIC HEARING:
Date: October 19, 2016
Time: 9:00 AM
Location: 19 Union Street, Conference Room 110, Augusta ME 04333
The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed above before October 7, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on October 29, 2016
Click here to submit comments.
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner
AGENCY NAME: MaineCare Services
ADDRESS: 242 State St.
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4058, FAX: (207) 287-1864
TTY: 711 (Deaf or Hard of Hearing)
E-Mail: andre[email protected]
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.