Section 20: Other Related Conditions - Maine
Section 20: Other Related ConditionsProvider ManualFebruary 2018-4389121610487This Instruction Manual is designed to be a living document. This manual will be reviewed at least quarterly and updated as necessitated by change in policy and/or practice.00This Instruction Manual is designed to be a living document. This manual will be reviewed at least quarterly and updated as necessitated by change in policy and/or practice.Table of Contents TOC \o "1-3" \h \z \u Introduction PAGEREF _Toc506211179 \h 3Office of Aging and Disability Services Overview PAGEREF _Toc506211180 \h 3Definitions PAGEREF _Toc506211181 \h 3ORC Services PAGEREF _Toc506211182 \h 6Introduction to Section 20: Home and Community Services for Adults with Other Related Conditions PAGEREF _Toc506211183 \h 6Eligibility for ORC Waiver PAGEREF _Toc506211184 \h 6Services Covered by ORC Waiver PAGEREF _Toc506211185 \h 6Non-Covered Services PAGEREF _Toc506211186 \h 7Applying for Services PAGEREF _Toc506211187 \h 7Change/Transition from Children’s to Adult Services PAGEREF _Toc506211188 \h 7Beginning Services PAGEREF _Toc506211189 \h 8Implementing Services PAGEREF _Toc506211190 \h 8Vendor Calls PAGEREF _Toc506211191 \h 9ORC Providers PAGEREF _Toc506211192 \h 9Professional Boundaries PAGEREF _Toc506211193 \h 9Provider Roles PAGEREF _Toc506211194 \h 9OADS Care Monitor PAGEREF _Toc506211195 \h 9Care Coordinator PAGEREF _Toc506211196 \h 10Conflict Free Care Coordination PAGEREF _Toc506211197 \h 11ORC Waiver Providers PAGEREF _Toc506211198 \h 12Provider Enrollment and Maintenance PAGEREF _Toc506211199 \h 12Care Plan PAGEREF _Toc506211200 \h 13Writing the Care Plan PAGEREF _Toc506211201 \h 13Revising the Care Plan PAGEREF _Toc506211202 \h 13Changing ORC Providers PAGEREF _Toc506211203 \h 14Transfer of Member Records PAGEREF _Toc506211204 \h 14Renewing the Care Plan PAGEREF _Toc506211205 \h 15MED Assessment PAGEREF _Toc506211206 \h 15Care Plan Schedule PAGEREF _Toc506211207 \h 15Service Limits PAGEREF _Toc506211208 \h 16Legal PAGEREF _Toc506211209 \h 17MaineCare Appeals PAGEREF _Toc506211210 \h 17Public Guardianship and Conservatorship PAGEREF _Toc506211211 \h 17Levels of Authorization Delegated by the Commissioner PAGEREF _Toc506211212 \h 17Motion for Change of Venue PAGEREF _Toc506211213 \h 17Reportable Events PAGEREF _Toc506211214 \h 17Reporting PAGEREF _Toc506211215 \h 18Documenting PAGEREF _Toc506211216 \h 18Confidentiality and Disclosure PAGEREF _Toc506211217 \h 19Standards and Procedures PAGEREF _Toc506211218 \h 20Employment PAGEREF _Toc506211219 \h 20Entitlement Programs and Benefits PAGEREF _Toc506211220 \h 20Housing Options PAGEREF _Toc506211221 \h 20Evaluations, Consultations, and Other Covered Services PAGEREF _Toc506211222 \h 20Prior Authorization Process PAGEREF _Toc506211223 \h 20Consultation and/or Request for Evaluation PAGEREF _Toc506211224 \h 21Assistive Technology Devices PAGEREF _Toc506211225 \h 21Communication Aids PAGEREF _Toc506211226 \h 22Consultation Services and Assessment PAGEREF _Toc506211227 \h 22Home Accessibility Adaptations PAGEREF _Toc506211228 \h 22Non-emergency Transportation Services PAGEREF _Toc506211229 \h 22Non-Traditional Communication Assessments PAGEREF _Toc506211230 \h 22Non-Traditional Communication Consultation PAGEREF _Toc506211231 \h 22Occupational Therapy (Maintenance) Services PAGEREF _Toc506211232 \h 23Physical Therapy (Maintenance) Services PAGEREF _Toc506211233 \h 23Specialized Medical Equipment PAGEREF _Toc506211234 \h 23Speech Therapy (Maintenance) Services PAGEREF _Toc506211235 \h 23Appendix F – Care Plan Schedule PAGEREF _Toc506211236 \h 24IntroductionOffice of Aging and Disability Services OverviewThe Office of Aging and Disability Services (OADS) is responsible for planning, developing, managing, and providing services to promote independence for elders and adults with brain injuries, intellectual and physical disabilities through the provision of services. These services include evidence based prevention programs, comprehensive home and community based services, Adult Protective Services, and Public Guardianship and Conservatorship Programs.OADS VisionWe promote individual dignity through respect, choice and support for all adults.OADS MissionTo promote the highest level of independence, health and safety of older citizens, vulnerable adults and adults with disabilities.OADS ValuesAppropriate Levels of SupportDignity of RiskFamily Caregiver Support and Informal SupportsIndividual/Person CenteredOptimizing IndependenceQuality of Care and ServicesDefinitionsAbuse means the infliction of injury, unreasonable confinement, intimidation or cruel punishment that causes or is likely to cause physical harm or pain or mental anguish; sexual abuse or sexual exploitation; or the intentional, knowing or reckless deprivation of essential needs as defined in 22 MRSA §3472.Assessing Services Agency (ASA) is an Authorized Agent of the Department of Health and Human Services (DHHS) for Medical Eligibility Determinations that conducts face-to-face assessments, using DHHS Medical Eligibility Determination form or other DHHS approved form. Authorized Agent is the organization authorized by the Department of Health and Human Services (DHHS) to perform specified functions pursuant to a signed contract or other approved signed agreement.BMS 99 is the assessment tool used to determine functional limitations of the member.Care Coordinator is a provider organization staff person who is responsible for the development and ongoing support of the implementation of the Care Plan. This includes monitoring of the health, welfare and safety of the Member. Care Plan is a comprehensive document that specifies the services a member will receive under this section and the way those services will be provided. Care Plans are only effective for 365 days.Care Plan Schedule is a schedule agreed to by the Member and ORC Waiver Providers and helps to ensure both parties know when services are expected to take place.Choice Letter is a letter that identifies the Member’s (and their Guardian’s, if applicable) decision to receive Waiver services instead of institutional care.Enterprise Information System (EIS) is a data collection tool managed by DHHS’ OADS and OIT (Office of Information Technology). EIS is utilized to ensure proper documentation and allow oversight of services Members are receivingExploitation means the illegal or improper use of an incapacitated or dependent member or that member’s resources for another’s profit or advantage as defined in 22?MRSA §3472.Habilitation is a service that is provided to assist a member to acquire a variety of skills, including self-help, socialization and adaptive skills. Habilitation is aimed at raising or retaining the level of physical, mental, and social functioning of a member. Habilitation is contrasted to rehabilitation which involves the restoration of function that a person has lost.Health and Welfare means the wellbeing of the Member. The Member’s health and welfare must be assured by an approved ORC care plan that the Member and their guardian (if applicable) agree to participate in, and the environment must be safe enough to ensure services can be provided without risk of harm or injury to the Member and individual providing services.Intellectual Disability means a diagnosis of Mental Retardation as defined in Section 317-319 in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (American Psychiatric Association), that manifested during the developmental period, in accordance with the definition of Intellectual Disability codified in 34-B MRSA § 5001. The terms “mental retardation” and “intellectual disability” are used interchangeably in these regulations. Letter of Medical Necessity means a letter completed by a licensed physician that confirms an individual has a certain medical diagnosis or has multiple certain diagnoses.Mandated Reporter means persons who must report to the Department when they know or have reasonable cause to suspect that an incapacitated or dependent adult has been or is likely to be abused, neglected or exploited as defined in 22 MRSA § 3477.Medical Eligibility Determination (MED) Tool means the form approved by DHHS to assess the medical service needs of the member. The information provided by the MED tool will be used in determining the eligibility for the waiver and authorizing services. Member is a person determined to be eligible for MaineCare benefits by the Office for Family Independence (OFI) in accordance with the eligibility standards published by the OFI in the MaineCare Eligibility Manual. Some members may have restrictions on the type and amount of services they are eligible to receive.Money Follows the Person-Homeward Bound Transition Coordinator is the person who is chosen by the member to provide transition Assistance from the agencies contracted by the Department for the Money Follows the Person-Homeward Bound program.Natural Supports include the relatives, friends, neighbors, and community resources that a member or family goes to for support. They may participate in the treatment team, but are not MaineCare reimbursable.Neglect means a threat to a member’s health or welfare by physical or mental injury or impairment, deprivation of essential needs or lack of protection from these as defined in 22 MRSA §3472.OADS Care Monitor is the Department of Health and Human Services (DHHS) professional who assists?the member with the member’s enrollment in the waiver services and monitors the services received to assure they are meeting the health and safety needs of the member.Other Related Conditions (ORC), based on 42 C.F.R. § 435.1011, means a severe, chronic disability that meets all the following conditions identified in 20.03 of MaineCare Benefits Manual.ORC Waiver Providers: Are agencies and organizations, and their affiliated staff, which provide waiver services to Section 20 ORC Members. Preliminary Care Plan is the Care Plan developed by the Care Monitor. On the date a Member starts to receive Section 20 ORC Waiver Services (known as the Start Date) the Preliminary Care Plan becomes the Care Plan.Prior Authorization (PA) is the process of obtaining prior approval as to the medical necessity and eligibility for a service.Renewal Date is the annual date a Member who is receiving Section 20 ORC Waiver Services must have a revised and approved Care Plan in place to continue services. Renewal Date is determined by the Member’s Start Date.Reportable Events are events that happen or may happen to Members that have or may have an adverse impact upon the safety, welfare, rights or dignity of adults with other related conditions.Start Date is the date a Member begins to receive Section 20 ORC Waiver Services. Utilization Review is a formal assessment of the medical necessity, efficiency and appropriateness of services and Care Plans on a prospective, concurrent or retrospective basis. The provider is required to notify DHHS or its Authorized Agent upon initiation of all services provided under Section 20 for the Authorized Agent to begin utilization review.Vendor Calls are a formal process of seeking a service for a Member that is identified in the approved Care Plan.ORC ServicesIntroduction to Section 20: Home and Community Services for Adults with Other Related ConditionsSection 20 Other Related Conditions refers to Chapter II, Section 20 of the MaineCare Benefits Manual. This service, typically referred to as “Section 20” or “ORC”, is a Home and Community Based Service (HCBS) Waiver that is also regulated by the Federal Center for Medicare and Medicaid Services (CMS). According to CMS: “Waivers are one of many options available to states to allow the provision of long term care services in home and community based settings?under the Medicaid Program.?States can offer a variety of services under an HCBS Waiver program.?Programs can provide a combination of standard medical services and non-medical services.”ORC services were developed to provide a comprehensive service package that allows Members to be served in the community. The ORC waiver is designed to maximize the opportunity for members to achieve the greatest degree of self-sufficiency and independence chosen by the Member. Member choice in all services and components of services is a primary goal. Additionally, the principles of conflict-free care coordination, services provided in the least restrictive modality and effective use of assistive technology for communication, environmental control and safety are inherent to this waiver.Eligibility for ORC WaiverThe process for determining eligibility for Other Related Conditions waiver is defined in 20.03 of MaineCare Benefits Manual.Services Covered by ORC WaiverAssistive Technology Device and ServicesNon-Traditional Communication AssessmentsCare Coordination ServicesNon-Traditional Communication ConsultationCommunication AidsOccupational Therapy (Maintenance) ServicesCommunity Support ServicesPersonal Care ServicesConsultation Services and AssessmentPhysical Therapy (Maintenance) ServicesEmployment Specialist ServicesSpecialized Medical EquipmentHome Accessibility AdaptationsSpeech Therapy (Maintenance) ServicesHome Support ServicesWork Support ServicesNon-emergency Transportation ServicesNon-Covered ServicesServices not authorized by the Care PlanServices to any member who is hospitalized, a nursing facility resident or ICF/IID residentAny service otherwise reimbursable under the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act, including by not limited to job development and vocational assessment or evaluations (Vocational Rehabilitation Services).Room and BoardServices provided directly or indirectly by the legal guardianWork Support or Employment Support Services when the member is not engaged in employmentSpecialized Medical Equipment and Supplies, Communication Aids, or Home Accessibility Adaptations unless the service has been determined non-reimbursable under other sections of the MaineCare Benefits Manual.Services funded by other sections of MaineCareSection 20 Waiver services may not be provided in a residence where other HCBS waiver services are provided. Exceptions considered on a case-by-case basis by the Department.Applying for ServicesAnyone can apply for ORC services, though not everyone is eligible. To apply, ask for the OADS ORC Care Monitor at 1-800-262-2232. The OADS Care Monitor must be provided the following forms: ORC Application A completed and signed Authorization to Release Information Letter of Medical NecessityChoice LetterThe OADS Care Monitor will then complete the Safety Risk Assessment and BMS 99. This documentation is reviewed with the Brain Injury Program Manager to determine if the applicant is eligible based on Chapter II, Section 20.03 of MaineCare Benefits Manual.A letter will be sent to the Applicant regarding their eligibility status. The OADS Care Monitor refers for the initial Medical Eligibility Determination (MED) assessment, but it is the Care Coordinator’s responsibility to refer for the subsequent annual MED assessments.Change/Transition from Children’s to Adult Services Although a youth may have received DHHS services as a child they may not meet the qualifications for DHHS programs or services that serve adults due to varying eligibility standards. Youth must apply for, and meet the eligibility criteria of the Section 20 waiver to receive services. This includes submitting an application, a comprehensive assessment and evaluation, and meeting the eligibility criteria of the program. It is crucial that the transition from Children’s to Adult services include joint planning to ensure the youth’s need for services such as housing, education, workforce and/or employment supports, medical care and monitoring, and community integration are addressed across the systems of care.For those youths who may qualify for more than one service, including Section 20 Services, it is recommended that a referral be made to all desired services.Beginning ServicesIf determined eligible, the OADS Care Monitor will reach out to the Member and arrange an initial planning meeting. The Member will be assigned an ORC number to be used in all correspondences to protect Private Health Information. This meeting involves the Member, Guardian (if applicable), and OADS Care Monitor. The goal of the meeting is to determine what ORC services the Member would like to receive and to identify providers for those services. Once the Member’s desired services and providers are identified the OADS Care Monitor will create a preliminary Care Plan and reach out to the Member’s chosen providers.The OADS Care Monitor will provide the Member with a list of providers to choose from and the list of services which each provide. If the Member would like a provider that is not listed the OADS Care Monitor will try to reach out to the desired provider and invite them to become an ORC provider should they qualify Those providers who are interested can work with OADS Care Monitor and ORC program staff to become an authorized ORC provider. The Member may request to meet with providers before making a final decision.Coordinating with all the chosen providers, the OADS Care Monitor will set up an initial Start date. The Start Date is when ORC services will be authorized and establishes the Renewal Date, which is the date the Care Plan must be renewed by each following year. Prior to the Start Date the OADS Care Monitor will provide the chosen Care Coordinator with the signed Care Plan, ORC Prior Authorization Request Form, Care Plan Schedule, Medical Eligibility Determination (MED) Assessment and Date, BMS 99, Choice Letter, and Renewal Date. If the Care Coordinator does not receive this information they must contact the OADS Care Monitor and request it.As Care Coordination is a Waiver Service, Care Coordination cannot begin until the Start Date. The OADS Care Monitor provides the role of Care Coordination only until the Start Date. All future Care Plan renewals and revisions are the responsibility of the Care Coordinator. Within 48 hours of the Start Date the Care Coordinator contacts the Member to schedule the initial meeting and confirm waiver services have started.Implementing ServicesAll ORC Services are individualized in each Members Care Plan. Care Plans are as varied as the Members, although they all use the same template.The Care Coordinator is responsible for maintaining the Care Plan. The Care Coordinator must provide all ORC Waiver Providers with updated and signed Care Plans, in their entirety, and Care Plan Services Prior Authorization Request Forms as they are revised or renewed. The Care Coordinator must meet with the Member face to face at least every 30 days to ensure that services and the living arrangement is still appropriate. This meeting can be a 1 on 1 meeting, a team meeting, or can include anyone the Member would like to invite.ORC Waiver Providers (such as Home Supports, Community Supports, Employment Supports, etc.) must meet with and support the Member as identified within the scope of the Care Plan and Prior Authorized Services. Care Coordinator and ORC Waiver Providers should have open communication and provide each other with updates as necessary to provide the best care and appropriate level of services to the Member. Care Coordinators should speak with providers as needed to assure ORC services are effectively meeting the needs of the Member.Vendor CallsVendor Calls are a formal process of seeking a service for a Member. The Care Coordinator completes a Vendor Call form and provides it to the OADS Care Monitor. The OADS Care Monitor will submit this form through the GovDelivery System so that all providers who have signed up to the listserv can be notified that a Member is interested in a service. Providers who would like to serve the Member will then contact the Care Coordinator identified on the Vendor Call form for more information. Do not enter any identifiable Member information in the Vendor Call form. Interested parties can sign up for the GovDelivery System by going to this link and selecting the listserv(s) for which you would like to receive notice.ORC ProvidersProfessional BoundariesAll ORC providers (Care Coordinators, ORC Waiver Providers, etc.) should be aware of the potential influence and perceived authority of their position on Members and take steps to ensure that professional boundaries are maintained. ORC providers must adhere to the roles and expectations of the job description and should adhere to the ethical requirements of their professional licensing.Contact with Members should be limited to those that are assigned to the ORC provider while employed as a provider and occur during working hours. Any planned interaction outside of the regular working relationship and/or scheduled work time must be authorized by a Supervisor. Concerns about a co-worker exceeding professional boundaries must be reported to a Supervisor.ORC Providers must not give or accept gifts or other items to or from Members.Provider RolesOADS Care MonitorThe OADS Care Monitor is an OADS Employee who assists Members with first accessing services and ensures that those services, provided by ORC providers, continue to meet the member’s health and welfare needs in the community setting.The OADS Care Monitor:Gathers Member information to determine eligibility with consultation from ORC Services Manager.Develops and implements the preliminary Care Plan. Transitions member to Care Coordinator once services are approved authorized. Provides incoming Care Coordinator with preliminary Care Plan, MED Assessment and Reassessment Date, BMS 99, Start Date, ORC Prior Authorization Request Form, Budget and Choice Letter.Visits the Member as needed. OADS Care Monitor can attend any meeting pertaining to their responsibilities or at the request of the Member.Reviews EIS documentation entered by Care Coordinators and ORC Waiver Providers.Reviews Reportable Events generated regarding Members.Provides preliminary information to agencies who are interested in becoming ORC Waiver Providers.Reviews and approves all revisions and renewals of Care Plans and Care Plan Services Prior Authorization Request Forms. OADS Care Monitor will provide approved Care Plans to the Care Coordinator and ORC Service Providers 3 business days prior to the Renewal Date.Assists Care Coordinator and Member with conducting vendor calls for ORC services.Sends approved Care Plan and Prior Authorization Request Forms directly to the providers.Care CoordinatorThe Care Coordinator is a non-OADS employee. They assist the Member in gaining access to needed waiver, other state plan services, and other non-MaineCare services. The Care Coordinator coordinates services delivered by the Providers to the Member.The Care Coordinator:Ensures they receive the Care Plan, MED Assessment and Reassessment Date, BMS 99, Care Plan Services Prior Authorization Request Form, Budget, Choice Letter, and Start Date when accepting a referral.Manages the Care Plan and all components including:The Service Prior Authorization Request FormEnsures each service item within the Member’s Care Plan and Budget Form stays within the allowable Services Limit and ensures the overall dollar amount stays within the overall allowable limit. Keeps track of the amount of each service used to date for the authorized service year on the Budget Form.Maintains ongoing communication with the team as agreed upon by the member.Schedules Team Meetings as pletes the ORC Prior Authorization Request Form when needed.Refers 30 days ahead of expiration date for a new MED Assessment to be completed annually.Requests any increase, change, or decrease in service as identified by Member with the Prior Authorization Request Form.Requests and coordinates any changes in Providers as identified by Member.Provides Members with a full list of ORC providers annually to allow them complete choice in providers.Renews Care Plan and Care Plan Services Prior Authorization Request Form annually and before the Renewal Date to prevent a lapse in services.Revises Care Plan and Care Plan Services Prior Authorization Request Form as needed. Ensures the Member, Guardian (if applicable), Care Coordinator, and applicable ORC Waiver Provider signatures are on all Revised and Renewed Care Plans.Submits Revised and Renewed Care Plans and Care Plan Services Prior Authorization Request Forms to the OADS Care Monitor.Evaluates and monitors services.Meets face to face with Member at least every 30 days. Fulfilling this requirement is documented by the 30 Day Note in pletes a 30 Day Note in EIS at least every 30 days or less.Start Date and End Date is the day of the face to face visit.Notes should be entered in EIS within 5 days of the End Date.The title must be formatted as follows: 30 Day [Date of visit 00/00/0000] Face to Face. Example: 30 Day [01/01/2001] Face to Face.The 30 Day Note should containObservationsActions Status of ServicesChanges in ServicesRelevant Information which follows the outline of the Care PlanAny Follow-Up required.Contact Notes: Any additional face-to-face contacts with the member shall be documented separately and titled “Contact Note [Date of Contact].Maintains open communication with ORC Waiver Providers. Provides updates as necessary to provide the best care and appropriate level of service to the Member. If providers are added and/or ended, it is the Care Coordinator’s responsibility to update the ending provider and send a referral to the added provider.Works with ORC Waiver Providers to ensure they are a part of the planning process to the extent indicated by the Member.Conflict Free Care CoordinationConflict free Care Coordination is designed to ensure that Members have choice of providers and options are not unduly influenced by providers who both coordinate and offer services. As an example, agencies that provide Care Coordination cannot provide other services to the Member (i.e. community supports, work supports, etc.).The concept of conflict free Care Coordination also applies to the Care Planning process. The Member has a choice between and among providers to meet their identified service needs. The Care Coordinator is responsible for ensuring the service options, which include MaineCare and non-MaineCare and paid and natural supports, are known to the Member.This choice of providers extends to the provision of Care Coordination. Members have the choice of any qualified and enrolled providers to provide Care Coordination. ORC Waiver ProvidersORC Waiver Providers consists of the non-OADS agencies, administrators and Direct Service Professionals (DSPs) that provide Community Support Services, Employment Specialist Services, Home Support (Per Diem, 1/4 hour and Remote Support), Personal Care Services, and Work Support Services to Section 20 ORC Members. Clarification regarding these supports can be found in Chapter II, Section 20.05 of MaineCare Benefits Manual.ORC Waiver Providers:Support the Member as identified in the Care Plan and within the scope of the Care Plan Services Prior Authorization Request Form.Enter weekly summary notes of services provided into EIS.Start Date is the Sunday of the week being summarized.End Date is the Saturday of the week being summarized.Notes should be entered within 5 days of the End Date.Titles must state the name of the service, the Start Date and End Date. (example: Home Support Note 1/7/2001 to 1/13/2001).Summaries should include:Progress towards goalsMember SuccessesMember ChallengesProvider ConcernsMajor events in the Member’s lifeChanges in the Member’s routineKeep copies of the most recent and signed Care Plan, in its entirety, from the Care Coordinator, and contact the Care Coordinator if they have reason to suspect they have not received the most recent Care Plan. If contacting the Care Coordinator does not yield any results the ORC Waiver Provider may contact the OADS Care Monitor.Participate in Plan Meetings to the extent desired by the Member.Maintains open communication with Care Coordinator. Provides updates as necessary to provide the best care and appropriate level of service to the Member.Provider Enrollment and MaintenanceNon-MaineCare Agency Providers wishing to enroll as a MaineCare agency provider will need to contact Molina HealthCare. Molina can be reached by telephone at 1-866-690-5585 (TTY: 711) or email through MaineCareEnroll@.MaineCare Agencies enroll electronically through Molina Health Care. To enroll as an Other Related Conditions agency provider the agency will need to choose the following provider and specialty type: Provide Type 73- Waiver Provider and Specialty 169 -ORC. Once the agency receives their welcome letter and contracts are attached, they may bill for services. Any questions regarding claims or member eligibility please call Provider Services at 1-866-690-5585, listen to options before selecting as options may change. Care Plan2724290146555The Care Plan is the Member directed document that guides how services are delivered under the ORC Waiver. The Care Coordinator is responsible for writing and revising the Care Plan ensuring the Care Plan reflects the needs and desires of the Member, and ensuring that the Care Plan meets the Member’s health and welfare needs in the community.Writing the Care PlanAll Care Plans must be completed using the same template. Care Plans are not to be password protected. The Care Plan must reflect the needs and desires of the Member. Of the services, available under the Section 20 Waiver, which services the Member wants, when they want them, who they want to provide those services, and what goals they want to accomplish with the help of those services must be documented. Remember that services are limited by the Care Plan Services Prior Authorization Form and MaineCare rules.Another piece of writing the Care Plan is completing the Care Plan Services Prior Authorization Request Form. The Care Plan Services Prior Authorization Request Form is what allocates the money available to the Member to spend on Section 20 services. Any service that is indicated on the Care Plan Services Prior Authorization Request Form must also be documented and accounted for in the Care Plan.A Care Plan is only effective for 365 days. Thus, the Care Plan must be renewed annually. If the Member desires a change in the plan, or if a major life change occurs, the Care Plan must be revised.Revising the Care PlanThe Care Plan is to be revised in the following situations:Adding a Service (Example: John would like to add Work Supports)Ending a Service (Example: Jane no longer wants to attend Community Supports)Changing a Service (Example: John would like to receive Home Supports from a different agency OR John would like to receive less Home Supports)Major Life Changes that Affect Services (Example: Jane’s sister Joyce is now her Guardian)Changing Care Coordination even between the same provider agency.Changes to the plan are at the discretion of the Member or because of a major life change. It is the providers’ responsibility to ensure that services follow MaineCare policy.If the Member would like a new provider, the Care Coordinator must work with the Member and provide them with all options, including all Care Coordination options. Even if the Member has not indicated they want to change providers the Care Coordinator must review the provider options available at least annually when creating the Care Plan. If the Member has a specific agency they would like to work with that is not an ORC provider the OADS Care Monitor will try to reach out to the desired provider and invite them to become an ORC provider. Those providers who are interested can work with OADS Care Monitor and OADS program staff to become authorized ORC vendors. See Provider Enrollment for more information.Changing ORC ProvidersMembers must be informed about available ORC Provider agencies and choose whom they receive services from. The Care Coordinator’s responsibility is to ensure that the Member has choice and that the discussions about options are documented.The Care Coordinator must obtain a signed Authorization to Release Information form before any information is shared. If possible, a transfer meeting should occur between the Member and/or guardian and agencies involved.If providers are added and/or ended, it is the current Care Coordinator’s responsibility to update the ending provider and send a referral to the added provider. During this transition a team meeting may be held to ensure services are not interrupted, though it is up to the Member to decide when they will no longer work with a provider.The Care Coordinator must update all affected providers of the changes being made, and ensure those providers that continue to support the Member receive an updated Care Plan Services Prior Authorization Request Form and Care Plan. The Revised Care Plan must be signed by the Member, the Guardian (if applicable) and the Care Coordinator to be valid.Changing Care CoordinatorsWhen a Member transfers between two Care Coordination agencies, the sending agency must assist the Member in choosing another Care Coordination agency. These discussions and the options presented must be documented.The sending Care Coordination agency must update the Care Plan and submit to the OADS Care Monitor for approval, as well update information about the Member in EIS. The OADS Care Monitor will confirm with the receiving Care Coordination agency that the referral has been accepted and set a start date for service.Transfer of Member RecordsOnce an Authorization to Release Information is obtained, The Care Coordinator will ensure that the Member’s record is transferred as per the arrangements made between the sending and receiving Care Coordinator Supervisors. This includes updating EIS with the new address and service agencies. The following documentation should be forwarded to the new Care Coordination agency:Care PlanCare Plan Services Prior Authorization Request Form BMS 99MED AssessmentPlan DatesCare Plan ScheduleAny assessments and/or reports (Assistive Technology Assessment, Psychological Evaluation, etc.).The sending Care Coordination Supervisor will assure that the record is complete prior to transfer.Renewing the Care PlanA Care Plan is only authorized for 365 days from its Renewal Date. Therefore, a Care Plan must be renewed once a year. 14 days prior to the Renewal Date the Care Coordinator must submit the following to the OADS Care Monitor:1. Revised and Signed Care Plan2. Updated Care Plan Services Prior Authorization Request Form3. Updated BMS 994.Updated Annual Choice of Waiver Services and Provider Letter5. Care Plan ScheduleOADS Care Monitor will provide approved Care Plan to the Care Coordinator 3 business days prior to the Renewal Date. Once approved by the OADS Care Monitor, the Care Monitor will submit the signed Care Plan and Care Plan Services Prior Authorization Request Form to all ORC Waiver Providers. MED AssessmentTo remain eligible for services the Member must have a Medical Eligibility Determination (MED) assessment completed annually. 30 days prior to the expiration date of the current MED assessment the Care Coordinator must submit the referral for a new MED assessment to the current assessing agency. If the MED assessment cannot be completed within one year of the previous MED assessment an agency supplied Attachment B will cover services until the assessment is completed.The OADS Care Monitor will electronically review the MED Date when reviewing a Care Plan Renewal. A Care Plan may not be approved if the MED assessment is more than a year old and there is no Attachment B.Care Plan ScheduleMembers must have a Care Plan Schedule completed by the Care Coordinator. This schedule is agreed to by the Member and ORC Waiver Providers and helps to ensure both parties know when services are expected to take place. The Member reserves the right to refuse services at any time, even if it conflicts with the Care Plan Schedule currently in place. A change in the schedule does not warrant a revision of the Care Plan unless the change will be long term or result in an increase in service hours.The Care Plan Schedule provides a visual and tentative weekly plan for the Member to be able to rely on staff being there for the times they need them, as well as for companies to be able to staff accordingly. The Schedule can change at any time and daily.Service LimitsThe Care Plan and Care Plan Services Authorization/ Revision Request-Service Form may not exceed the limits listed below. The limits can be found in Chapter II, Section 20.07 of MaineCare Benefits Manual.ServicesLimitsAssistive Technology Assessment 32 units per service yearAssistive Technology Transmission $50.00 per service monthAssistive Technology $6,000.00 per service yearCare Coordination Services400 units per service yearThis is conflict free. Care Coordination Provider cannot provide any other waiver services to the Member receiving Care munication Aids$6,000.00 per service yearCommunity Support Services*128 units per week, annual total of 6656 units per service yearConsultation Services64 units per service year, each type of Consultation ServiceEmployment Specialist Services72 units per service yearHome Accessibility Adaptations$3,000.00 per service yearHome Support (1/4 hour)64 units per dayHome Support (Remote Support)64 units per dayHome Support (Per Diem)Per Diem $287.91Non-Traditional Communication Assessment64 units per service yearNon-Traditional Communication Consultation64 units per service yearOccupational Therapy Maintenance8 units per week, 416 per service yearPersonal Care Services52 units per dayPhysical Therapy Maintenance8 units per week, 416 units per service yearSpecialized Medical Equipment and SuppliesAny item over $500.00 requires documentation from a physician, Occupational Therapist, Physical Therapist, or Speech TherapistSpeech Therapy Maintenance 8 units per week, 416 units per service yearWork Support Services*128 units per week, 6656 units per service year*Community Support and Work Support Services unit allotments are combined. When members use a combination of both services, there is a weekly limit of 128 units per week and an annual limit of 6656 units on the total combined expenditures for the services.LegalMaineCare Appeals-50609520701000In accordance with Chapter I of the MaineCare Benefits Manual, members have the right to appeal in writing or orally any decision made by DHHS to reduce, deny or terminate services provided under this benefit. The right to appeal does not extend to changes in law or policy adversely affecting some or all recipients.-5334009461500The appeal must be (a) requested in writing and mailed to the address below, or (b) requested by telephone by calling Local: 207-287-6598, Toll Free: 1-800-606-0215 or TTY: 711.Office of Aging and Disability ServicesDepartment of Health and Human Services11 State House StationAugusta, ME 04333-0011Public Guardianship and ConservatorshipPublic guardianship appointments are made to provide continuing care and supervision of incapacitated adults, and public conservatorship appointments are made to protect, preserve, manage and apply estates of incapacitated adults, when it has been determined that no suitable private guardian or conservator is available and willing to assume responsibilities for such service.Public Wards receiving Section 20 ORC Services will receive Guardianship Representation from OADS Adult Protective Services Case Workers.Levels of Authorization Delegated by the CommissionerOADS Adult Protective Services Case Workers may make decisions on behalf of public wards and protected persons, except as otherwise provided in Maine statute and OADS policy. Refer to OADS policy 10-149 Ch. 5 Section 15.09: Adult Protective Services: Guardianship/Conservatorship, Levels of Authorization Delegated by the Commissioner. Authorizations will be consistent with the Probate Court appointment and within the appropriate scope of the Case Workers level of authority.When the public appointment includes financial authority, OADS Adult Protective Services Case Workers are responsible for identifying assets and obligations of the Member, and securing and using those assets for the benefit of the Member.Motion for Change of VenueUpon change of residence of the Ward or protected person, OADS Adult Protective Services Case Workers will determine if a motion for change of venue is appropriate and work with a Supervisor for assistance in completing the required documentation for the Probate Court.Reportable Events The Reportable Events system enables providers of services, including ORC providers, to report certain events to OADS as required by state rule and by DHHS policy. The purpose of the Reportable Events system is to ensure that events that have or may have an adverse impact on the safety, welfare, rights or dignity of persons served under the ORC waiver are documented, reported, investigated and reviewed. DHHS Rule 14-197 Chapter 12 also contains procedures that the Adult Protective Services follows to investigate allegations of abuse, neglect, and exploitation of adults pursuant to the Adult Protective Services Act, 22 M.R.S.A. §3471 and 3473. ReportingIf the following events occur the Department must be notified immediately. Notification during business hours is done by contacting the OADS Care Monitor at 1-800-262-2232 and asking for the ORC Care Monitor. After hours and during the weekend notification is done by contacting Adult and Child Emergency Services (ACES) at 1-800-624-8404. After notification, the report must be documented in EIS. ?Abuse, neglect, or exploitation of a person?Death?Serious illness or injury?Lost or missing person?Assaults?Suicide attempts or threats of suicide?Dangerous situations that pose an imminent risk of harm?Physical plant disastersAll Member deaths, even if expected, must be reported. Following a Member death the Care Coordinator must complete a Death Report/Mortality Assessment within EIS.Other events that must be documented in EIS within one (1) business day include the following:?Mistreatment?Emergency services?Dangerous situations not included in (2) (a) above?Rights violations?Medication error or refusal?Failure to obtain consent of public or private guardian or other legally-authorized representative prior to implementation of new, changed or additional medical order, including changes in medication or DNR orders, when the person with mental retardation or autism cannot give informed consent ?Missing medication suggesting the possibility of theft. This includes a pattern of missing medication, or a significant amount of missing medications, especially Schedule II drugs?Physical plant dangers?Restraint?Use of mechanical devices and supports, not applied under the supervision of a qualified professional or part of an approved treatment plan?Self-injurious behaviors?Other events not listed above, but which create a dangerous or harmful situationDocumentingAll Reportable Events witnessed by ORC providers should be documented electronically through EIS by following instructions found here. If the provider does not have EIS access a copy of the Reportable Event forms can be found here and needs to be submitted to the Information Data Specialist (IDS) in your regional OADS office. The Reportable Event form doesn’t replace the need to communicate with your Supervisor when an adverse event occurs. It is not used for notifying the Department for any events that must be reported immediately, only for documentation. Once the Department is notified of the Reportable Event in EIS should be completed.The Care Coordinator, if aware a Reportable Event took place, should check EIS to ensure a Reportable Event was submitted. If no Reportable Event was submitted the Care Coordinator may create the Reportable Event with second hand information if the party that witnessed the Event refuses to do so.If the reportable event involves more than one Member a reportable event must be completed for each Member. If the reportable event involves a Member assaulting another Member, then two separate reportable incidents have occurred and separate reports must be filed for each person.ORC members or other community members who do not have EIS access but have concern an adult is being neglected, abused, or exploited may contact Adult Protective Services (APS) Intake at 1-800-624-8404, or a report can be submitted electronically here. Confidentiality and DisclosureMember’s records, including protected health information, are private and confidential. Records include both electronic and paper documents. Member’s medical and administrative information cannot be disclosed to others except as provided by statute. Only the minimum information necessary to conduct business is to be used or shared. Records created by other persons or agencies that are included in a Member’s record can only be disclosed in accordance with the terms of the release or within the terms of applicable statutes.When DHHS is appointed as a person’s public guardian or conservator, it has the authority and discretion to authorize disclosure of relevant information in its records, within the scope of its legal appointment. DHHS will make reasonable efforts to maintain the person’s privacy to the maximum extent possible.Protected information is relevant information that may not be disclosed under the terms of applicable law without appropriate authorization or court order. Such information includes but is not limited to names of reporters who have requested confidentiality; work products between DHHS staff and their attorney; and non-conviction data.Refer to the Privacy and Security of Health Information section of the Department’s website for information about protection of health information and for the contact information for the Department’s Privacy Officer. An Authorization to Release Information is not required in emergency situations or when meeting mandatory reporting requirements. ORC Providers are required to utilize their own agency Authorization to Release Information forms.Standards and ProceduresEmploymentDHHS is committed to supporting career development and meaningful employment for all working age adults. Being employed is part of the natural course of adult life. Employment provides individuals with economic gain, personal growth, and opportunities to contribute to one’s community.The Care Coordinator is responsible for reviewing the employment status of Members, at least annually during the Care Planning process, and documenting that the person’s employment and the ongoing support needs, both natural and paid, has been reviewed. If the Member is not employed then the conversation should be about why work is important, interests, services available and potential barriers to employment. Documentation of the conversations and actions to be taken must be included in the Care Plan.The OADS website, Employment Services and Supports has tools and resources to assist in discussions about employment. For more information, go to the Employment for Me website, which provides additional resources for workers with disabilities.Entitlement Programs and BenefitsCare Coordinators are responsible for assisting Members in applying for entitlement programs and for the timely completion of benefit applications and reviews (such as MaineCare, Medicare, TANF, Food Stamps, Property Tax Rebate, Heating Fuel Assistance, Low Cost Drug program, VA and SSI etc.).When OADS acts as Representative Payee or fiduciary, Guardian Representatives will ensure that reports are submitted to Social Security Administration, Veterans Administration, and other entities as needed. Social Security’s Guide for Representative Payees is here. Care Coordinators should refer to agency policy regarding private Representative Payee responsibilities.Housing Options There are several possible living arrangements for Members. The Care Coordinator is responsible for promoting a Member’s independence by facilitating and advocating for the least restrictive housing option. On an ongoing basis, the Care Coordinator should be discussing the skills needed for the Member to live more independently and the benefits of moving to less restrictive settings.? The Care coordinator is expected to describe all housing options so that the Member is informed of their housing options and choices.? The Member’s satisfaction with the present living arrangement should be assessed during the monthly visit conducted by the Care Coordinator.?? Evaluations, Consultations, and Other Covered ServicesPrior Authorization ProcessThe member indicates the need and/or desire for assessment or service.Care Coordinator updates care plan then submits the document to OADS for approval along with the Care Plan Services Prior Authorization Request Form.OADS approves or denies the request.If approved, the Care Coordinator makes arrangements for the service.Service Provider becomes prior-authorized to provide the assessment or service to Member.Consultation and/or Request for Evaluation The Member, along with the Care Coordinator determines which evaluations and consultations are indicated. The results of evaluations and consultations must be documented. Documentation of evaluations and consultations will be uploaded to EIS when that capacity is enabled. Prior to such time, documents will be forwarded to the Care Coordinator and the Care Monitor upon completion. The Care Coordinator is responsible for ensuring that the Authorization to Release Information form is signed when requesting the service or receiving the report. The Care Coordinator is also responsible for ensuring that a qualified interpreter, if needed, is scheduled to attend the appointment. Refer to the Chapter I, Section 1.06-3 of the MaineCare Benefits Manual for information on MaineCare coverage of Interpreter Services.When requesting an evaluation/consultation:Request the referral one to three months prior to the date the report is needed, and make sure evaluator is aware of relevant plete a Referral Form if one is requested by the service provider. Attempt to ensure that a person who is knowledgeable about the Member is available to the therapist or clinician during the evaluation/consult.?Assistive Technology DevicesAssistive technology device refers to a piece of equipment or product that is used to increase, maintain, or improve functional capabilities of the Member. In order to receive this service, the Member must receive prior authorization from OADS. The Care Coordinator and the Member themselves cannot purchase equipment and be reimbursed. Either the OADS approved Assistive Technology Provider or the ORC Home Support Provider can purchase the equipment and bill MaineCare for reimbursement. The Care Coordinator will determine who is reimbursed after gathering information from both parties. This service covers:The evaluation of Assistive Technology needsPurchasing, leasing or providing for the deviceSelecting, designing, fitting, customizing, adapting, maintaining, and repairing the deviceCoordination and use of necessary therapies, interventions or servicesTraining for the Member, family, guardian, and/or authorized representativesTraining for the professional who provides related service to the MemberCommunication AidsCommunication Aids are devices or services that assist a Member with hearing, speech, or vision impairments to effectively communicate with providers, family, friends, and other community members. In order to receive this service, the Member must receive prior authorization from OADS. This service covers the following:Communicators, including repair and maintenance Speech amplifiers, aids and assistive devices, including repair and maintenance.Consultation Services and AssessmentThis service consists of clinical and therapeutic services that assist unpaid caregivers or paid support staff in carrying out Care Plans that are necessary to improve the Member’s independence and inclusion in their community. Providers of this service are professionals in Psychology, Occupational Therapy, Physical Therapy, Speech Therapy, and Behavioral Health. The service may include assessment, development of Care Plan, training and technical assistance to carry out the care Plan, and monitoring the Member and provider in implementation of the Care Plan. Reimbursement shall be made only to providers not already reimbursed for consultation as part of another service. Personnel who provide services under Care Coordination may not be reimbursed for Consultation Services. In order to receive this service, the Member must receive prior authorization from OADS.Home Accessibility AdaptationsThis service consists of physical adaptations to the private residence of the Member or Member’s family that is both required by the Care Plan and necessary to ensure the health, welfare, and safety of Member or enable Member to function with greater independence. Examples include ramps, grab-bars, widening doorways, and modifying bathroom facilities. Excluded examples are general utility and not of direct medical or remedial benefit to Member. This service may not be furnished to living arrangements that are owned or leased by providers of waiver services. In order to receive this service, the Member must receive prior authorization from OADS.Non-emergency Transportation ServicesThis service enables members to gain access to Section 20 services as specified by the Care Plan. This service is provided under Chapter II, Section 113 of the MaineCare Benefits Manual. Whenever possible, family, friends or agencies which can provide this service without charge are utilized. In order to receive a prior authorization for this service, the Member must have the need documented in their care plan.Non-Traditional Communication AssessmentsThis service includes assessments that determine the Member’s level of communication present via gesture, sign language, or unique individual communication style. Assessment recommendations are made to optimize communication to maximize social integration. In order to receive this service, the Member must receive prior authorization from OADS.Non-Traditional Communication ConsultationThis service consists of consultation provided to the Member, their direct support staff, and others to assist the Member to maximize their communication ability as determined from a Non-Traditional Communication Assessment. This service is intended to enable members of the team to communicate expressively and receptively with the member during all day-to-day activities, which helps the member to actively participate in his/her Care Plan. In order to receive this service, the Member must receive prior authorization from OADS.Occupational Therapy (Maintenance) ServicesThis service consists of direct therapy and consultation services to maintain the member's optimal level of functioning within the member's current environment. The intent is to prevent regression, loss of movement, injury and medical complications that would result in a higher level of skilled care. In order to receive this service, the Member must receive prior authorization from OADS.Evaluative and rehabilitative therapy is included in the State Plan and is not a covered service.Physical Therapy (Maintenance) ServicesThis service consists of direct therapy and consultation services to maintain the member's optimal level of functioning within the member's current environment. The intent is to prevent regression, loss of movement, injury and medical complications that would result in a higher level of skilled care. In order to receive this service, the Member must receive prior authorization from OADS.Evaluative and Rehabilitative Therapy is included in the State Plan and is not a covered service under this waiver.Specialized Medical EquipmentSpecialized Medical Equipment consists of devices or appliances specified in Care Plan that:Increases Member’s ability to perform activities of daily livingEnables Member to perceive, control, or communicate with their environmentIs necessary for life support or to address physical conditionsEquipment not available under State Plan that is necessary to address functional limitationsNecessary medical supplies not available under State PlanExcluded are items that are not of direct medical or remedial benefit to the member. In order to receive this service, the Member must receive prior authorization from OADS.Speech Therapy (Maintenance) ServicesThis service consists of direct therapy and consultation services to maintain the member's optimal level of functioning within the member's current environment. The intent is to prevent regression, loss of movement, injury and medical complications that would result in a higher level of skilled care. In order to receive this service, the Member must receive prior authorization from OADS.Evaluative and Rehabilitative Therapy is included in the State Plan and is not a covered service under this waiver.Appendix F – Care Plan ScheduleMember Name:______________________ Care Plan Effective Date:_____________________ Care Plan End Date:_______________________?Sunday?MondayTuesdayWednesdayThursdayFridaySaturday12AM12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?1AM1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?12:00 to 12:15?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?2AM2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?3AM3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?4AM4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?5AM5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?6AM6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?7AM7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?8AM8:00 to 8:15 ?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:45 to 9:00 ?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?9AM9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?10AM10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?11AM11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00? Remote Support Staffing In-Person Support Staffing Backup Support Community Support ?Sunday?MondayTuesdayWednesdayThursdayFridaySaturday12PM12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:00 to 12:15?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:15 to 12:30?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:30 to 12:45?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?12:45 to 1:00?1PM1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:00 to 1:15?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:15 to 1:30?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:30 to 1:45?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?1:45 to 2:00?2PM2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:00 to 2:15?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:15 to 2:30 ?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:30 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?2:45 to 3:00?3PM3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:00 to 3:15?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:15 to 3:30?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:30 to 3:45?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?3:45 to 4:00?4PM4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:00 to 4:15?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:15 to 4:30?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:30 to 4:45?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?4:45 to 5:00?5PM5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:00 to 5:15?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:15 to 5:30?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:30 to 5:45?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?5:45 to 6:00?6PM6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:00 to 6:15?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:15 to 6:30?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:30 to 6:45?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?6:45 to 7:00?7PM7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:00 to 7:15?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:15 to 7:30?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:30 to 7:45?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?7:45 to 8:00?8PM8:00 to 8:15 ?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:00 to 8:15?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:15 to 8:30?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:30 to 8:45?8:45 to 9:00 ?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?8:45 to 9:00?9PM9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:00 to 9:15?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:15 to 9:30?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:30 to 9:45?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?9:45 to 10:00?10PM10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:00 to 10:15?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:15 to 10:30?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:30 to 10:45?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?10:45 to 11:00?11PM11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:00 to 11:15?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:15 to 11:30?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:30 to 11:45?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00?11:45 to 12:00? Remote Support Staffing In-Person Support Staffing Backup Support Community Support The Department of Health and Human Services (DHHS) does not discriminate on the basis of disability, race, color, creed, gender, sexual orientation, age, or national origin, in admission to, access to, or operations of its programs, services, or activities, or its hiring or employment practices. This notice is provided as required by Title II of the Americans with Disabilities Act of 1990 and in accordance with the Civil Rights Act of 1964 as amended, Section 504 of the Rehabilitation Act of 1973, as amended, the Age Discrimination Act of 1975, Title IX of the Education Amendments of 1972 and the Maine Human Rights Act and Executive Order Regarding State of Maine Contracts for Services. Questions, concerns, complaints or requests for additional information regarding the ADA may be forwarded to DHHS’ ADA Compliance/EEO Coordinators, 11 State House Station – 221 State Street, Augusta, Maine 04333, 207-287-4289 (V), 207-287-3488 (V), TTY users call Maine relay 711. Individuals who need auxiliary aids for effective communication in program and services of DHHS are invited to make their needs and preferences known to the ADA Compliance/EEO Coordinators. This notice is available in alternate formats, upon request. ................
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