MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapter II, Section 92, Behavioral Health Home Services

Notice of Agency Rule-making Proposal

 

AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy

 

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 92, Behavioral Health Home Services

 

PROPOSED RULE NUMBER:

 

CONCISE SUMMARY:

 

The Department of Health and Human Services (“the Department”) proposes the following changes to 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter II, Section 92, Behavioral Health Home Services.

 

This rule is proposed in order to enhance safeguards and protections of client rights under the Bates, et al. v. Commissioner, DHHS, et al, consent decree. The proposed changes address referrals to and terminations from Behavioral Health Home Services for members with Serious and Persistent Mental Illness. Prior to terminating a member's services, providers must receive written approval from the Office of Behavioral Health (OBH); must issue a 30-day advanced written termination notice to the member, with an exception for cases involving imminent harm; and must assist the member in obtaining clinically necessary services from another provider prior to termination. In addition, providers must accept Department referrals within seven (7) calendar days and may only decline referrals with written approval from OBH. 

 

Additionally, in furtherance of consent decree principles, this rule proposes to add language for timeliness standards for Adults with Serious and Persistent Mental Illness, consistent with those in Section 17 Community Support Services for this population. These standards require that providers must conduct an initial face-to-face intake or initial assessment visit within seven (7) calendar days of the date of referral. This rule also proposes giving members the option to request to “hold for service” if providers are unable to meet the seven (7) calendar day face-to-face requirement of new referrals but the member would still like to wait until that provider can accept their referral. Members may elect to hold for service only after an agency has adequately informed the member of their other area service options.

 

Lastly, the Department proposes updates to formatting, citations, and references where necessary, including changing “Office of Substance Abuse and Mental Health Services” to “Office of Behavioral Health” and removing potentially stigmatizing language based on recommendations from the Maine’s opioid task force and legislation passed in 2018 to minimize stigma (P.L. 2017, ch. 407). 

 

See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.

 

STATUTORY AUTHORITY: 22 M.R.S. §§ 42(1), 3173; P.L. 2017, ch. 407

 

PUBLIC HEARING:

 

No public hearing scheduled. During the Civil State of Emergency declared by the Governor, public hearings are now closed to the public physically attending.  During this State of Emergency, the Department will be providing a 30-day comment period instead of a public hearing. 

 

30-DAY DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on May 21, 2021.

 

AGENCY CONTACT PERSON:   Melanie Miller, Comprehensive Health Planner II

              Melanie.Miller@maine.gov

AGENCY NAME:                                   MaineCare Services

ADDRESS:                                               109 Capitol Street, 11 State House Station

                                                                   Augusta, Maine 04333-0011

TELEPHONE:                                        207-624-4087 FAX: (207) 287-6106

                                                                  TTY: 711 (Deaf or Hard of Hearing)

 

IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.

 

CONTACT PERSON FOR SMALL BUSINESS INFORMATION (if different): N/A