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

Notice of Agency Rule-making Adoption

 

AGENCY: Department of Health and Human Services, MaineCare Services

 

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

 

ADOPTED RULE NUMBER:

 

CONCISE SUMMARY:

 

This letter gives notice of an adopted rule: 10-144 C.M.R Chapter 101, MaineCare Benefits Manual, Chapter II, Section 92, Behavioral Health Home Services.

 

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

 

This adopted rule enhances safeguards and protections of client rights under the Bates, et al. v. Commissioner, DHHS, et al, consent decree. The rule addresses 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 added 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 gives 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.

 

The Department also updated 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 Maine’s opioid task force and legislation passed in 2018 to minimize stigma (P.L. 2017, ch. 407). 

 

Considering public comment, in addition to the changes to the final rule described above, the Department made the following change to the final rule:

 

• The Department has amended the term “Department referrals” to “referrals” under 92.02-3 D in the adopted rule. 

 

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

 

 

EFFECTIVE DATE:                       July 1, 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)