Bates Consent Decree Rules Adopted
Maine Department of Health & Human Services sent this bulletin at 07/14/2021 12:50 PM EDT
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Bates Consent Decree Rules Adopted
This message is intended for providers of the following sections of the MaineCare Benefits Manual:
- Section 17, Community Support Services
- Section 65, Behavioral Health Services
- Section 92, Behavioral Health Home Services
- Section 97, Private Non-Medical Institution Services, Appendix E
The Office of MaineCare Services (OMS) has adopted final rules in the MaineCare Benefits Manual to better conform with the Bates v. AMHI Consent Decree that is binding on the Department. These requirements for “Protections for Adults with Serious and Persistent Mental Illness” were previously added to MBM Chapter II, Section 65 (Behavioral Health Services), effective August 19, 2020, and OMS issued guidance on April 20, 2021 explaining its intent to adopt these rules in Sections 17, 92, and 97 and to have them take effect July 1, 2021.
Effective July 1, 2021 the changes requiring authorization to decline referrals or terminate services for adults with serious mental illness have been adopted in rules for Section 17 (Community Support Services), Section 92 (Behavioral Health Home Services), and Section 97 (Private Non-Medical Institutions, Appendix E) .
For background, in 2004, the Maine Law Court held in Bates v. Department of Behavioral and Developmental Services (2004 ME 154, ⁋ 68) that the State must provide the same community mental health services to qualifying non-class members as are required for class members under the Consent Decree, and that qualifying non-class members are all adults with serious and persistent mental illness. More information on the Consent Decree and the Department’s response can be found here.
Through these rules, the Department has established protections for Adults with Serious and Persistent Mental Illness, including requiring providers to seek approval from the Office of Behavioral Health prior to terminating services or declining a referral, requiring service providers to issue a 30-day advanced written notice to members prior to terminating services (with exceptions in specific situations), and requiring providers to accept Department referrals within the specified timeframe.
For more information on specific changes within each of the rules, please see the adopted rulemaking announcements at the following links:
Please contact your Provider Relations Specialist with questions.