Subsection 144-101-II-20.10 - PROVIDER QUALIFICATIONS AND REQUIREMENTSTo provide services under this section a provider must be a qualified vendor as approved by DHHS and enrolled by the MaineCare program. Once a provider has been authorized to provide services, the provider cannot terminate the member's services without written authorization from DHHS.
20.10-1Assistive Technology Services-In order to provide Assistive Technology Services, a provider must be an OADS approved agency and employ: A. A Licensed Occupational Therapist; orB. A Licensed Speech Pathologist; or C. A certified Direct Support Professional (DSP) who is also certified as a Rehabilitation Engineering Technologist (RET) or an Assistive Technology Professional (ATP).20.10-2Care Coordination Services- In order to provide Care Coordination Services, a provider must be an OADS-approved agency and employ: A. A Registered Nurse; orB. A Registered Occupational Therapist; orC. A Licensed Social Service or health professional with four years of education in health or social services field and one year of community experience in providing the direct service. 20.10-3Career Planning - In order to provide Career Planning Services, a provider must be an OADS-approved Provider Agency and the individual providing the service must meet one of the following training requirements and must have completed an additional 12 hours of Career Planning and Discovery training provided through Maine's Workforce Development System:A. Certificate as a Direct Support Professional (DSP) as detailed in 20.10-6; orB. Employment Specialist National Certification approved by the Association of Community Rehabilitation Educators (ACRE).20.10-4Communication Aids- In order to provide Communication Aids, an independent (non-agency) provider must possess a Certificate of Clinical Competence-Speech Pathology (CCC-SP) or be a Licensed Speech Language Pathologist (SLP), or a Licensed Audiologist. An agency provider of Communication Aids must be a licensed speech and hearing agency or licensed Home Health Agency and the staff person must possess a Certificate of Clinical Competence-Speech Pathology (CCC-SP).20.10-5Consultation Services- In order to provide Consultation Services a provider must: A. Possess a certificate of Clinical Competence in Speech Pathology for Speech Consultation; orB. Be a Licensed Occupational Therapist for Occupational Therapy Consultation; orC. Be a Physical Therapist for Physical Therapy Consultation; orD. Be a Psychological Examiner or Be a Licensed Clinical Psychologist for Psychological Consultation; orE. Be a Licensed Clinical Social Worker (LCSW) or Be a Licensed Clinical Professional Counselor (LCPC) for Behavioral Consultation.20.10-6Community Support, Home Support, Work Support Services- Community Support, Home Support, and Work Support Services must be provided by a Direct Support Professional (DSP), a Personal Support Specialist (PSS) or a Personal Care Assistant (PCA), and the individual providing the services must:A. Meet one of the following training requirements: i. Have successfully completed the appropriate training as a Direct Support Professional curriculum as adopted by DHHS, orii. Demonstrated proficiency through DHHS's approved Assessment of Prior Learning, oriii. Have successfully completed the curriculum from the Maine College of Direct Support within 90 days of date of hire and completed the following five modules from the College of Direct Support prior to providing services to a member alone: 1. Safety at Home and in the Community 4. Individual Rights and Choiceiv. Hold a valid certificate of training as a personal support specialist/personal care assistant issued as a result of completing the Department approved personal support specialist training curriculum and passing the competency-based examination of didactic and demonstrated skills. The training course must include at least fifty (50) hours of formal classroom instruction, demonstration, return demonstration, and examination. Tasks covered under this section must be covered in the training; orv. Be a PCA or PSS who successfully completed a Department-approved curriculum prior to September 1, 2003. Such individuals will be grandfathered as a qualified PCA or PSS; and Documentation of completion must be retained in the personnel record. B. Have a background check consistent with Section 20.10-16;C. Have a valid driver's license, if transporting members;D. Be at least 18 years of age;E. Have graduated from high school or acquired a GED;F. Have completed Reportable Events and Behavior Regulations Training.20.10-7Employment Specialist Services-In order to provide Employment Specialist Services, a provider must:A. Possess a national certification by the Association of Community Rehabilitation Educators (ACRE); andB. Pass a background check consistent with Section 20.10-16; andC. Possess a valid driver's license, if transporting members; andD. Be at least 18 years of age;E. Possess a high school degree or GED; andF. Have one year of experience working with people with disabilities in a work setting.20.10-8Home Accessibility Adaptations- In order to provide Home Accessibility Adaptations, a provider must be approved by the Office of Aging and Disability Services (OADS).20.10-9Non Traditional Communication Assessment and Consultation- In order to provide Non Traditional Communication Assessment and Consultation, a provider must;A. Possess a Houston Certificate or other training approved by DHHS; orB. Be a Licensed Speech Language Pathologist. 20.10-10Occupational Therapy (Maintenance)- In order to provide Occupational Therapy (Maintenance) Services, a provider must be a Licensed Occupational Therapist.20.10-11Personal Care-In order to provide Personal Care Services, a provider must;A. Possess a valid certificate or training for nursing assistants and be listed on the Maine Registry of Certified Nursing Assistants; orB. Hold a valid certificate of training, issued within the past three (3) years, for nurse's aide or home health aide training that meets the standards of the Maine State Board of Nursing nursing assistant training program; orC. If a CNA's status on the Maine Registry of Certified Nursing Assistants has lapsed, or an individual holds a valid certificate of training meeting the standards of the Maine State Board of Nursing nursing assistant program issued more than three (3) years ago, the individual must have passed the competency-based examination of didactic and demonstrated skills from the Department's approved personal support specialist curriculum. A certificate of training as a personal care assistant/personal support specialist is awarded upon passing this examination; orD. Hold a valid certificate of training as a PSS or PCA issued as a result of completing the Department approved personal support specialist training curriculum and passing the competency-based examination of didactic and demonstrated skills. The training course must include at least fifty (50) hours of formal classroom instruction, demonstration, return demonstration, and examination. Tasks covered under this section must be covered in the training; orE. Be a PCA or PSS who successfully completed a Department-approved curriculum prior to September 1, 2003. Such individuals will be grandfathered as a qualified personal care assistant/PSS; orF. Be qualified as a DSP as described in 20.10-6.20.10-12Physical Therapy (Maintenance) Services-In order to provide Physical Therapy (Maintenance) Services, a provider must be a Licensed Physical Therapist.20.10-13Specialized Medical Equipment- In order to provide Specialized Medical Equipment, a provider must be approved by the Office of Aging and Disability Services (OADS).20.10-14Speech Therapy (Maintenance) Services- In order to provide Speech Therapy (Maintenance) Services, a provider must possess a Certificate of Clinical Competence in Speech Pathology (CCC-SP).20.10-15Emergency Intervention-Providers must meet training requirements on approved behavioral interventions procedures (e.g.,Mandt) if applicable and indicated as a need in the member's Care Plan.20.10-16Background Check Criteria-Providers must conduct background checks on all prospective employees, persons contracted or hired, consultants, volunteers, students, and other persons who may provide services under this Section. Background checks on persons professionally licensed by the State of Maine will include a confirmation that the licensee is in good standing with the appropriate licensing board or entity. The provider shall not hire or retain in any capacity any person who may directly provide services to a member under this section if that person has a record of:
A. any criminal conviction that involves abuse, neglect or exploitation;B. any criminal conviction in connection to intentional or knowing conduct that caused, threatened, solicited or created the substantial risk of bodily injury to another person;C. any criminal conviction resulting from a sexual act, contact, touching or solicitation in connection with any victim; orD. any other criminal conviction, classified as Class A, B or C or the equivalent of any of these, or any criminal conviction based upon reckless conduct that caused, threatened, solicited or created the substantial risk of bodily injury to another person within the preceding two (2) years; orE. any criminal conviction within Title 29-A, chapter 23, subchapter 2, article 1, or Title 29-A, chapter 23, subchapter 5. Employment of individuals with records of such convictions more than five (5) years prior to the time of the background check is a matter within the provider's discretion after consideration of the individual's criminal record in relation to the nature of the position. The member receiving services must approve the employment of such staff in writing if the provider decides to hire a staff person with a conviction. The provider shall contact child and adult protective services (including the Office of Aging and Disability Services) units within DHHS to obtain any record of substantiated allegations of abuse, neglect or exploitation against an employment applicant before hiring the same. In the case of a child or adult protective services investigation substantiating abuse, neglect or exploitation by a prospective employee of the provider, it is the provider's responsibility to decide what hiring action to take in response to that substantiation, while acting in accordance with licensing standards.
20.10-17Informed Consent PolicyProviders must put in place and implement an informed consent policy approved by the Department. For the purposes of this requirement, informed consent means consent obtained in writing from a member or the member's legally authorized representative for a specific treatment, intervention or service, following disclosure of information adequate to assist the person in making the consent. Such information may include the diagnosis, the nature and purpose of the procedure(s) or service(s) for which consent is sought, all material risks and consequences of the procedure(s) or service(s), an assessment of the likelihood that the procedure(s) or service(s) will accomplish the desired objective(s), any reasonably feasible alternatives for treatment, with the same supporting information as is required regarding the proposed procedure(s) or service(s), and the prognosis if no treatment is provided. At a minimum, a provider's informed consent policy must ensure that members served by the provider (and their guardians, where applicable) are informed of the risks and benefits of services and the right to refuse or change services or providers.
20.10-18Reportable EventsProviders shall comply with all terms and conditions of the Department's Regulations Governing Reportable Events, Adult Protective Investigations and Substantiation Hearings. All staff must receive training in mandatory reporting/reportable events before they provide any services under this waiver.
20.10-19Requirements for Residential Settings Owned or Controlled by a ProviderWhere the member receives Home Support Services in a residential setting owned or controlled by the provider, the provider must ensure that the following requirements are met:
A. The member must occupy the residence pursuant to a lease or other written, legally enforceable agreement providing comparable protections, including eviction and appeal processes required under Maine law;B. The member must have privacy in his or her unit, including doors lockable by the member, with only appropriate staff having keys to such doors;C. Where members share a unit, each member must have choice of roommates;D. The member must have the freedom to furnish or decorate the unit;E. The member must control his or her own schedule and activities;F. The member must have access to food at any time;G. The member must be allowed to receive visitors of his or her choosing at any time; andH. The setting must be physically accessible. These requirements may only be modified where necessary to respond to a specific assessed need. Modifications require clinical documentation supporting the need, and must be identified and justified in the Care Plan.
The following requirements must be documented in the member's Care Plan in order to modify the Requirements for Residential Settings Owned or Controlled by a Provider:
A. Identify a specific and individualized assessed need;B. Document the positive interventions and supports used prior to any modifications to the Care Plan;C. Document less intrusive methods of meeting the need that have been tried but did not work;D. Include a clear description of the condition that is directly proportionate to the specific assessed need;E. Include a regular collection and review of data to measure the ongoing effectiveness of the modification;F. Include established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;G. Include informed consent of the member; andH. Include an assurance that the interventions and supports will cause no harm to the member. C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-20, subsec. 144-101-II-20.10