Section 118-5-16 - Private Non-medical Institutions (PNMI)16.1.Provider agreements. All PNMIs must have a provider agreement that encompasses the MaineCare Provider Supplier Agreement on file with the Department of Health and Human Services, Division of Licensing and Regulatory Services. Providers must also contract with the department and satisfactorily meet all contract and provider agreement provisions.16.2.Compliance with regulations. A PNMI providing substance abuse services shall comply with all portions of these regulations in Section 16 (Substance Abuse Treatment Services) pertaining to the component, module, substance abuse treatment services, and sites offered by the PNMI.16.3.Coordination of PNMI services. It is the responsibility of the PNMI provider to coordinate PNMI services with other "in-home" services to address the full range of member needs. Other MaineCare covered services shall not duplicate PNMI services included in the facility's PNMI rate. Services that are part of the PNMI rate may not be billed to MaineCare separately by other providers. For example, if the PNMI provides personal care services, and a member receives Home and Community Based Waiver Services, the personal care services shall be delivered by the PNMI provider and not by a certified nursing assistant (CNA), home health aide (HHA), or personal care assistant (PCA) as otherwise allowed.16.4.Personal care staff and services. PNMIs approved and funded by OSA in licensed/certified facilities may also provide personal care services necessary for the promotion of ongoing treatment and recovery. 16.4.1. The personal care services provided by the PNMI are prescribed by a physician upon or within thirty (30) days of admission, are in accordance with the member's plan of care, are supervised by a registered nurse at least every ninety (90) days, and are not provided by a member of the client's family as described in the MaineCare Benefits Manual, Chapter II, Section 97.01-6 or the pertinent Appendix of the MaineCare Benefits Manual, Chapter III, Principles of Reimbursement. 16.4.3.1. assistance or supervision of activities of daily living that could include bathing, dressing, eating, toileting, ambulation, personal hygiene activities, grooming, and the performance of incidental household tasks essential to the activities of daily living and to the maintenance of the member's health and safety within the substance abuse treatment PNMI;16.4.3.2. supervision of or assistance with administration of physician ordered medication;16.4.3.3. personal supervision or being aware of the member's general whereabouts, observing or monitoring the member while on the premises to ensure their health and safety, reminding the member to carry out activities of daily living, and assisting the member to carry out activities of daily living, and assisting the member in adjusting to the group living facility;16.4.3.4. arranging transportation and making phone calls for medical or treatment appointments as recommended by medical providers, or as indicated in the member's plan of care;16.4.3.5. observing and monitoring clients and reporting changes in the client's normal appearance, behavior, or state of health to medical providers or supervisory personnel as appropriate;16.4.3.6. arranging or providing motivational, diversionary, and behavioral activities which focus on social interaction to reduce isolation or withdrawal and to enhance communication and social skills necessary for ongoing treatment and recovery, as described in the member's plan of care;16.4.3.7. monitoring and supervising client's participation in the treatment; and16.4.3.8. psychosocial services including assisting clients to adjust to the substance abuse treatment PNMI, to live as independently as possible, to cope with personal problems during periods of stress, to accept and adjust to their personal life situations, to accept and cope with their chemical addictions and to decrease unhealthy behaviors leading to possible relapse into active addiction, in addition to providing services and a supportive environment which promotes feelings of safety and freedom from danger, fear or anxiety as well as services that assist the client to manage mental health symptoms and behaviors related to co-occurring disorders .16.4.2. Alcohol and drug treatment PNMIs that provide personal care services shall maintain documentation that each staff member providing such services has received forty (40) hours of orientation and training in personal care procedures appropriate to clients. Areas of training must include introduction to chemical addictions, assistance in self-administration of medicine, infection control, bowel and bladder care, nutrition, methods of moving clients, co-occurring disorders training and health oriented record keeping.16.4.3. Personal care services shall consist of, but are not limited to, the following:16.5.Clinical consultant services. Clinical consultant services must be provided by licensed or certified professionals as described in the MaineCare Benefits Manual, Chapter II, Section 97.07-2, who are working within all State and Federal regulations specific to the services provided. For substance abuse facilities, clinical consultants may include substance abuse services including methadone maintenance services.16.6.Surveillance and Utilization Review Services (SURS). A PNMI is subject to the surveillance and utilization review requirements set out in the MaineCare Benefits Manual, Chapter I.16.7.Time studies. A PNMI is required to complete all time studies in accordance with the MaineCare Benefits Manual, Chapter II, Section 97.07-8. 14-118 C.M.R. ch. 5, § 16