Developmental Services - Case Management Manual

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Protocol for the Provision of Case Management Services for People who do not Receive Mainecare Services

10/17/2008 revised January 2013

Purpose - this protocol is to provide guidance for District Offices who receive a request to provide case management services for people who are not Mainecare eligible but have been found eligible for Developmental Services. The following guidelines will be utilized in deciding when and what type of services will be provided:

  1. According to 34-B 5201-6 as well as Mainecare rule case management is an entitlement only for Mainecare recipients. During the intake process this procedure should be shared with individuals who are not eligible for Mainecare.
  2. The following should be considered when determining the assignment of case management services to a person who is not Mainecare eligible. The Supervisor of the District Office makes the determination:
    1. Is the person in an adult protective situation where the assignment of a case manager is necessary to assure health and safety?
    2. Does the person need a public guardian?
    3. Has the person been denied Mainecare as a result of benefits being too high (ex. SSDI)? If the person is found eligible for section 21 or 29 will this make the person eligible for Mainecare? If this appears to be the case the following steps can be taken:
      1. If the person has identified a community case management agency and they are willing to accept the person and assist them with the processes involved in becoming Mainecare eligible understanding they can not bill for any service provided until they are eligible a referral can occur.
      2. A state case manager can be assigned to assist the person to become Mainecare eligible and then a decision can be made by the consumer regarding future case management.
    4. Upon review by the Supervisor it is felt that an assignment of case management to assist the person to connect to available resources/needs is beneficial to the person and that there are resources available in the office to provide that service maintain the standard set in law, policy, and oversight. The Supervisor has the right to time limit this service.