Children's Behavioral Health Services
65 HCT (Children’s Home and Community and Community Based Treatment-formerly
65M/N)
The following is for providers of 65 HCT, families who wish
to learn more or understand the service and the Targeted Case
Managers of families who decide in a team meeting that there
is a need for referral of this service. It has information
about the service, all the forms for referral and any changes
as well as the required assessment tool for determining need
(CAFAS).
The target being for families, professionals involved with
these families who recommend referral to the service as well
as the direct providers of the service. It provides information
on the nature of the service, the policy requirements, billing,
as well as instruction on completion of the forms required
for referral.
*For a free viewer or to request
a hard copy
Forms |
| 65 HCT Referral Form (Updated January, 2009) |
|
Microsoft
Word* |
|
| Change of Status Form for MaineCare 65 HCT (Children’s Home and Community and Community
Based Treatment-formerly 65M/N) (January
2009) |
|
Microsoft Word* |
|
65 HCT Service - Change in Status Form Instructions
(Updated January, 2009)
|
|
Microsoft
Word* |
|
| Change in Status Codes (Updated January, 2008) |
|
Microsoft
Word* |
|
| |
Parent Fact Sheet |
| Parent Fact Sheet to 65 HCT (Children’s Home and Community and Community Based
Treatment-formerly 65M/N) Services (Updated June 14,
2006) |
|
Microsoft
Word* |
Adobe
PDF* |
| |
HCT Provider list |
District 1=York District (York County) &
District 2=Cumberland District (Cumberland County) |
HTML |
|
|
| District 3=Western Maine
District (Androscoggin, Oxford and Franklin Counties) & District
4=Mid Coast District (Lincoln, Knox, Waldo and Sagadahoc
Counties) & District 5=Central Maine District (Somerset
and Kennebec Counties) |
HTML |
|
|
| District 6=Penquis District (Piscataquis
and Penobscot Counties) & District 7=Downeast District
(Washington and Hancock Counties) & District 8=Aroostook
District (Aroostook County) |
HTML |
|
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| Complete list of CBHS Providers |
HTML |
|
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| |
District Contracts |
| 65 HCT Contacts - District 1 & 2 |
HTML |
|
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| 65 HCT Contacts - District 3, 4, & 5 |
HTML |
|
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| 65 HCT Contacts - District 6, 7, & 8 |
HTML |
|
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| Contact Home page |
HTML |
|
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| |
Manuals |
| 65 HCT New Program Establishment Process (Updated
June 16, 2006) |
|
Microsoft
Word* |
Adobe
PDF* |
| 65 HCT Provider Manual (updated June 14, 2006) |
|
Microsoft
Word* |
Adobe PDF* |
| 65 HCT Provider Manual Changes Effective 7/1/07 |
|
Microsoft Word* |
Adobe PDF* |
| 65 HCT Provider Manual Revisions (June 01, 2007) |
|
Microsoft Word* |
Adobe
PDF* |
| Revisions: 65 HCT Provider Manual (v6/14/06) as of
July 1, 2007 |
|
Microsoft Word* |
Adobe
PDF* |
| |
Policy |
| MaineCare 65 HCT Policy |
HTML |
|
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