Children's Behavioral Health

Announcement for the Implementation of Section 32 Childrens Home and Community Based Waiver

January 19, 2012

Hello:

This is the first in a series of announcements to help inform, prepare and instruct families, guardians, targeted case managers and others in the community about the implementation of The Children's Home and Community Based Waiver, Section 32.  This announcement contains the list of the required supporting documentation that will be needed to accompany the application for the service.  The application form and instructions are not yet available but will be distributed in the near future.

We are providing this list to allow anyone considering submitting an application additional time to gather the required documentation.  Please periodically review the Children's Behavioral Health Services website for additional upcoming information, including the application form instructions. You may also access a link to the Recently Adopted Rules and Chapter II of Section 32 through that website which sets forth eligibility criteria.

Required Supporting Documentation

  1. An evaluation by a licensed professional who is practicing within the scope of their license. For example: Medical Doctor, Psychiatrist or Licensed Clinical Psychologist – administered within the past 3 years
  2. If the evaluation by the licensed professional does not contain information on each Axis from the Diagnostic and Statistical Manual of Mental Disorders (DSM), please include a Diagnostic Evaluation with multi-axial diagnosis from a licensed professional who is practicing within their scope of their license. This diagnostic evaluation including the 5 Axes from the Diagnostic and Statistical Manual of Mental Disorders (DSM) must have been administered with the past three (3) years.
  3. Functional Assessment -Vineland or Adaptive Behavioral Assessment Scale (ABAS) – within the past year (1 year)
  4. Current medications and progress notes from a prescriber as to reason why medication is prescribed and its effectiveness.
  5. Treatment Summary(ies) by a service provider(s) such as Psychologists, Psychiatrist, Licensed Clinical Social Workers, etc. for all services the child has received in the past 6 months and for any specialized hospital or residential stay(s) within the past year (1 year) include the following:
    1. Clearly demonstrates presenting behavior (frequency, intensity, duration), medical needs, and/or symptoms of ID/MR/PDD
    2. Document where and under what conditions the behavior occurred (if applies)
    3. Document clinical modalities/interventions being used and what is currently recommended
    4. What is working?
    5. What are the barriers to treatment efficacy/why is this level of care insufficient to meet the needs?
    6. What is the current plan based on the presenting behaviors, medical needs, and/or symptoms of ID/MR/PDD?

Any other documentation describing dangerous behavior, medical needs, and/or symptoms of ID/MR/PDD (this can come from the parent, teacher, other source)

If you have any additional questions, please contact:

Children's Behavioral Health:

Cumberland/York Counties,
Contact: CBHS, 161 Marginal Way, Portland, ME 04101
Mike Parker at 822-0139; Mike Parker

Androscoggin, Franklin, Oxford, Somerset, Kennebec, Lincoln, Waldo, Knox or Sagadahoc Counties,
Contact: CBHS, 35 Anthony Ave, Augusta, ME 04333
Nadine Martin at 624-5257; Nadine Martin

Penobscot, Piscataquis, Hancock, Washington, or Aroostook Counties,
Contact: CBHS, 176 Hogan Road, Bangor, ME 04401
Cheryl Hathaway at 941-4442; Cheryl Hathaway