Office information

• Adult Protective Services
• Services
• FAQs
• Policy/Reports
• Rulemaking
• OES Publications
• Upcoming Events
• Weblinks
• About Us

Information for

• Providers
• Staff/Provider Training

Social Services Help

Adult Day Services - Section 61 Adult Day Funding for Consumers/Caregivers

On this page...

Section 61 funding Consumer Eligibility for Section 61 funding Enrolling in Section 61 Applying for Section 61 Annual Re-Assessment for Section 61 MED Tool (MED Form) Goold Health Systems Assessments 2009 Income Guidelines

Section 61 Rules Information for Consumers Consumer Complaints Section 61 Denials Denial/Reduction/Termination Letters Resource Guides for Elders and Adults with Disabilities Adult Day Resources Adult Day Activities

---

 

Section 61 funding

The Office of Elder Services offers Adult Day funding to those with financial need.  Eligible consumers who are not eligible for MaineCare and who are not currently funded through certain state-funded programs may be able to receive OES funding.  This funding, which falls under Section 61 of the OES policy manual, is currently offered in the form of reimbursement to providers at a maximum of 30 hours/week, or 129.9 hours a month.  The current maximum reimbursement rate is $9.45/hour. 

[back to top]

Consumer Eligibility for Section 61 funding

Section 61 funding was established as a safety net for people lacking the resources to pay for Adult Day on their own.  After exhausting other sources of funding, those with financial need are encouraged to apply for Section 61 funding through a local Adult Day provider.   However, individuals that are financially eligible for MaineCare must apply for MaineCare Adult Day funding.  For more information on MaineCare, please visit MaineCare.

To receive Section 61 funding, consumers must meet certain income and asset guidelines.  The 2009 income guidelines for consumers can be found below. The current Section 61 asset limit is $50,000 for an individual and $75,000 for couples. 

While consumers receiving funding through Section 61 are asked to pay a co-pay of 20% of their Section 61 costs, people with assets under $15,000 may be eligible for a co-pay waiver.  Please contact your local Adult Day provider for further information on eligibility.

[back to top]

Enrolling in Section 61

All consumers must have a medical eligibility assessment (please see below).  You will complete this assessment with your Adult Day provider, or with Goold Health Systems.  Goold provides free comprehensive medical eligibility assessments to determine consumer eligibility for a variety of programs, including Adult Day and home-based care.  Please visit http://www.maine.gov/dhhs/oes/home_care/h_c_care.htm for further details.  If you have already had a Goold assessment, that assessment can be used in place of the medical eligibility assessment through your Adult Day provider.

[back to top]

Applying for Section 61

Please complete the following forms with your Adult Day provider.

1. Section 61 Funds Request form Microsoft Word or Adobe PDF (*free viewer)
   You will need to indicate:
   1. the number of hours per week the consumer would like Section 61 funding
   2. if the consumer will request a co-pay waiver
   3. a description of the consumer’s need for Adult Day services
2. Financial assessment form Microsoft Word or Adobe PDF (*free viewer)
   
   The consumer’s income and assets will be listed here.  The consumer must indicate that s/he agrees to the payment conditions established here by signing this document where indicated.
   1. Please note that consumers do not need to include Term Life insurance in their financial asset portion, as Term Life has no cash value (and therefore is not a liquid asset). 
   2. Please try to ensure that the financial information provided is as accurate as possible.
3. Optional Waiver Co-Payment Allowable Expense Worksheet Microsoft Excel (*free viewer)
   
   This worksheet is only needed if the consumer is requesting a co-pay waiver.  You will be asked to provide a detailed list of the consumer’s monthly expenses and income.  Waivers may be granted if the sum of the consumer’s monthly expenses and co-pay is greater than his/her monthly income.

[back to top]

Annual Re-Assessment for Section 61

Each Adult Day provider must complete (1) annual MED tool assessments and (2) annual financial assessments for each consumer every 12 months (from the date the consumer first enrolled in Section 61) to determine ongoing eligibility for Adult Day.

[back to top]

MED Tool (MED Form)

• MED Form Adobe PDF (*free viewer)
• Instructions for MED Tool Microsoft Word (*free viewer)
• MED Tool Powerpoint Presentation Power Point (*free viewer)

The MED form is used to assess new consumers for Adult Day and Section 61 funding. If a consumer has not had a Goold assessment, the ADS provider, will need to complete the MED form before the consumer can receive Section 61 funding. Please contact the Office of Elder Services for any questions on completing the MED form.

[back to top]

Goold Health Systems Assessments

That all consumers, especially those needing additional services beyond Adult Day, Contact Goold Health Systems for an assessment. The State of Maine requires this assessment to determine consumer eligibility for a variety of services (state-funded or through MaineCare). Anyone can request an assessment by calling 1-800-609-3210. Please visit this page on care choices to learn more about Goold assessments.

We recommend that a caregiver/family member be present at the assessment to assist the consumer in answering questions about his/her needs. If the Goold assessing nurse does not find the consumer eligible for Adult Day, the consumer may still be able to access Section 61 funding for Adult Day.

[back to top]

2009 Income Guidelines

• 2009 Section 61 Income Guidelines Microsoft Word (*free viewer)
  
  In this chart issued by MaineCare, the 200% federal poverty level applies to Adult Day. For co-pay waiver eligibility, the 2009 income upper limit for a single consumer is $1,805, and $2,429 for a 2-person household.

[back to top]

Section 61 Rules

• DHHS OES Section 61 Rules Microsoft Word or Adobe PDF (*free viewer)
• DHHS Regulations Governing the Licensing and Functionnig of Adult Day Services Programs Microsoft Word or Adobe PDF (*free viewer)

[back to top]

Information for Consumers

Adult Day providers should give each consumer a copy of the release of information s/he signed for the Office of Elder Services.

Adult Day providers should give each consumer a copy of his/her service plan, which is created based on the MED assessment results, in an understandable format.  Each consumer should be informed of how his/her co-payment for Section 61 funding was calculated.

Adult Day providers should inform new ADS consumers of additional resources in the community that may be useful to consumers.

[back to top]

Consumer Complaints

If a consumer (or a representative for a consumer) has a complaint about Adult Day Services, the consumer should be provided with information on how to contact the Long Term Care Ombudsman. The Long Term Care Ombudsman Program (www.maineombudsman.org) can be reached at 1-800-499-0229.

[back to top]

Section 61 Denials

Individuals must be financially and medically eligible for Adult Day services to receive Section 61 funding. Individuals residing in hospitals, nursing facilities, licensed residential care facilities, or assisted living program are not eligible for Section 61 Adult Day funding.

Individuals eligible for the following programs cannot receive funding through Section 61:

1. MaineCare Private Duty Nursing/Personal Care Services
2. MaineCare Home and Community-Based Benefits
3. MaineCare Adult Day Health
4. MaineCare Consumer-Directed Attendant Services

Individuals participating in the following programs cannot receive funding through Section 61:

1. In-Home and Community-Based Support Services (OES Policy Manual, Section 63) Microsoft Word (*free viewer)
2. Respite Care for People with Alzheimer’s Disease or Related Disorders(OES Policy Manual, Section 68) Microsoft Word   (*free viewer)
3. Consumer-Directed Home-Based Care (26 M.R.S.A. Section 1412-G) Microsoft Word

[back to top]

Denial/Reduction/Termination Letters

DHHS regulations require that Section 61-funded Adult Day providers notify current and potential consumers when OES Section 61 funding for Adult Day is being denied, reduced, or terminated.  Consumers also should be provided with notification of their right to a hearing.  Templates for letters and hearing rights are provided below.

Each letter gives the consumer 10 days notice, from the date of the discharge/reduction, before the discharge/termination/reduction goes into effect. 

• Section 61 Denial Letter  Microsoft Word (*free viewer)
• Section 61 Discharge/Termination Letter  Microsoft Word (*free viewer)
• 10_60 Day Hearing Rights  Microsoft Word (*free viewer)

[back to top]

Resource Guides for Elders and Adults with Disabilities

The Office of Elder Services publishes several booklets, “Home Care Where To Find It” and the “Resource Directory for Older People in Maine,” which contain a variety of resources for consumers.

[back to top]

Adult Day Resources

Met Life publishes a variety of guides for the elderly, for caregivers, and retirees.

• Several of these guides can be found at MetLife Consumer Guides
• A guide to “Choosing Adult Day Services” (Adobe PDF*)(*free viewer)

[back to top]

Adult Day Activities

The internet contains a wealth of information on suggested activities for Adult Day programs.

• Suggested Activity Books:
  • Field of Themes, 100 Activities for Our Senior Friends
    Co-authored by Barbara Fister, the Director of My Friend’s Place, an Adult Day program funded through Section 61 out of Bangor, Maine. To order please visit http://www.gbgm-umc.org/my_friends_place/field_of_themes.htm
  • The Best Friends Book of Alzheimer’s Activities
    Designed for adults with Alzheimer’s disease.  To order please visit http://www.bestfriendsapproach.com/Books.html)

[back to top]

Maine.gov | DHHS Home | Site Policies | Language Access | Comments/Questions