Forms and Protocols

These protocols and forms are used by Case Managers supporting adults with Intellectual or Developmental Disability (IDD) and/or Autism, as well as Children’s and Mental Health Case Managers supporting adults who utilize MaineCare Benefits Manual Sections 21 and 29 waiver programs.

Protocols & Instructions

The following documents help guide Case Managers to access resources available to the individuals and families they support, including how to complete various forms and submit initial classification packets, changes in service/authorization requests, Clinical Review Team requests, and annual reclassification packets.

This page also includes Person-Centered Planning forms for case managers who do not have access to members’ records in EIS. When available, copies of PowerPoint presentations with more detailed instructions and examples are included. 

Self-Direction Tools for Case Managers can be found on the Self-Direction Services page under Self-Direction Resources.

General Developmental Disability Services Case Management Protocols

Waiver Protocols for Developmental Disability Services Case Managers

Waiver Protocols for Children's & Mental Health Case Managers

Clinical Review Team (CRT) Guidelines for Case Managers and Providers

Please note that the following services are only available for members on Section 21 except for Assistive Technology

Forms

All forms on this page are for case managers to use as templates. Please note that some forms must be saved in Word and cannot be scanned and emailed as an attachment. Forms in Excel must be saved in Excel or scanned and sent as an attachment (in PDF format).

Agency Resources

Please see the section on Clinical Review Team Guidelines for more information on the services the CRT approves before prior authorizations are entered.

PCP Forms are used by Children’s and Mental Health case managers who do not have access to the PCP assessment in EIS. They will need you to complete these pages for Initial Classifications, annual service plans, and Changes in Service requests.

General Forms for Developmental Disability Services Case Managers

Waiver Forms for Developmental Disability Case Managers

Waiver Application Forms for Children's & Behavioral Health Case Managers

Section 21 and Section 29 Waiver Application Forms

Initial Classification Forms for Children's & Behavioral Health Case Managers

Annual Reclassification Forms for Children's & Behavioral Health Case Managers

Changes in Waiver Service for Children's & Behavioral Health Case Managers

Other Waiver Related Forms

Other Forms and Resources