Attention Children’s Residential Care Facility (CRCF) Providers

Jul 11, 2022

CRCFs, also referred to as Private Non Medical Institution (PNMI) Appendix D facilities, serve children with mental health disorders, substance use disorders, intellectual disabilities, autism spectrum disorders, and children with co morbid diagnoses and treatment needs. MaineCare Benefits Manual Chapter II, Section 97, Appendix D identifies CRCFs as either having an Intellectual Disability/Developmental Disability (ID/DD) or Mental Health (MH) model of service. Youth are currently designated to one model based on their identified clinical need. The Department recognizes that children may have both ID/DD and MH treatment needs, and that the interventions most appropriate to meet a child’s treatment needs may not cleanly align with one model or the other. 

Effective immediately, CRCF service providers may request that Kepro clinical staff re-evaluate a child’s treatment needs to determine which model of treatment best fits the current clinical need. For future assessments, Kepro assessors will also indicate if a child may benefit from interventions from both the ID/DD CRCF and MH CRCF models. Providers must request this updated evaluation in the Atrezzo portal. Do this by adding the child’s current presentation to the CRCF authorization in Atrezzo. Please include how the current symptoms, behaviors, and limitations are attributed to ID/DD or MH to be treated in the CRCF. 

Add the following note in the child’s current CRCF authorization in Atrezzo: “Provider requests evaluation of service need to be changed from ID/DD CRCF to MH CRCF or from MH CRCF to ID/DD.” This will not require a new virtual team assessment.   

If a child is being reviewed to qualify for the ID/DD CRCF, please include the most recent functional assessment score.  

The Kepro clinical team will review the request and current documentation. We will make a  determination within 48 business hours, based on the information provided in the Atrezzo record.    

The CRCF services application, directions, and Provider Guide are available at Maine ASO | Children’s Residential Care Facility (CRCF) Services webpage.  

If you have questions, please contact the Kepro Intake team by email or call 1-866-521-0027.