MaineCare Notice of Agency Rule-making Proposal, Chapters II and III, Section 23, Developmental and Behavioral Health Clinic Services

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes.  The MaineCare Benefits Manual is available on-line at the Secretary of State’s website

Below, please find a MaineCare Notice of Agency Rule-making Proposal. You can access the complete rule at http://www.maine.gov/dhhs/oms/rules/index.shtml.

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Notice of Agency Rule-making Proposal

AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. Ch. 101, Chapters II and III, Section 23, Developmental and Behavioral Health Clinic Services

PROPOSED RULE NUMBER:

CONCISE SUMMARY:

  1. MaineCare Benefits Manual, Chapters II, Section 23, Developmental and Behavioral Health Clinic Services

The Department of Health and Human Services (the “Department”) proposes the following changes to 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter II, Section 23, Developmental and Behavioral Evaluation Clinic Services.

The proposed rule adds “Foster Care Comprehensive Health Assessments” (CHA) as a covered service in accordance with P.L. 2019, ch. 162 (An Act To Ensure the Provision of Medical Assessments for Youth in Foster Care), codified at 22 MRSA §4063-A. The new service will provide timely, comprehensive evaluations for children in foster care that align with the Child Welfare League of America (CWLA) and the American Academy of Pediatrics Standards for Health Care Services for Children in Out of Home Care.

This service includes an initial comprehensive assessment that includes a medical exam, a psychosocial evaluation, and a final report that is submitted to the Department. The service also includes a six (6) to eight (8) month follow-up comprised of another medical evaluation and a psychosocial evaluation. Providers who meet the criteria to provide the CHA do not have to hold a Developmental and Behavioral Evaluation Clinic contract with the Department.

The rule adds a cost of living adjustment in accordance with 22 MRSA §3137-J (2)(D)(3). Each July 1st the Department will apply an annual cost of living adjustment proportional to the percentage increase in the Maine minimum wage, as determined by the Maine Department of Labor, so long as the service has not received any other adjustments within the previous twelve months. The Maine Department of Labor determines the percentage increase, if any, as of August of the previous year over the level as of August of the year preceding that year in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) for the Northeast Region, as published by the United States Department of Labor, Bureau of Labor Statistics, with the amount of the minimum wage increase rounded to the nearest multiple of 5¢.

Other proposed changes to the rule include adding a definition of “trauma-informed care,” which is a requirement to provide CHAs, making structural changes, removing unnecessary provisions, and making minor technical changes.

  1. MaineCare Benefits Manual, Chapter III, Section 23, Allowances for Developmental and Behavioral Evaluation Services

The Department proposes to repeal 10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 23, and list the specific reimbursement rates for the three services in the Chapter II and on the MaineCare Provider Fee Schedule available on the Department's website in accordance with 22 MRS §3173-J.

This rulemaking complies with 22 M.R.S. §3173-J. The Department issued a Rate Determination Initiation Notice on October 14, 2022. The Department held a public rate forum on November 23, 2022, to collect stakeholder input and comments to inform the Rate Determination process and accepted written comments through December 2, 2022.

See http://www.maine.gov/dhhs/oms/rules/index.shtml  for rules and related rulemaking documents.

STATUTORY AUTHORITY: 22 M.R.S. §§42, 3137-J , 4063-A,  

DATE, TIME, AND PLACE OF PUBLIC HEARING: 8:30am; Tuesday, February 20, 2024

The Department will hold a combined in-person and remote (via Zoom) public hearing.

Location: State Office Building, Conference Rooms Maine A and Maine B, 109 Capitol Street, Augusta, ME

Zoom Meeting link: https://mainestate.zoom.us/j/88019527507

Meeting ID:880 1952 7507

Some devices may require downloading a free app from Zoom prior to joining the public hearing event. The Department requests that any individual requiring special arrangements to attend the hearing in person contact the agency person listed below 5 days in advance of the hearing.

In addition to the public hearing, individuals may submit written comments to DHHS by the date listed in this notice.

DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on March 1, 2024.

AGENCY CONTACT PERSON:           Laurel Noddin, Comprehensive Health Planner II

AGENCY NAME:                                  MaineCare Services

ADDRESS:                                             109 Capitol Street, 11 State House Station

                                                                Augusta, Maine  04333-0011

                                                                laurel.noddin@maine.gov

TELEPHONE:207-624-4019 FAX: (207) 287-6106

                                                            TTY: 711 (Deaf or Hard of Hearing)

IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.

CONTACT PERSON FOR SMALL BUSINESS INFORMATION (if different): N/A

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