Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 295 - DENTAL SERVICES DEVELOPMENT AND SUBSIDY PROGRAMS › Section 144-295-I - DEFINITIONS

Current through 2024-29, July 17, 2024
A. Unless otherwise indicated, the following
				terms shall have the following meanings specific to the Dental Services
				Development and Subsidy Program as authorized and funded by 22 MRSA §2127.
B. Defined Terms
Board
: A board of directors or other
				  governing body that has responsibility for the governance and administration of
				  the oral health care program. In the case of a public entity, an advisory or
				  steering committee that is identified to maintain oversight of the project or
				  initiative receiving funds through this Section, and to represent it, through
				  reporting mechanisms or other defined relationship(s) within that entity's
				  structure, may serve as the governing body. Community groups in initial
				  organizational stages that do not have formal boards or governing bodies are
				  also eligible to receive funding through this Section when a steering committee
				  that functions as a governing body is identified.
Community-operated non-profit oral health care
				  program
: an oral health services program that is governed and
				  administered by a public or private non-profit agency or entity, and that
				  itself provides clinical oral health services.
Coverag
e: the hours that an oral health
				  program providing clinical services is open to provide those services.
Dental Care Analysis Area:
An area as
				  defined by the Department of Human Services for the purpose of analyzing health
				  service patterns and areas for federal and/or state designation as having a
				  shortage of dentists to meet the needs of the population.
Dental Services Development and Subsidy
				  Program(s):
The program(s) funded as a result of Title 22 MRSA,
				  Section2127.
Department:
The Maine Department of Human
				  Services
Full-time equivalent dentist
: a dentist who
				  actively practices at least 40 hours per week serving the targeted
				  population.
In-kind support:
Support for a program or
				  initiative that is provided without charge but for which an equivalent dollar
				  amount can be calculated and documented.
Oral health services
: Oral health services
				  include clinical dental services, and community education and oral health
				  education and case management services.
"Clinical dental services" includes the full range of
					 dental services, including without limitation preventive, pediatric,
					 restorative, surgical, orthodontic, endodontic, and prosthodontic
					 services.
										 "Community education and oral health education" mean
					 education, whether targeted to the community or to individuals, that is
					 designed to encourage good oral hygiene practices that will contribute to
					 preventing tooth decay and other oral diseases.
										"Oral health case management services" are case
					 management services that facilitate the provision of oral health care services
					 to individuals.
Patient screening process
: A process to
				  determine a potential patient's eligibility for any available and applicable
				  programs, such as but not necessarily limited to Medicaid and Cub Care (Maine's
				  State Children's Health Insurance Program); and which also determines
				  eligibility for services under a sliding fee scale, and which point on that
				  scale will apply for each patient.
Sliding scale or sliding fee scale
: A fee
				  scale that adjusts the fee charged to a patient according to the patient's
				  income and family size.
Underserved areas or populations
: Areas or
				  populations in the State that have been designated as underserved for clinical
				  oral health services as determined by the Commissioner of Human Services and as
				  defined in rules adopted by the Department of Human Services. Such a
				  designation may be limited to a geographic area of the State or to a specific
				  practice location at the discretion of the Commissioner of Human Services. In
				  the absence of a determination by the Commissioner of Human Services or the
				  adoption of rules by the Department of Human Services defining an underserved
				  population area,
underserved population area
means an area of
				  the state designated by the federal government as a dental health professional
				  shortage area.
Voucher system
: A system wherein payment to
				  another dental provider is authorized by an oral health program to purchase for
				  a patient a specified clinical dental service which otherwise could not be
				  provided.
Voucher payment
: The payment that is made
				  by the oral health program to another dental provider in order to reimburse
				  that dental provider for the service(s) provided.