Code of Maine Rules › 14 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 197 - OFFICE OF AGING AND DISABILITY SERVICES › Chapter 11 - CONSUMER-DIRECTED PERSONAL ASSISTANCE SERVICES › Section 197-11-02 - ELIGIBILITY FOR SERVICES

Current through 2024-29, July 17, 2024
(A)
General
				and Specific Requirements.
To be eligible for services a consumer must:
(1) Be at least 18;
(2) Live in Maine; "Live in Maine" means to
				have legal residence in Maine and be present in Maine for 183 days of the year,
				except for Maine resident students attending school. consumer's relocating may
				be allowed up to one month's program services to assist the consumer to make a
				transition to other services;
(3)
				Lack sufficient personal and/or financial resources for in-home
				services;
(4) Be ineligible for the
				MaineCare Private Duty Nursing Personal Assistance Services, MaineCare Adult
				Day Health, MaineCare Consumer Directed Assistant Services programs. consumer's
				who are eligible for the MaineCare Home and Community Based Waiver program may
				be deemed eligible for supplemental funds under this program, subject to
				availability of funds;
(5) Not be
				residing in a hospital or nursing facility;
(6) Agree to pay the monthly calculated
				consumer payment. This payment may be subsequently waived or reduced if the
				consumer's application for a waiver or reduction is approved.
(7) Not have a guardian or a
				conservator:
(8) Eligibility for
				the Consumer Directed HBC Program requires a significant level of skill and
				responsibility from the consumer. In order to be eligible for CDHBC services, a
				consumer must be capable of performing all the tasks and responsibilities of an
				employer. In order to best determine the applicant's ability to function in
				this role, the Authorized Agent will assess the individual's cognitive
				abilities as follows:
(A) Based on actual
				performance during skills training. The assessor will review the consumer's
				ability to understand and retain the elements included in the regular course of
				consumer skills training.
(A) In
				actual performance as a consumer of program services. During the course of
				using program services, and particularly during the first year of service, the
				Authorized Agent will continually assess the consumer's ability to successfully
				participate in the Program. Included in skills training will be:
(1) Understanding of the consumer's
				disability, including health issues and relevant adaptive equipment and ability
				to explain disability to others;
(2) Ability to understand and communicate
				assistance needs;
(3) Ability to
				understand and communicate safe and unsafe conditions;
(4) Ability to handle finances associated
				with the program;
(5) Ability to
				communicate effectively in writing, verbally or using adaptive
				equipment;
(6) Demonstrated ability
				to direct others as needed in an employment relationship;
(7) Ability to create and carry out daily
				work plans for PAs;
(8)
				Understanding of local resources and ability to self refer for needed
				services;
(9) Demonstrated ability
				to create and carry out a hire plan for PAs;
(10) Ability to train and supervise
				PAs;
(11) Ability to retain PAs as
				employees;
(12) Ability to
				successfully carry out the responsibilities of program consumer's as specified
				in the Department's rules;
(13)
				Demonstrated understanding of HIPAA confidentiality requirements.
At any point during the initial evaluation, or in the course
				  of ongoing service, that the Authorized Agent determines the consumer is unable
				  to carry out the requirements of this section, the consumer will be found
				  ineligible for the program.
(9) The individual must agree to undergo
				consumer instruction and testing within thirty (30) days of the assessment in
				order to develop and verify that they have attained the skills needed to hire,
				train, schedule, supervise, and document the provision of Personal Assistance
				Services identified in the authorized plan of service. consumer's who do not
				complete the instruction or do not demonstrate to the Authorized Agent that
				they have attained the skills needed to hire, fire, train, schedule, supervise
				and document the delivery of their identified care services, are not eligible
				for services under this Section;
(10) The consumer may not reside in a
				licensed residential setting. The individual's residence, while using Consumer
				Directed Home Based Care Services, may be the individual's home or a
				transitional living program. Personal Assistance Services cannot be delivered
				in an Adult Family Care Home (AFCH) setting or other licensed Assisted Living
				Facility which is currently reimbursed by state and/or federal funds for
				providing Personal Assistant Services; and
(11) If the assessment for continued
				eligibility indicates medical eligibility for a MaineCare program and potential
				financial eligibility for MaineCare, consumer's will be given written notice
				that the consumer has up to thirty (30) days to file a MaineCare application.
				If Personal Assistance Services are currently being received, services shall be
				discontinued if an Office of Integrated Access and Support notice is not
				received within thirty (30) days of the assessment date indicating that a
				financial application has been filed. Services shall also be discontinued if,
				after filing the application within thirty (30) days, the application
				requirements have not been completed in the time required by MaineCare
				policy.
(12) If individuals are
				deemed not eligible for the program, efforts will be made to provide
				information and referral services to assist consumer's in reaching appropriate
				service alternatives.