Code of Maine Rules › 14 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 193 - OFFICE OF ADULT MENTAL HEALTH › Chapter 6 - MENTAL HEALTH LICENSING REGULATIONS › THE LISCENSURE PROCESS

Current through 2024-29, July 17, 2024
All agencies that are found in substantial compliance with
				  the core standards will be issued a Mental Health Agency License. The license
				  will list each of the service-specific standards with which the agency will
				  have been found to be in substantial compliance in the operation of services
				  and/or programs. The decision as to which service-specific standards are to be
				  applied to which programs or services will be made jointly by the Division of
				  Licensing and the agency in preparation for the licensure survey.
It is the Division of Licensing's intention to make the
				  licensure process as fair and consistent as possible for all applicants
				  pursuing mental health licensure. In order to achieve this, we have developed
				  the following protocols to assist all applicants toward this end.
Technical assistance is offered to all applicants on an
				  informal and formal basis and provides agencies with education and consultation
				  through a variety of means. Technical assistance tools have been prepared for
				  this purpose. We provide technical assistance through on-site meetings and
				  training sessions, telephone consultation and written correspondence.
New applicants and agencies preparing to deliver a new
				  service are permitted a six month period from the receipt of their application
				  until actual licensure. Technical assistance is provided in order to clarify
				  licensing requirements and assist in preparation for the site review. All
				  agencies are held accountable for compliance with all licensing
				  standards.
Agencies that currently hold a Mental Health Agency License
				  will be notified of the availability of technical assistance six months prior
				  to the license expiration date. Three months before the license expires,
				  Licensing will forward an application packet to the agency. Upon receipt of the
				  completed application packet, Licensing will contact the agency to set up the
				  actual site review.
While all agencies are required to comply with, all
				  regulatory requirements, protocols have been established to allow agencies to
				  apply for waivers of one or more of these requirements. These protocols include
				  a waiver process, deemed status and affiliated service agreements.
Upon completion of the licensure survey, Licensing will
				  prepare a site review report that includes recommendations regarding licensure
				  status. The license which will accompany the report will be signed by the
				  Director of the Division of Licensing and the Commissioner of the Department of
				  Mental Health and Mental Retardation. The Commissioner holds the ultimate
				  authority to issue or deny licensure and to award deemed status. The
				  Commissioner also is authorized to exempt certain programs from these standards
				  and to waive specific requirement except those provisions which are otherwise
				  required by law or judicial decree.
The site review report is a comprehensive document that
				  contains agency identifying information, services and programs reviewed,
				  services to be listed on the license, a list of deficiencies, consultative
				  comments and commendations. All items will address regulatory requirements. New
				  providers achieving an initial license will be issued a provisional license,
				  for a maximum of one year. Providers found in significant non-compliance with
				  the standards will be issued a conditional license for a maximum of one year,
				  pursuant to 34-B-MRSA, at the end of which time they will either achieve
				  substantial compliance or face the loss of the license.
The completed site review report will be forwarded to the
				  agency's Executive Director as well as the governing body President.
				  Accompanying the report will be a plan of correction form for the agency to
				  complete and return to Licensing. The process is designed to insure that
				  deficiencies are resolved in a timely manner and to enable Licensing to
				  provide, if indicated, technical assistance regarding the agency's corrective
				  actions.
Also accompanying the site review report is a Satisfaction
				  Survey. This survey is designed to identify both strengths and weaknesses in
				  the licensing process, standards and reviewers. The responses are forwarded
				  directly to the Director of the Division of Quality Management in order to
				  enable agencies to comment freely about the licensing process. Information from
				  these questionnaires is entered into a database and de-identified reports are
				  periodically produced in order to review and improve all aspects of the
				  licensing process.
Providers who find themselves in disagreement with either a
				  finding of the Division of Licensing or the interpretation of it licensing
				  standard are encouraged to request an appeal of the finding. The opportunity
				  exists a formal review by the Commissioner of the Department of Mental Health
				  and Mental Retardation.
The Division will continue to develop and review policies and
				  procedures, review standards for current appropriateness and work to improve
				  the licensing process. Consultative comments from all interested persons will
				  be considered in our ongoing effort to continue to be as fair and consistent as
				  possible.