Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter II - Specific Policies By Service › Section 144-101-II-2 - Adult Family Care Services › Subsection 144-101-II-2.01 - DEFINITIONS

Current through 2024-29, July 17, 2024
2.01-1
Activities of Daily Living
					 (ADLs)
include bed mobility, transfer, locomotion, dressing, eating,
					 toilet use, bathing, personal hygiene, and walking.
2.01-2
Adult Family Care Home (AFCH
					 )
means a residential style home for eight or fewer residents, which is
					 licensed by the Department pursuant to the Regulations Governing the Licensing
					 and Functioning of Assisted Housing Programs: Level III Residential Care
					 Facilities or Assisted Housing Programs: Level IV Residential Care Facilities
					 and is primarily engaged in providing services to the elderly.
2.01-3
Adult Family Care (AFC)
					 Services
include personal care services such as: assistance with
					 activities of daily living and instrumental activities of daily living,
					 personal supervision, protection from environmental hazards, diversional and
					 motivational activities, dietary services and care management, as further
					 defined in the Regulations Governing the Licensing and Functioning of Assisted
					 Housing Programs: Level III Residential Care Facilities or Assisted Housing
					 Programs: Level IV Residential Care Facilities.
2.01-4
Cueing
means any spoken
					 instruction or physical guidance that serves as a signal to do a specified
					 activity. Cueing is typically used when caring for individuals who are
					 cognitively impaired.
2.01-5
Department
means the Maine Department of Health and Human Services
					 (DHHS).
2.01-6
Individual
					 Service Plan (ISP)
means a written service plan developed with a
					 resident based upon an assessment of the resident's needs and abilities, and
					 including (as appropriate) habilitative or rehabilitative goals and objectives,
					 program goals and objectives, and the resources and methods necessary to
					 implement the plan.
2.01-7
Instrumental Activities of Daily Living (IADL)
include main meal
					 preparation; routine housework; grocery shopping and storage of purchased
					 groceries; and laundry either within the residence or at an outside laundry
					 facility.
2.01-8
MaineCare
					 Weight
is the resource group weight applied to each resource group to
					 calculate the resource-adjusted price for each member residing in the adult
					 family care home.
2.01-9
Member
is an individual who is deemed eligible for MaineCare
					 services.
2.01-10
Minimum
					 Data Set- Assisted Living Services (MDS-ALS)
is the assessment tool
					 approved by the Department to provide a comprehensive, accurate, standardized,
					 reproducible assessment of each resident's functional capacity. The Department
					 utilizes this tool to divide members into resource groupings that determine the
					 resource-adjusted price for each member.
2.01-11
Physician
means an
					 individual currently licensed by the Board of Licensure in Medicine to practice
					 medicine or by the Board of Osteopathic Licensure to practice osteopathy in the
					 State of Maine, or the State or Province in which services are
					 provided.
2.01-12
Provider
means the entity licensed by the Department, pursuant to
					 the Regulations Governing the Licensing and Functioning of Assisted Housing
					 Programs: Level III Residential Care Facilities . Provider, owner, licensee and
					 operator are all synonymous terms.
2.01-13
Registered Nurse or "Registered
					 Professional Nurse"
means an individual who is currently licensed by the
					 Maine State Board of Nursing to practice professional nursing.
2.01-14
Remote Island Facility
means a facility located on an island not connected to the mainland by a
					 bridge.
2.01-15
Resource
					 Adjusted Price
is the per diem rate the Department determines and pays
					 to adult family care providers for the provision of services to a member. The
					 Department determines this rate by considering the resources required to serve
					 the needs of members based on assessment by the MDS-ALS assessment.
2.01-16
Unadjusted Price
is the
					 price calculated for payment prior to resource group adjustment. This
					 represents the average reimbursement for the service.