Items not included above but which have been recommended in a Personal Plan are subject to approval by DHHS for reimbursement. DHHS does not cover those adaptations or improvements to the home that are of general utility, and are not of direct medical or remedial benefit to the member. Adaptations that add to the total square footage of the home are also excluded from this benefit except when necessary to complete an adaptation (e.g. in order to improve entrance/egress to a residence or to configure a bathroom to accommodate a wheelchair). In-floor radiant heating is not allowable. General household repairs are not included in this benefit. All services must be provided in accordance with applicable local, State or Federal building codes. Home Accessibility Adaptations may not be furnished to adapt living arrangements that are owned or leased by providers of waiver services. The limit for adaptations is ten thousand dollars ($10,000) in a five (5) year period, with an additional annual allowance up to three hundred dollars ($300) for repairs and replacement per year. All items in excess of five hundred dollars ($500) require documentation from a physician or other appropriate professionals such as OT, PT or Speech therapists that the purchase is appropriate and medically necessary to meet the member’s need. Medically necessary home modifications that cannot be obtained as a covered service under any other MaineCare benefit may be reimbursed under this section if they meet all requirements of this Section. 21.05-11 Home Support-Agency Per Diem is provided at the provider’s managed service location by a Direct Support Professional to improve and maintain a member’s ability to live as independently as possible. Home Support is direct support to a member and includes primarily habilitative training and/or personal assistance with Activities of Daily Living (ADL) and/or Instrumental Activities of Daily Living (IADL self-care, self-management), development and personal well-being. Agency Home Support is constant daily support that includes personal care, protective oversight, and supervision in accordance with the member’s Personal Plan, depending upon the member’s activities. Payment is not made for the cost of room and board, including the cost of building maintenance, upkeep and improvement. 21.05 COVERED SERVICES (cont.) Payment is not made directly, or indirectly, to the member's immediate family.
General medical practitioner; Occupational therapist; Physical therapist; or Speech therapist. 21.10-4 An Employment Specialist is a person who provides Employment Services or Work Support and has: Successfully completed an Employment Specialist Certification program as approved by DHHS. Certification must occur within six months of date of hire; approved courses are listed at: Supervision during the first six months of hire must be from a Certified Employment Specialist in order to provide services; Work Support staff can either be certified as an Employment Specialist or complete the Approved Direct Support Curriculum along with additional modules specific to employment; Graduated from high school or acquired a GED; Has a background check consistent with Section 21.10-13; and Worked for a minimum of one (1) year with a person or persons having an Intellectual Disability or Autism Spectrum Disorder in a work setting. An Employment Specialist who also provides Career Planning must have completed the additional twelve (12) hours of Career Planning and Discovery provided through Maine’s Workforce Development System and six (6) hours of Department approved continued education every twelve (12) months. 21.10-5 Phase-Out of Family-Centered Support DHHS is discontinuing the Family-Centered Support service. If a bed becomes vacant in a Family-Centered Support home, that vacancy may be filled. 21.10 PROVIDER QUALIFICATIONS AND REQUIREMENTS (cont.) Existing Family-Centered Support providers must meet all the requirements of a Direct Support Professional as set forth in these rules. Effective with this rule, no new licenses or license transfers for Family-Centered Support homes will be approved. Providers of Family-Centered Support shall not transfer, in whole or in part, ownership, management, or responsibility for day-to-day operations of the Support home to another individual or entity. DHHS will not authorize Family-Centered Support services under a new license. 21.10-6 Residential Vacancies in Two-Person Homes