MaineCare Notice of Agency Emergency Rule-making Adoption: MaineCare Benefits Manual, Chapter II, Section 97, Private Non-Medical Institution Services

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.

Below, please find a MaineCare Notice of Agency Emergency Rulemaking Adoption. You can access the complete rule at http://www.maine.gov/dhhs/oms/rules/index.shtml.

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Notice of Agency Emergency Rule-making Adoption

Agency: Department of Health and Human Services, Office of MaineCare Services, Division of Policy

Chapter Number and Rule Title: 10-144 C.M.R. Chapter 101, MaineCare Benefits Manual (“MBM”), Chapter II, Section 97, Private Non-Medical Institution Services

Adoption Filing Number:

Concise Summary:

Pursuant to 5 M.R.S. § 8054, the Department of Health and Human Services (Department) may adopt a rule on an emergency basis where it finds that immediate adoption is necessary to avoid an immediate threat to public health, safety or general welfare. When doing so, the Department may modify applicable provisions under 5 M.R.S. §§ 8052 and 8053 if necessary to mitigate or alleviate the threat just found to exist. The Department has concluded that the need to satisfy certain deadlines in the state of Maine’s December 20, 2024, settlement agreement with the United States, regarding enhancements to the Department’s children’s behavioral health services represents such a threat and justifies the emergency adoption of this rule, which shall be effective for no more than ninety (90) days, under 5 M.R.S. § 8054(3).

This emergency rule makes the following changes to comply with the settlement agreement:

  • Adds a definition for “Child and Family Team”.
  • Consolidates the eligibility criteria for Child and Adolescent Therapeutic Foster Care (TFC).
  • Removes the TFC member eligibility requirement to receive a score of 50 or higher on the Child and Adolescent Functional Assessment Scale and adds a requirement that members must receive a score of Level two or higher on the Age-Appropriate Level of Care/Service Intensity Tool as assessed and            determined by the Department or its Authorized Entity through the Single Assessment, as provided in Chapter I, Section 7, Children’s Behavioral Health Services Global Rule.
  • Clarifies that eligibility fo Children’s Residential Care Facilities (CRCF) will be determined through the Single Assessment as provided in Chapter I, Section 7, Children’s Behavioral Health Services Global Rule.
  • Adds comprehensive assessment requirements for TFC, including, but not limited to, when comprehensive reassessments must occur.
  • Adds individual treatment plan requirements for TFC, including, but not limited to, identifying providers involved in the member’s care and anticipating and appropriately planning for significant transitions in the member’s life.
  • Adds care coordination requirements for TFC providers, including, but not limited to, identifying risks that may lead to an out-of-home placement and ensuring the member, family, legal guardian, and/or resource family, as applicable, know how to raise issues with existing services or lack of services.
  • Adds a Cost-of-Living Adjustment provision for all Section 97 CRCF services pursuant to 22 M.R.S. § 3173-J, 22 M.R.S. § 7402(1), and the Settlement Agreement.

Effective Date: January 30 2026

Agency Contact Person: Henry Eckerson, Children’s and Behavioral Health Policy Manager

Agency Name: Department of Health and Human Services, Office of MaineCare Services, Division of Policy

Mailing Address: 11 State House Station, 109 Capitol Street, Augusta, ME 04333-0011

Telephone Number: (207) 624-4045

Email Address: henry.eckerson@maine.gov