10-144 Chapter 116 page 1

10144 DEPARTMENT OF HUMAN SERVICES

BUREAU OF MEDICAL SERVICES

Chapter 116: REGULATIONS GOVERNING THE FILING AND REVIEWING OF PROVIDER AGREEMENT APPLICATIONS FOR BOARDING CARE FACILITIES ON A FLAT RATE OF REIMBURSEMENT

A. Purpose and Findings

The 110th Legislature has appropriated funds sufficient to support an additional 60 boarding care beds statewide in homes on a flat rate of reimbursement. The purpose of these regulations is to establish an orderly and appropriate system for the selection of boarding home operators to develop these 60 beds.

Successful applicants will be awarded a provider agreement to authorize acceptance of Stateassisted residents at a rate of reimbursement authorized by the Legislature of $355 per resident per month. In addition to the requirements of these regulations the successful applicant will be required to meet all regulations governing licensure of boarding care facilities in order to receive a license.

B. Priority Areas

The Department will accept applications for boarding care provider agreements from applicants residing in fifteen areas of Maine. The areas were selected on the basis of current availability of longterm care beds. All areas identified below have fewer than the mean number of longterm care beds for the State as a whole. Longterm care beds include boarding care (BC), adult foster care (AFC), and intermediate care (ICF) beds. Bed availability was determined according to the following formula:

(3 x #BC beds) + (2 x #AFC beds) + (# of ICF beds)

Population/1000 65+

The Department reserves the right to allocate any or all or the 60 beds to any of the priority areas based on the quality of applications received.

C. Application Process

1. In order to be considered eligible for any of the 60 beds, applicants must file an application with the Manager of the Boarding Home Program.

2. All completed applications will be grouped according to service area and reviewed competitively with all other applications for that area. Applications which do not contain all required information will not be considered.

3. Special applications have been developed for this purpose and must be used by all applicants. They may be obtained from the Manager of the Boarding Home Program, Bureau of Medical Services, Department of Human Services, 221 State Street, Station #11 Augusta, Maine 04333.

D. Criteria for Reviewing Provider Agreement Applications

1. Applicants must demonstrate in the application that they have the ability to provide quality boarding care.

2. Applicants must demonstrate financial feasibility by comparing estimated resources to expenditures.

3. Applicants must demonstrate the availability of community resources and how they will access them.

4. Applicants must demonstrate a willingness to participate in a joint plan of care for the residents if one is developed by outside agencies.

E. Statutory Authority

These regulations are adopted pursuant to 22 M.R.S.A. §§ 3, 7, 42 (1), 3273 (1), 3273 (3), 7902.

BOARDING HOME SURROUNDING MUNICIPALITIES

ANALYSIS AREA

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Bucksport Blue Hill, Brooksville, Bucksport, Castine, Deer Isle,

Frenchboro, Isle Au Haut, Orland, Penobscot, Sedgwick,

Stonington, Surry, Swans Island, and Verona.

Bridgton Baldwin, Batchelders Grant, Bridgton, Brownfield, Casco,

Cornish, Denmark, Fryeburg, Harrison, Hiram, Lovell,

Mason Township, Naples, Parsonsfield, Porter, Sebago,

Stoneham, Stow, and Sweden.

Rumford Andover, Andover North Surplus,

Andover South Surplus, Byron, Carthage, Dixfield,

Grafton Township, Hanover, Lincoln Plantation,

Megalloway Plantation, Mexico, Melton Township, Newry,

Peru, Riley Township, Roxbury, and Upton.

Lincoln Burlington, Carroll Plantation, Chester, Drew Plantation,

Millinocket East Millinocket, Edinburg, Enfield, Grand Falls

Plantation, Howland, Kingman Township, Lakeville

Plantation, Lee, Lincoln, Rowell, Macivahoc Plantation,

Mattamiscontis Township, Mattawamkeag, Maxfield, Medway,

Millinocket, Medunkus Township, Passadumkeag, Prentiss

Plantation, Seboeis Plantation, Springfield, Summit

Township, TA R7, T2 R8 NWP, T2 R9 NWP, T3 R1 NBPP,

Webster Plantation, Winn, and Woodville.

York Eliot, Kennebunk, Kittery, Ogunquit, South Berwlck,

Wells and York.

Sanford Acton, Alfred, Berwick, Lebanon, Limerick, Newfield

North Berwick, Sanford, Shapleigh and Waterboro.

Jonesport Addison, Beals, Beddington, Cherryrield, Columbia,

Columbia Falls, Deblois, Barrington, Jonesport,

Milbridge, and Steuben.

Ellsworth Amherst, Aurora, Bar Harbor Cranberry Isles, Dedham,

Eastbrook, Ellsworth, Franklin, Gouldsboro, Great Pond

Plantation, Hancock, Lamoine, Mariaville, Mount Desert,

Osborn, Otis, Sorrento, Southwest Harbor, Sullivan, T7

SD, T8 SD, T32 MD, Tremont, Trenton, Waltham,

and Winter Harbor.

Waldoboro Alna, Boothbay Harbor, Bremen, Bristol, Damariscotta,

Edgecomb, Jefferson, Monhegan Plantation, Newcastle,

Nobleboro, South Bristol, Southport, and Waldoboro.

Calais Alexander, Baileyville, Baring Plantation, Calais,

Charlotte, Codyville Plantation, Cooper, Crawford, Dyer

Township, Fowler Township, Grand Lake Stream, Indian

Township, Lambert Lake Township; Meddybemps, Number 21

Plantation, Princeton, Robbinston, T18 ED BPP, Tl9 ED

BPP, Talmadge, Topsfield, Vanceboro, and Waite.

Caribou- Ashland, Blaine, Bridgewater, Caribou, Castle Hill,

Presque Isle Caswell Plantation, Chapman, Connor Township, Cox Patent, E. Plantation, Easton, Fort Fairfield, Garfield Plantation, Limestone, Mapleton, Mars Hill, Masardis, Nashville Plantation, New Sweden, Oxbow Plantation, Perham, Portage Lake, Presque Isle, Squapan Township, Stockholm, TD R2 WELS, T10 R3 WELS, T10 R6 WELS, Tll R4 WELS, Wade, Washburn, Westfield, Westmanland, and Woodland.

BathBrunswick Arrowsic, Bath, Bowdoin, Bowdoinham, Brunswick, Freeport, Georgetown, Harpswell, Perkins Township, Phippsburg Pownal, Topsham, West Bath, Westport, Wiscasset, and Woolwich.

Portland Buxton, Cape Elizabeth, Cumberland, Falmouth, Gorham

Gray, North Yarmouth, Portland, Raymond, Scarborough,

South Portland, Standish, Westbrook, Windham, and

Yarmouth.

Bangor Alton, Argyle Township, Bangor, Bradley, Brewer, Carmel,

Clifton, Corinna, Corinth, Dixmont, Eddington, Etna,

Exeter, Glenburn, Greenbush, Greenfield, Hampden,

Hermon, Holden, Hudson, Kenduskeag, Levant, Milford,

Newburgh, Newport, Old Town, Orono, Orrington, Plymouth, Stetson, and Veazie.

Biddeford Arundel, Biddeford, Dayton, Hollis, Kennebunkport,

Limington, Lyman, Old Orchard Beach, and Saco.

EFFECTIVE DATE: December 21, 1982

AMENDED: April 29, 1983

EFFECTIVE DATE (ELECTRONIC CONVERSION): May 5, 1996