KEPRO SUPPORTED SERVICES

An Overview

 

SERVICE TYPE

DESCRIPTION

Section 17 - Community Support Services

 

Community Support Service means a rehabilitative service that is provided in the context of a supportive relationship, pursuant to an individual support plan that promotes a person’s recovery, and integration of the person into the community, and sustains the person in his or her current living situation or another living situation of his or her choice.

Section 21 - Home and Community Based Benefit

for members with Intellectual Disabilities or Autistic

Disorders (Home Supports)

The Home and Community Based Benefit (HCB or Benefit) for members with Intellectual Disabilities or Autistic Disorders gives members eligible for this Benefit the option to live in their own home or in another home in the community thus avoiding or delaying institutional services. The Benefit is offered in a community-based setting as an alternative for members who qualify to live in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). The Benefit supplements, rather than replaces supportive, natural personal, family, work, and community relationships and complements.

Section 28 - Rehabilitative and Community

Support Services for Children with Cognitive

Impairments and Functional Limitations

 

Treatment Services for Children with Cognitive Impairments and Functional Limitations are medically necessary treatment services for members under the age of 21. Treatment services are designed to retain or improve functional abilities which have been negatively impacted by the effects of cognitive or functional impairment and are focused on behavior modification and management, social development, and acquisition and retention of developmentally appropriate skills.

Specialized Services for Children with Cognitive Impairments and Functional Limitations are medically necessary, evidence based treatment services for members under the age of 21, that utilize behavioral interventions designed to improve socially significant behaviors and developmentally appropriate skills to a measurable degree.

Section 46 - Psychiatric Hospital Services

Psychiatric Hospital is a hospital that is primarily engaged in providing psychiatric services for the diagnosis, treatment and care of persons with mental illness. A psychiatric hospital must be licensed as a psychiatric hospital by the Department of Health and Human Services (DHHS).

Section 65 - Behavioral Health Services

Psychiatric Hospital is a hospital that is primarily engaged in providing psychiatric services for the diagnosis, treatment and care of persons with mental illness. A psychiatric hospital must be licensed as a psychiatric hospital by the Department of Health and Human Services (DHHS).

Section 92 - Behavioral Health Homes

A Behavioral Health Homes Organization (BHHO) is a community-based mental health organization, that is licensed in the state of Maine, has been approved by MaineCare to provide Section 92 services for members (both adults and children) eligible for such services, and that satisfies the additional provider requirements and standards set forth herein.

Section 97 - Private Non-Medical Institution

(PNMI) Services

A Private Non-Medical Institution (PNMI) is defined as an agency or facility that is not, as a matter of regular business, a health insuring organization, hospital, nursing home, or a community health care center, that provides food, shelter, personal care, and treatment services to four or more residents in single or multiple facilities or scattered site facilities.

Section 13 - Targeted Case Management

Targeted Case Management is a child centered, family driven and community based service. Case Managers conduct intake, coordinate comprehensive assessments of the child’s strengths and needs, produce an individualized support plan (ISP) to address those needs, coordinate, advocate for and develop services identified in the plan, monitor the child’s progress, and evaluate the appropriateness and effectiveness of services.

The case manager will work with the family to assist with the coordination and advocacy of services for the child.

Section 93 - Opioid Health Homes

A group of providers that furnishes services based on an integrated care delivery model focused on whole-person treatment including, but not limited to, counseling, care coordination, medication-assisted treatment, peer support, and medical consultation for individuals who have been diagnosed with an opioid dependency. An OHH is a team of providers that have completed an application and been approved by the Department to provide OHH services.

Section 65 - Children's home and Community

Based Treatment

Children's home and Community Based Treatment is for members in need of mental health treatment based in the home and community who need a higher intensity of service than outpatient, but a lower intensity than Children’s ACT.

Section 28 - Rehabilitative and Community

Support Services

Section 28 - Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations

Section 97 - Intensive Temporary Residential Treatment

 

Section 97- Intensive Temporary Residential Treatment Services (ITRT) are defined as child care facility private non-medical institution model of service services for children with mental retardation, autism, severe mental illness, and/or emotional disorders, who require 24 hour supervision to be safely placed in their home and community.