Appendix K Amendment Office Hours Sections 18 20

Appendix K Amendment: Office Hours Sections 18, 20, 21 and 29: Alternative Settings and Emergency Quarantine Service June 23, 2020

Panel • Office of Maine. Care Services – Heather Bingelis – Tom Leet – Tammy Usher • Office of Aging and Disability Services – Derek Fales – Betsy Hopkins – Emily Kalafarski Maine Department of Health and Human Services 2

Agenda 1. Alternative Settings - Description, Authority, Requirements, Process, Examples 2. Emergency Quarantine Service - Description, Authority, Requirements, Process, Examples 3. Frequently Asked Questions 4. Resources 5. Additional Questions? Maine Department of Health and Human Services 3

Alternative Settings: Description • Temporary Service Locations • To meet needs of members specifically impacted by COVID-19 public health emergency • Examples are hotels, shelters, schools, churches, agency vacant sites, group homes not yet licensed, etc. • Ensure health, safety, and comfort of members and staff Maine Department of Health and Human Services 4

Alternative Settings: Authority https: //www. maine. gov/dhhs/oads/docs/covid-19/maine-appendix-k. pdf Appendix K-2 b iv (note: Section 19 portion is omitted, for clarity. ) Maine Department of Health and Human Services 5

Alternative Settings: Requirements • Provider already enrolled with Maine. Care • Includes service locations that have not yet gone through Maine. Care enrollment process • Not required to enroll alternative settings, due to temporary nature • Bill under the NPI for the regular service location Maine Department of Health and Human Services 6

Alternative Settings: Process • Submission of Alternative Setting Form to Resource. Coordinator-OADS@maine. gov , approval by Elizabeth Hardink (18 and 20), Emily Kalafarski (21 and 29) or Derek Fales (18, 20, 21, 29). • The start date of services in the Alternate Setting can be no more than sixty (60) days from the date the Person-Centered Plan/ Care Plan was updated. • Temporary Physical Address updated by Case Manager/ Care Coordinator in EIS/ Me. Care Maine Department of Health and Human Services 7

Alternative Settings: Examples • A Home Support- Agency provider serving a member at an unenrolled group home site for a quarantine period after travel outside of Maine. • A Shared Living Oversight Agency serving a member at a hotel, due to individuals in the Shared Living setting testing COVID-19 positive. • A Home Support- Agency provider serving a COVID 19 positive member at a previously vacant group home, to separate from housemates. Maine Department of Health and Human Services 8

Emergency Quarantine Service: Description • • To care for member testing positive for COVID-19 Regular location or alternative setting May begin on date member tests positive Prior authorization period will be 30 days or less, as requested Per diem unit, $665. 28 Procedure Code T 2025 May be provided by a second agency under a subcontractual arrangement Maine Department of Health and Human Services 9

Emergency Quarantine Service: Authority https: //www. maine. gov/dhhs/oads/docs/covid-19/maine-appendix-k. pdf Appendix K-2 b iii. (note: Shared Living addition to Section 20 is omitted, for clarity. ) Maine Department of Health and Human Services 10

Emergency Quarantine Service: Requirements • The waiver provider must: • Submit a roster of all staff delivering this service, trainings, and status of background checks; • Ensure that staff have successfully completed the following within the past 12 calendar months: – – – First Aid Cardiac Pulmonary Resuscitation (CPR) Abuse/Neglect/Exploitation reporting Reportable Event reporting Agency-specific training on medication and personal care • Ensure all medication administration is provided by a Certified Residential Medication Administrator (CRMA) or have comparable staff training delivered by the agency and submit a plan for safe administration of medication if a CRMA is not available Maine Department of Health and Human Services 11

Emergency Quarantine Service: Process • Submission of Emergency Quarantine Service Form to Resource. Coordinator-OADS@maine. gov , approval by Resource Coordinator (21 and 29) or Care Monitor (18 and 20). • The start date of services in the Alternate Setting can be no more than sixty (60) days from the date the Person-Centered Plan/ Care Plan was updated. • Temporary Physical Address updated by Case Manager/ Care Coordinator in EIS/ Me. Care, if applicable. Maine Department of Health and Human Services 12

Emergency Quarantine Service: Examples • A member moving into a hotel to receive 24 hour care after testing COVID-19 positive, in order to separate from housemates who have not tested positive. • A member who had previously received only shared staffing remaining in her agency group home and receiving exclusive support. Maine Department of Health and Human Services 13

Frequently Asked Questions 1. When a member is COVID-19 positive, should the Emergency Quarantine Service always be requested? 2. Can a member receive the Emergency Quarantine Service at an alternative setting? 3. Can a member receive the Emergency Quarantine Service in addition to another per diem service? 4. I talked to OADS about using an alternative setting but I didn’t fill out the form yet. What now? Maine Department of Health and Human Services 14

Resources • Alternative Setting and Emergency Quarantine Service Forms, at OADS COVID-19 Resources Maine Department of Health and Human Services 15

Resources, continued • Maine. Care’s Alternative Settings Guidance, which provides additional detail regarding 1135 authority for state plan services taking place in alternative settings. Maine Department of Health and Human Services 16

Questions? OADS@Maine. gov – subject line: Appendix K Question Maine Department of Health and Human Services * 17