MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures)

What this rule requires your agency to do

• 1A provider agency must check the Maine Registry of Certified Nursing Assistants and Direct Care Workers and conduct criminal background checks for applicants for PSS, CNA, or home health aide positions, and must not employ any individual prohibited from employment under Title 22 MRSA sec. 1717.(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))
• 2Provider agencies must develop and implement written policies and procedures ensuring PSSs do not smoke or consume alcohol or controlled substances in the Member's home or vehicle during work hours, and prohibiting abuse, neglect, or misappropriation of a Member's property; the family provider agency must check the CNA/Direct Care Worker registry and conduct a criminal background check for any personal care assistant hired.(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))
• 3Excluding the family provider service option, a PSS must receive on-site supervisory visits from the employing agency at least quarterly for Level III, IV, and V Members, and at least once every 6 months plus quarterly phone calls for Level I and II Members; an initial in-home visit must occur prior to the start of personal care services.(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))
• 4Providers must maintain a specific record for each Member (demographics, MED form, authorized plan of care, emergency contacts, plan-of-care tasks/schedule, entrance/exit times and total hours per visit, medication pass counts for Level IX, and signed/dated progress notes), and the nursing plan of care and physician orders must be reviewed and signed by the physician at least every 62 days.(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))
• 5A newly hired PSS not yet meeting training/examination requirements (except family provider service option) must complete an 8-hour orientation (job shadowing capped at 2 of the 8 hours) before delivering services, and must demonstrate competency in all required tasks before assignment to a Member's home (except health maintenance activities).(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))
• 6A PSS must meet one of the specified training/examination requirements; an untrained individual may be hired only if enrolled in a certified training program within 60 days of hire and completing training and examination within nine months, after which reimbursement must stop until requirements are met; the PSS training curriculum must include at least 50 hours of formal classroom instruction, demonstration, return demonstration, and examination.(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))
• 7Home health aides and CNAs must have completed CNA training consistent with Maine State Board of Nursing rules and be listed on the Maine Registry of Certified Nursing Assistants and Direct Care Workers.(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))
• 8Effective January 1, 2020, providers of Private Duty Nursing and Personal Care Services must comply with the Maine DHHS Electronic Visit Verification (EVV) system, electronically verifying the type of service, the individual receiving service, the date, the location, the individual providing service, and the start and end times (per 21st Century CURES Act sec. 12006); PDN Level IX, care coordination, and skills training are exempt.(MaineCare Benefits Manual, Chapter II, Section 96 - Private Duty Nursing and Personal Care Services, Subsection 96.07 (Policies and Procedures))