Home Health Care Services in Maine help individuals especially seniors and persons with disabilities, maintain independence by delivering medical and non-medical care in the comfort of their homes. These services are funded through MaineCare (Maine’s Medicaid program), including Home and Community-Based Services (HCBS) Waivers, private insurance, and Medicare for eligible individuals.

1. GOVERNING AGENCIES

Agency: Maine Department of Health and Human Services (DHHS)
Role: Oversees licensing and regulation of home health agencies and HCBS Waiver programs

Agency: Office of MaineCare Services
Role: Administers Medicaid-funded home health and personal support services under Section 40 and Section 19 waivers

Agency: Division of Licensing and Certification (DLC)
Role: Issues licenses for Home Health Agencies and conducts compliance inspections

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures that Maine’s programs meet federal HCBS standards

2. HOME HEALTH CARE SERVICE OVERVIEW

Home health care providers offer skilled nursing and personal care services to eligible individuals at home. These services can include:

• Skilled nursing (e.g., wound care, medication management)
• Physical, occupational, and speech therapy
• Personal support (e.g., bathing, dressing, toileting)
• Homemaker services (e.g., light housekeeping, laundry)
• Care coordination and case management
• Telehealth support and monitoring

Services must be ordered by a physician and align with the individual’s plan of care or person-centered service plan (PCSP) under HCBS Waivers.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business entity with the Maine Secretary of State
• Obtain EIN and Type 2 NPI
• Apply for a Home Health Agency (HHA) license through the Division of Licensing and Certification
• Obtain Medicaid Provider Enrollment through MaineCare (via the Health PAS Online Portal)
• Submit proof of liability insurance, policies, and staff credentials
• Meet staffing, documentation, and training requirements outlined in state regulations

4. MAINECARE ENROLLMENT & SECTION WAIVER PARTICIPATION

Step 1: Prepare Business and Clinical Documents

• Organizational chart, policies and procedures, HIPAA policies
• Staff licensure and background checks

Step 2: Apply for HHA License via DLC

• Submit HHA application with applicable fees and documentation
• Prepare for an onsite survey if required

Step 3: Enroll with MaineCare

• Create account on Health PAS Online
• Complete provider enrollment for relevant sections (e.g., Section 19, Section 40)
• Upload supporting documents including state license and certifications

Step 4: Begin Service Delivery upon Approval

• Accept referrals through case managers and discharge planners
• Deliver care as outlined in approved plans

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC certificate
• IRS EIN Letter and NPI confirmation
• HHA license issued by the Division of Licensing and Certification
• Approved MaineCare provider enrollment

Policy & procedure manual including:

• Plan of care templates and physician orders
• Incident reporting and medication logs
• Infection control and emergency response plans
• Client rights and grievance procedures
• Staff credentials, orientation materials, and training logs

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Maine RN license, CPR certification, experience in home health or geriatrics

Role: Home Health Aide (HHA)
Requirements: CNA license or HHA training, supervision by RN, background check

Role: Therapist (PT/OT/ST)
Requirements: Maine license in specialty, experience in community-based rehab

Training Requirements for All Staff:

• HIPAA and infection control
• Home safety and client rights
• Emergency procedures and documentation standards
• Annual continuing education

7. MEDICAID WAIVER SERVICES

Home Health Care is funded through:

• MaineCare Section 40: Home Health Services
• MaineCare Section 19: Elderly and Adults with Disabilities Waiver
• MaineCare Section 96: Private Duty Nursing
• Medicare (Part A) for skilled care after hospital discharge
• Veterans Administration (VA) benefits for eligible veterans

Approved providers may deliver:

• Nursing and therapy services
• ADL assistance and caregiver training
• Case coordination and outcome documentation
• 24-hour on-call support (as required by licensure)

8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 1–2 weeks

Phase: State Licensure Application (HHA)
Timeline: 30–90 days (may include on-site inspection)

Phase: MaineCare Enrollment
Timeline: 30–60 days after licensure approval

Phase: Staff Onboarding and System Setup
Timeline: 2–4 weeks

Phase: Referral Activation and Billing Setup
Timeline: Ongoing

9. CONTACT INFORMATION

Maine Division of Licensing and Certification
Website: https://www.maine.gov/dhhs/dlc
Phone: (207) 287-9300

Office of MaineCare Services
Email: provider-enrollment@mainecare.maine.gov
Website: https://www.maine.gov/dhhs/oms

Health PAS Online Portal (MaineCare Enrollment)
Website: https://mainecare.maine.gov

Maine Board of Nursing
Website: https://www.maine.gov/boardofnursing

10. SCOPE OF WORK

• Business registration (LLC, EIN, NPI)
• HHA licensing application and compliance support
• MaineCare Section 19/40 enrollment navigation
• Policy & procedure manual for clinical and non-clinical care
• Templates for care plans, incident logs, and client documentation
• Website, domain, and HIPAA email setup
• Staff onboarding packets, credentialing trackers
• Audit and survey preparation tools
• Referral networking with hospitals, care managers, and families