What are the programs that EIM Administers?

EIM is a MaineCare provider who delivers Care Coordination services throughout the State of Maine for two MaineCare programs, Private Duty Nursing and Personal Care Services (PDN) and Home & Community Benefits for Elders & Adults with Disabilities (HCB).  EIM is also contracted with the Office of Aging and Disability Services to provide Care Coordination throughout the State of Maine for a state funded program, In-Home and Community Support Services for Elderly and Other Adults, commonly referred to as Home Based Care (HBC). A Change Healthcare assessment is required for all programs.

In-Home and Community Support Services for Elderly and Other Adults - Commonly Known as Home Based Care (HBC)

This program is for consumers who are 18 years and older. HBC requires both financial and medical eligibility in order to access services. There is no income limit and the asset limit is $50,000.00 for an individual and $75,000.00 for a couple. Change Healthcare will calculate an estimated monthly copayment at the time of the medical assessment. EIM will then complete a financial review to determine the actual monthly copayment. Covered services under HBC include Care Coordination, Personal Care Services, Nurse, Adult Day, Homemaker, Occupational Therapy, Physical Therapy, Speech and Language Therapy, Mental Health Services, Home Modifications, Emergency Response Service, and Respite. The consumer has a choice in how they would like to receive their Personal Care Services. Consumers can choose to access an EIM-contracted Personal Care provider located in the community or use the self-directed option called Family Provider Service Option (FPSO). FPSO allows a consumer or an adult who is 21 years or older to register as the Personal Care Agency solely for the purpose of managing the adult's own services. There are times when the State of Maine has implemented a HBC waitlist to access services under this program. Eligibility and service delivery for this program are governed by Section 63 of the Office of Aging and Disability Services Manual. There is currently a waitlist in effect.

The Home & Community Benefit for Elders & Adults with Disabilities (HCB)

This program is for consumers who are 18 years and older.  HCB requires both MaineCare and medical eligibility in order to access services. The Department of Health and Human Services (DHHS) is responsible for determining a consumer's Long Term Care MaineCare eligibility and cost of care. DHHS bills the consumer directly for their monthly cost of care. Covered services under HCB include Care Coordination, Personal Care Services, Nurse, Adult Day, Homemaker, Occupational Therapy, Physical Therapy, Speech and Language Therapy, Masters Social Work, Environmental Modifications, Emergency Response Service, and Respite. The consumer has a choice in how they would like to receive their Personal Care Services. The consumer can choose to access a MaineCare Personal Care provider located in the community or use the Participant Directed Option (PDO). PDO allows a member or member's representative to manage attendant services. Eligibility and service delivery for this program are governed by Section 19 of the MaineCare Benefits Manual; Home and Community Benefits for Elders & Adults with Disabilities.

The Private Duty Nursing and Personal Care Services (PDN)

The Private Duty Nursing and Personal Care Services (PDN) has no age limit to access services. PDN requires both MaineCare and medical eligibility in order to access services. The Department of Health and Human Services is responsible for determining a consumer's Community MaineCare eligibility. The consumer's monthly cost of care under PDN is determined and billed directly to the consumer by the home care provider agency delivering services according to regulation. Covered services under PDN include Care Coordination, Personal Care Services, and Nurse services. The consumer has a choice in how they would like to receive their Personal Care Services. The consumer can choose to access a MaineCare Personal Care provider located in the community or the use self directed option called Family Provider Service Option (FPSO). FPSO allows a consumer or an adult who is 21 years or older to register as the Personal Care Agency solely for the purpose of managing the adult's own services. Eligibility and service delivery for this program are governed by Section 96 of the MaineCare Benefits Manual - ages 21 and over or under 21 years old if accessing the Family Provider Service Option under PDN level 4 only.