PERSONAL CARE SERVICES PROVIDER IN MAINE

Fatumata Kaba
Aug 12
4 min read

ENABLING INDEPENDENT LIVING THROUGH COMPASSIONATE, HANDS-ON SUPPORT FOR DAILY ACTIVITIES

Personal Care Services (PCS) in Maine support individuals who need help with daily living activities due to aging, physical or developmental disabilities, or chronic conditions. These services help participants remain at home and engaged in their communities, while reducing reliance on institutional care. PCS are delivered through MaineCare (Medicaid) under programs like the Section 19 Elderly and Adults with Disabilities Waiver, Section 96 Private Duty Nursing and Personal Care, and other long-term services and supports (LTSS) options.

1. GOVERNING AGENCIES

Agency: Maine Department of Health and Human Services (DHHS) — Office of MaineCare Services (OMS)

Role: Administers Medicaid-funded PCS under applicable waiver programs and the State Plan

Agency: Maine DHHS — Office of Aging and Disability Services (OADS)

Role: Defines eligibility, monitors provider quality, and authorizes services under Sections 19, 20, 21, and 29

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure PCS meet HCBS standards under 1915(c) waivers and State Plan services

2. PERSONAL CARE SERVICE OVERVIEW

Personal Care Services provide non-medical assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) to help participants live safely and independently.

Approved services may include:

Bathing, dressing, grooming, and toileting
Assistance with ambulation, transfers, and mobility
Meal preparation and feeding
Light housekeeping and laundry (related to personal care)
Medication reminders and health monitoring support
Companionship and safety supervision
Escort to appointments or errands

PCS must be authorized in the participant’s Plan of Care (POC) or Service Plan, and all care must be documented and aligned with MaineCare requirements.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Maine Secretary of State
Obtain IRS EIN and Type 2 NPI
Enroll with MaineCare as a PCS or Home-Based Care Provider
Maintain general liability and workers’ compensation insurance
Ensure all staff pass background checks, elder abuse screening, and CNA or PCA certification (as required)
Develop a Personal Care Services Policy & Procedure Manual
Ensure compliance with HIPAA, state health rules, and documentation standards

4. PROVIDER ENROLLMENT PROCESS

Step 1: MaineCare Provider Enrollment

Apply via the MaineCare Provider Enrollment Portal: https://mainecare.maine.gov
Select the appropriate provider type (e.g., Section 96 Personal Care, Section 19 Waiver)

Step 2: Licensing and Policy Development

If applicable, register with Division of Licensing and Certification
Submit organizational documents, service delivery protocols, and care plan templates

Step 3: Staff Credentialing and Training

Hire PCAs or CNAs with required training
Implement tracking systems for hours worked, supervision, and performance

Step 4: Referrals and Service Launch

Receive client authorizations through OADS, case managers, or service coordinators
Begin services according to the individual’s care plan and MaineCare billing codes

5. REQUIRED DOCUMENTATION

Articles of Incorporation or business registration
IRS EIN and NPI confirmation
MaineCare enrollment confirmation
Proof of liability and worker’s compensation insurance
Personal Care Services Policy & Procedure Manual, including:
- Client intake and ADL assessment forms
- Daily visit logs and timekeeping sheets
- Incident reporting and grievance procedures
- Emergency response and supervision protocols
- Consent forms and participant rights notices
- Staff credentialing, training logs, and evaluation tools
- MaineCare billing and audit-ready documentation

6. STAFFING REQUIREMENTS

Role: Personal Care Attendant (PCA) / Certified Nursing Assistant (CNA)

Requirements: State-approved training or certification; background check; CPR/First Aid (recommended); experience with ADLs and elder care

Role: Program Supervisor or RN (for oversight)

Requirements: RN license or supervisory experience in personal care settings; responsible for quality review and care plan compliance

Training Requirements for All Staff:

HIPAA and participant confidentiality
Infection control and elder abuse prevention
ADL/IADL documentation
Emergency preparedness
Maine-specific mandatory reporting laws

7. MAINECARE WAIVER & STATE PLAN PROGRAMS

PCS are reimbursed under:

Section 19 — Elderly and Adults with Disabilities Waiver
Section 96 — Private Duty Nursing and Personal Care
Section 21 and 29 — Waivers for Adults with Intellectual and Developmental Disabilities (I/DD)
Section 20 — Children with Complex Medical Needs
State Plan MaineCare PCS — for medically necessary in-home support
Money Follows the Person (MFP) — transition support from institutional settings