Maine - Homemaker Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-10

MaineCare funds Homemaker Services primarily through the MaineCare Benefits Manual (MBM) Chapter II, Section 19 (Home and Community Benefits for the Elderly and Adults with Disabilities) and state-funded Section 63 programs. The service provides general household support, including meal preparation, laundry, shopping, and light housekeeping, for members who are unable to perform these tasks independently.

Before an agency can enroll as a MaineCare provider for this service, it must first secure the appropriate operating authority—either a Home Health Care Services license or registration as a Personal Support Services Agency—from the Maine DHHS Division of Licensing and Certification (DLC). Only after this structural prerequisite is met can the provider submit an enrollment application through the MaineCare Health PAS Online Portal.

1. Service Definition and Scope

In Maine, Homemaker Services are defined under MBM Section 19 and Section 63 as assistance with general household tasks. These services are authorized when the member is unable to manage the home or when the individual regularly responsible for these activities is temporarily absent or unable to manage the home.

The scope of the service is strictly limited to instrumental activities of daily living (IADLs) and does not include hands-on personal care or nursing tasks, which fall under separate service definitions and require different staff qualifications.

• Service Scope: Includes sweeping, mopping, dusting, making beds, washing dishes, and personal laundry.
• Meal Preparation: Includes planning meals, grocery shopping, and preparing food according to the member's dietary needs.
• Errands: Includes shopping for essential items and picking up medications, provided it is documented in the care plan.
• Exclusions: Cannot include hands-on assistance with bathing, dressing, toileting, or medication administration.
• Authorization: Must be explicitly detailed in the member's Person-Centered Service Plan approved by the assessing agency.

2. Regulatory and Oversight Agencies

The Maine Department of Health and Human Services (DHHS) divides oversight of Homemaker Services among three primary divisions. Licensing and registration are handled by the Division of Licensing and Certification (DLC), while Medicaid enrollment and billing are managed by the Office of MaineCare Services (OMS).

Programmatic oversight, waiver administration, and policy development for older adults and adults with disabilities are managed by the Office of Aging and Disability Services (OADS).

• Division of Licensing and Certification (DLC): Issues licenses and registrations for home care agencies (https://www.maine.gov/dhhs/dlc).
• Office of MaineCare Services (OMS): Manages Medicaid provider enrollment and the MaineCare Benefits Manual (https://www.maine.gov/dhhs/oms).
• Office of Aging and Disability Services (OADS): Administers Section 19 waiver programs and oversees care coordination (https://www.maine.gov/dhhs/oads).
• Health PAS Online Portal: The official MaineCare provider enrollment and MMIS billing system (https://mainecare.maine.gov).

3. Gatekeeping Prerequisites: Who Can Even Apply

Maine does not require a Certificate of Need (CON) for basic Homemaker Services, nor does it restrict enrollment to closed networks or RFP procurements for standard Section 19 waiver providers. However, a strict sequential prerequisite exists regarding state operating authority.

An applicant cannot submit a MaineCare provider enrollment application for Homemaker Services without first holding an active Home Health Care Services license or a Personal Support Services Agency registration from the Maine DHHS DLC. The MaineCare enrollment portal will automatically reject applications lacking this foundational DLC approval.

• Operating Authority Prerequisite: Must hold an active DLC license or registration before applying to MaineCare.
• Business Registration: Must be registered and in good standing with the Maine Secretary of State.
• NPI Requirement: Must obtain a National Provider Identifier (NPI) specific to the agency location.
• Physical Location: Must maintain a physical business office in Maine or a border state if serving border members.

4. Licensure and Certification Requirements

Agencies providing Homemaker Services must comply with 10-144 CMR Chapter 119 (Regulations Governing the Licensing and Functioning of Home Health Care Services) or Chapter 125 (Regulations Governing the Licensing of Personal Support Services Agencies), depending on their broader service mix.

The DLC application process requires submission of organizational documents, a detailed policy and procedure manual, and a designated administrator who meets state qualifications.

• Application Form: DLC Home Care Agency initial application packet.
• Fee: Initial licensing or registration fee as determined by the DLC fee schedule (typically $200-$500 depending on agency type).
• Administrator Qualifications: Must designate an administrator with experience in health care or human services administration.
• Policy Manual: Must submit policies covering client rights, grievance procedures, and incident reporting.

5. Medicaid Provider Enrollment

Once DLC registration or licensure is secured, the agency must enroll as a MaineCare provider through the Health PAS Online Portal. Providers enroll under the specific provider type and specialty codes corresponding to Section 19 or Section 63 services.

The enrollment process requires a signed MaineCare Provider Agreement and completion of an ownership and control disclosure form.

• Enrollment Portal: Applications must be submitted electronically via the Health PAS Online Portal.
• Provider Type: Typically enrolled under Provider Type 85 (Personal Care Agency) or similar, depending on exact services.
• Application Fee: Subject to the ACA Medicaid application fee (approx. $709 for 2024) unless waived via Medicare enrollment.
• Site Visit: OMS or its designee may conduct a pre-enrollment site visit for moderate or high-risk provider categories.

6. Staffing, Training and Background Checks

Staff providing Homemaker Services must meet the qualifications outlined in MBM Section 19. While they do not need the full Personal Support Specialist (PSS) certification required for hands-on care, they must complete agency-based orientation and training specific to household management.

Maine mandates comprehensive background checks for all direct care workers prior to client contact, utilizing the Maine Background Check Center (MBCC).

• Age Requirement: Homemakers must be at least 17 years of age.
• Background Check: Mandatory screening through the Maine Background Check Center (MBCC) prior to hire.
• Disqualifying Offenses: Cannot employ individuals with convictions for abuse, neglect, exploitation, or certain violent felonies.
• Orientation: Must complete agency-specific training on infection control, emergency procedures, and mandated reporting.

7. Documentation, Policies and Records

Providers must maintain comprehensive records that comply with MBM Chapter I and Chapter II, Section 19. This includes maintaining a copy of the member's Person-Centered Service Plan and documenting every service delivery encounter.

MaineCare requires providers to implement an Electronic Health Record (EHR) system or equivalent secure electronic documentation method to track service delivery and support Electronic Visit Verification (EVV) where applicable.

• Service Notes: Must document the date, start and end times, specific tasks performed, and the worker's signature for every visit.
• Care Plan: Must maintain a current copy of the OADS-approved Person-Centered Service Plan in the member's file.
• Record Retention: All clinical and billing records must be retained for a minimum of five years.
• Incident Reporting: Must have policies for reporting critical incidents to OADS within 24 hours.

8. Billing, Rates and Claims

Homemaker Services are billed to MaineCare using the Maine Integrated Health Management Solution (MIHMS) via the Health PAS Online Portal. Services are typically billed in 15-minute increments using specific HCPCS codes (e.g., S5130).

Rates are established by the DHHS Rate Setting Unit and published in the MaineCare Fee Schedule. Providers cannot bill members for the difference between the MaineCare rate and their private pay rate.

• Billing System: Claims are submitted through MIHMS via the Health PAS Online Portal.
• Procedure Code: Typically billed using HCPCS code S5130 (Homemaker service, NOS; per 15 minutes).
• Rate Schedule: Current reimbursement rates are listed on the MaineCare Provider Fee Schedule webpage.
• Prior Authorization: Claims will deny if the service is not prior-authorized by the assessing agency in the MIHMS system.

9. Approval Sequence and Timeline

The pathway to becoming a billable Homemaker provider in Maine follows a strict sequence: corporate formation, DLC licensure/registration, and finally MaineCare enrollment.

The entire process typically takes 3 to 6 months, heavily dependent on the completeness of the DLC application and the current processing queue at OMS.

• Step 1: Entity formation and obtaining an NPI (1-2 weeks).
• Step 2: Submission of DLC application and policy manual (DLC review takes 30-60 days).
• Step 3: Submission of MaineCare enrollment via Health PAS (OMS review takes 30-45 days).
• Step 4: Receipt of MaineCare Welcome Letter and authorization to accept referrals.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied at the DLC stage due to incomplete policy manuals or failure to designate a qualified administrator. At the MaineCare enrollment stage, mismatched NPI data or missing ownership disclosures are the primary causes for return.

During post-enrollment audits, the most common survey citations involve missing background checks and inadequate daily service documentation.

• Licensure Denial: Incomplete policies regarding client rights or grievance procedures.
• Enrollment Return: Discrepancies between the legal name on the W-9 and the DLC registration.
• Audit Finding: Failure to run MBCC background checks prior to the first day of client contact.
• Audit Finding: Service notes lacking specific start/end times or missing the worker's signature.

11. Key Contacts and Resources

Providers should rely on official Maine DHHS websites for the most current regulations, fee schedules, and provider manuals. The MaineCare Benefits Manual is hosted on the Secretary of State's website.

For enrollment assistance, providers can contact the MaineCare Provider Enrollment unit directly.

• MaineCare Provider Portal: https://mainecare.maine.gov
• Division of Licensing and Certification: https://www.maine.gov/dhhs/dlc
• Office of Aging and Disability Services: https://www.maine.gov/dhhs/oads
• MaineCare Benefits Manual (Secretary of State): https://www.maine.gov/sos/rulemaking/agency-rules/mainecare-benefits-manual
• Maine Background Check Center: https://www.maine.gov/dhhs/dlc/background-check-center

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