Maine Supports Intensity Scale (SIS) Assessments:

Maximus Supporting Various Programs Supporting Mainers | Maine SIS-A Program Leadership Transition | Participate in a SIS-A Assessment | Meet New Clinical Assessor, Heath Giedris | Review Program Resources

In this Newsletter:

• Insights: Maximus Partnering with OADS on Programs Supporting Mainers
• Introductions: New Maine SIS-A Program Leaders
• Schedule a SIS-A Assessment
• Meet the Team: Heath Giedris
• Review Program Resources

Partnership with OADS Providing Services That Support Mainers

Maximus is privileged to partner with the State of Maine’s Department of Health and Human Services, through the Office of Aging and Disability (OADS) to administer conflict free assessment services. These diverse programs help to ensure Mainers are connected with the health services and supports they need. This comprehensive portfolio of program assessments and evaluations includes:

Assessing Services Agency (ASA)

In 2018, OADS selected Maximus to administered Statewide Assessing Services as the single Assessing Services Agency (ASA). In this role, the company provides assessments for a series of programs, including:

• Acquired Brain Injury (ABI)
  
  Acquired Brain Injury (ABI) is an injury to the brain that results from trauma, infection, vascular lesions, or anoxia. It can result in physical, behavioral or mental dysfunction affecting an individual’s ability to function independently. This evaluation requires a neuropsychologist evaluation and completion of the Mayo Portland Adaptability Inventory and Health and Safety tool to determine medical eligibility for specialized ABI services either in the facility setting or at home.
  

• Intermediate Care Facilities (ICF-IDD)
  
  Intermediate Care Facilities (ICF) are specialized facilities for Individuals with Intellectual/Developmental Disabilities (IDD), or other related conditions, who require care and services above the level of room and board but not that of a hospital or skilled nursing facility. Medical eligibility requires a physician certification that the person have a need for at least 8 hours of licensed nurse supervision per day. The focus of these facilities is to assist individuals to reach their maximal level of functioning capabilities, with healthcare and rehab services while providing 24 hour care.




• Long Term Care (LTC) Advisory
  
  The Long-Term Care (LTC) Advisory is an assessment that provides advice to the individual and family/guardian to determine if the person is eligible for possible facility admission, or in-home services funded through MaineCare or state funded home-based care programs. Individuals choosing to enter a nursing facility must have this type of assessment to comply with the State statutes unless entering under skilled care. ABI, ORC, ICF/IDD, GPU.




• Other Related Conditions
  
  Other Related Conditions (ORC) constitute Cerebral Palsy, Epilepsy, or other condition besides mental illness which found to be closely related to Intellectual Disability, resulting in impairment or general intellectual functioning or adaptive behavior, similar to that of persons with Intellectual Disabilities and requires similar treatment or services.
  
  The State of Maine requires a Medical Eligibility Determination assessment and completion of the BMS 99 to determine an individual’s medical eligibility for services under the Other Related Conditions Waiver. The program provides community integration through existing natural supports and community relationships, such as Care Coordination, Home Support, Community Support, and Work Support.
  

Click here to learn more about the ASA.

Preadmission Screening and Resident Review (PASRR) Assessments


Preadmission Screening and Resident Review (PASRR) is a federally required program enacted to ensure that individuals with a Serious Mental Illness (SMI), Intellectual Disability (ID), or an Other Related Condition (ORC) are not inappropriately institutionalized in nursing facilities. 


• Everyone seeking entry to a Medicaid certified nursing facility, regardless of their payor source, expected length of stay, or current location, must be screened for a potential SMI, ID, and/or ORC before admission. This is referred to as a Level I PASRR screen. 
  
• People who meet criteria for a PASRR exemption or post-admission assessment activity will also be identified, as well as those who require a comprehensive Level II assessment before nursing facility admission. Note: some Maine service providers refer to this as the “Maximus assessment”.

Click here to learn more about the Maine PASRR Program.

• Contact the Maximus – Maine PASRR support team for PASRR referrals.
• Call – 833.525.5784 - Choose Option #3
• Email – MEASAPASRR@maximus.com




Supports Intensity Scale (SIS ®)


OADS expanded its partnership with Maximus in March 2023 when the company was selected to administer Supports Intensity Scale for Adults (SIS-A) assessments for Mainers. This comprehensive planning tool, developed and maintained by the American Association for Intellectual and Developmental Disabilities (AAIDD), measures exceptional medical and behavioral needs, as well as the areas of home living, community living, lifelong learning, employment, health and safety, and social activities.

Community Case Managers use the SIS-A to support the Person-Centered Planning process. It will also support the new Lifespan Waiver. This waiver offers new services and innovations to participants. Taking the SIS-A will not affect your current service options.


Click here to learn more about the SIS-A.



• Contact the Maximus – SIS-A support team to schedule an assessment.
• Call – 833.771.4639 
• Email – Maine-SIS@maximus.com

On January 1, another important change was made to the leadership team as Lisa Horan transitioned to Program Manager for the Maine SIS-A team. She’s been an integral part of the team since OADS’ partnership with Maximus began on the SIS-A program in early 2023. In her new role, Lisa will provide day-to-day management for the team of Clinical Assessors and administrative staff.

Meet New SIS-A Clinical Assessor, Heath Giedris


As well as the additions to our leadership team, we’re also pleased to introduce the newest member of our program team. Heath Giedris joins us as a Clinical Assessor. In this role, Heath contacts the Member, Case Manager, family members, guardians, and others to schedule the appointment. He then facilitates the assessment interview with all those attending. Once completed, the results are sent to the Member’s Case Manager. The SIS-A results can help the Case Manager with Person-Centered Planning for the Member.