C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-29, subsec. 144-101-II-29.16

Current through 2024-51, December 18, 2024

Subsection 144-101-II-29.16 - APPENDIX III Performance Measures

The primary goal of Performance Measurement is to use data to determine the level of success a service is achieving in improving the health and well-being of members. Performance Goals and Performance Measures assist to monitor quality, inform and guide reimbursement decisions and conditions of provider participation across MaineCare services. This focus on Performance Measurement is anticipated to enhance the overall quality of services provided and raise the level of public accountability for both the DHHS and MaineCare providers.

29.16-1Performance Goals

Members receiving this service will experience improved or preserved functional abilities while being able to live in a safe and stable setting within the community.

29.16-2Performance Measures

a. 65% of members receiving Work Support-Individual services will have worked a total number of hours of paid employment during the quarter that is greater than the total number of Work Support-Individual support hours they received during the quarter.

b. 100% of members receiving Work Support Services-Group making less than minimum wage, will have a Personal Plan in place that identifies how Work Supports is being utilized to increase the member's productivity and ensure good job match in order to move toward an hourly wage that meets or exceeds the State of Maine minimum wage standard.

29.16-3Performance Measure Data Source

Providers must electronically enter member level data into a DHHS defined web-based data collection system by the fifteenth of the month after the quarter ends.

29.16-4Performance Measurement Compliance

DHHS may exercise the following steps to ensure compliance:

Step 1: DHHS will notify the provider in writing of any compliance and performance issues identified by DHHS staff. The notice will include the performance provision that is in noncompliance and a date by which the provider will correct or remedy the identified non-compliance/performance issue.

Step 2: If the compliance/performance issues described by DHHS in Step 1 have not been addressed by the specified dates, the provider and a representative of DHHS will meet, discuss, and document the compliance/performance issues. DHHS and the provider will develop a corrective action plan which must include:

1. A statement of the corrective actions required for compliance with the Performance Measures;

2. The date by which the provider will comply with the terms of the Performance Measures;

3. The consequences for non-compliance which may include the sanctions described in Chapter I of this manual or other consequences as determined by the DHHS; and 4. Signatures of the provider and DHHS representative.

Step 3: In accordance with Chapter I, if the provider fails to undertake the corrective actions in the corrective action plan, DHHS may impose sanctions, up to and including termination of the Provider Agreement in accordance with the procedures described in Chapter I, General Administrative Policies and Procedures, Section 1.03-4, "Termination of Participation by Provider or DHHS" and Section 1.19, "Sanctions/Recoupments".

C.M.R. 10, 144, ch. 101, ch. II, 144-101-II-29, subsec. 144-101-II-29.16