10- 144 C.M.R. ch. 295, § I

Current through 2024-51, December 18, 2024
Section 144-295-I - DEFINITIONS
A. Unless otherwise indicated, the following terms shall have the following meanings specific to the Dental Services Development and Subsidy Program as authorized and funded by 22 MRSA §2127.
B. Defined Terms

Board: A board of directors or other governing body that has responsibility for the governance and administration of the oral health care program. In the case of a public entity, an advisory or steering committee that is identified to maintain oversight of the project or initiative receiving funds through this Section, and to represent it, through reporting mechanisms or other defined relationship(s) within that entity's structure, may serve as the governing body. Community groups in initial organizational stages that do not have formal boards or governing bodies are also eligible to receive funding through this Section when a steering committee that functions as a governing body is identified.

Community-operated non-profit oral health care program: an oral health services program that is governed and administered by a public or private non-profit agency or entity, and that itself provides clinical oral health services.

Coverage: the hours that an oral health program providing clinical services is open to provide those services.

Dental Care Analysis Area: An area as defined by the Department of Human Services for the purpose of analyzing health service patterns and areas for federal and/or state designation as having a shortage of dentists to meet the needs of the population.

Dental Services Development and Subsidy Program(s): The program(s) funded as a result of Title 22 MRSA, Section2127.

Department: The Maine Department of Human Services

Full-time equivalent dentist: a dentist who actively practices at least 40 hours per week serving the targeted population.

In-kind support: Support for a program or initiative that is provided without charge but for which an equivalent dollar amount can be calculated and documented.

Oral health services: Oral health services include clinical dental services, and community education and oral health education and case management services.

"Clinical dental services" includes the full range of dental services, including without limitation preventive, pediatric, restorative, surgical, orthodontic, endodontic, and prosthodontic services. "Community education and oral health education" mean education, whether targeted to the community or to individuals, that is designed to encourage good oral hygiene practices that will contribute to preventing tooth decay and other oral diseases. "Oral health case management services" are case management services that facilitate the provision of oral health care services to individuals.

Patient screening process: A process to determine a potential patient's eligibility for any available and applicable programs, such as but not necessarily limited to Medicaid and Cub Care (Maine's State Children's Health Insurance Program); and which also determines eligibility for services under a sliding fee scale, and which point on that scale will apply for each patient.

Sliding scale or sliding fee scale: A fee scale that adjusts the fee charged to a patient according to the patient's income and family size.

Underserved areas or populations: Areas or populations in the State that have been designated as underserved for clinical oral health services as determined by the Commissioner of Human Services and as defined in rules adopted by the Department of Human Services. Such a designation may be limited to a geographic area of the State or to a specific practice location at the discretion of the Commissioner of Human Services. In the absence of a determination by the Commissioner of Human Services or the adoption of rules by the Department of Human Services defining an underserved population area, underserved population area means an area of the state designated by the federal government as a dental health professional shortage area.

Voucher system: A system wherein payment to another dental provider is authorized by an oral health program to purchase for a patient a specified clinical dental service which otherwise could not be provided.

Voucher payment: The payment that is made by the oral health program to another dental provider in order to reimburse that dental provider for the service(s) provided.

10- 144 C.M.R. ch. 295, § I