Maine Department of Health and Human Services Forms

This document provides instructions for completing the Mainecare Cost Report for Psychiatric Residential Treatment Facilities (PRTF) in Maine. It includes guidance on reporting expenses and financial information related to providing psychiatric residential treatment services.

This document is a checklist used for reporting the costs of Mainecare services for the ICF/IDD program in Maine.

This type of document provides instructions on how to complete an Agreement Closeout Report for a Fee-For-Service agreement in the state of Maine.

This document is used for applying for benefits in Maine under programs like SNAP (food assistance), TANF (cash assistance), or Mainecare (health insurance).

This type of document is used for applying for transitional transportation assistance in the state of Maine.

This document is used for applying for transitional child care in the state of Maine.

This document is an application for Long Term Care Mainecare in the state of Maine. It is used to apply for financial assistance for long-term care services for individuals who meet certain eligibility criteria.

This form is used for verifying enrollment or completion of courses at a community college in Maine.

This Form is used for screening individuals who are interested in living in a group home in Maine. It provides information about the screening process and includes a fact sheet about group homes.

This document describes the snap changes made to existing group homes in the state of Maine.

This Form is used for reporting lost or stolen Electronic Benefit Transfer (EBT) cards in the state of Maine and requesting a replacement.

This document provides instructions for completing the cost report for nursing care facilities in Maine that participate in the Mainecare program. It is a single-level cost report and includes detailed guidelines on how to accurately report the costs associated with providing nursing care services. The instructions help facilities understand the information required and how to fill out the form correctly.

This document provides instructions for completing the Mainecare Cost Report for Nursing Care Facilities that have multiple levels of care with one Residential Care Facility (RCF) in the state of Maine. It guides nursing care facilities in submitting accurate financial information for reimbursement purposes.