Children's Behavioral Health Services

MaineCare, Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations (RCS)

Rehabilitative and Community Services (RCS) is for children or youth up to the age of 21 who have a developmental disability that affects their every day functioning. (Ex. Autism, intellectual disability (MR), Retts Syndrome, PDD). Services include skill building in activities of daily living and behavior management.

Services may be delivered in individual or group settings, and are intended to help the child function better in home and community through working on goals identified in a treatment plan. Services must be authorized by the Department and are reviewed periodically to assure medical necessity.

 

*For a free viewer or to request a hard copy

Form #	Name of Form	Word (Electronic)	PDF (Write Out)
1	Table of Forms and Instructions (Read Only)	Microsoft Word*	Adobe PDF*
1A	Table of Content (Read Only)	Microsoft Word	Adobe PDF*
2	Referral	Microsoft Word*	Adobe PDF*
3	Comprehensive Assessment: Guide to Conversation	Microsoft Word*	Adobe PDF*
4	Comprehensive Assessment Extension Request (No Longer Used)
5	Comprehensive Assessment: Narrative Summary	Microsoft Word*	Adobe PDF*
6	Comprehensive Assessment: Score Summary	Microsoft Word*	Adobe PDF*
7	Treatment Plan Meeting Record	Microsoft Word*	Adobe PDF*
8	Individual Treatment Plan	Microsoft Word*	Adobe PDF*
9	Crisis Plan	Microsoft Word*	Adobe PDF*
10	Prior Authorization Face Sheet	Microsoft Word*	Adobe PDF*
11	90-Day Review (Read only)	Microsoft Word*	Adobe PDF*
12	Continuing Stay Request	Microsoft Word*	Adobe PDF*
13	Discharge Summary (Read Only)	Microsoft Word*	Adobe PDF*
14	Change of Status	Microsoft Word*	Adobe PDF*
14A	Change of Status Levels and Codes (Read Only)	Microsoft Word*	Adobe PDF*
15	Specialized Service Rate Request	Microsoft Word*	Adobe PDF*
16	Procedures for CBHS Contracted Providers (Read Only)	Microsoft Word*	Adobe PDF*
17	Grandfathered Supervisor	Microsoft Word*	Adobe PDF*
18	Procedures for School Providers (Read Only)	Microsoft Word*	Adobe PDF*
19	Individual Child’s Enrollment Form for School Providers	Microsoft Word*	Adobe PDF*
20	Specialized Services Rate Approved Providers (Read Only)	Microsoft Word*

RCS 28 Provider list
District 1=York District (York County) & District 2=Cumberland District (Cumberland County)		HTML
District 3=Western Maine District (Androscoggin, Oxford and Franklin Counties) & District 4=Mid Coast District (Lincoln, Knox, Waldo and Sagadahoc Counties) & District 5=Central Maine District (Somerset and Kennebec Counties)		HTML
District 6=Penquis District (Piscataquis and Penobscot Counties) & District 7=Downeast District (Washington and Hancock Counties) & District 8=Aroostook District (Aroostook County)		HTML
Complete list of CBHS Providers		HTML
District Contacts
District 1 & 2		HTML
District 3, 4, & 5		HTML
District 6, 7, & 8		HTML
Contact Home page		HTML
Manual
MaineCare Benefits Manual, Chapters II & III, Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations		Microsoft Word *