MaineCare Section 17: What's Really Going On?
Section 17: What’s Really Going On? What do I need to know?
Are you worried you might lose Section 17 services because of the recent changes? This guide answers some common questions and explains the changes to Section 17 eligibility.
What has changed about Section 17?
There was a lot of incorrect information in the news when these changes were first announced in March 2016. Many reports said that only people with schizophrenia or schizoaffective disorder would be eligible for services under Section 17. This is not true. Section 17 eligibility rules have changed, but they are not that limited.
Who is still eligible?
First, you might want to try our Section 17 Eligibility Tool (below) if:
- You are worried about losing your Section 17 services.
- You don’t know if you are still eligible.
- You don’t get these services now, but want to know if you are eligible.
- You are a healthcare provider and you want to help your clients figure out if they are eligible.
You can answer these questions:
- On your own
- With the help of your healthcare provider or caseworker
- With someone you trust
If you have this information, it will help you answer the questions:
- Your primary diagnosis
- Your LOCUS score
- Your recent mental healthcare history
Don’t worry if you don’t have all of this information. The tool can still help you figure out what to do.
We have done our best to break down the new rules correctly. But we still aren’t sure how they will work in practice. This tool may not be perfect. No matter what result you get from the Eligibility Tool, you should talk with your healthcare provider.
- To start, click on the blue "play" button below.
- Click on your answer to each question.
- If you make a mistake, and need to go back, you can use the "back" button in the bottom left of the window.
Section 17 Eligibility Tool
If you want to learn more about the new eligibility requirements, we’ve broken them down below. You can also find the Section 17 Eligibility Form here. You can print this form out and take it to your healthcare provider. They can use it to help you get, or keep up Section 17 services.
You are eligible for Section 17 services if:
1. You are 18 or older (or an emancipated minor).
a. You have a primary diagnosis of Schizophrenia OR Schizoaffective Disorder (If yes, skip to 3)
b. You have a different primary diagnosis (other than: Neurocognitive Disorders, Neurodevelopmental Disorders, Antisocial Personality Disorder or Substance Use Disorder) AND you have at least one of these risk factors:
- You are afraid that you will become homeless, or you are already homeless;
- You are afraid that you will be arrested;
- You think you will need over-night mental health care for more than three days (72 hours);
- You think that you will be put in residential treatment (a long-term mental healthcare facility) if you do not get community support services;
- You have gotten treatment in Riverview Psychiatric Center or Dorothea Dix Psychiatric Center in the last two years (24 months) for something other than Neurocognitive Disorders, Neurodevelopmental Disorders, Antisocial Personality Disorder or Substance Use Disorder;
- You have been discharged from an overnight mental healthcare stay in the last two years (24 months);
- You have gotten over-night treatment because of a mental illness for 3 days (72 hours) twice or more in the last two years (24 months);
- You have ever been committed by a civil (not criminal) court for psychiatric treatment as an adult (This is also known as being “blue-papered”);
- When you were under 21, you were eligible as a child with severe emotional disturbance AND you have gotten a written opinion from a clinician within the last year (12 months) that says you had at least one of the risk factors listed above at the time the clinician issued the written opinion.
3. You have a LOCUS score of at least 17 (or at least 20 if you need a case worker/Community Rehabilitation Services).
What do I need to do if I get services under Section 17 now? Will I lose these services?
If you are getting services under Section 17 now, you should NOT be losing them any time soon.
Even if you are not eligible under the new rules, your healthcare provider can ask for an extension of your services. This means that they can ask for your services to continue until June, 2017. They might have to do this several times because these extensions are for 3 or 4 months at a time. If you are worried about losing these services, talk with your healthcare provider.
What can I do if I am denied services under Section 17?
You have the right to an appeal if you are denied, or if your services are terminated. If you get cut off from these services, get in touch with your healthcare provider as soon as you can. Any denial or cut off notice will be sent directly to your provider. It is important to get in touch with them because if you appeal the cut off within 10 days, you will continue to get your regular care until the issue is worked out. If you are worried that this will happen to you, tell your healthcare provider ahead of time that you want to be contacted immediately if you are cut off from these services.
If you have been receiving Section 17 services, there is no reason you should have to lose your services before June, 2017, even if you are not eligible under the new rules!
Contact PTLA if you think you should be receiving these services and:
- you are denied,
- you are cut off before June, 2017,
- you need to appeal,
- you are told you can’t apply for these services, or
- you are told you aren’t eligible, and you thank that is incorrect.
Published May 2016