THOMAS J. YARCHESKI, as Representative of B.K.Y. Petitioner/Appellant
DEPARTMENT OF HEALTH & HUMAN SERVICES, Respondent/Appellee
Plaintiff-Pro Se Thomas Yarcheski
Defendant's Attorneys: Kevin Beal, AAG Halliday Moncure,
three consolidated appeals from administrative agency actions
are before the court for decision.
addition, Petitioner's Motion to Sanction
Respondent's Attorney and Respondent's Motion to
Dismiss are before the court.
court elects to decide these appeals and the pending motions
without oral argument. See M.R. Civ. P. 7(b)(7),
8OC(1) (oral argument to be scheduled "[V]nless the
court otherwise directs." See also Lindemann v.
Comm'n on Governmental Ethics & Election
Practices, 2008 ME 187, ¶26, 961 A.2d 538 (Rule 8OC
permits court to direct that oral argument not be scheduled).
B.K. T. 's MaineCare Services
Thomas Yarcheski is the husband of B.K.Y. B.K.Y. is the
recipient of home health services under the State of
Maine's MaineCare program.
MaineCare program is the state component of the joint
state-federal program known as Medicaid, codified as Title
XIX of the Social Security Act. See 42 U.S.C.
§§ 1396-1396v (2017); 42 C.F.R. § 430.0
(2017). See also Biewald v. State, 451 A.2d 98, 99
(Me. 1982). The MaineCare program is administered by the
Respondent in these appeals, the Maine Department of Health
and Human Services (DHHS). DHHS has promulgated a set of
regulations known as the MaineCare Benefits Manual and
codified at 10-144 Code of Maine Regulations chapter 101.
See https://www.maine.gOv/sos/cec/rules/l 0/chl
receives services under the DHHS Section 19 program, which
offers services in the home and community for elderly and
disabled adults. See 10-144 C.M.R. ch. 101(11),
§ 19.01 et seq. Services rendered to a Section
19 recipient are coordinated by a "service coordination
agency" (SCA) that assesses the recipient's needs
and develops a plan for in-home services by direct care
providers. In B.K.Y.'s case, the SCAs have been Elder
Independence of Maine (EIM) and AlphaOne.
of Section 19 home services can elect to have an agency
arrange for and manage the direct care providers who come to
the home, or can elect the Participant-Directed Option and
arrange for and manage providers on their own.
elected the Participant-Directed Option. The regulations
define the participant-directed option as "a choice
offered to members to manage their Attendant Services.
Specifically, the member hires, discharges, trains, schedules
and supervises the Attendant(s) providing services. A member
who chooses to engage in the Participant-Directed Option is
considered the employer of his or her Attendant(s)." 10
C.M.R. ch. 101(11), § 19.01-23.
MaineCare recipient of Section 19 services who has elected
the Participant-Directed Option may designate a
"representative" to manage the recipient's
care. The MaineCare Benefits Manual defines a
"representative" as "an individual responsible
for managing Attendant Services on ...