January 13, 2025
Minutes
Minutes
Attendees via Zoom: Catherine Thibedeau, Nora Eskin, Alyssa MacDonald, Betsy Hopkins, Bonnie-Jean Brooks, Brett Bulmer, Carol, Carol Snyder, Darryl Wood, David Cowing, Eida Ulloa-Fonseca, Hanna Daigle, Heidi Mansir, Ian Teague, Jennifer Frey, Joanna Bulger, Julianne Zaharis, Kathy Son, Kelly S, Kim Humphrey, Kristin McPherson, Kristin Overton, Laura Abbott, Laura Cordes, Laurie Caldwell, Lillian Campbell, Liz Burgess, Lorraine DeFreitas, LyAnn Grogan, Maggie Hoffman, Margaret Cardoza, Mark Eves, Mark Kemmerle, Marti Howard, Megan Salvin, Melissa Bliss, Michaela York, Paula Bush, Rachel Dyer, Rob Moran, Robin Levesque, Scott McKeough, Shelley Zielinski, Spencer Reed, Stacy Lamontagne, Steve Francek, Teague Morris, Todd Goodwin, Ann Walp, Vickey Merrill, Cullen Ryan, a few people who joined after the meeting began and left prior to the conclusion of the meeting.
Cullen Ryan introduced himself and welcomed the group. Minutes from the last meeting were accepted.
Featured Speakers: Catherine Thibedeau and Nora Eskin, Independence Advocates of Maine. Topic: An overview of Tech-First Service Delivery (Assistive Technology, Remote and Virtual Supports, use of Just-In-Time staff vs. Just-In-Case staff) – what is available here in Maine at this time and what the future may hold.
Cullen: I am pleased to welcome Catherine Thibedeau and Nora Eskin, with Independence Advocates of Maine, presenting an overview of Tech-First Service Delivery (Assistive Technology, Remote and Virtual Supports, use of Just-In-Time staff vs. Just-In-Case staff) – what is available here in Maine at this time and what the future may hold. This Coalition has existed for almost 19 years. One of the things we did early on was create the DD Continuum of Care, which includes a lot of principles, and some of them are very pertinent to today’s presentation. One was dignity of risk – which allows people the opportunity to enjoy all of the things that make life fulfilling even if there’s a little risk involved. Assistive technology (AT) says, “we don’t always need human beings there all of the time” and that technology can step in to allow people to be as independent as possible while helping to mitigate risk. Assistive technology allows for this in a really creative way. This should be a wonderful presentation, thank you for putting it together and for being here today!
Catherine Thibedeau: Thank you for having us! We’re here to talk about tech-first service delivery from the participants’ perspectives. Independence Advocates of Maine was awarded three different innovation grants, which just wrapped up December 31st. Some of what you’ll hear today is our philosophy on tech-first.
Begin Presentation (click here for the presentation)
Catherine: Enabling Technology focuses on the person with planning, education, and training – it’s not just dumped on the person. It’s also not the only way an individual can be supported. It’s usually in combination with in-person support – which may fade over time with the use of technology. Frustrations led us to this work (see slide 3). We have a risk-adverse, fear-driven culture that constantly contemplates the “what if’s”, and staff are often there “just in case”. We took these frustrations and turned them into opportunities for tech-enabled support (see slide 5). You can mitigate risk with technology very simply and insert “just in time” staff as needed.
Nora Eskin: There are three categories under the Enabling Technology umbrella: Assistive technology, remote support, and durable medical equipment. If there’s something you’re struggling with there’s probably some technology that can help.
Assistive Technology: Hygiene routines are very intense sensory experiences for people, which can make enduring hygiene routines quite difficult. Adding something like a color-changing showerhead or a shower speaker may make these hygiene routines more bearable. AT is entirely based on the needs/desires of the individual. (See slide 7 for more examples of assistive technology.)
Remote Support: If someone needs help remembering to take their meds at 6pm, two-way communication through a tablet that only comes on to assist with this then goes off afterwards is a way to remedy this in the least intrusive way. Remote support can include cameras, but it certainly doesn’t have to. Just like with AT, remote support is entirely based on the needs/desires of the individual. (See slide 8 for more examples of remote support.)
Catherine: Enabling technology planning and support: When we’re talking about AT and remote support it’s all done through screenings and assessments. If it’s deemed by the individual and the team as something they want to explore, we do an assessment. As part of our grants, we were able to have a demonstration center, where people were able to come in and have an equipment trial. We use Enabling Technology Plans to talk about the goals of the technology, how it’s utilized, how it’s maintained, etc. We also ensure everyone has an orientation to this technology and on-going training.
Nora reviewed three case studies (see slides 10 through 15 of the presentation).
Nora: Case Study 1, Amy – Door sensors and motion sensors were installed in the home, used mostly to ensure Amy got out to work on time. This was a way to support her without having staff in the home. A concern staff had was that there was a lot of remote monitoring. We discovered when we switched to remote support, roommate conflict went down significantly – most of the conflict had been around getting staff attention etc. One thing we did use remote support for was cooking. Prior to remote support, generally staff cooked their dinner. This worked, however all of the ladies in the home were great cooks. With remote support, staff can check in with them over safety etc., but allowing this dignity of risk to cook independently there was huge growth. Amy struggled with reading competency – with the use of assistive technology we used voice-activated technology for cooking appliances etc. In the past staff would wake Amy up when it was time to get up for work. We installed automated curtains which would open in the morning when it was time for Amy to get up for work. In-person staff were still needed for medication support daily and meal prep a few times a week. All of the roommates also function as natural support for each other. It’s always important to consider natural support in all of this as well. (Nora reviewed two additional case studies – see slides 13 through 15.)
We’re not using technology just to use it – we’re really looking at the person, their needs, their goals, and their wants.
Catherine: Most of what we’ve presented is covered under Section 21 and 29, though some are not. There are some differences in Section 21 and 29 currently. There are specific covered services, limits, and qualifications. (See slide 16 for specifics and links to related materials.) (Click here for the MaineCare Manual; click here for the Assistive Technology Request Guidelines document; click here for the Section 21/29 AT and RS side-by-side doc.)
Catherine: Through this work we were able to look at best practices and trends nationally. I would highly recommend exploring these:
Agencies: Charles Lea Center; Core Services of NE Tennessee; Vista Supports LLC
States: Tennessee DIDD Enabling Technology Program; Minnesota NEAT - Networking in Education and Assistive Tech; Pennsylvania Remote Supports Requirements
Vendors: Tech-First SHIFT; Simply Home: GrandCare
Catherine: Maine has a long way to go to catch up with the bell curve – we’re in the 3-4% “innovators” section of the bell curve (see slide 18). However, there’s a lot of interest in Maine which is very exciting. As the Lifespan Waiver has been thought through it’s been forward-thinking in the use of technology, which is hopeful for the future.
Discussion:
Cullen: I know there are people here who provide and/or receive similar services – I wanted to provide them the opportunity to speak to their experiences.
-A provider stated that the presentation was spot on. It’s been very helpful for clients with his agency to get the support they need when they need it.
-A parent stated that her daughter receives local support through remote monitoring through Waypoint. Prior to receiving local support, she received out-of-state remote support. The latter wasn’t as successful as local support. Just as with in-person staff, having consistent remote staff is imperative.
Catherine: There is a model where the company that holds the equipment also provides the monitoring. That’s another way of looking at service delivery. I agree with you on your assessment regarding local support.
A question was asked: How do you manage confidentiality using devices like Alexa?
Catherine: I want to push back a little on this. What’s more intrusive/less confidential – a staff person standing right there next to you, or a device to which you can directly speak? If something can be used by the general public, why would a person with disabilities not be able to use it? Recording comes with different requirements and considerations and is not something we utilize in our philosophy of services. But there is the ability to have cameras that record, but I’m not the best person to address that as that’s not what we do. Everything comes with consent, and everyone is aware of what’s happening. There needs to be choice, and group choice in group settings. Tablets are set up where an individual can call out to their staff, or where staff can call in – but that doesn’t mean that the staff can automatically call in. In some instances, they might be able to in common areas etc.
-A parent stated that the presentation and what was discussed is fantastic. It was asked how training works regarding all of this when it comes to staff turnover.
Nora: There will always be the issue of staff turnover, and with any new implementation, there will be some pushback because it is new and a change. For staff turnover, though we haven’t had a ton, we treat support related to technology as another service. Everything we use is documented in plans, regardless of how small it is. Documentation helps to ensure that everything goes smoothly even with staff turnover. Agency-wide training regarding enabling technology was really helpful to ensure everyone was on the same page.
Catherine: We have a whole separate set of slides for providers that want to become tech-first agencies and there is also training. The rate determination process will be helpful, as we’re seeing some challenges with all of the things required to get AT successfully implemented, especially in the first year – it’s eight (8) hours a year with a professional. Hopefully, this will be looked at in the rate determination process.
-It was asked if safety device plan, positive support plan, or behavioral support plan management is used.
Nora: Yes, if someone is wearing a device for location tracking, we would have to go into that. This presentation really just covered the basics. We’d start by asking the individual, then the guardian, then we would go through that process.
Catherine: This is just emerging in Maine, so we’re navigating this all together as there’s not a lot of guidance. I think we could improve on having clear guidance on what to do and when in Maine, but that will come with time.
-It was asked if they’ve found that there’s a gap in Case Manager knowledge around this.
Nora: Yes, there is an educational gap. If Case Managers aren’t aware of all of the resources/supports out there it’s hard for people to access them. It’s all about exposure and information. Learning about an entirely new service is a lot, but I’ve found that AT is a good gateway into talking more about other technological options.
- It was asked if someone who is not served through a specific provider could “purchase” enabling tech through a different provider. Example: could a person who has chosen self-directed home and community support staffing be able to be assessed for overnight remote support from a provider agency?
Catherine: Yes, this is a possibility. We also do a lot of a-la-carte services at our agency. I don’t know the intersection of this and self-direction though, but hopefully Betsy can speak to that.
Betsy Hopkins: We’re expanding services that can be self-directed in the Lifespan Waiver. AT is included in self-direction but I’m not sure about remote support – I can look into that.
-It was stated that Maine CITE is the state AT Program. They are presenting at the MACSP meeting in February. You can learn about programs and free AT demo/loan program at mainecite.org.
-A self-advocate asked if there has been an evaluation of the before/baseline without the services vs. the service is implemented. She stated that she has concerns about increased isolation due to less interaction with people due to the increased use of technology.
Catherine: There are strategies to evaluate success. It’ goes back to that individual person-centered approach. If someone is an extremely social person, and Nora does the assessment she’ll look at that and ensure that she doesn’t recommend technology that would create an isolating situation. The real value of having an expert on AT/remote support is that they can keep an eye on that and evaluate that. For some people isolation is a real concern – when that’s a concern and evaluated early on, you’d build a plan with that in mind.
Nora: Social isolation is a common concern, especially from families. I think that in most situations, social interaction isn’t solely with paid staff. If that’s not the case, what’s great about remote support is that it really is possible to have really personal, close relationships with staff even if they’re only supporting you remotely. Technology can help create a balance – but it is person-specific.
Catherine: Having technology help with some of the more ordinary aspects of daily life allows in-person staff to really concentrate on meaningful connections with the individual.
-A provider stated that for their remote support, the individuals served first spent time in-person with their remote support to help develop that relationship so there’s a good comfort level reaching out remotely.
-A self-advocate asked if Voc Rehab/Division of the Blind and Visually Impaired is involved with using AT/remote support for employment.
Catherine: We’re in the phase of coming together as stakeholders and beginning to have conversations. Maine CITE has become more engaged in working with the Section 21/29 world. There is no concerted collective effort, but through the innovation grants we’ve had a huge community of practice which is promising for this cross-sector collaboration.
Nora: We’re in the early adoption part of the curve for technology support. Employment and tech support are further behind. One of our grants was solely focused on AT for employment. People who support employment need to be aware that this technology can support employment. There’s a positive trend in that direction but it is early on. I’m hoping over the next couple of years this becomes more prevalent across employment agencies.
Cullen: I want to thank you both for that wonderful presentation, for what you’re doing, and for being innovators. This is really exciting, and finding more ways to innovate will be very helpful for our system of care. Thank you again – well done!
End Presentation (round of applause would have occurred were it not for everyone being muted and on Zoom)
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Betsy Hopkins: I wanted to start by saying this was a great presentation! Our Innovation Summit will feature a Tech Expo, at the suggestion of Independence Advocates of Maine, which will provide people with the opportunity to test out some of the technology you’ve heard about today.
The Biennial Budget came out late Friday – I don’t know about a lot of the specifics. Broadly, it allows us to continue services at current rates. It supports continuing Lifespan development which we’re excited about.
Timeline for Lifespan Waiver Implementation: The Department expects the Lifespan program to be ready for enrollment by July 2026. (Click here for the Department’s announcement, which includes more information.) Adjusting the Lifespan Waiver timeline reflects the Department's unwavering commitment to a thoughtful and effective rollout with ample opportunities for feedback from interested parties. It responds to feedback received from many individuals, families and providers who are hopeful that Lifespan will address shortcomings in the current system but are concerned that a roll out of this magnitude is not rushed. Together, we are paving the way for a brighter future for the individuals we serve, and the Department looks forward to continuing this important work with all interested parties. The waiver application is being drafted with plans to be available for public comment this winter.
Rate Study: The Rate Study has been completed, and we hope it will be posted around the same time as the Lifespan Waiver, possibly a little sooner. The rates include the new rates for Lifespan as well as Sections 21 and 29.
Intake and Eligibility Rule: We’re in the process of updating the Rule, and we’ll let you know when this is posted for Public Comment.
Licensing Rule: This is still under review by our Attorney General’s Office.
AMENDED PROPOSED RULE: 10-149 CMR Ch. 5 Sec. 2 Developmental Disability Services for Adults with an Intellectual Disability or Autism Spectrum Disorder: Click here for more information.
Accessible Home Attachment Pilot Program: OADS is facilitating the Accessible Home Attachment Pilot Program, in partnership with WheelPad L3C. The Department has a limited number of SuitePAD units for the purpose of this pilot program. SuitePAD is an accessible bedroom and bathroom addition for your home. To apply, complete and submit the following application to [email protected].
Home and Community-Based Services Quality Assurance Project Town Hall: In December 2024, the Maine Department of Health and Human Services (DHHS) started a project to improve quality of home and community-based services (HCBS). DHHS is working with a group called Alvarez and Marsal (A&M). This project is for people who have an intellectual disability, an autism spectrum disorder, or an acquired brain injury and receive personal care, homemaker, home health services, or habilitation services such as home and community support.
Some key terms you might hear during this project are:
We Want to Hear from You! DHHS is hosting a town hall meeting to share information and listen to your ideas. A&M will explain the project and ask for your feedback. Your input will help DHHS understand what’s working and what needs improvement. This is your chance to make a difference in how problems like injuries or medication mistakes are handled.
Important Details:
If you can’t join the live session, recordings will be available on the DHHS website. You can also send your feedback by email. Click here to register.
We hope you’ll join us! Together, we can make home and community services better for everyone. Please note there are other ongoing town halls related to the Access Rule that may touch on incident management topics. This session will focus on how OADS manages reportable events in certain waiver programs, specifically:
OADS Celebrates Conclusion of Innovative HCBS Projects and Looks Ahead to 2025 Innovation Summit: The Office of Aging and Disability Services (OADS) proudly announced the successful conclusion of our Innovation Projects funded by FMAP/ARPA to enhance service delivery for Home and Community-Based Services (HCBS) waivers. Over the past year and a half, OADS has spearheaded 19 innovative pilot sub-projects across MaineCare sections 18 (Brain Injury), 19 (Aging), 21 (Comprehensive Intellectual and Developmental Disabilities (IDD) and Autism), and 29 (Community IDD and Autism).
These pilots have fostered creativity, collaboration, and tangible improvements in service delivery. Supported by our partner, the National Disability Institute (NDI), the initiative encompassed diverse solutions to address the unique needs of waiver participants. As the initiative wraps up in December 2024, NDI will deliver a comprehensive final report, complete with an evaluation of outcomes. Here are a few standout examples of the innovative sub-projects:
For a full list of the funded projects and their objectives, please visit our Innovation Pilot website.
Looking Ahead: OADS Innovation Summit
Building on the success of these projects, OADS is looking forward to our Innovation Summit, a national and regional conference set to take place in Portland, Maine, on May 19–20, 2025. This event will bring together thought leaders, practitioners, and stakeholders to explore cutting-edge advancements in service delivery.
Key Features of the Innovation Summit:
For more information about registration, speakers, and schedules you can visit our Innovation Summit website.
Cullen: Thank you for being here and for providing all of this information, Betsy, and thank you for funding these innovative projects!
DHHS – Children’s Behavioral Health Services (CBHS), Office of Behavioral Health (OBH) - www.maine.gov/dhhs/obh/support-services/childrens-behavioral-health - No Update
DOL – Division of Vocational Rehabilitation (DVR) - www.maine.gov/rehab/dvr
Libby Stone-Sterling could not attend today’s meeting but sent the following update via email:
Office of Special Services and Inclusive Education (OSSIE) - www.maine.gov/doe/learning/specialed - No Update
Disability Rights Maine (DRM) Update: Megan Salvin was in attendance but had no updates to provide to the group.
Federal & Housing Updates:
Cullen: As we saw in the last Administration when Trump was President, Medicaid appears to again be the target of cuts through various Medicaid per capita cap and block grant proposals floating around Congress (see below for more information). We will be watching this closely. Our Delegation has been great and has been advocating for all the right bills and for housing and quality services for people in Maine, including people with ID/DD. Additionally, Maine is still under a Section 8 freeze – complicating efforts to find affordable housing for populations that need it.
State Legislature Update:
Laura Cordes – MACSP (Maine Association for Community Service Providers): The First Regular Session of the 132nd Legislature is underway. Committee Assignments have been made. The First Session is the longer of the two sessions. Any lawmaker could file any bill – meaning there will be more bills to contend with. Cloture, which is when bills must be filed, occurred on January 10th. This was later than usual in an effort to prevent legislators from filing placeholders (concept drafts) and instead requiring full bills to be submitted. Bills are now being printed from the Revisor’s Office and being posted online.
As I have in previous years, I created the MCHQS 132nd Maine Legislature First Regular Session 2025 Resource Document, which is a Google Document that anyone can edit. This document includes summary document links under the Budget section. There’s also a Memo I linked to that came up from the Department discussing what they’re doing to cut and initiate savings. Part A of the Budget goes through each program line-by-line, and that is also linked.
The Legislature will be looking at the Governor’s proposed Biennial Budget and her Supplemental Budget as well.
Released on Friday – click here for the General Fund Budget Language; click here for Part A.
Supplemental Budget: Also released Friday – click here for the General Fund Language; click here for Part A. (The Governor’s announcement regarding the Supplemental Budget stated that it includes “newly recognized revenue from the Revenue Forecasting Committee to fill the FY25 MaineCare gap” discussed in the State Legislature Update at last month’s meeting).
As I mentioned last month, there has been concern about being able to fund/sustain the new rates being proposed as well as the existing codified rate setting system. As I reported last month, a MaineCare notice came out that was quite surprising – the Department said they would not be adjusting rates with a COLA January 1st, and it will be reliant on additional appropriations through the Supplemental Budget.
It appears the Supplemental Budget as introduced will not remedy this so we will have to advocate for funds to be included to fix this. The Biennial Budget specifically suspends COLA adjustments for the biennium (FY 26 and FY 27) and stipulates that rate adjustments are subject to available appropriations. The Biennial Budget includes language for prior Section 21 COLAs, providing $23 million in General Fund per year to provide sufficient funding for prior cost-of-living adjustments for providers who serve MaineCare patients with intellectual disabilities or autism spectrum disorders (this appears to be a fix for funding to maintain the rates that went into effect 1/1/2024).
There is a budget deficit, which will have to be accounted for somehow, and it could be through not meeting rate obligations. There is a meeting with the Department to discuss this further. As Betsy stated the new rates will be posted – but there is a difference between posting the rates and having them be implemented.
The Appropriations Committee has yet to be briefed by the Governor or her staff on the budgets; this will happen soon and will be followed by meetings/public hearings.
(It is important to note that the Biennial Budget and the Supplemental Budget only came out late Friday, January 10th. The information provided here is mainly a cursory review and may not be reflective of all budget initiatives.)
Cullen: One bill I am aware of is a bill to cap the length of time that someone is on a waitlist for a MaineCare service at 6 months, which I believe was submitted.
Cullen: Please continue to raise your voice and tell your stories so when Legislators and Committees begin considering bills, including the Supplemental and Biennial Budgets, they have the information necessary to make good policy decisions on the needs of people with disabilities in Maine. Sharing personal stories is not only effective, but essential to betting the system of care. Thank you, Laura, for this information, for all you do, and for all you will do as the Legislative Session gets underway! I also want to take the time to thank each of you as we go into 2025. It will be a very busy stretch but thank you for rallying and answering calls to action throughout the Legislative Session. We are all better for your advocacy.
The next meeting will be on Monday, February 10, 2025, 12-2:00pm, via Zoom*.
Featured Speaker: Libby Stone-Sterling, Director, Bureau of Rehabilitation Services, Maine Department of Labor.
Topic: Overview of the Pathways to Partnerships Grant: This innovative grant is exploring how offering model services to children as young as 10 can improve post-secondary employment and education goals for students with disabilities.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
(In 2025 the October meeting will be the 3rd Monday due to the holiday)
The Maine Coalition for Housing and Quality Services provides equal opportunity for meeting participation. If you wish to attend but require an interpreter or other accommodation, please forward your request two weeks prior to the monthly meeting to [email protected].
Cullen Ryan introduced himself and welcomed the group. Minutes from the last meeting were accepted.
Featured Speakers: Catherine Thibedeau and Nora Eskin, Independence Advocates of Maine. Topic: An overview of Tech-First Service Delivery (Assistive Technology, Remote and Virtual Supports, use of Just-In-Time staff vs. Just-In-Case staff) – what is available here in Maine at this time and what the future may hold.
Cullen: I am pleased to welcome Catherine Thibedeau and Nora Eskin, with Independence Advocates of Maine, presenting an overview of Tech-First Service Delivery (Assistive Technology, Remote and Virtual Supports, use of Just-In-Time staff vs. Just-In-Case staff) – what is available here in Maine at this time and what the future may hold. This Coalition has existed for almost 19 years. One of the things we did early on was create the DD Continuum of Care, which includes a lot of principles, and some of them are very pertinent to today’s presentation. One was dignity of risk – which allows people the opportunity to enjoy all of the things that make life fulfilling even if there’s a little risk involved. Assistive technology (AT) says, “we don’t always need human beings there all of the time” and that technology can step in to allow people to be as independent as possible while helping to mitigate risk. Assistive technology allows for this in a really creative way. This should be a wonderful presentation, thank you for putting it together and for being here today!
Catherine Thibedeau: Thank you for having us! We’re here to talk about tech-first service delivery from the participants’ perspectives. Independence Advocates of Maine was awarded three different innovation grants, which just wrapped up December 31st. Some of what you’ll hear today is our philosophy on tech-first.
Begin Presentation (click here for the presentation)
Catherine: Enabling Technology focuses on the person with planning, education, and training – it’s not just dumped on the person. It’s also not the only way an individual can be supported. It’s usually in combination with in-person support – which may fade over time with the use of technology. Frustrations led us to this work (see slide 3). We have a risk-adverse, fear-driven culture that constantly contemplates the “what if’s”, and staff are often there “just in case”. We took these frustrations and turned them into opportunities for tech-enabled support (see slide 5). You can mitigate risk with technology very simply and insert “just in time” staff as needed.
Nora Eskin: There are three categories under the Enabling Technology umbrella: Assistive technology, remote support, and durable medical equipment. If there’s something you’re struggling with there’s probably some technology that can help.
Assistive Technology: Hygiene routines are very intense sensory experiences for people, which can make enduring hygiene routines quite difficult. Adding something like a color-changing showerhead or a shower speaker may make these hygiene routines more bearable. AT is entirely based on the needs/desires of the individual. (See slide 7 for more examples of assistive technology.)
Remote Support: If someone needs help remembering to take their meds at 6pm, two-way communication through a tablet that only comes on to assist with this then goes off afterwards is a way to remedy this in the least intrusive way. Remote support can include cameras, but it certainly doesn’t have to. Just like with AT, remote support is entirely based on the needs/desires of the individual. (See slide 8 for more examples of remote support.)
Catherine: Enabling technology planning and support: When we’re talking about AT and remote support it’s all done through screenings and assessments. If it’s deemed by the individual and the team as something they want to explore, we do an assessment. As part of our grants, we were able to have a demonstration center, where people were able to come in and have an equipment trial. We use Enabling Technology Plans to talk about the goals of the technology, how it’s utilized, how it’s maintained, etc. We also ensure everyone has an orientation to this technology and on-going training.
Nora reviewed three case studies (see slides 10 through 15 of the presentation).
Nora: Case Study 1, Amy – Door sensors and motion sensors were installed in the home, used mostly to ensure Amy got out to work on time. This was a way to support her without having staff in the home. A concern staff had was that there was a lot of remote monitoring. We discovered when we switched to remote support, roommate conflict went down significantly – most of the conflict had been around getting staff attention etc. One thing we did use remote support for was cooking. Prior to remote support, generally staff cooked their dinner. This worked, however all of the ladies in the home were great cooks. With remote support, staff can check in with them over safety etc., but allowing this dignity of risk to cook independently there was huge growth. Amy struggled with reading competency – with the use of assistive technology we used voice-activated technology for cooking appliances etc. In the past staff would wake Amy up when it was time to get up for work. We installed automated curtains which would open in the morning when it was time for Amy to get up for work. In-person staff were still needed for medication support daily and meal prep a few times a week. All of the roommates also function as natural support for each other. It’s always important to consider natural support in all of this as well. (Nora reviewed two additional case studies – see slides 13 through 15.)
We’re not using technology just to use it – we’re really looking at the person, their needs, their goals, and their wants.
Catherine: Most of what we’ve presented is covered under Section 21 and 29, though some are not. There are some differences in Section 21 and 29 currently. There are specific covered services, limits, and qualifications. (See slide 16 for specifics and links to related materials.) (Click here for the MaineCare Manual; click here for the Assistive Technology Request Guidelines document; click here for the Section 21/29 AT and RS side-by-side doc.)
Catherine: Through this work we were able to look at best practices and trends nationally. I would highly recommend exploring these:
Agencies: Charles Lea Center; Core Services of NE Tennessee; Vista Supports LLC
States: Tennessee DIDD Enabling Technology Program; Minnesota NEAT - Networking in Education and Assistive Tech; Pennsylvania Remote Supports Requirements
Vendors: Tech-First SHIFT; Simply Home: GrandCare
Catherine: Maine has a long way to go to catch up with the bell curve – we’re in the 3-4% “innovators” section of the bell curve (see slide 18). However, there’s a lot of interest in Maine which is very exciting. As the Lifespan Waiver has been thought through it’s been forward-thinking in the use of technology, which is hopeful for the future.
Discussion:
Cullen: I know there are people here who provide and/or receive similar services – I wanted to provide them the opportunity to speak to their experiences.
-A provider stated that the presentation was spot on. It’s been very helpful for clients with his agency to get the support they need when they need it.
-A parent stated that her daughter receives local support through remote monitoring through Waypoint. Prior to receiving local support, she received out-of-state remote support. The latter wasn’t as successful as local support. Just as with in-person staff, having consistent remote staff is imperative.
Catherine: There is a model where the company that holds the equipment also provides the monitoring. That’s another way of looking at service delivery. I agree with you on your assessment regarding local support.
A question was asked: How do you manage confidentiality using devices like Alexa?
Catherine: I want to push back a little on this. What’s more intrusive/less confidential – a staff person standing right there next to you, or a device to which you can directly speak? If something can be used by the general public, why would a person with disabilities not be able to use it? Recording comes with different requirements and considerations and is not something we utilize in our philosophy of services. But there is the ability to have cameras that record, but I’m not the best person to address that as that’s not what we do. Everything comes with consent, and everyone is aware of what’s happening. There needs to be choice, and group choice in group settings. Tablets are set up where an individual can call out to their staff, or where staff can call in – but that doesn’t mean that the staff can automatically call in. In some instances, they might be able to in common areas etc.
-A parent stated that the presentation and what was discussed is fantastic. It was asked how training works regarding all of this when it comes to staff turnover.
Nora: There will always be the issue of staff turnover, and with any new implementation, there will be some pushback because it is new and a change. For staff turnover, though we haven’t had a ton, we treat support related to technology as another service. Everything we use is documented in plans, regardless of how small it is. Documentation helps to ensure that everything goes smoothly even with staff turnover. Agency-wide training regarding enabling technology was really helpful to ensure everyone was on the same page.
Catherine: We have a whole separate set of slides for providers that want to become tech-first agencies and there is also training. The rate determination process will be helpful, as we’re seeing some challenges with all of the things required to get AT successfully implemented, especially in the first year – it’s eight (8) hours a year with a professional. Hopefully, this will be looked at in the rate determination process.
-It was asked if safety device plan, positive support plan, or behavioral support plan management is used.
Nora: Yes, if someone is wearing a device for location tracking, we would have to go into that. This presentation really just covered the basics. We’d start by asking the individual, then the guardian, then we would go through that process.
Catherine: This is just emerging in Maine, so we’re navigating this all together as there’s not a lot of guidance. I think we could improve on having clear guidance on what to do and when in Maine, but that will come with time.
-It was asked if they’ve found that there’s a gap in Case Manager knowledge around this.
Nora: Yes, there is an educational gap. If Case Managers aren’t aware of all of the resources/supports out there it’s hard for people to access them. It’s all about exposure and information. Learning about an entirely new service is a lot, but I’ve found that AT is a good gateway into talking more about other technological options.
- It was asked if someone who is not served through a specific provider could “purchase” enabling tech through a different provider. Example: could a person who has chosen self-directed home and community support staffing be able to be assessed for overnight remote support from a provider agency?
Catherine: Yes, this is a possibility. We also do a lot of a-la-carte services at our agency. I don’t know the intersection of this and self-direction though, but hopefully Betsy can speak to that.
Betsy Hopkins: We’re expanding services that can be self-directed in the Lifespan Waiver. AT is included in self-direction but I’m not sure about remote support – I can look into that.
- Betsy provided the following update in the meeting chat from Derek Fales: There is no plan to self-direct the service home support- remote support for Section 29. A member could plan to use their savings from self-directed services to plan to have a remote support such as a personal emergency services device and subscription.
-It was stated that Maine CITE is the state AT Program. They are presenting at the MACSP meeting in February. You can learn about programs and free AT demo/loan program at mainecite.org.
-A self-advocate asked if there has been an evaluation of the before/baseline without the services vs. the service is implemented. She stated that she has concerns about increased isolation due to less interaction with people due to the increased use of technology.
Catherine: There are strategies to evaluate success. It’ goes back to that individual person-centered approach. If someone is an extremely social person, and Nora does the assessment she’ll look at that and ensure that she doesn’t recommend technology that would create an isolating situation. The real value of having an expert on AT/remote support is that they can keep an eye on that and evaluate that. For some people isolation is a real concern – when that’s a concern and evaluated early on, you’d build a plan with that in mind.
Nora: Social isolation is a common concern, especially from families. I think that in most situations, social interaction isn’t solely with paid staff. If that’s not the case, what’s great about remote support is that it really is possible to have really personal, close relationships with staff even if they’re only supporting you remotely. Technology can help create a balance – but it is person-specific.
Catherine: Having technology help with some of the more ordinary aspects of daily life allows in-person staff to really concentrate on meaningful connections with the individual.
-A provider stated that for their remote support, the individuals served first spent time in-person with their remote support to help develop that relationship so there’s a good comfort level reaching out remotely.
-A self-advocate asked if Voc Rehab/Division of the Blind and Visually Impaired is involved with using AT/remote support for employment.
Catherine: We’re in the phase of coming together as stakeholders and beginning to have conversations. Maine CITE has become more engaged in working with the Section 21/29 world. There is no concerted collective effort, but through the innovation grants we’ve had a huge community of practice which is promising for this cross-sector collaboration.
Nora: We’re in the early adoption part of the curve for technology support. Employment and tech support are further behind. One of our grants was solely focused on AT for employment. People who support employment need to be aware that this technology can support employment. There’s a positive trend in that direction but it is early on. I’m hoping over the next couple of years this becomes more prevalent across employment agencies.
Cullen: I want to thank you both for that wonderful presentation, for what you’re doing, and for being innovators. This is really exciting, and finding more ways to innovate will be very helpful for our system of care. Thank you again – well done!
End Presentation (round of applause would have occurred were it not for everyone being muted and on Zoom)
DHHS – Office of Aging and Disability Services (OADS) - www.maine.gov/dhhs/oads
Betsy Hopkins: I wanted to start by saying this was a great presentation! Our Innovation Summit will feature a Tech Expo, at the suggestion of Independence Advocates of Maine, which will provide people with the opportunity to test out some of the technology you’ve heard about today.
The Biennial Budget came out late Friday – I don’t know about a lot of the specifics. Broadly, it allows us to continue services at current rates. It supports continuing Lifespan development which we’re excited about.
Timeline for Lifespan Waiver Implementation: The Department expects the Lifespan program to be ready for enrollment by July 2026. (Click here for the Department’s announcement, which includes more information.) Adjusting the Lifespan Waiver timeline reflects the Department's unwavering commitment to a thoughtful and effective rollout with ample opportunities for feedback from interested parties. It responds to feedback received from many individuals, families and providers who are hopeful that Lifespan will address shortcomings in the current system but are concerned that a roll out of this magnitude is not rushed. Together, we are paving the way for a brighter future for the individuals we serve, and the Department looks forward to continuing this important work with all interested parties. The waiver application is being drafted with plans to be available for public comment this winter.
Rate Study: The Rate Study has been completed, and we hope it will be posted around the same time as the Lifespan Waiver, possibly a little sooner. The rates include the new rates for Lifespan as well as Sections 21 and 29.
Intake and Eligibility Rule: We’re in the process of updating the Rule, and we’ll let you know when this is posted for Public Comment.
Licensing Rule: This is still under review by our Attorney General’s Office.
AMENDED PROPOSED RULE: 10-149 CMR Ch. 5 Sec. 2 Developmental Disability Services for Adults with an Intellectual Disability or Autism Spectrum Disorder: Click here for more information.
Accessible Home Attachment Pilot Program: OADS is facilitating the Accessible Home Attachment Pilot Program, in partnership with WheelPad L3C. The Department has a limited number of SuitePAD units for the purpose of this pilot program. SuitePAD is an accessible bedroom and bathroom addition for your home. To apply, complete and submit the following application to [email protected].
Home and Community-Based Services Quality Assurance Project Town Hall: In December 2024, the Maine Department of Health and Human Services (DHHS) started a project to improve quality of home and community-based services (HCBS). DHHS is working with a group called Alvarez and Marsal (A&M). This project is for people who have an intellectual disability, an autism spectrum disorder, or an acquired brain injury and receive personal care, homemaker, home health services, or habilitation services such as home and community support.
Some key terms you might hear during this project are:
- Reportable Event: When something harmful happens, like an injury or a mistake with medicine.
- Incident Management: How DHHS tracks and fixes these kinds of problems.
We Want to Hear from You! DHHS is hosting a town hall meeting to share information and listen to your ideas. A&M will explain the project and ask for your feedback. Your input will help DHHS understand what’s working and what needs improvement. This is your chance to make a difference in how problems like injuries or medication mistakes are handled.
Important Details:
- When: Tuesday, January 21, 2025
- Time: 3:00pm- 4:00pm
- Who: Individuals and families using services, advocates, and support groups
- Where: Online (you'll need to register using the link below)
If you can’t join the live session, recordings will be available on the DHHS website. You can also send your feedback by email. Click here to register.
We hope you’ll join us! Together, we can make home and community services better for everyone. Please note there are other ongoing town halls related to the Access Rule that may touch on incident management topics. This session will focus on how OADS manages reportable events in certain waiver programs, specifically:
- Section 21 (Home and Community Benefits for Members with Intellectual Disabilities or autism spectrum disorder) and
- Section 29 (Support Services for Adults with Intellectual Disabilities or autism spectrum disorder).
OADS Celebrates Conclusion of Innovative HCBS Projects and Looks Ahead to 2025 Innovation Summit: The Office of Aging and Disability Services (OADS) proudly announced the successful conclusion of our Innovation Projects funded by FMAP/ARPA to enhance service delivery for Home and Community-Based Services (HCBS) waivers. Over the past year and a half, OADS has spearheaded 19 innovative pilot sub-projects across MaineCare sections 18 (Brain Injury), 19 (Aging), 21 (Comprehensive Intellectual and Developmental Disabilities (IDD) and Autism), and 29 (Community IDD and Autism).
These pilots have fostered creativity, collaboration, and tangible improvements in service delivery. Supported by our partner, the National Disability Institute (NDI), the initiative encompassed diverse solutions to address the unique needs of waiver participants. As the initiative wraps up in December 2024, NDI will deliver a comprehensive final report, complete with an evaluation of outcomes. Here are a few standout examples of the innovative sub-projects:
- Youth Self-Advocacy Growth: (This is the program that DRM is presented on today) - Programs empowering youth with intellectual and developmental disabilities to advocate for themselves and actively participate in their communities.
- Remote Medical Services for IDD and Autism: Effective, cost-saving telehealth solutions designed specifically for individuals with IDD and autism, enhancing access to care while reducing barriers.
- Community Connection Mobile App: A user-friendly tool connecting HCBS waiver participants to essential community services and resources.
- Rapid Interventions for Traumatic Brain Injury (TBI): An in-state service model providing swift and specialized treatment for individuals with TBI.
For a full list of the funded projects and their objectives, please visit our Innovation Pilot website.
Looking Ahead: OADS Innovation Summit
Building on the success of these projects, OADS is looking forward to our Innovation Summit, a national and regional conference set to take place in Portland, Maine, on May 19–20, 2025. This event will bring together thought leaders, practitioners, and stakeholders to explore cutting-edge advancements in service delivery.
Key Features of the Innovation Summit:
- Expert Panels and Presentations: Featuring leaders in aging, disability services, and healthcare innovation.
- Tech Expo: A hands-on showcase of the latest tools, services, and assistive technologies that are shaping the future of HCBS.
- Networking Opportunities: Facilitating connections among participants to share insights and foster collaboration.
For more information about registration, speakers, and schedules you can visit our Innovation Summit website.
Cullen: Thank you for being here and for providing all of this information, Betsy, and thank you for funding these innovative projects!
DHHS – Children’s Behavioral Health Services (CBHS), Office of Behavioral Health (OBH) - www.maine.gov/dhhs/obh/support-services/childrens-behavioral-health - No Update
DOL – Division of Vocational Rehabilitation (DVR) - www.maine.gov/rehab/dvr
Libby Stone-Sterling could not attend today’s meeting but sent the following update via email:
- WOLF Camp: This is a fun opportunity for young people with disabilities to build skills. Coming up in February on the Orono campus (click here for the flyer).
- BRS Stakeholders Meeting: This is an opportunity to hear more and ask questions about current programs and services offered through the Division of Vocational Rehabilitation and Division for the Blind and Visually Impaired – Join Zoom Meeting
https://mainestate.zoom.us/j/87100494296?pwd=UEdsNWJzMjNaVmZaNkYwTTNvK2Z2UT09. Meeting ID: 871 0049 4296 Passcode: 64519723 - We’re Hiring! The State of Maine is hiring a State Accessibility Coordinator for an anticipated vacancy. The position closes on 1/15 (click here for more information).
Office of Special Services and Inclusive Education (OSSIE) - www.maine.gov/doe/learning/specialed - No Update
Disability Rights Maine (DRM) Update: Megan Salvin was in attendance but had no updates to provide to the group.
Federal & Housing Updates:
Cullen: As we saw in the last Administration when Trump was President, Medicaid appears to again be the target of cuts through various Medicaid per capita cap and block grant proposals floating around Congress (see below for more information). We will be watching this closely. Our Delegation has been great and has been advocating for all the right bills and for housing and quality services for people in Maine, including people with ID/DD. Additionally, Maine is still under a Section 8 freeze – complicating efforts to find affordable housing for populations that need it.
- FY 25 Budget – Congress passed, and the President Joe Biden signed into law on 12/21 a bill to temporarily extend funding for the federal government and provide assistance to communities and individuals impacted by recent disasters. The agreement funds the federal government until 3/14/25. It also provides approximately $110 billion in disaster relief, including $29 billion for the Federal Emergency Management Agency’s (FEMA) Disaster Relief Fund and $12 billion for HUD’s Community Development Block Grant-Disaster Recovery (CDBG-DR) program. Final FY 25 appropriations will be addressed under the new Congress. Additionally, per CBPP: “The Republican-led Congress appears poised in January to quickly pass a budget resolution, an internal budget plan for Congress that unlocks the reconciliation process. A reconciliation bill is not subject to the Senate’s filibuster and so can pass with only 51 votes in the Senate and does not have to be signed by the President so this could occur prior to Inauguration.
- House T-HUD Bill: On 7/10 the House Appropriations Committee passed its proposal to cut funding for HUD programs in FY 25 spending bill. Overall, the proposal would fund HUD at $73.2 billion – $2.3 billion, or about 3%, less than the FY 24 funding level. No housing-related amendments were passed.
- Senate T-HUD Bill: In August, the Senate’s THUD Appropriations Committee approved its FY 25 draft spending bill. Overall, the bill provides $78.2 billion for HUD’s affordable housing, homelessness, and community development programs, an increase of $8.2 billion – or more than 10% – over FY24-enacted levels. The bill proposes:
- $35.3B for $2.9B increase for Tenant-Based Rental Assistance (TBRA) program ($2.9B increase vs FY 24 and $3 billion more than the funding proposed in the House THUD bill). The funding provided may be sufficient to cover the full cost of renewing existing TBRA voucher contracts.
- Increased funding for: Project-Based Rental Assistance (PBRA), the HOME Investment Partnership Program (HOME), and Section 202 Housing for the Elderly.
- Congressional Medicaid Per Capita Cap Proposals – There are various Medicaid Per Capita Cap policy proposals currently floating around in Congress. Per the Center on Budget and Policy Priorities: Recent proposals from Republican congressional leaders and a conservative think tank would impose a per capita cap on federal Medicaid funding or, similarly, turn Medicaid into a block grant. These proposals would dramatically change Medicaid’s funding structure, deeply cut federal funding, and shift costs and financial risks to states. Should this happen, faced with large and growing reductions in federal funding, states could cut eligibility and benefits, which could put millions of people at risk of losing health coverage and access to Medicaid-funded services.
- HR 7024 The Tax Relief for American Families and Workers Act – On 8/1, the Tax Relief for American Families and Workers Act (formerly S 1557/ HR 3238 The Affordable Housing Credit Improvement Act – see below for more info. On this bill which is included in HR 7024) was brought to the Senate floor for a vote, and it failed to pass. The legislation passed the House of Representatives earlier this year by a wide bipartisan vote of 357 to 70. The provisions in H.R. 7024 would finance the construction of over 200,000 new affordable homes nationwide. As a result, these provisions would finance 1,500 new rental homes in Maine generating new jobs throughout Maine.
- The American Housing and Economic Mobility (AHEM) Act of 2024 – Senators Elizabeth Warren (D-MA) and Raphael Warnock (D-GA) and Representative Emanuel Cleaver (D-MO) reintroduced the American Housing and Economic Mobility (AHEM) Act in the Senate and House on 7/9. The bill would provide the large-scale investments required to construct nearly 3 million new units of affordable housing. If enacted, the AHEM Act would provide:
- More than $44 billion dollars in the national Housing Trust Fund (HTF) annually for 10 years, resulting in $445 billion in total investments to build, repair, and operate nearly 2 million homes for households with low incomes.
- More than $1 billion in the construction of new rental housing and homeownership opportunities in rural communities.
- S 570/H.R. 1342, Medicaid Dental Benefit Act of 2023 – Introduced by Senator Cardin, this bill requires state Medicaid programs to cover dental and oral health services for adults. It also increases the Federal Medical Assistance Percentage (i.e., federal matching rate) for such services. The Centers for Medicare & Medicaid Services (CMS) must develop oral health quality and equity measures and conduct outreach relating to such coverage. Additionally, the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission must report on specified information relating to adult oral health care.
- S 2767/HR 5408 SSI Savings Penalty Elimination Act – This bipartisan, bicameral bill was reintroduced in the Senate and House. The bill will update SSI’s asset limits for the first time since the 1980s to ensure people with disabilities and seniors are able to prepare themselves for a financial emergency without putting the benefits that they rely on to live at risk. After advocacy from Maine Senator Collins signed on to this bill.
- HR 7055 The Eliminating the Marriage Penalty in SSI Act (EMPSA) – This bill excludes a spouse's income and resources when determining eligibility for Supplemental Security Income (SSI), and disregards marital status when calculating the SSI benefit amount, for an adult who has a diagnosed intellectual or developmental disability. (SSI is a federal income supplement program designed to help aged, blind, and disabled individuals with limited income and resources meet basic needs.).
- S 1557/ HR 3238 The Affordable Housing Credit Improvement Act – Senator Angus King cosponsored bipartisan legislation to create nearly two million new affordable homes across the country – including thousands in Maine. The Affordable Housing Credit Improvement Act would expand the Low-Income Housing Tax Credit (LIHTC) to provide more homes for low-income people, support small businesses trying to attract workers, and fill the state’s gap of more than 20,000 affordable housing units. It appears this bill has strong bipartisan support, increasing its likelihood for passage.
- S 1332 / HR 2941 The Recognizing the Role of Direct Support Professionals Act – The Recognizing the Role of Direct Support Professionals Act would give a standard occupational classification to Direct Support Professionals, an important first step toward professionalizing this career and improving salaries and training. The Senate passed this bill the week of 5/6. The House has yet to approve its companion bill.
- S4120 / HR 7994 The Long-term Care Workforce Support Act – This bill would increase FMAP and offer grants to all DSPs and caregivers for the elderly and for people with I/DD and autism. VOR worked with members of the Senate Aging and Disability Policy Committee and other peer organizations to improve this bill from its original form. It is not perfect, and it contains one major flaw to which we continue to object (the permanent reauthorization of the Money Follows the Person Rebalancing Demonstration Program) but we will continue to work to improve this bill and remove its flaws.
- HR 7267 Disability Community Act of 2023 – This bill would amend title XIX of the Social Security Act to provide a temporary higher Federal medical assistance percentage for Federal expenditures under the Medicaid program that are associated with the cost of compliance with certain Federal regulations with respect to services furnished in certain intermediate care facilities or home and community-based services furnished to individuals with intellectual and developmental disabilities.
- S 7302 The Credit for Caregiving Act of 2024 (Sen. Michael Bennett (D-CO)) – This bill would amend the Internal Revenue Code of 1986 to provide a nonrefundable credit for working family caregivers. In the case of an eligible caregiver, there shall be allowed as a credit against the tax imposed by this chapter for the taxable year an amount equal to 30 percent of the qualified expenses paid by the taxpayer during the taxable year to the extent that such expenses exceed $2,000. The tax credit does not exceed $5,000 per year.
- HR 3380 - HEADs UP Act of 2023 (Rep. Seth Moulton (D-MA)) – This bill authorizes the Department of Health and Human Services (HHS) to award grants to support health centers that provide services for individuals with developmental disabilities, including dental care. Grant recipients must provide specialized treatment to individuals with developmental disabilities, as necessary.
- HR 553 Workplace Choice and Flexibility for Individuals with Disabilities Act (Rep. Glenn Grothman (R-WI-6)) – This bill would amend the Rehabilitation Act of 1973 to clarify the definition of competitive integrated employment.
- HR 1296 Restoration of Employment Choice for Adults with Disabilities Act (Rep. Glenn Grothman (R-WI-6)) – To amend the Rehabilitation Act of 1973 to ensure workplace choice and opportunity for young adults with disabilities.
State Legislature Update:
Laura Cordes – MACSP (Maine Association for Community Service Providers): The First Regular Session of the 132nd Legislature is underway. Committee Assignments have been made. The First Session is the longer of the two sessions. Any lawmaker could file any bill – meaning there will be more bills to contend with. Cloture, which is when bills must be filed, occurred on January 10th. This was later than usual in an effort to prevent legislators from filing placeholders (concept drafts) and instead requiring full bills to be submitted. Bills are now being printed from the Revisor’s Office and being posted online.
As I have in previous years, I created the MCHQS 132nd Maine Legislature First Regular Session 2025 Resource Document, which is a Google Document that anyone can edit. This document includes summary document links under the Budget section. There’s also a Memo I linked to that came up from the Department discussing what they’re doing to cut and initiate savings. Part A of the Budget goes through each program line-by-line, and that is also linked.
The Legislature will be looking at the Governor’s proposed Biennial Budget and her Supplemental Budget as well.
Released on Friday – click here for the General Fund Budget Language; click here for Part A.
Supplemental Budget: Also released Friday – click here for the General Fund Language; click here for Part A. (The Governor’s announcement regarding the Supplemental Budget stated that it includes “newly recognized revenue from the Revenue Forecasting Committee to fill the FY25 MaineCare gap” discussed in the State Legislature Update at last month’s meeting).
As I mentioned last month, there has been concern about being able to fund/sustain the new rates being proposed as well as the existing codified rate setting system. As I reported last month, a MaineCare notice came out that was quite surprising – the Department said they would not be adjusting rates with a COLA January 1st, and it will be reliant on additional appropriations through the Supplemental Budget.
It appears the Supplemental Budget as introduced will not remedy this so we will have to advocate for funds to be included to fix this. The Biennial Budget specifically suspends COLA adjustments for the biennium (FY 26 and FY 27) and stipulates that rate adjustments are subject to available appropriations. The Biennial Budget includes language for prior Section 21 COLAs, providing $23 million in General Fund per year to provide sufficient funding for prior cost-of-living adjustments for providers who serve MaineCare patients with intellectual disabilities or autism spectrum disorders (this appears to be a fix for funding to maintain the rates that went into effect 1/1/2024).
There is a budget deficit, which will have to be accounted for somehow, and it could be through not meeting rate obligations. There is a meeting with the Department to discuss this further. As Betsy stated the new rates will be posted – but there is a difference between posting the rates and having them be implemented.
The Appropriations Committee has yet to be briefed by the Governor or her staff on the budgets; this will happen soon and will be followed by meetings/public hearings.
(It is important to note that the Biennial Budget and the Supplemental Budget only came out late Friday, January 10th. The information provided here is mainly a cursory review and may not be reflective of all budget initiatives.)
Cullen: One bill I am aware of is a bill to cap the length of time that someone is on a waitlist for a MaineCare service at 6 months, which I believe was submitted.
Cullen: Please continue to raise your voice and tell your stories so when Legislators and Committees begin considering bills, including the Supplemental and Biennial Budgets, they have the information necessary to make good policy decisions on the needs of people with disabilities in Maine. Sharing personal stories is not only effective, but essential to betting the system of care. Thank you, Laura, for this information, for all you do, and for all you will do as the Legislative Session gets underway! I also want to take the time to thank each of you as we go into 2025. It will be a very busy stretch but thank you for rallying and answering calls to action throughout the Legislative Session. We are all better for your advocacy.
The next meeting will be on Monday, February 10, 2025, 12-2:00pm, via Zoom*.
Featured Speaker: Libby Stone-Sterling, Director, Bureau of Rehabilitation Services, Maine Department of Labor.
Topic: Overview of the Pathways to Partnerships Grant: This innovative grant is exploring how offering model services to children as young as 10 can improve post-secondary employment and education goals for students with disabilities.
Unless changed, Coalition meetings are on the 2nd Monday of the month from 12-2pm.
(In 2025 the October meeting will be the 3rd Monday due to the holiday)
The Maine Coalition for Housing and Quality Services provides equal opportunity for meeting participation. If you wish to attend but require an interpreter or other accommodation, please forward your request two weeks prior to the monthly meeting to [email protected].