Home and Community-Based Services Quality Assurance Project Town Hall Announcement
 
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.

The project will examine how DHHS handles problems to improve services and make them safer and better. The goal is to improve how DHHS manages these events, so that everyone gets the highest quality support.  This is part of a larger effort to meet new Medicaid rules from the Centers for Medicare & Medicaid Services.

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).

​If you require accommodation, such as real-time transcription and captioning (CART), American Sign Language (ASL), or other language interpretation, please contact April Keyes at [email protected]

Elevating Family Voice Summit: Partnership vs Participation
Please Join Us: March 26th, 20259:00 am – 2:30 pmAugusta Civic Center76 Community Drive, Augusta Maine 04330
Exhibitors: $50 per table (Limit 2 Individuals)
Participant: $20
 
 
Maine Parent Federation is partnering with the Maine CDC and Maine State Parent Ambassadors to offer the Elevating Family Voice Summit.
 
For more information and to register please visit:
 
Elevating Family Voice Summit - Maine Parent Federation

TO: Interested Parties

FROM: Paul Saucier, Director, Office of Aging and Disability Services
​
SUBJECT: Repeal of 14-197 C.M.R. Chapter 3 Definition of Mental Retardation and Autism; Appeal Procedure and replace with 10-149 C.M.R. Chapter 5 § 2 Developmental Disability Services for Adults with an Intellectual Disability or Autism Spectrum Disorder.

PROPOSED RULE: 10-149 CMR Chapter 5 § 2 Developmental Disability Services for Adults with an Intellectual Disability or Autism Spectrum Disorder.

This memo gives notice of proposed rulemaking re: Developmental Disability Services for Adults with an Intellectual Disability or Autism Spectrum Disorder.  

This proposed rule previously was the subject of a public hearing, held on August 14, 2024, and a public comment period that closed on August 24, 2024.  Following and more than fourteen days after the close of public comments, the Department decided to substantively amend the proposed eligibility criteria for developmental disability services set forth in the proposed rule in §§ 2.04-3(A) (for persons with an intellectual disability) and 2.04-3(B) (for persons with Autism Spectrum Disorder).  Because of these changes, the Department determined that it should elicit additional public comment on the proposed rulemaking.

As noted prior to the August 14, 2024, public hearing, the purpose of the rulemaking is to clarify the application of Developmental Disability Services available at OADS that are supported exclusively with state funds.  The rule also shifts away from being a description of the client intake and eligibility determination processes, which are internal to the agency, and instead clearly explains the services available to applicants deemed eligible for Developmental Disability Services at OADS. 

When the Department finds an individual eligible for Developmental Disability Services, there are certain noticing requirements which are clearly stated.  The option to appeal the Department’s eligibility determination is brought into alignment with the Department’s standard fair hearing process, clarifying the Department’s role in the fair hearing process.  Finally, this rule implements a clear timeliness standard for the fair hearing process and updates the requirements for confidentiality.

The regulations of the Office of Aging and Disability Services (OADS) are currently divided into two Chapters:  10-149 (formerly the Office of Elder Services) and 14-197 (formerly the Office of Adults with Cognitive and Physical Disability Services).  OADS is in the process of combining these two former State agency policy manuals into one by eliminating use of 14-197 and creating a single comprehensive OADS Policy Manual under 10-149.  This rulemaking repeals the current 14-197 Chapter 3 and replaces that with 10-149, Chapter 5, Section 2:  Developmental Disability Services.  The rule also contains many formatting corrections, ensures use of gender-neutral language, and includes many clarifying edits.

The Department is providing notice that the rule will be repealed and replaced to better reflect current terminology, the practices of the programs, and to bring the rule into compliance with 34-B M.R.S § 5467.
Rules and related rulemaking documents may be reviewed at, or printed from, the Department rulemaking  website at https://www.maine.gov/dhhs/about/rulemaking or for a fee, interested parties may request a paper copy of rules by calling (207) 287-7055 or Maine Relay number 711.

A concise summary of the proposed rule is provided in the Notice of Agency Rulemaking Proposal, which can be found at http://www.maine.gov/sos/cec/rules/notices.html. This notice also provides information regarding the rulemaking process.  Please address all comments to the agency contact person identified in the Notice of Agency Rulemaking Proposal.           

Home and Community-Based Services Access Rule
Town Hall Announcement

In April 2024, the Centers for Medicare & Medicaid Services (CMS) introduced the Ensuring Access to Medicaid Services Rule (Access Rule). This new rule is designed to make it easier for people to access home and community-based services (HCBS) and to improve the quality of these services. If you receive personal care, homemaker, home health services, or habilitation services such as home support, work support, or community support, this applies to you. The goal is to help people who receive Medicaid HCBS services have better lives and outcomes.

Here in the state of Maine, we are committed to the goals of the Access Rule. We are beginning to plan for how to meet these new requirements. Over the coming months, the Maine Department of Health and Human Services (DHHS) will ask for your input on our plans.

At this time, DHHS would like to invite you to a town hall session to discuss the new CMS Access Rule and its requirements. We will explain the rule, and we look forward to hearing your thoughts and feedback on the rule. As part of our planning, it’s also important for us to hear from you around what is working well and where we can improve. This town hall is the first of several opportunities for you to give input that will help us create a plan to follow the new rule. Please note, the rule includes elements about other medical services that will be addressed separately by the Office of MaineCare Services (OMS). This session will focus specifically on HCBS programs offered by the Office of Aging and Disability Services (OADS).
​
Please register using the link below that matches your relationship with Maine’s OADS programs. You will need to register to receive the town hall meeting link. If you cannot attend one of the town halls, you will be able to view recordings of the sessions on the DHHS website and provide written feedback via email.
______________________________________________________________________ 
Target Audience: Providers, Advocacy Organizations, Advisory Groups, etc. – Intellectual and Developmental Disabilities and/or Autism Population
When: Tuesday, January 7th from 12-1:30pm
Registration Link: https://mainestate.zoom.us/meeting/register/tZMkd-GqrzwjHta_xzg0KJfzUE0FJmAA5bEy
______________________________________________________________________
Target Audience: Providers, Advocacy Organizations, Advisory Groups, etc. – Older Adults and Adults with Physical Disabilities Population
When: Thursday, January 9th from 12-1:30pm
Registration Link: https://mainestate.zoom.us/meeting/register/tZEsf-CtqDgqEt2QywnRv8lD_rqWbUae5nIV
______________________________________________________________________
Target Audience: Individuals and Families – Individuals with Intellectual and Developmental Disabilities and/or Autism
When: Monday, January 13th from 4-5:30pm
Registration Link: https://mainestate.zoom.us/meeting/register/tZAuf-irpjIiH9L-7YNwkCUxVJP721fI1sjy
______________________________________________________________________
Target Audience: Individuals and Families – Older Adults and Adults with Physical Disabilities
When: Tuesday, January 14th from 4-5:30pm
Registration Link: https://mainestate.zoom.us/meeting/register/tZMsc-iorT0oHdAlI9tyh-xkx-_5qLdNjL33
______________________________________________________________________
If you require accommodation, such as real-time transcription and captioning (CART), American Sign Language (ASL), or other language interpretation, please contact April Keyes by email: [email protected] 

December 16, 2024
The Department expects the Lifespan program to be ready for enrollment by July 2026.
After a busy year of development efforts, the DHHS Office of Aging and Disability Services (OADS) has updated its implementation schedule for the new Lifespan waiver program. When launched, the new program will offer supports to individuals with intellectual disabilities across their lifespan, beginning at age 14 and continuing through all phases of adulthood. This innovative approach will enable individuals to have different levels of support at different points in their lives without needing to move from one program to another. In particular, enrollment of youth (beginning at 14 years) will facilitate more effective transition from school to employment and community support services.
The Lifespan waiver program requires approval by the federal Centers for Medicare & Medicaid Services (CMS) to obtain federal matching Medicaid funds. After a year of discussions, CMS and the Department have outlined an approach that is approvable under Section 1915(c) of the federal Medicaid statute (Title XIX of the Social Security Act). Before submitting the waiver application to CMS, the Department will post a draft for 30 days of public comment. The Department expects to post the draft waiver in the first half of 2025. Given the change in federal administration, CMS is not expected to act on any waiver applications until spring of 2025.
Once CMS approves the waiver application, the Department will prepare a MaineCare rule to implement it. This will be a major substantive rule, which means it requires approval of the Legislature. The Department expects to provisionally adopt the rule in late 2025 and submit it to the Legislature for review during the Second Regular Session of the 132nd Legislature in 2026, in time for a July 2026 roll-out of the program. As with all provisionally adopted major substantive rules, the effective date is dependent upon legislative action.
In the meantime, development of the program and related efforts continue. In December 2025, OADS announced the successful conclusion of its Innovation Pilot Projects funded under the American Rescue Plan Act to enhance service delivery for Home and Community-Based Services (HCBS) waivers. In 2023 and 2024, grantees undertook 19 innovative pilot projects across MaineCare sections 18 (Brain Injury), 19 (Aging), 21 (Comprehensive Intellectual and Developmental Disabilities (IDD) and Autism), and 29 (Community IDD and Autism). Supports and lessons from these pilots will inform the new and improved supports offered in the Lifespan program. Many will also be featured at the Innovation Summit, a national and regional conference set to take place in Portland, Maine, May 19--20, 2025. This event will bring together thought leaders, practitioners, and interested parties to explore cutting-edge advancements in service delivery.
In further preparation for Lifespan, the Department is offering Readiness Grants to providers interested in offering new Lifespan supports. The deadline for applying for Readiness Grants is December 20, 2024. As of December 2024, the Department has received between eight and fifteen grant applications for each new service to be offered. OADS and its contractor, the National Disability Institute (NDI), will work with grantees to ensure they receive the training and technical assistance they need well before Lifespan goes live in 2026.
OADS and the Department's Division of Licensing and Certification (DLC) are also working on a new licensing rule that will soon require all intellectual disability provider agencies to become licensed. The Department expects to issue the draft rule for public comment in 2025, with the goal of having the new licensing approach in place prior to the Lifespan launch. Licensing all agencies, regardless of size or types of services offered, will ensure consistent oversight of providers. Currently, only residential providers with homes of three or more beds are required to have licenses.
OADS is also working with its actuarial contractor to complete a rate study that will be used to establish rates for Lifespan and update rates for existing IDD and related waiver programs (MaineCare Policy Manual Sections 18, 20, 21 and 29). The Department will hold a public forum to share results of the rate study and solicit feedback early in 2025.
OADS also implemented its new case management information system, Evergreen, in 2024. Monthly releases continue to add features and continuously improve the system's functionality. Further updates to Evergreen are planned to address Lifespan needs, including integration with the standardized assessment (Supports Intensity Scale, or SIS-A) that will enable tiered rates, including enhanced rates for individuals with behavioral health and medical needs.

Commitment to Excellence

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 not be 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.

Nominations Needed
​
Elevating Family Voice Summit: Partnership vs Participation
 
Maine Parent Federation is partnering with the Maine CDC and Maine State Parent Ambassadors to offer the Elevating Family Voice Summit.
 
As part of the summit, we will be featuring a parent/caregiver panel and an organization panel. We are currently seeking nominations of both parents/caregivers and organizations who have knowledge and experience with positive family engagement to impact systems change.
 
If you know of somebody who may be interested, with their permission, please complete the corresponding nomination form.
 
Parent/Caregiver Nomination Form
Organization Nomination Form
 
 
Please see our attached Save the Date flyer with more information about the summit.

Enroll in this free 2-hour online training and automatically receive your letter of completion when you have finished all the work! People with disabilities often have highly involved families and caregivers in their lives. This online course will address ways to include families in the employment development process while continuing to maintain a focus on self-determination and person-centered planning. The course will be available 24/7 during the month of November so you can log in at your convenience and complete the work. We will leave registration open until November 30 for easy enrollment. The course has 2 hours’ worth of content, and you will receive a letter of completion which can be used for educator professional credits and employment staff professional development hours. This course is appropriate for educators, employment specialists, career planners and job coaches who assists individuals with disabilities to find and maintain jobs in the community.

Date: November 1–30, 2024
Cost: FREE
Questions? Contact Lara Enein at [email protected]

REGISTER for the training

Lifespan Provider Readiness Project - Kickoff Meeting
October 31, 2024 1:00-2:30PM
​
Please join the Office of Aging and Disability Services (OADS) and the National Disability Institute in a presentation and QA session regarding the start of the Lifespan Provider Readiness Project.

The project will provide technical assistance to providers in anticipation of the waiver, which may include stipends to qualified provider applicants.  The goal will be to support a cohort of providers who commit to offering services under the proposed Lifespan Waiver; for them to be fully licensed, onboarded and approved by the Lifespan start date.  Lifespan is estimated to start in later 2025.

We invite you to attend this session to learn about the project, and to ask questions.  The meeting will be recorded for reference, and the presentation slides and the meeting recording will be available on the Lifespan Provider web page following the meeting.   

All attendees are required to register for the session using the link below.  A link to join the Zoom session will be sent to your email after you have registered.

October 31, 2024 1:00-2:30 PM
Registration Link: https://mainestate.zoom.us/meeting/register/tZMof-ioqzMvHdKtw6nsEU_J6yEoMVX44bE4

If you need an accommodation, such as real time transcription and captioning (CART), American Sign Language (ASL) or other language interpretation, please contact Miranda Whalen at [email protected]