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 the quality of home and community-based services (HCBS). DHHS is working with a group called Alvarez and Marsal (A&M). This project is meant to help many groups that interact with HCBS, including the people who provide residential services such as home and community support for people who have an intellectual disability or autism spectrum disorder.
​
Some key terms you might have heard during this project are:

• Quality Assurance: The process of ensuring that programs meet standards and deliver services safely and effectively.
• Incidents: This includes Reportable Events, which are when something bad happens, like an injury or a mistake with medicine. This also includes Abuse, Neglect, and Exploitation.
• Incident Management: How DHHS tracks and addresses these kinds of problems.

Thank You!
Thank you to everyone who participated in the HCBS Quality Assurance project’s town halls and focus groups back in January and February.
Thank you as well to everyone who participated in the focus groups in April where A&M introduced initial ideas about how to strengthen the incident management system.
Your feedback on what does work and what does not work in the incident management system, and whether certain ideas would help to make the system better, was incredibly valuable!

We Want to Share What We Found With You!
DHHS is now at the stage of the project where it is looking to share the final report and next steps with groups involved in incident management. DHHS will host town halls to communicate this information to many people. This is a chance to know what changes might happen to continue trying to keep people safe and healthy.
There will be two different town halls where DHHS talks about the final report. One town hall will be for members, self-advocates, families, guardians, and advocacy organizations. The second town hall will be for providers, Case Managers, Care Coordinators, and other interested groups. DHHS encourages you to join the town hall meant for you.
In these town halls, DHHS will talk about:

1. Summary of what was found during the HCBS Quality Assurance project.
2. Explanation of considerations that could strengthen incident management.
3. Introduction of DHHS’ next steps.
4. Questions & Answers

HCBS Quality Assurance Project Report Town Hall for Members, Self-Advocates, Families, Guardians, and Self-Advocacy Groups.
Important Details:

• When: Thursday, May 29th, 11:00 am – 12:30 pm
• Who: Members, Self-Advocates, Families, Guardians, and Self-Advocacy Groups
• Where: Online Zoom Webinar
• Register Here: https://mainestate.zoom.us/webinar/register/WN__cgWJJFpQBiiyPIi6QuIow

HCBS Quality Assurance Project Report Town Hall for Providers, Case Managers, Care Coordinators, and Other Interested Groups.
Important Details:

• When: Friday, May 30th, 11:00 am – 12:30 pm
• Who: Providers, Case Managers, Care Coordinators, and Other Interested Groups
• Where: Online Zoom Webinar
• Register Here: https://mainestate.zoom.us/webinar/register/WN_HQ2tLZyoSriEiAWor_VTwg

If you aren’t able to join either of these sessions, you can still send your feedback or thoughts by email to [email protected].

Request for signatures against federal elimination of programs supported by Developmental Disabilities Assistance and Bill of Rights Act ("DD Act"). Please sign https://forms.office.com/Pages/ResponsePage.aspx?id=Caa7LBr7Nkqpk-8CuFnH7gRvXtcIDrxIqYm06Io1MfxUOURES0UyS1YxRDA4RzI2Ulc3TjJTQVNSRC4u
 
The current budget proposal on Capitol Hill in DC eliminates many programs that support people with disabilities. This includes "DD Act" programs: University Centers for Excellence in Developmental Disabilities (UCEDDs), state councils on developmental disabilities, and protection & advocacy organizations.
 
In Maine, these eliminations would affect UMaine Center for Community Inclusion and Disability Studies, Maine Developmental Disabilities Council, and Disability Rights Maine. It would also affect Speaking Up for Us, which is partially supported by Maine DD Council.
 
These programs support advocacy, research, policy analysis, systems change, demonstration projects, and more to improve the lives of people with disabilities and their families.
 
Please add your signature--either as an individual or for the organization you represent--to the letter at <https://forms.office.com/Pages/ResponsePage.aspx?id=Caa7LBr7Nkqpk-8CuFnH7gRvXtcIDrxIqYm06Io1MfxUOURES0UyS1YxRDA4RzI2Ulc3TjJTQVNSRC4u> https://forms.office.com/Pages/ResponsePage.aspx?id=Caa7LBr7Nkqpk-8CuFnH7gRvXtcIDrxIqYm06Io1MfxUOURES0UyS1YxRDA4RzI2Ulc3TjJTQVNSRC4 <https://forms.office.com/Pages/ResponsePage.aspx?id=Caa7LBr7Nkqpk-8CuFnH7gRvXtcIDrxIqYm06Io1MfxUOURES0UyS1YxRDA4RzI2Ulc3TjJTQVNSRC4>
 
If you're unable to sign electronically (it's just a google form), you can also email Julia Endicott at [email protected]
 

Forwarded Action alert from Maine Parent Federation

Action Alert Important Public Hearings
Restraint & Seclusion, De-escalation Training, Behavioral Health Supports, and Lifespan Waiver
Wednesday, April 23rd 

There are a number of public hearings which will be occurring tomorrow Wednesday, April 23rd at 1:00 PM in both the Educational and Cultural Affairs and Health and Human Services Committees.
 
LD 1248 - "An Act Regarding Physical Escort and Restraint and Seclusion of Students in Schools".
 
The bill would make it easier to physically restrain students, which disproportionally impacts students with disabilities, in two ways:

• It would redefine "physical escort" (which, under Maine law, is voluntary and therefore not restraint) so that it wouldn't have to be voluntary. In order words, if a student were physically and involuntarily moved to a safe location, it would no longer be considered a restraint.
• It would allow restraint if there was any risk of injury (even nonserious injury, even if psychological injury).

Unfortunately, the public hearing is happening during school vacation week. This makes it easy for school personnel to testify but it makes it difficult for families and students to testify, especially in person. There are multiply ways to participate and testify, see below for instructions.
 
Additional bills in the Education and Cultural Affairs Committee you may be interested in testifying on are:

• LD 1097 - An Act to Provide De-escalation and Behavior Intervention Training for School Personnel
• LD 1398 - An Act Regarding Behavioral Health Support for Students in Public Schools

 
There will also be a bill regarding the Lifespan Waiver being heard in the Health and Human Services Committe.

• LD 1606 - An Act to Require Data Collection and Major Substantive Rulemaking for the Lifespan Waiver Providing Home and Community-based Services for Individuals with Intellectual and Developmental Disabilities, Autism Spectrum Disorder or Other Related Conditions

 
All four of these bills are scheduled for public hearing Wednesday, April 23rd starting at 1:00 PM. You can testify on as many bills as you like, but if you testify online (written and/or zoom) then you have to fill out the form for each bill separately.
 
To testify:

• Go to this testify link
• Choose "Public Hearing"
• In the drop-down menu choose the appropriate committee "Education and Cultural Affairs" for LD's 1248, 1097, and 1398 and Health and Human Services for 1606.
• Choose "Apr 23 2025 1:00 PM" from the "Choose date" pull-down menu
• Choose the bill which you are submitting testimony for.

 
You can upload written testimony or type it into the text box. If you want to testify via zoom then be sure to check the "I would like to testify electronically over Zoom" checkbox, in which case the legislature will email you a link to use to testify.
 
After you've filled everything out, check "I'm not a robot" and click "Submit/Register"
 
If you would like to testify in-person all hearings are held in Augusta at the Cross Building, 111 Sewell Street Augusta. Education and Cultural Affairs is room 208 and Health and Human Services is across the hall in room 209. Please be sure to bring 20 copies of your testimony.
 
Please feel free to disseminate this information to anybody and everybody you think would be interested.
 
If you have any questions or concerns, please feel free to contact Carrie Woodcock, [email protected].
 
Kind Regards,
Carrie Woodcock - Maine Parent Federation

The Disability Rights Section of the U.S. Department of Justice recently signed an agreement with Maine that requires the State to make changes to its services for children with behavioral health disabilities. These changes will give parents, children, and young adults (up to their 21st birthday) choices so children and young adults can remain at home with services, or can return home from facilities and get the services they need. 
 
We want to meet with people who will be impacted by these changes, including children and young adults (up to their 21st birthday), families, providers, and advocates. We will be holding in-person meetings at the following times and locations:
 

• Portland – 4:00–5:30 pm on Tuesday, April 29, at the Reiche Community Center, 166 Brackett Street (the entrance to the Community Center is on Clark Street)
• Fort Kent – 4:00–5:30 pm on Wednesday, April 30, at the Fort Kent Public Library, 1 Monument Square
• Augusta – 10:00–11:30 am on Thursday, May 1, at the Lithgow Public Library, 45 Winthrop Street
• Bangor – 4:30–6:00 pm on Thursday, May 1, at the Bangor Public Library, 145 Harlow Street

 
We will share information and updates about our agreement with Maine. We will also invite you to share your experiences with the State’s behavioral health services for children. Please feel free to share this invitation with others who are interested in attending. If you have any questions about the meetings, we encourage you to reach out to Margaret Girard, [email protected] (Portland and Augusta meetings) or Victoria Thomas, [email protected] (Fort Kent and Bangor meetings). 
                            
Margaret Girard
Trial Attorney
Disability Rights Section
Civil Rights Division
U.S. Department of Justice
(202) 598-5668
[email protected]
She/her/hers
 
Please let me know if you need an accommodation for a disability.

Home and Community-Based Services Quality Assurance Project Focus Group AnnouncementIn December 2024, the Maine Department of Health and Human Services (DHHS) started a project to improve the quality of home and community-based services (HCBS). DHHS is working with a group called Alvarez and Marsal (A&M). This project is meant to help many groups that interact with HCBS, including the people who supervise those who provide case management services for people who have an intellectual disability or an autism spectrum disorder and receive home and community support.

Some key terms you might have heard during this project are:

• Reportable Event: When something bad happens, like an injury or a mistake with medicine.
• Incident Management: How DHHS tracks and fixes these kinds of problems.

Thank You!
Thank you to everyone who participated in the HCBS Quality Assurance project’s town halls and focus groups back in January and February. Your feedback on what does work and what does not work in the incident management system was incredibly valuable!

We Want to Hear from You Again!
DHHS is now at a stage in the project where they plan to share ideas for strengthening the incident management system with different groups, including members, families, and guardians.
A&M will host a focus group to present these initial ideas and gather your feedback. Your input will help DHHS understand your perspective on potential opportunities to enhance the incident management system. This is another opportunity to share what would best support your experiences!
In this focus group, A&M will talk about:

1. Summary of what was talked about during the town halls and focus groups in January and February.
2. Introduction / discussion of ideas for the incident management system.
3. Close out / open discussion.

Important Details - Session #1:
When: April 9, 3:00-4:00 pm (each session is limited to 15 attendees)
Who: Individuals and families using services, advocates, and support groups
Where: Online (Zoom meeting, you'll need to register using the button below)

Click here to Register!

Important Details - Session #2:
When: April 10, 12:00-1:00 pm (each session is limited to 15 attendees)
Who: Individuals and families using services, advocates, and support groups
Where: Online (Zoom meeting, you'll need to register using the button below)

Click here to Register!

You can also send your feedback by email to [email protected]

​We hope you’ll join us! Together, we can make home and community services better for everyone.
Please note that 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].

Section 21 Home Support- Agency Per Diem: Authorizations in Two-Person Homes Requirements Reminder
​
With the end of the COVID-19 public health emergency and Appendix K flexibilities, Section 21 Home Support- Agency Per Diem providers must follow service requirements outlined in the MaineCare Benefits Manual (MBM) regarding the number of members served. MBM Ch. II, Section 21.10-6 states "As of December 24, 2012, Home Support- Agency Per Diem placements will only be approved at provider-controlled homes where a minimum of two (2) Members reside.”
As a general rule, providers should always identify two members in their requests submitted in Atrezzo for rate determination. To clarify, two members should also be identified in Atrezzo requests when a home is entirely vacant; it is not permissible to request authorization for one member to move in while the provider works to fill the vacancy. The Department will only issue authorizations for a setting with one member when there is:

• a relevant approved Americans with Disabilities Act (ADA) modification; or
• a recent housemate departure, as outlined at MBM Ch. II, Section 21.10-6, Residential Vacancies in Two-Person Homes.

In the event of recent housemate departure, the provider must fill the vacancy or provide written notice of ending services to the member remaining at the setting. Case Managers may be asked for support to:

• submit an ADA request due to individual needs found on the ADA/Civil Rights Compliance webpage; or
• assist a member to consider their options for new services, service locations, and/or providers.

For questions, please contact Emily Kalafarski at [email protected].

Action Alert from MACSP:

The MaineCare Section 21 Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder Waiver Renewal is open for public comment through Sunday, March 9 at 11:59pm.

Below is the action alert that we are sharing with our members and allies to encourage the Department to implement a true per diem rate OR to lower the staffing level back to 85% until such time as new rates or a true per diem model is implemented.

https://www.votervoice.net/MEACSP/campaigns/122953/respond​

Thanks again for your support and advocacy!

From AARP and The Arc:

Senator Cortez-Masto (D-NV) will be serving as the new Democratic co-lead of the SSI Savings Penalty Elimination Act in the Senate. We remain immensely grateful to Senator Brown and his staff for their extensive efforts steering this bill last congress. Cortez-Masto's team was in part motivated to take up this issue thanks to direct engagement from constituents, so we are particularly thankful to everyone who did so much to bring directly impacted voices in front of congressional offices and staff.
 
Currently, Senator Cortez-Masto and Senator Cassidy are aiming to re-introduce the bill in March, and have requested help reconfirming organizational endorsements. The House co-leads, Rep. Davis and Rep. Fitzpatrick, expect to re-introduce the bill in the House shortly after the Senate version is reintroduced. The new bill text has no changes other than updating the effective dates and is available at this link: (https://drive.google.com/file/d/1Yr_E5aPGtVFjl0VYGxFWSvYuMv256Tu3/view?usp=sharing).
 
Please consider signing onto this joint letter to express your organization’s support for and endorsement of the bill. The letter is mostly the same as our joint letter from the 118th, but it includes some additional information about how the bill addresses a harmful marriage penalty.
 
You can view the letter and sign on using the form at this link: https://forms.gle/6fZbQRJP2Vtk9YdM7
 
The deadline for sign-on's and endorsements is COB March 7th.