DHHS Notice of Agency Waiver Renewal MaineCare Benefits Manual, Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

Notice of Agency Waiver Renewal  
AGENCY: Department of Health and Human Services, MaineCare Services
 
RULE TITLE OR SUBJECT: Chapter 101, MaineCare Benefits Manual, Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder.
 
WAIVER: ME.0467, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver
 
CONCISE SUMMARY: The Department is planning to renew the Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder waiver, known in Maine as Section 29 of the MaineCare Benefits Manual. This waiver renewal incorporates internally-generated updates to the waiver’s appendices. Some of the major changes in the renewal are as follows: 

• Appendix A: Updated Waiver Operational and Administrative Functions.
• Appendix B: Updated Individual Cost Limits, including Participant Safeguards, Eligibility Groups Served in the Waiver, Number of Individuals Served, Post-Eligibility Treatment of Income, Level of Care Method of Remediation, Freedom of Choice, and Access to Services
• Appendix C:
  • Revised Service Definitions for Adult Foster Care/Shared Living, Home Support – Quarter Hour, Work Support-Individual, Work Support-Group, Community Support, and Career Planning to incorporate requirements for the federal Home-and Community-Based Services Settings Rule.
  • Updated Service Definitions for Home Support-Quarter Hour, Home Support-Remote Support, Work Support, Adult Foster Care/Shared Living, and Career Planning for accuracy and completeness.
  • Separated Community Supports into different tiers of service delivery: Community Only-Individual, Community Only-Group, and Center-Based, to more broadly support individualized needs of the participant population. The new services will have updated requirements and limits.
  • Updated Provider Qualifications for a Direct Support Professional delivering Career Planning, Community Support, Home Support (Quarter Hour & Remote), and Adult Foster Care/Shared Living.
  • Updated Provider Agency Standards for Career Planning.
  • Revised/updated payment for services furnished by relatives (C-2-e) to align waiver language and the MaineCare rule regarding circumstances under which payment to legal guardians for providing Shared Living services can be made.
  • Added Provisional Provider Approval to C-2-f.
  • Updated limits on Sets of Services (C-4) to include an exceptions process, additional service limitations and updated annual cost limit.
• Appendix D:
  • Updated and revised Service Plan Development, including Process, Risk Mitigation, Informed Choice, approval, Monitoring, and Quality Improvement Measures, for accuracy and completeness.
  • Added qualifications for Case Managers and Social Workers.
• Appendix F: Updated Opportunity to Request a Fair Hearing, Dispute Resolution, and the State Grievance and Complaint System, for completeness and accuracy.
• Appendix G:
  • Updated Response to Critical Events, Safeguards Concerning Restraints, and Medication Monitoring for completeness and accuracy.
  • Included protocols and processes for reportable events; critical incidents; and allegations of abuse, neglect and/or exploitation.
  • Amended and updated performance measures for the next waiver cycle.
• Appendix H: Updated the System Improvement Plan to align with the HCBS Quality Framework.
• Appendix I: Updated Financial Integrity, Accountability, and Rate Setting Methodology. Furthermore, rates and caps have been amended to comply with legislative directive PL 2019 ch. 616, An Act Making Supplemental Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2020 and June 30, 2021. The rates for certain services will now reflect the rate models prepared for the Department by Burns & Associates, Inc in July 2020.
• Appendix J: Updated and included Cost Neutrality and Derivation of Estimates for the five years of the waiver renewal (through December 31, 2025). DHHS is accepting comments August 14, 2020 through September 13, 2020. Any interested party may obtain a copy of the waiver application by going to the website noted below or at any regional Office for Family Independence (a list of the offices and locations can be found at this link http://www.maine.gov/dhhs/ofi/offices/index.html). A printed copy may be obtained by calling Thomas Leet at (207) 624-4068 or emailing thomas.leet@maine.gov . 

See http://www.maine.gov/dhhs/oms/rules/index.shtml for the complete waiver renewal draft with all proposed changes and to submit comments.
 
STATUTORY AUTHORITY:             CFR §441.304
DEADLINE FOR COMMENTS:        Comments must be received by 11: 59 PM, September 13, 2020.
 
AGENCY CONTACT PERSON:       Thomas Leet, Long-Term Services and Supports Manager
AGENCY NAME:                                 MaineCare Services
ADDRESS:                                            109 Capitol Street, 11 State House Station
                                                                Augusta, Maine 04333-0011
          Thomas.leet@maine.gov
TELEPHONE:                                     207-624-4068 FAX: (207) 287-1864 TTY: 711