Proposed Rule Changes:
MaineCare Benefits Manual, Chapter II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder
Comment Deadline: August 21, 2017
Concise Summary: The proposed rule change will expand the number of members who are eligible as Priority 1 on the waitlist for Chapter II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. The proposed language addresses waitlist eligibility for members whose primary caregiver has reached the age of 65 or has a terminal illness and is having difficulty providing the necessary supports to the member, where the member has no other responsible or willing caregiver. The proposed rule specifies criteria whereby those members may qualify as Priority 1 based on the member’s medical condition or behavioral need; high risk for institutionalization; history of hospitalizations; and imminent danger to the member or others. A provision is also included specifying that Priority 1 is granted only when the member’s needs cannot be met absent provision of services under this comprehensive waiver program. Therefore, Priority 1 on the Section 21 waitlist would be available only for members who specifically need these services; members whose needs could be met with the less intense services provided under the State Plan or Section 29 would be referred to those services. This provision does not preclude the member waiting at another Priority level on the Section 21 waitlist. This rulemaking is required in order to establish clear criteria for prioritization of members, beyond what currently exists. While the Department may offer funded openings to Priority 2 members in the event Priority 1 is exhausted, the Department wishes to establish clear, codified criteria to guide access, now and in the future. The proposed rule also expands the number of members who are eligible as Priority 2. The proposed language expands eligibility to members whose primary caregiver has reached the age of sixty and is having difficulty providing the necessary supports to the member in the family home. A definition of primary caregiver is also included. This will supersede language in the current rule that applies this criterion only to the member’s parents. The proposed provision expands the Priority 2 provision to members being cared for by extended family members, and whose parents are deceased, missing, or unable to care for the member. The proposed rule requires an annual review of the priority assignments of members, in order to remain on the Section 21 waitlist.
Submitting comments is simple. Click one of the methods for submitting comments below (directly on the Department's website through a fill-in form, or via email).
Office of MaineCare Services
11 State House Station,
Augusta, Maine 04333-0011
Click here to visit the proposed policy/rules section of the Office of MaineCare Services website.
MaineCare Benefits Manual, Chapter II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder
Comment Deadline: August 21, 2017
Concise Summary: The proposed rule change will expand the number of members who are eligible as Priority 1 on the waitlist for Chapter II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. The proposed language addresses waitlist eligibility for members whose primary caregiver has reached the age of 65 or has a terminal illness and is having difficulty providing the necessary supports to the member, where the member has no other responsible or willing caregiver. The proposed rule specifies criteria whereby those members may qualify as Priority 1 based on the member’s medical condition or behavioral need; high risk for institutionalization; history of hospitalizations; and imminent danger to the member or others. A provision is also included specifying that Priority 1 is granted only when the member’s needs cannot be met absent provision of services under this comprehensive waiver program. Therefore, Priority 1 on the Section 21 waitlist would be available only for members who specifically need these services; members whose needs could be met with the less intense services provided under the State Plan or Section 29 would be referred to those services. This provision does not preclude the member waiting at another Priority level on the Section 21 waitlist. This rulemaking is required in order to establish clear criteria for prioritization of members, beyond what currently exists. While the Department may offer funded openings to Priority 2 members in the event Priority 1 is exhausted, the Department wishes to establish clear, codified criteria to guide access, now and in the future. The proposed rule also expands the number of members who are eligible as Priority 2. The proposed language expands eligibility to members whose primary caregiver has reached the age of sixty and is having difficulty providing the necessary supports to the member in the family home. A definition of primary caregiver is also included. This will supersede language in the current rule that applies this criterion only to the member’s parents. The proposed provision expands the Priority 2 provision to members being cared for by extended family members, and whose parents are deceased, missing, or unable to care for the member. The proposed rule requires an annual review of the priority assignments of members, in order to remain on the Section 21 waitlist.
Submitting comments is simple. Click one of the methods for submitting comments below (directly on the Department's website through a fill-in form, or via email).
- Click here to submit comments directly online. Please note that the yellow highlighted sections are required. Your email address is not required, but it is advantageous to include it.
- Click here to send comments via email.
Office of MaineCare Services
11 State House Station,
Augusta, Maine 04333-0011
Click here to visit the proposed policy/rules section of the Office of MaineCare Services website.