Notice of Waiver Amendments - ME.0276: Home and Community Benefits for the Elderly and ME.0457: Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

Maine Department of Health & Human Services sent this bulletin at 11/05/2018 10:45 AM EST

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The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.

Below, please find two MaineCare Notices of Agency Waiver Amendments. You can access the complete details at http://www.maine.gov/dhhs/oms/rules/index.shtml.

Notice of Agency Waiver Amendment

AGENCY: Department of Health and Human Services, MaineCare Services

RULE TITLE OR SUBJECT: Chapter 101, MaineCare Benefits Manual, Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities

WAIVER: ME.0276: Home and Community Benefits for the Elderly and Adults with Disabilities

CONCISE SUMMARY: The State of Maine is planning to amend the Home- and Community-Based waiver, known in Maine as Section 19 of the MaineCare Benefits manual. The waiver serves the elderly and adults with disabilities who need nursing facility level-of-care to remain at home while receiving the necessary care that allows them to live independently in the community. DHHS is proposing to make changes to comply with legislative directive P.L. 2017, ch. 459, Part B, which provided funding to increase rates to reflect the final rates modeled in the February 1, 2016 report "Rate Review for Personal Care and Related Services: Final Rate Models" prepared for the Department by Burns & Associates, Inc. The increased rates are effective starting July 1, 2018. Appendix J reflects the rate increase in years one through five. The Department is also proposing to increase the annual cost limit (Appendix B-2-a), consistent with the legislation’s directive regarding increasing monetary caps (P.L. 2017, ch. 459, Sec. B-3). DHHS proposes to increase the annual cost limit to $65,100, and to increase the monthly cap to $5,425 (Appendix C-4).

Additionally, DHHS is proposing to increase the number of participants served by this waiver. For the first five years of this waiver, DHHS proposes to raise the unduplicated number of participants to 2,119, 2,331, 2,415, 2,550, and 2,665 respectively (Appendix B-3-a).

To comply with Federal requirements in the 21st Century CURES Act, DHHS is adding a requirement in Appendix C that providers of Personal Care, Attendant Care, Respite Care in the home, and Home Health Services must comply with Maine DHHS Electronic Visit Verification system standards and requirements. This requirement will be effective January 1, 2020.

DHHS is accepting comments from October 30, 2018 through November 29, 2018. Any interested party may obtain a copy of the waiver application by going to the website noted below, 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), or a printed copy may be obtained by calling Rachel Posner at (207) 624-6951 or emailing at rachel.posner@maine.gov.

See http://www.maine.gov/dhhs/oms/rules/index.shtml for waiver renewal and to submit comments

STATUTORY AUTHORITY: CFR §441.304

DEADLINE FOR COMMENTS: Comments must be received by midnight, Thursday, November 29, 2018.

AGENCY CONTACT PERSON: Rachel Posner, Comprehensive Health Planner

AGENCY NAME: MaineCare Services

ADDRESS: 242 State Street, 11 State House Station

Augusta, Maine 04333-0011

Rachel.posner@maine.gov

TELEPHONE: 207-624-6951 FAX: (207) 287-1864 TTY: 711

Notice of Agency Waiver Amendment

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 Autistic Spectrum Disorder

WAIVER: ME.0457: Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder

CONCISE SUMMARY: The State of Maine is planning to amend the Home- and Community-based Services waiver, known in Maine as Section 29 of the MaineCare Benefits Manual. The waiver serves participants with Intellectual Disabilities and Autism Spectrum Disorder. DHHS is proposing to make changes to comply with legislative directive P.L. 2017, ch. 459, Parts A and B, which provided funding to increase reimbursement rates for Home Support, Shared Living, Community Support, Employment Specialist Services, Work Support, Career Planning, and Respite services. The increased rates are effective starting July 1, 2018. Appendix J reflects the rate increase in years three through five. The legislation also provides that the Department ensure that caps and limitations on services are increased to reflect the rate increases. Therefore, DHHS also proposes to raise limits within this waiver, to ensure that rate increases do not result in any decrease in level of services for participants. The annual limit for participants who receive Home Support, Community support, or Shared Living will increase to $58,168.50 (Appendix C-4), and the annual limit for Respite Services will increase to $1,224.60 per year (Appendix C1/C3).

Additionally, DHHS is proposing to increase the number of participants served by this waiver. DHHS proposes to raise the unduplicated number of participants to 2,635 for years three through five (Appendix B-3-a). For years three through five, DHHS proposes to raise the number of participants served at any point in time to 2,470 (Appendix B-3-b).

To comply with federal requirements in the 21st Century CURES Act, DHHS is adding a requirement in Appendix C that providers of Home Support-1/4 Hour and Respite services in the home must comply with Maine DHHS Electronic Visit Verification system standards and requirements. This requirement will be effective January 1, 2020.

Performance measures have been updated in Appendices A, B, C, D, G, and I. These revisions will make the performance measure in this waiver (ME.0467) consistent with those in ME.0159.

Appendix G, Participant Safeguards, has been updated to reflect changes in Maine's regulations governing Reportable Events (14-197 C.M.R. Ch. 12) and Adult Protective Services (10-149 C.M.R. Ch. 1).

See http://www.maine.gov/dhhs/oms/rules/index.shtml for waiver renewal and to submit comments.