Attention: Providers of Sections 18, 19, 20, 21 and 29: Certain Service Caps and Related Provisions in Appendix K Amendment Extended Through August 31, 2020

Attention: Providers of Sections 18, 19, 20, 21 and 29: Certain Service Caps and Related Provisions in Appendix K Amendment Extended Through August 31, 2020

Appendix K to Maine’s Home- and Community-Based Services waiver programs provides flexibility to operate waiver programs during an emergency.   

Section K-2.b.ii. of Appendix K was originally set to expire on May 31, 2020, but due to continuing need, the Department extended this provision until June 30, 2020. At this time, based on the number of COVID-19 positive cases among HCBS participants and staff, the Department finds a continuing need to extend Section K-2.b.ii.through August 31, 2020.   

The provisions in Section K-2.b.ii. continue to be subject to prior approval. This includes, but is not limited to the following flexibilities:  

• Budget allocations may be exceeded to address emergency needs; 
• Certain service caps may be exceeded to address emergency needs. These vary by waiver. Please read the provisions below carefully; 
• Recognizing that staff shortages persist, staffing levels may fall below authorized levels provided that agencies can ensure members’ health and safety; and 
• Data transmission charges may be allowed up to $200 per person per month to accommodate greater access to telehealth services.  

Further extensions of Section K-2.b.ii. will be considered in late August based on continuing need at that time. 

Appendix K, Section K-2.b.ii Provisions Extended Through August 31, 2020 

Appendix C-4:  

The budget allocations enumerated in Appendix C-4 of the Home- and Community-Based Services for Members Brain Injury (ME 1082), the Elderly and for Adults with Disabilities (ME 0276), the Home and Community Based Services for Adults with Other Related Conditions (ME 0995), the Home and Community Based Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder (ME 0159), and the Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder (ME0467) waivers may be temporarily exceeded to provide needed services for emergency care provision.   

Service Limits in Sections C-1/C-3  

ME.0276.R05.03 (Section 19) 

• Increase the limit of available hours within Personal Care Services by up to 20 percent per week.  
• Increase the limit for the provision of care coordination by up to 20 percent per month  
• Increase the limit on Assistive Technology Device and Services to $6,000 and $200 per month for Assistive Technology- Transmission with prior authorization, and remove these services from the monthly program cap.  
• Increase the limit on Respite Services by up to 20 percent per week.  
• Increase the limit on Home Delivered Meals from one meal/day to two meals/day and remove the total cost from the monthly cap of combined Personal Care, Attendant Care, Respite, Assistive Technology and Living Well/Matter of Balance services.  
• Remove budget allocation limits and individual caps on service to accommodate these temporary service increases.   

ME.1082.R01.02 (Section 18), ME.0995.R01.01 (Section 20), ME.0159.R06.04 (Section 21), and ME.0467.R02.04 (Section 29)  

• Increase the service limits to Quarter Hour Home Supports to up to 64 units per day  
• For Per Diem Home Support, an agency may deliver less direct support than authorized and continue to receive the approved reimbursement rate. An agency will not be subject to minimum staffing requirements if the agency determines that it may provide for members’ health and safety with fewer staff and maintains staffing of at least 50 percent of authorized levels.  
• Increase the limit on Assistive Technology Transmission to $200 per month for data transmission with prior authorization and remove Assistive Technology Transmission from the overall cap for 1082.R01.02 and ME.0995.R01.01.  
• Modify limitations on Respite Services for ME.0467.R02.04.  
• Modify limits on Care Coordination units for ME.1082.R01.02 and ME.0995.R01.01.