Mainecare Notice of Agency Waiver Application Submission, New 1915(c) Home and Community-Based Services (HCBS)
Maine Department of Health & Human Services sent this bulletin at 04/14/2026 08:00 AM EDT
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Below, please find a MaineCare Notice of Agency Waiver Application Submission. You can access the complete rule at http://www.maine.gov/dhhs/oms/rules/index.shtml.
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Notice of Agency Waiver Application Submission, New 1915(c) Home and Community-Based Services (HCBS)
AGENCY: Department of Health and Human Services, Office of MaineCare Services
RULE TITLE OR SUBJECT: Chapter 101, MaineCare Benefits Manual, Section 24, Home and Community Based Services Across the Lifespan for Individuals with Intellectual Disabilities or Autism Spectrum Disorder
WAIVER: ME.026, Home and Community Based Services Across the Lifespan for Individuals with Intellectual Disabilities or Autism Spectrum Disorder Waiver
CONCISE SUMMARY: The Department of Health and Human Services (the Department) plans to submit a 1915(c) Home and Community-Based Services (HCBS) waiver application to the Centers for Medicare and Medicaid Services (CMS) for the newly developed Home and Community Based Services Across the Lifespan for Individuals with Intellectual Disabilities or Autism Spectrum Disorder (Lifespan Waiver). This new HCBS 1915(c) waiver proposes to offer a range of home and community-based services options to individuals with intellectual disabilities (ID), autism spectrum disorder (ASD), or other related conditions (ORC) aged 14 years and above.
The Lifespan Waiver proposes to implement service delivery options for participants and their families, tailored to the participant’s phase in their lifespan, living situation, and assessed needs. Like Maine’s five other 1915(c) waivers [ME.1082 (MaineCare Benefits Manual (MBM) Section 18), ME.0276 (MBM, Section 19), ME.0995 (MBM, Section 20), ME.0159 (MBM, Section 21), and ME.0467 (MBM, Section 29)], Lifespan waiver services are delivered primarily in private homes and integrated community settings including places of employment, as well as in some specific types of provider-owned and/or operated settings, including residential settings.
The Lifespan Waiver includes a comprehensive array of services to flexibly respond to the participant’s changing needs and ensure seamless transitions as they occur across the lifespan. This includes expanding opportunities for self-direction and increasing access to competitive integrated employment. Additionally, this waiver proposes to focus on promoting independence, strengthening family and other natural supports and fostering full community integration.
The Lifespan Waiver will operate Statewide and concurrently with two 1915(b)(4) waivers: one providing Non Emergnecy Transportation (NET) and one implementing selective contracting for Community Resource Coordination (CRC) - the Lifespan Waiver case management service, which will be available through a limited network pursuant to the 1915(b)4 waiver application submitted concurrently with this application.
The Department is committed to ensuring all waiver participants have a choice of qualified providers for Lifespan Waiver services. The network of willing and qualified providers is responsible for delivering the array of proposed services, except CRC services. Further, the Lifespan Waiver incorporates innovation and technology solutions to address challenges in the direct service workforce. The waiver proposes simplified and effective payment methods for the state and the provider network, including alternative payment methods to promote quality, efficiency and economy of scale.
Appendix A Waiver Administration and Operation: The proposed Lifespan waiver establishes that DHHS’ Office of MaineCare Services (OMS) is the single State Medicaid Agency (SMA) for Maine and responsible for the administration of the Medicaid Program and this waiver. The proposed waiver further specifies that OMS delegates day-to-day operational authority of this waiver to the Operating Agency (OA): the Office of Aging and Disability Services (OADS).
Appendix B Participant Access and Eligibility: The proposed Lifespan application specifies that participants must meet institutional level of care criteria to gain access to the Lifespan Waiver. To ensure that eligible Participants have access to truly individualized services and support based on age, living situation, individually identified goals and their assessed needs, the Lifespan Waiver design includes four distinct Participant groupings, each with a specified annual budget cap and set of services.
Appendix C Participant Services: The Lifespan Waiver proposes a comprehensive array of newly developed services while incorporating certain existing services provided under Maine’s Section 21, Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder waiver. Examples of the newly developed services include Community Resource Coordination, Community Transition Case Management, Family Empowerment and Systems Navigation, Private Duty Nursing, Employment Exploration, and Remote Monitoring and On-Call Response. The accompanying draft includes the full list of newly developed and existing services included with the Lifespan Waiver application.
Appendix D: Participant-Centered Planning and Service Delivery: The Lifespan Waiver establishes that the Person-Centered Service Plan (PCSP) and process aligns with Maine’s Global HCBS Waiver Person-Centered Planning and Settings Rule (“the Global Rule”) as set forth in Chapter 101 of the MaineCare Benefits Manual (MBM), Section I, Ch. 6 and this waiver. This includes
Appendix E Participant Direction of Services: The Lifespan Waiver incorporates expanded opportunities for participants to self-direct certain services. This includes provisions requiring Financial Management and Supports Brokerage services as well as options for using employer authority and/or budget authority to manage the delivery of and budget for their self-directed services. The Lifespan Waiver aligns similar processes, service descriptions, and similar provisions with Maine’s ME.0467 1915(c) waiver.
Appendix F Participant Rights: The Lifespan Waiver establishes that OADS is responsible for the operation of the grievance system for participants with intellectual disabilities, autism or acquired brain injuries who are 18 years of age and older served by the Department and aligns similar processes and similar provisions with ME.0467 and ME.0159 1915(c) waivers. Additionally, the Lifespan Waiver incorporates new requirements and establishes that the Children’s Behavioral Health Services (CBHS) is responsible for the operation of the grievance system for participants with intellectual disabilities, autism or acquired brain injuries who are younger than 18 years of age.
Appendix G Participant Safeguards: The Lifespan Waiver establishes that providers must comply with the following state statutes and regulations that define reporting requirements for incidents involving children or adults (depending on the population). For adults, the Lifespan Waiver aligns similar processes and similar provisions with ME.0467 and ME.0159 1915(c) waivers.
1. Children Abuse, Neglect, Exploitation (ANE) - 22 M.R.S. § 4011-A
2. Adults ANE – 22 M.R.S. § 3477
3. Individuals with I/DD and Autism Critical Incidents - 34-B M.R.S. §5604-A
4. ANE Regulation – 10-149 CMR Ch. 2
5. Reportable Event Regulation – 14-197 CMR Ch. 12
Appendix H Quality Improvement Strategy: The Lifespan Waiver incorporates the Department’s Quality Improvement strategy by aligning similar processes and provisions with Maine’s ME.0467 and ME.0159 1915(c) waivers.
Appendix I Financial Accountability: The Lifespan Waiver establishes the methods employed to ensure integrity of payments financial accountability by aligning similar processes and similar provisions with Maine’s ME.0467 and ME.0159 1915(c) waivers.
Appendix J Cost-Neutrality Demonstration: The Lifespan Waiver establishes that the waiver is cost neutral in Appendix J-1: Composite Overview and Demonstration of Cost-Neutrality Formula, and Appendix J-2: Derivation of Estimates, for the five years of this waiver cycle (through 2032).
Please see the accompanying draft application for Maine’s complete proposed Lifespan Waiver.
DHHS is accepting comments through 11:59 pm, May 13, 2026. Any interested party may obtain a copy of the waiver amendment 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 Lisa Weaver at (207) 624-4050 or emailing lisa.weaver@maine.gov.
See https://www.maine.gov/dhhs/about/rulemaking for waiver amendment and to submit comments.
STATUTORY AUTHORITY: 42 CFR §441.304
DEADLINE FOR COMMENTS: Comments must be received by 11:59 pm, May 13, 2026.
AGENCY CONTACT PERSON: Heather Bingelis, Comprehensive Health Planner II
AGENCY NAME: MaineCare Services
ADDRESS: 109 Capitol Street, 11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-624-4951 FAX: (207) 287-1864 TTY: 711
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