Developmental Services - Support Waiver

Application Process

DHHS- Developmental Services
7/9/2007

Must be at least 18 years old.
Must be eligible for Adult Mental Retardation Services (Intake completed)
Must have an Individual Support Coordinator or Community Case Manager
Must agree to a minimum of support to include planning, application/reclassification of the waiver program, and a minimum of two visits a year to the applicable site (community program, work site/or provider of work services) provided by the ISC or CCM.
Must be Maine Care Eligible (assurance from ISC or CCM)

Step 1: Planning

Needs and services to be provided by Support Waiver must be identified in plan; identify both service needed and frequency/amount of service
Action plan must identify ISC/CCM as responsible person for classification process
ISC/CCM signature on plan is indication that they acknowledge and agree with the recommended services and units or cost included in the plan and other supporting documentation; cover sheet as noted above, written estimate for environmental accessibility adaptations, etc.

Step 2: Choice Letter

ISC/CCM must provide explanation to participant and/or guardian and have signed either at or after the planning meeting

Step 3: BMS-99

Step 4: Submission of Material for eligibility & level of care determination

Copies of the plan and the Choice Letter are sent to the Support Waiver Manager.
NOTE: They should not be sent until the BMS-99 is complete in EIS.
Send PCP and Choice Letter to:

Ron Bridges, Support Waiver Manager
175 Lancaster Street
Portland, ME 04401

1. Determination of eligibility/level of care

Based on the three documents noted above, the Support Waiver Manager makes a decision on eligibility

If determined eligible, appropriate notification is sent electronically back to the ISC/CCM and the appropriate regional Resource Coordinator is copied.
If consumer is determined eligible:
1. Appropriate notification is sent electronically back to the ISC/CCM
2. Written notification will be sent to Consumer or Guardian stating eligible or ineligible for waiver. Grievance materials will be included.

2. Authorization for Services

The Support Waiver office transfers the appropriate information into an authorization format within EIS and the result is a “Summary of Authorized Services”