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The MaineCare Benefits Manual Section 20 Waiver Program -- Home and Community Based Services for Adults with Other Related Conditions (ORC) -- offers home and community-based services to individuals with Cerebral Palsy, Epilepsy, and Other Related Conditions. It allows participants to choose home and community based services rather than services provided in an institutional setting.
ORC Forms/Protocols
Forms
- ORC Application (Word)
- ORC Letter of Medical Necessity (Word)
- ORC Community Choice Letter (Word)
- ORC Annual Provider and Services Choice Letter (Word)
- ORC Care Plan Form (PDF)
- Section 20 Authorization Request Form (Word)
- Authorization-Release (PDF)
- ORC Safety Risk Assessment (Word)
- ORC Budget Worksheet 2024 and 2025 Rates (Excel)
- ORC Budget Worksheet 2025 Rates (Excel)
- ORC Consumer Satisfaction Survey (Word)
- HCBS Requirements Modification Addendum (Word) and Decision Tree (PPT) for Section 20
- Service Implementation Plan (Word)
- ORC Waiver - Provider List (PDF)
Policies:
MaineCare Benefits Manual