Proposed Rulemaking

ASPIRE Rule #28P - TANF Earnings Disregard Extensions

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Concise Summary:

This rule change aligns ASPIRE Program rules with changes to the Maine Public Assistance Manual that require the Department to consider receipt of the TANF earnings "Step" disregard as a condition for extended eligibility when a family has received TANF past the federal and state lifetime limit of 60 months. Step budgeting detailed in the Maine Public Assistance Manual, 10-144 C.M.R. Ch. 331, Chapter IV, Step Disregard, requires a disregard of most or all of an individual's earned income for a period of months. This extension is required in 22 M.R.S. 3762(18) and 10-144 C.M.R. Ch. 331 Chapter I(J)(3)(g)(i). This extension shall be applied only if the individual both received the Step disregard and reached the 60-month limit on or after October 1, 2019. Therefore, it will not be applied to recipients who reached the limit prior to that date but may be applied to current or future recipients if they qualify for the Step disregard. Additionally, changes were made to the Index to bring it in line with recent changes to the sections and pages that refer to each topic.

Submit Comments (Opens in new window) - Comment Deadline: April 26, 2021 | Posted: March 24, 2021

Food Supplement Rule #219P - Temporary Student Policy

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Concise Summary:

This rule change proposes to implement expanded eligibility for post-secondary students from January 16, 2021 through any certification period begun during the COVID-19 Public Health Emergency (PHE) or within 30 days of the date the COVID-19 PHE is terminated. This temporary expansion of eligibility for students would change the previous restriction on student eligibility for Food Supplement Program benefits. 7 U.S.C. 2015(e) and 7 C.F.R. 273.5. As a result, Food Supplement benefits will be available to more individuals. A rule change is necessary to remain in compliance with P.L. 116-260. The Consolidated Appropriations Act, 2021 (P.L. 116-260) Title VII Nutrition and Agriculture Relief, Subtitle A Nutrition, Section 702(e) requires that students enrolled at least half-time in an institution of higher education and are eligible for work study or with an expected family contribution of $0 are not per se ineligible for Food Supplement Program benefits based on their student status. This expansion of eligibility is effective for any certification period in effect between January 16, 2021 and until 30 days after the COVID-19 PHE ends. This rulemaking is distinct from 217P which was proposed on February 17, 2021, though both arise from the same Consolidated Appropriations Act, 2021. The Department implemented these changes on an emergency basis on February 18, 2021 effective January 16, 2020, in Rulemaking No. FS219E. Because the emergency rule is effective for only 90 days, this rulemaking is necessary to make the changes permanent. The Consolidated Appropriations Act was enacted on December 27, 2020, requiring expanded student eligibility be implemented no later than January 16, 2021. Food and Nutrition Services (FNS) provided the final guidance in a February 2, 2021 memo. Accordingly, the Department proposes to adopt this rule change to apply retroactively, effective January 16, 2021, to Food Supplement eligibility. Retroactive rulemaking is authorized by the Legislature in accordance with 22 M.R.S. 42(8) because this rule would provide a benefit to recipients or beneficiaries and would not have an adverse financial effect on either providers or beneficiaries or recipients. Additionally, the Department regularly reviews rules for readability, consistency, and contemporaniousness. To these ends, the following changes are proposed: 1) Formatting and enumeration would be updated for ease of reference and consistency with other sections of this manual, and other Office for Family Independence manuals; 2) The list of exemptions to student ineligibility would be reorganized to list them from the easiest to verify and apply to the most cumbersome; 3) Incorrect citations would be corrected. 4) Redundant conjunctions would be removed; 5) Names of programs would be updated or added as needed; 6) Gender specific pronouns would be replaced with gender neutral ones; 7) The Subsection on treatment of income would be dramatically reworded to read more like a list of requirements and less like an instruction manual for Department staff,and be updated to minimize redundancies; and 8) A detailed example that has caused some confusion about income and expense averaging strategies would be removed, and the process for that averaging would be consolidated to its own paragraph for emphasis.

Comment deadline past Comment Deadline: April 12, 2021 | Posted: March 10, 2021

MaineCare Rule #295P - Updates to Parts 9, (Special) Limited Benefit Groups, and 18, Presumptive Eligibility Determined By Hospitals

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Concise Summary:

The Department proposes various substantive and technical changes in Part 9, as well as in Part 18 of the MaineCare Eligibility Manual, 10-144 C.M.R. Ch. 332, primarily with regard to presumptive eligibility determinations. Additionally, the Department regularly reviews policies to ensure clarity and conformity with state and federal Medicaid requirements. The Department proposes to add clarification to other sections of Parts 9 and 18 of this Manual to clarify eligibility criteria and processes. None of these clarifications make substantive changes to existing eligibility criteria or processes in a way that diminishes beneficiaries' rights. Indeed, it could be that more beneficiaries are determined eligible for MaineCare services as a result of the new presumptive eligibility process for the limited family planning benefit group (Part 9, Sec. 4). Within Part 9, Section 1, the Department proposes the following changes. References to "HIV/AIDS Waiver" would be changed to Benefit for People living with HIV/AIDS. Language would be added to specify that this benefit is also referred to as the Special Benefit Waiver or SBW. Changes also include specifying which type of coverage was being referenced at each step, specifying that action was being taken on benefits not the individual, and removing unnecessary words. The Department proposes changes in Subsection 1(A) specifying that this requirement only applies to individuals who qualify for SSI-Related MaineCare based on disability (not age). Language would be added to Subsection 1(C) specifying that SSI-Related budgeting procedures (in Part 7) apply. To improve specificity, the due date of premiums would be added to the first paragraph of Subsection 2. Subsection 2(A)(1) would be amended to clarify that multiple month payments should be made in advance of the due date. Subsection 2(A)(2) would be amended to clarify that notice will be sent to the individual, allowing for e-noticing or mail as opposed to handing it to them. The last paragraph of Subsection 2(A)(3) would be amended to clarify that the date in question is the last day of the grace period. Subsection 2(B)(2)(b) would be amended to allow for a person other than a relative to be responsible for an individuals premium payments. Subsection 3(A) would be amended to clarify that continuous coverage will only be granted pending a hearing decision if the request for hearing is received during the Adverse Action Notice Period. In Part 9, Section 2, the Department proposes the following change to clarify that there are, in fact, two distinct Breast and Cervical Cancer programs. A sentence would be added to the end of the first paragraph referencing the program available under 10-144 C.M.R. Ch. 708. In Part 9, Section 4, the Department proposes to add language to 10-144 C.M.R. Ch. 332, the MaineCare Eligibility Manual, to comply with 22 M.R.S. 3173-G. Specifically, the rule sets forth the conditions for a provider to make a presumptive eligibility determination for the limited family planning coverage group, the process for making such a determination, the duration of the presumptive decision, and the process for securing ongoing eligibility. These changes shall be effective retroactive to October 1, 2020. Other proposed changes are part of a standardization of practice across all OFI rules. References to MaineCare coverage that does not limit its coverage to a specific system or condition would be consistently changed to full MaineCare. Furthermore, this rulemaking proposes to make changes in Part 18 of the Manual regarding requirements for hospitals to utilize Hospital Presumptive Eligibility, per Maines SPA that was approved by CMS on October 28, 2020. The proposed changes clarify the Hospital Presumptive Eligibility process and impose an 80% performance standard and a process for enforcing same. The primary substantive changes are proposed regarding the presumptive eligibility determination process. The rule implements the legislatures requirement that presumptive eligibility determinations be permitted for the limited family planning benefit group. It also reduces the penalties associated with performance standards and clarifies requirements for hospital presumptive eligibility determinations.

Comment deadline past Comment Deadline: March 22, 2021 | Posted: February 17, 2021

Food Supplement Rule #217P - Increases Pursuant to P.L. 116-260

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Concise Summary:

This rule change proposes to implement increases to the maximum and minimum allotments from January 1, 2021 through June 30, 2021. As a result, Food Supplement benefits would increase for some households. Furthermore, it proposes to increase eligibility thresholds. As a result, more households would be eligible for Food Supplement benefits. A rule change is necessary to remain in compliance with P.L. 116-260. The Consolidated Appropriations Act, 2021 (P.L. 116-260) requires that Food Supplement Program maximum and minimum allotments be increased by 15 percent for the period of January 1, 2021 through June 30, 2021. Food and Nutrition Services (FNS) provided the exact figures and guidance in a December 28, 2020 memo. The Department implemented these changes on an emergency basis on February 1, 2021 effective January 1, 2020, in Rulemaking No. FS217E. Because the emergency rule is effective for only 90 days, this rulemaking is necessary to make the changes permanent. Additionally, a rule change is necessary to remain in compliance with Federal regulation 7 C.F.R. 273.9(a)(3), which requires that Food Supplement Program income limits be updated each year, effective October 1. Non-compliance could result in federal penalties or loss of federal funds. Maine exercises an option for Broad Based Categorical Eligibility under 7 C.F.R. 273.2(j)(2) which includes a 185% Federal Poverty Level (FPL) test. Since this figure is not included in the figures updated each federal fiscal year per 7 C.F.R. 273.9(a)(4), it is updated as soon as the the FPLs are published. This year, they were published at https://aspe.hhs.gov/poverty-guidelines on January 13. See also, Annual Update of the HHS Poverty Guidelines, 86 Fed. Reg. 7,732 (February 1, 2021) https://www.federalregister.gov/documents/2021/02/01/2021-01969/annual-update-of-the-hhs-poverty-guidelines. Finally, the rule change proposes to remove end dates from the last set of figures of each chart to alleviate unnecessary future rule making should the figures remain the same. Some charts would, also, be condensed to more clearly show where figures have been retained for an extended period of time.

Comment deadline past Comment Deadline: March 22, 2021 | Posted: February 17, 2021

FSET Rule #5 - Bachelors Programs Approved

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Concise Summary:

Effective October 1, 2020, this rulemaking proposes to expand Maine's FSET post-secondary educational opportunities for FSET participants to include some 4-year degree programs that lead to high wage, in demand occupations, as defined by the Maine Department of Labor at 12-597, Chapter 2, Rule Governing the Competitive Skills Scholarship Program. Maine Department of Health and Human Services recently renewed its formal partnership with the Maine Department of Labors Competitive Skills Scholarship Program (CSSP) to include the CSSP program in its array of FSET services. This change will allow co-enrolled FSET and CSSP participants to most efficiently participate in educational programming. As detailed in its website at http://www.mainecareercenter.gov/cssp.shtml, the program includes "certificate programs and two- and four-year degrees - training for industry recognized credentials, and support leading to skilled, well-compensated jobs with anticipated high employment demand." The Department of Labor maintains this list of jobs considered high-wage, in demand occupations, which have an average wage at or above the average wage for all occupations in Maine and are projected to have a minimum number of job openings annually. In partnering with the CSSP program, Maine DHHS staff will utilize the expertise of the Maine Department of Labor to identify which occupations are high wage, in demand occupations, and support the degrees needed accordingly through its FSET program. The rulemaking also clarifies that participants may be co-enrolled with more than one FSET provider only when the providers are delivering different components of services, as defined in the rule. Effective March 8, 2021, this rulemaking proposes to strike language disallowing reimbursement for on the job training or work experience. This change aligns Maines policy with new federal rules adding subsidized employment as an allowable component. Retroactive rulemaking is authorized by the Legislature in accordance with 22 M.R.S. 42(8) because this rule provides a benefit to recipients or beneficiaries and does not have an adverse financial effect on either providers or beneficiaries or recipients. This amendment is expected to be annually cost neutral, as the same number of participants will be served, and providers will be held to the established budgets and caps for services and participant reimbursements in their contracts or Memorandum of Understanding as previously approved.

Comment deadline past Comment Deadline: March 8, 2021 | Posted: February 3, 2021

Food Supplement Rule #215P - FFY 2021 Budgeting Figures

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Concise Summary:

A rule change is necessary to remain in compliance with Federal regulation 7 C.F.R. 273.9(d). 7 C.F.R. 273.9 requires that Food Supplement Program income and asset limits, maximum and minimum allotments, standard deductions, maximum shelter deductions, homeless shelter deductions, standard utility allowances (SUAs) and income change reporting thresholds be updated each year, effective October 1. This year, the United States Department of Agriculture (USDA) COLA Memo FY2021 provided more generous income limits, maximum allotments, standard deductions (for most households), maximum shelter deduction, and homeless shelter deduction. The same memo showed no change in minimum allotments, the standard deductions for households of one to three members, asset limits or income change reporting thresholds. Each state agency is charged with determining standard utility allowances and having those approved by USDA. The utility allowance values were calculated to remain the same using The Consumer Price Index published by the Bureau of Labor Statistics of the Department of Labor, and were submitted to and approved by USDA. Non-compliance could result in federal penalties or loss of federal funds. The Department implemented these changes on an emergency basis on October 1, 2020, effective October 1, 2020, in Rule No. FS215E. Because the emergency rule is effective for only 90 days, this rulemaking is necessary to make the changes permanent. Retroactive rulemaking is necessary to keep Maine's policies in line with federal requirements, and is authorized under 22 M.R.S. 42(8) as it benefits Food Supplement recipients and does not have an adverse financial impact on any provider, member, recipient or beneficiary.

Comment deadline past Comment Deadline: November 23, 2020 | Posted: October 21, 2020

Food Supplement Rule #214P - FFY 2021 ABAWD

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Concise Summary:

7 CFR 273.24 provides that no individual shall be eligible to participate in the Supplemental Nutrition Assistance Program (SNAP) as a member of any household if the individual received program benefits for more than 3 months during any 3-year period in which the individual was subject to but did not comply with the ABAWD work requirement. PL 116-127 (Families First Corona Virus Response Act) 2301 suspended these requirements from April 1, 2020 through the month following the month the public health emergency (PHE) declaration by the Secretary of Health and Human Services, based on an outbreak of COVID-19 is lifted. The PHE declaration has not been lifted, as of the date of this proposed rulemaking. The proposed rule implements the national suspension of the ABAWD requirements under the Families First Corona Virus Response Act, for the period of September 1, 2020 through September 30, 2020. 7 C.F.R. 273.24(f) provides that, upon the request of the State agency, the Secretary may waive the applicability of the 3-month ABAWD time limit for any group of individuals in the State if the Secretary makes a determination that the geographic area in which the individuals reside has an unemployment rate of over 10 percent, or does not have a sufficient number of jobs to provide employment for the individuals. The proposed rule implements the July 15, 2020, ABAWD geographic state-wide waiver approval, pursuant to 7 C.F.R. 273.24(f)(2) and Section 6(o) of the Food and Nutrition Act of 2008, for the period October 1, 2020 through September 30, 2021, or until the date at which the new waiver standards become effective, whichever occurs earlier. The Department's waiver request was approved by the U.S. Department of Agriculture, Food and Nutrition Service (FNS), on July 15, 2020. USDA: Able-Bodied Adults Without Dependents (ABAWD) Waiver Response, Serial Number 2190025. In the July 15, 2020 FNS Waiver Response, FNS determined that the Department met the waiver requirement by providing a copy of the Department of Labor Trigger Notice No. 2020-17, effective May 10, 2020, showing that, state-wide, Maine qualified for extended unemployment benefits. This rule change will enhance nutritional stability and consistency for thousands of Maine households at a time of financial and health uncertainty. The Department is proposing to adopt this rule with a retroactive application to September 1, 2020. Retroactive rulemaking is authorized by the Legislature in accordance with 22 M.R.S. 42 (8) because this rule provides a benefit to recipients or beneficiaries and does not have an adverse financial effect on either providers or beneficiaries or recipients.

Comment deadline past Comment Deadline: Monday, November 2, 2020 | Posted: September 30, 2020

MaineCare Rule #298P - COVID-19 Testing for Uninsured Individuals

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Concise Summary:

The Families First Coronavirus Response Act (FFCRA) H.R. 6201, 116 Cong. (2019-2020), P.L. No. 116-127 (3/18/2020), 134 Stat. 178 et seq. specified in Division F, Section 6004 (a) (3) that State Medicaid programs were authorized to create an optional coverage group to ensure that services related to testing and diagnosis of COVID-19 are available in response to the pandemic, pursuant to Section 1902(a)(10)(A)(ii)(XXIII) of the Social Security Act, 42 U.S.C. 1396a(a)(10) as amended. This is a limited coverage benefit that is effective no earlier than March 18, 2020 and ends on the last day of the month in which the federal public health emergency ends, unless otherwise directed by the Centers for Medicare and Medicaid Services. Coverage under this group is available to individuals who are without health insurance, or whose health insurance coverage does not meet the requirements for minimum essential coverage. This rule change adopts the eligibility criteria established within the Act into the MaineCare Eligibility Manual. This rule change will reduce barriers to COVID-19 testing and treatment which will improve health outcomes for the specific individuals covered and reduce the spread of this virus throughout the Maine population as a whole. Additionally, the Department regularly reviews policies to ensure clarity and conformity with state and federal requirements. Clarification was added to each section of Part 9 of this Manual to clarify eligibility criteria and processes. Changes were made to word choice for readability and in the interest of gender neutrality where appropriate.

Comment deadline past Comment Deadline: August 9, 2020 | Posted: July 9, 2020

ASPIRE Rule #25P - Working Cars for Working Families

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Concise Summary:

The Department was directed to operate a Working Cars for Working Families program, 22 M.R.S. 3769-F, by the 128th Legislature as part of the 2017-2018 biennial budget. The purpose is to assist participants in obtaining and maintaining sustainable employment by providing them with access to reliable, affordable transportation. The rule establishes the program, sets out eligibility and ongoing participation criteria, and describes the application and decision processes, including termination of services and appeal rights.

Comment deadline past Comment Deadline: August 20, 2020 | Posted: June 3, 2020