MaineCare Notice of Agency State Plan Submission, 1915(k) Community First Choice State Plan Option

Oct 25, 2022

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes.  The MaineCare Benefits Manual is available on-line at the Secretary of State’s website. 

Below, please find a Notice of Agency State Plan Submission. You can access the complete notice at http://www.maine.gov/dhhs/oms/rules/index.shtml.

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Notice of Agency State Plan Submission

AGENCY:  Maine Department of Health and Human Services, Office of MaineCare Services

RULE TITLE OR SUBJECT: 1915(k) Community First Choice State Plan Option Submission

CONCISE SUMMARY: The Maine Department of Health and Human Services (DHHS) plans to submit a 1915(k), Community First Choice (CFC) State Plan Option application to the Centers for Medicare & Medicaid Services (CMS) in the near future.  DHHS is proposing to provide home and community-based attendant services and supports to Medicaid members who meet institutional level of care eligibility and who are eligible for medical assistance under the State plan. The CFC Option was originally established under the Affordable Care Act of 2010.

In 2019, DHHS hosted the State Convening on Aging and Long-Term Services and Supports (the “Convening”), including over sixty stakeholders from across the state.  The objectives of the Convening included reviewing opportunities and challenges related to aging in Maine; gathering feedback on Governor Mills’ administration’s priorities for aging and long-term services and supports (LTSS); and establishing a process to advance policy in this area.  Following the Convening, DHHS Commissioner Jeanne M. Lambrew convened the Aging and LTSS Advisory Committee, including nineteen community stakeholders with contributions from DHHS and the Maine Department of Labor, to formulate specific policies and to advance reform priorities for the state.  One of the key recommendations from the Advisory Committee included development and implementation of a Medicaid 1915(k) CFC State Plan Option in Maine.

The CFC expands opportunities for the provision of home and community-based LTSS to facilitate community integration and expand access to opportunities for MaineCare members to select and receive eligible services, with an emphasis on self-directed supports.  Self-direction is a model of service delivery that helps participants of all ages, with many types of disabilities, maintain their independence at home and within their communities. When a person self-directs services through the 1915(k) option, they decide how, when, and by whom their services and supports will be delivered. 

Under the CFC Option, eligible MaineCare Members will have access to personal care/attendant services as well as options to receive Matter of Balance (Falls Prevention), Chronic Disease Self-Management, Assistive Technology Devices and Services, Personal Emergency Response Services, Skills Training and Financial Management Services through self-direction.    

The Department is accepting comments from October 25, 2022 through November 23, 2022. Any interested party may obtain a copy of the full draft CFC application by going to the website noted below: http://www.maine.gov/dhhs/ofi/offices/index.html. A printed copy may be obtained by calling Heather Bingelis at (207) 624-6951 or emailing heather.bingelis@maine.gov.

See http://www.maine.gov/dhhs/oms/rules/index.shtml for draft application and to submit comments

DEADLINE FOR COMMENTS:          Comments must be received by 11:59 pm, November 23, 2022.

AGENCY CONTACT PERSON:          Heather Bingelis, Comprehensive Health Planner II

AGENCY NAME:                                 Office of MaineCare Services

ADDRESS:                                            109 Capitol St.

                                                               Augusta, Maine 04333-0011

EMAIL:                                                 heather.bingelis@maine.gov 

TELEPHONE:                                      207-624-6951 FAX: (207) 287-1864 TTY: 711