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MaineCare Section 20 · CMS 0995.R02.00

Home and Community Based Services for Adults with Other Related Conditions Waiver

Effective July 1, 2023 through June 30, 2028 · Last reviewed October 7, 2026

Provides care coordination, career planning, community support, home support (1/4 hour), home support-per diem, personal care, financial management services, individual goods and services, supports brokerage, work support, assistive technology, communication aids, consultation and assessment, employment specialist services, home accessibility adaptations, home support-remote support, non-traditional communication consultation, non-medical transportation, non-traditional communication assessment…

Who it serves

Intellectual Disability or Developmental Disability, or Both The state further specifies its target group(s) as follows: HCBS Waiver: ME.0995.R02.00 - Jul 01, 2023 Persons with related conditions means individuals who have a severe, chronic disability that meets all of the following criteria: (a) It is attributable to (1) Cerebral palsy or epilepsy; or (2) Any other condition, other than mental illness, found to be closely related to Intellectual Disability because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that o…

Medical eligibility

Evaluation/Reevaluation of Level of Care As specified in 42 CFR §441.302(c), the state provides for an evaluation (and periodic reevaluations) of the need for the level(s) of care specified for this waiver, when there is a reasonable indication that an individual may need such services in the near future (one month or less), but for the availability of home and community-based waiver services. Reasonable Indication of Need for Services. In order for an individual to be determined to need waiver services, an individual must require: (a) the provision of at least one waiver service, as document…

Financial eligibility

Miller Trust State: No Other specified Medicaid eligibility groups served in the waiver: • -Adult Group as specified in §435.119 Furnishes waiver services to individuals in the special home and community-based waiver group under 42 CFR § 435.217. Special income level: 300% of the SSI Federal Benefit Rate (FBR).

Services

Assistive Technology

Limits: Assisted Technology Services are limited to $6,926.40 per year per participant. The components above are subject to the following limits: The Assistive Technology Device and services described above in paragraphs (B) and (C) are subject to a combined limit of $6,926.40 annually. The services described above in paragraphs (A), (D), (E) and (F) are subject to a combined limit of 32 units (8 hours)…

Providers: The Office of Aging and Disability Services (OADS) approved Agency

Case Management

Limits: Care Coordination is limited to 400 units a year.

Providers: Service Coordination Agency (SCA)

Communication Aids

Limits: Only communication aids that cannot be obtained as a covered service under other sections of the MaineCare Benefits Manual will be reimbursed under this section. For communication aids costing more than $500.00, the participant must obtain documentation from a licensed speech pathologist assuring the medical necessity of the devices or services. There is a $6,815.22 annual limit on this service.

Providers: Independent Practitioners, Speech and Hearing Agencies and Home Health Care Agencies

Consultation and Assessment

Limits: Consultation Services are limited to 64 units per service year for each type of Consultation Service. .0995.R02.00 - Jul 01, 2023

Providers: Home Health Agency, Individual Practitioner

Day Habilitation

Limits: .0995.R02.00 - Jul 01, 2023 Community Support is limited to 128 units per week, for an annual total of 6656 units. The combined limit for Community Support and Work Support limit is 128 units per week. Nothing prohibits one-to-one (1:1) service delivery. Community Support can be provided by a one participant to one DSP ratio (1:1) but shall…

Providers: Individual Employee Application for 1915(c) HCBS Waiver: ME.0995.R02.00 - Jul 01, 2023 of 273 09/01/2023, OADS approved Agency

Employment Specialist Services

Limits: Employment Specialist Services are limited to 72 units per service year. Employment Specialist Services cannot be provided at the same time as Work Support.

Providers: Employment Specialist Application for 1915(c) HCBS Waiver: ME.0995.R02.00 - Jul 01, 2023 of 273 09/01/2023, Supported Employment Agency

Financial Management Services

Imported from NASDDDS 1915(c) Waiver Services Database, CMS WMS extract current as of 2026-04-02. Use as a research accelerator only; validate against the CMS waiver package before relying on it. Participant-directed: Yes. Provider-managed: No. Waiver expiration date in source extract: 30/06/2028.

Habilitation

Limits: Any service delivered out of state must be prior authorized. Home Support is limited to 64 units per day.

Providers: Personal Care Agency, The Office of Aging and Disability Services (OADS) approved Provider Agency

Home Accessibility Adaptations

Limits: Home Accessibility Adaptations are limited to $3,148.20 per year. All items in excess of $500.00 require documentation from a physician or other appropriate professional, such as an Occupational Therapist, Physical Therapist, or Speech Therapist that the purchase is appropriate to meet the participant's need. Medically necessary home accessibility adaptations that cannot be obtained as a covered…

Providers: Independent Service Provider

Home Support-Per Diem

Limits: Payments are not made for room and board, the cost of facility maintenance, upkeep, or improvement. The cost of transportation is included in the residential habilitation rate.

Providers: Personal Care Agency

Home Support-Remote Support

Limits: Remote Support is not available at the same time as any other type of Home Support or Personal Care. Home Support-Remote Support is limited to 64 units per day.

Providers: OADS approved provider

Non-Medical Transportation

Limits: Service Delivery Method (check each that applies) : Participant-directed as specified in Appendix E Provider managed Specify whether the service may be provided by (check each that applies) : Legally Responsible Person Relative Legal Guardian

Providers: Broker

Non-Traditional Communication Assessments

Limits: Non-Traditional Communication Assessment is limited to 64 units per service year.

Non Traditional Communication Consultation

Limits: Non-Traditional Communication Consultation is limited to 240 units per service year.

Providers: Individual Practitioner Application for 1915(c) HCBS Waiver: ME.0995.R02.00 - Jul 01, 2023 of 273 09/01/2023

Occupational Therapy (Maintenance)

Limits: Occupational Therapy (Maintenance) is limited to 8 units per week up to 416 units per service year. Evaluative and rehabilitative Occupational Therapy is included in the State Plan and is not covered as a component of maintenance therapy.

Providers: Home Health Agency, Individual Practitioner

Other Supports for Participant Direction

Imported from NASDDDS 1915(c) Waiver Services Database, CMS WMS extract current as of 2026-04-02. Use as a research accelerator only; validate against the CMS waiver package before relying on it. Participant-directed: Yes. Provider-managed: No. Waiver expiration date in source extract: 30/06/2028. Alternate service name: Individual Goods and Services.

Personal Care

Imported from NASDDDS 1915(c) Waiver Services Database, CMS WMS extract current as of 2026-04-02. Use as a research accelerator only; validate against the CMS waiver package before relying on it. Participant-directed: No. Provider-managed: Yes. Waiver expiration date in source extract: 30/06/2028.

Physical Therapy (Maintenance)

Limits: Physical Therapy (Maintenance) is limited to 8 units per week up to 416 units per service year. Evaluative and rehabilitative Physical Therapy is included in the State Plan and is not covered as a component of maintenance therapy.

Providers: Home Health Agency, Individual Practitioner

Shared Living (Adult Foster Care)

Limits: Service Delivery Method (check each that applies) : Participant-directed as specified in Appendix E Provider managed .0995.R02.00 - Jul 01, 2023 Specify whether the service may be provided by (check each that applies) : Legally Responsible Person Relative Legal Guardian

Providers: OADS approved provider

Specialized Medical Equipment and Supplies

Providers: Businesses specializing in Durable Medical Equipment (DME)

Speech Therapy (Maintenance)

Limits: Speech Therapy (Maintenance) is limited to 8 units per week up to 416 units per service year. Evaluative and rehabilitative Speech Therapy is included in the State Plan and is not covered as a component of maintenance therapy.

Providers: Speech and Hearing Agency

Supported Employment

Limits: The maximum annual allowance is 60 hours to be delivered within a six-month period. No two six-month periods may be provided consecutively. Career Planning may not be provided at the same time as Home Support, Employment Specialist Services or Work Support.

Providers: OADS Approved Provider Agency

Work Support

Limits: Work Support is limited to 128 units per week, for an annual total of 6656 units. The combined limit for Community Support and Work Support limit is 128 units per week. .0995.R02.00 - Jul 01, 2023

Providers: Supported Employment Agency, Work Support Professional

Provider qualifications

Staff training and program requirements

Training requirements by role

Sources

ME Home and Community Based Services for Adults with Other Related Conditions Waiver (0995.R02.00)

Questions

Who does MaineCare Section 20 serve?

Intellectual Disability or Developmental Disability, or Both The state further specifies its target group(s) as follows: HCBS Waiver: ME.0995.R02.00 - Jul 01, 2023 Persons with related conditions means individuals who have a severe, chronic disability that meets all of the following criteria: (a) It is attributable to (1) Cerebral palsy or epilepsy; or (2) Any other condition, other than mental illness, found to be closely related to Intellectual Disability because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that o…

What services are in Section 20?

Assistive Technology, Case Management, Communication Aids, Consultation and Assessment, Day Habilitation, Employment Specialist Services, Financial Management Services, Habilitation, Home Accessibility Adaptations, Home Support-Per Diem, Home Support-Remote Support, Non-Medical Transportation, Non-Traditional Communication Assessments, Non Traditional Communication Consultation, Occupational Therapy (Maintenance), Other Supports for Participant Direction, Personal Care, Physical Therapy (Maintenance), Shared Living (Adult Foster Care), Specialized Medical Equipment and Supplies, Speech Therapy (Maintenance), Supported Employment, Work Support

What staff requirements are recorded for this waiver?

Criminal background investigation; Extraordinary care by legally responsible person

Where does this page get its facts?

The services, eligibility notes, and requirements come from the approved CMS waiver application 0995.R02.00. Last reviewed 2026-10-07.

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