Quarterly Update: Supporting Adults with Developmental Disabilities and Brain Injury in their Homes and Communities

January 24, 2020

The Maine Department of Health and Human Services (DHHS) provides home- and community-based services to adults with intellectual or developmental disabilities (IDD), Autism Spectrum Disorder (ASD), and brain injury primarily through MaineCare-funded programs. These are often called waiver programs because they operate with special exceptions from the federal government and are referred to by their Section number, which is where they can be found in the MaineCare rules.

The biennial budget that took effect July 1 included funding to serve an additional 167 people in the current fiscal year under Section 21. To date, 61 additional people have received Section 21 services as a result and 89 are considering offers. After receiving an offer, people have up to six months to start services. This time allows people to evaluate the options available from providers in their areas.

Since our last update in October, the number of people served in the Section 21 and 29 waivers declined slightly. The Section 21 decline is due to people no longer using the program. The Section 29 decline is the result of participants moving over to Section 21 as part of the new offers. We will now begin offering the newly available Section 29 openings.

Applications continue to come in for both waivers, but the new  Section 21 offers has resulted in a net decline of the waitlist. The Section 29 waitlist increased but we expect to see it level off in the next quarter as we offer the openings created by those who have moved to Section 21.

Table 1 provides a snapshot of the programs as of the start of this quarter of the year.

Table 1. Developmental Disabilities and Brain Injury Program Participants and Wait Lists, as of January 1, 2020
Waiver Program Participants Waitlist With Other Coverage (see Table 2) Without Other Coverage (Percent of Current Participants)
Brain Injury (Section 18) 203 63 22 41 (20%)
Other related Conditions (Section 20) 41 24 6 18 (44%)
Comprehensive Services for IDD/ASD (Section 21) 3,179 1,621 1,123 498 (16%)
Support Services for IDD/ASD (Section 29) 2,207 368 159 209 (9%)
Total Unduplicated Members 5,630 1,966 1,254 712 (13%)

Most of the individuals on waiting lists for Sections 18, 20, 21, and 29 (1,254 out of 1,966, or 64%), currently have coverage under a different Section of MaineCare. This includes, for example, 995 people who are receiving services under Section 29 while they await services under Section 21 (Table 2), representing 60% of the Section 21 waitlist.  

Table 2. Other Coverage of Wait List Members for Sections 18, 20, 21, and 29, as of October 1, 2019
Other Coverage (by Section) Unduplicated Members Requesting Waiver Services
Adult Family Care Home (Section 2) 1
Brain Injury (Section 18) 1
Elderly and Adults with Disabilities (Section 19) 21
Other Related Conditions (Section 20) 2
Comprehensive Services for IDD/ASD (Section 21) 4
Adult Day Health (Section 26) 9
Children's Services (Section 28) 156
Support Services for IDD/ASD (section 29) 995
Intermediate Care Facility for IDD (Section 50) 6
Nursing Facility (Section 67) 15
Family Provider Service Option (Section 96) 34
Private NonMedical Institution (Section 97) 17
Brain Injury Services (Section 102) 12
Total Unduplicated Members 1,254

On December 13, the Department shared its Community 2.0 reform ideas for serving more people with more flexible and responsive services over the lifespan, as individuals' needs and goals change over time. Stakeholders are encouraged to send comments on Community 2.0 by January 31 to inform the Department's priorities in this area for the next fiscal year.  Comments may be sent to the mailbox indicated in the December 13 update.