December 16, 2024
The Department expects the Lifespan program to be ready for enrollment by July 2026.
After a busy year of development efforts, the DHHS Office of Aging and Disability Services (OADS) has updated its implementation schedule for the new Lifespan waiver program. When launched, the new program will offer supports to individuals with intellectual disabilities across their lifespan, beginning at age 14 and continuing through all phases of adulthood. This innovative approach will enable individuals to have different levels of support at different points in their lives without needing to move from one program to another. In particular, enrollment of youth (beginning at 14 years) will facilitate more effective transition from school to employment and community support services.
The Lifespan waiver program requires approval by the federal Centers for Medicare & Medicaid Services (CMS) to obtain federal matching Medicaid funds. After a year of discussions, CMS and the Department have outlined an approach that is approvable under Section 1915(c) of the federal Medicaid statute (Title XIX of the Social Security Act). Before submitting the waiver application to CMS, the Department will post a draft for 30 days of public comment. The Department expects to post the draft waiver in the first half of 2025. Given the change in federal administration, CMS is not expected to act on any waiver applications until spring of 2025.
Once CMS approves the waiver application, the Department will prepare a MaineCare rule to implement it. This will be a major substantive rule, which means it requires approval of the Legislature. The Department expects to provisionally adopt the rule in late 2025 and submit it to the Legislature for review during the Second Regular Session of the 132nd Legislature in 2026, in time for a July 2026 roll-out of the program. As with all provisionally adopted major substantive rules, the effective date is dependent upon legislative action.
In the meantime, development of the program and related efforts continue. In December 2024, OADS announced the successful conclusion of its Innovation Pilot Projects funded under the American Rescue Plan Act to enhance service delivery for Home and Community-Based Services (HCBS) waivers. In 2023 and 2024, grantees undertook 19 innovative pilot projects across MaineCare sections 18 (Brain Injury), 19 (Aging), 21 (Comprehensive Intellectual and Developmental Disabilities (IDD) and Autism), and 29 (Community IDD and Autism). Supports and lessons from these pilots will inform the new and improved supports offered in the Lifespan program. Many will also be featured at the Innovation Summit, a national and regional conference set to take place in Portland, Maine, May 19--20, 2025. This event will bring together thought leaders, practitioners, and interested parties to explore cutting-edge advancements in service delivery.
In further preparation for Lifespan, the Department is offering Readiness Grants to providers interested in offering new Lifespan supports. The deadline for applying for Readiness Grants is December 20, 2024. As of December 2024, the Department has received between eight and fifteen grant applications for each new service to be offered. OADS and its contractor, the National Disability Institute (NDI), will work with grantees to ensure they receive the training and technical assistance they need well before Lifespan goes live in 2026.
OADS and the Department's Division of Licensing and Certification (DLC) are also working on a new licensing rule that will soon require all intellectual disability provider agencies to become licensed. The Department expects to issue the draft rule for public comment in 2025, with the goal of having the new licensing approach in place prior to the Lifespan launch. Licensing all agencies, regardless of size or types of services offered, will ensure consistent oversight of providers. Currently, only residential providers with homes of three or more beds are required to have licenses.
OADS is also working with its actuarial contractor to complete a rate study that will be used to establish rates for Lifespan and update rates for existing IDD and related waiver programs (MaineCare Policy Manual Sections 18, 20, 21 and 29). The Department will hold a public forum to share results of the rate study and solicit feedback early in 2025.
OADS also implemented its new case management information system, Evergreen, in 2024. Monthly releases continue to add features and continuously improve the system's functionality. Further updates to Evergreen are planned to address Lifespan needs, including integration with the standardized assessment (Supports Intensity Scale, or SIS-A) that will enable tiered rates, including enhanced rates for individuals with behavioral health and medical needs.
Commitment to Excellence
Adjusting the Lifespan Waiver timeline reflects the Department's unwavering commitment to a thoughtful and effective rollout with ample opportunities for feedback from interested parties. It responds to feedback received from many individuals, families and providers who are hopeful that Lifespan will address shortcomings in the current system, but are concerned that a roll out of this magnitude not be rushed. Together, we are paving the way for a brighter future for the individuals we serve, and the Department looks forward to continuing this important work with all interested parties.