The MaineCare Benefits Manual Section 20 Waiver Program -- Home and Community Based Services for Adults with Other Related Conditions -- offers home and community-based services to individuals with Cerebral Palsy, Epilepsy, and Other Related Conditions. It allows participants to choose home and community based services rather than services provided in an institutional setting.
ORC Forms/Protocols
Forms
- ORC Application (Word)
- ORC Letter of Medical Necessity (Word)
- ORC Community Choice Letter (Word)
- ORC Annual Provider and Services Choice Letter (Word)
- ORC Care Plan Form
- Section 20 Authorization Request Form (Word)
- Authorization-Release (PDF)
- ORC Safety Risk Assessment (Word)
- Members Seeking BI/ORC Services Form
- ORC Budget Worksheet (Excel)
- ORC Consumer Satisfaction Survey (Word)
- EIS New User Form (Word)
- HCBS Requirements Modification Addendum (Word) and Decision Tree (PPT) for Section 20
- Service Implementation Plan (Word)
Policies:
MaineCare Benefits Manual