Waiver Letter #15

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					                                                                   Department of Health and Human Services
                                                       Adults with Cognitive and Physical Disabilities Services
                                                              32 Blossom Lane, Marquardt Building, 2nd Floor
                                                                                      # 11 State House Station
                                                                                   Augusta, Maine 04333-0011
                                                                                            Tel: (207) 287-4242
                                                                      Fax: (207) 287-9915; TTY: 1-800-606-0215

Waiver Letter #15

September 24, 2010

Topic: Shared living

Message to Shared Living Program Stakeholders

This is in follow-up to Waiver letter #12 and as such, also relates to the legislative directive to re-
design the shared living program that operates under the MaineCare Section 21 waiver for adults with
intellectual disabilities. A stakeholder group and subgroups have been meeting regularly and have
completed certain segments of the work. Below we will give a status report on a “Shared Living
Handbook,” a standardized provider application, a rate revision and we will also summarize the next
steps in the process.

Shared Living Handbook

The Shared Living Handbook is attached and will be posted on OACPDS website. (We will notify you
of the link next week). The handbook was designed to provide information regarding the Shared
Living Program. In addition the handbook outlines the responsibilities of the Provider, Oversight
Agency, and Case Manager.

Standardized Provider Application

A standard application for providers has been developed. This is not an employment application. The
group determined that having a standard process for initial determination of an individual’s ability to
be a Shared Living provider was important. This application can be used by a potential provider with
any approved Shared Living agency.

Rate Revision

In addition to the re-design initiatives above, the Department was directed to reduce rates according
to the following budget language:

“The department is authorized to adopt rules effective October 1, 2010 to establish a reimbursement
structure that produces an additional $500,000 in General Fund savings in fiscal year 2010-11.”

The figure identified in the legislation is the state share of the MaineCare funds only. Factoring in the
federal funds at the total the reduction to shared living services is just under $2 million.

                                       Caring..Responsive..Well-Managed..We are DHHS.
The stakeholder subgroup and representatives of the Maine Association of Community Services
Providers have analyzed responsibilities associated with shared living and the budget requirements
and rates that will be enacted by emergency rule on October 1, 2010 are as follows:

September 24, 1010
Page 2

Shared Living       1 person   $126.19
(with increased
support)                       $183.52

Shared Living       2 people    $63.10
(with increased
support)                       $120.42

These materials and letter will be posted on our web site early next week. In addition a quality
assurance tool (home visit tool) will be completed in the near future for use by the case manager and
oversight agency. A question and answer format will also be posted next week on the web site for
further clarification on a number of issues related to shared living.

Next Steps:
  1. Amend the federal waiver application to separate shared living out of home supports and have
      it as a distinctive service.
  2. Continue to explore a better approach to identifying and paying for respite services.
  3. Review the present system for increase support to determine if a better approach is available.
  4. Continue to explore the issue of employer/employee relationship in this model.

Thank you.

Jane J. Gallivan
Jane J. Gallivan

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