Intellectual disabilities and autism spectrum disorder are developmental disorders that affect a person’s cognitive, social, and adaptive functioning. According to the Centers for Disease Control and Prevention, about one in six children in the United States have a developmental disability, and about one in 54 have autism.
For many people with intellectual disabilities or autism, living at home and in the community is preferable to institutional care. However, they may need various services and supports to maintain their health, safety, and quality of life. In addition, their family members or friends may provide unpaid care for them, which can be challenging and stressful.
A Medicaid waiver program in Maine can help people with intellectual disabilities or autism and their caregivers access support services (SS). This program is called the Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver, or Section 29 Waiver for short.
Ahead, we cover the Section 29 Waiver, who is eligible for it, what services and supports it offers, and how it compensates caregivers.
The Section 29 Waiver is a Medicaid program that provides SS for adults with intellectual disabilities or autism who meet the intermediate care facility for individuals with intellectual disabilities (ICF/IID) level of care. The waiver aims to prevent or delay institutionalization and promote community integration for people with intellectual disabilities or autism.
The waiver serves up to 3,000 participants at any given time. The target population includes adults aged 18 or older who have intellectual disabilities or autism, as defined by the Maine Department of Health and Human Services (DHHS).
The waiver operates under the authority of Section 1915c of the Social Security Act, which allows states to waive certain Medicaid rules and offer SS to specific groups of people who would otherwise need institutional care. The waiver is administered by the Maine DHHS Office of Aging and Disability Services (OADS).
To be eligible for the Section 29 Waiver, a person must meet the following criteria:
The income limit for the waiver is 300% of the Supplemental Security Income (SSI) federal benefit rate, which is $914 per month for an individual and $1,371 per month for a couple in 2023. The asset limit is $10,000 for an individual and $15,000 for a couple. There are some exceptions and deductions that may apply to these limits.
The Section 29 Waiver offers services and supports designed to help people with intellectual disabilities or autism live independently and participate in their communities. These services include:
The amount and frequency of services are determined by the person’s needs and preferences and the availability of funds. The services are provided by qualified providers contracted or enrolled with DHHS. The person can choose their providers from a list of available options.
The Section 29 Waiver is similar to the Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Waiver (Section 21 Waiver) in many ways. Both waivers serve adults with intellectual disabilities or autism who meet the ICF/IID level of care and offer a variety of home and community-based services. Both waivers also allow self-direction and compensation for caregivers.
However, some differences between the two waivers may affect a person’s choice of which waiver to apply for. Some of these differences are :
These differences may affect which waiver suits a person’s needs and preferences. A person can apply for both waivers simultaneously but only enroll in one waiver at a time. A person’s case manager can help them compare the two waivers and make an informed decision.
One of the benefits of the Section 29 Waiver is that it allows people with intellectual disabilities or autism to self-direct some of their services, which means they can have more control and flexibility over how, when, where, and by whom their services are delivered. Self-direction also enables people to hire and pay their family members or friends as caregivers for certain services, such as community support, homemaker, respite, shared living, or supportive home care.
To self-direct their services, people need to work with a support broker, who is a person who helps them plan, manage, and monitor their services. The support broker also assists them with hiring, training, supervising, and paying their caregivers. The caregivers are paid through a financial management service (FMS), which is an entity that handles the payroll and tax responsibilities for the self-directed services.
The amount of compensation for caregivers depends on several factors, such as the type and duration of service, the qualifications and experience of the caregiver, and the rates set by DHHS. According to the MaineCare Benefits Manual Chapter II Section 29 Appendix C-1, the hourly rates for self-directed services range from $12.50 to $20.00 as of July 1, 2020. The annual limits for self-directed services range from $2,500 to $75,000 per person.
If you or someone you know has an intellectual disability or autism and needs support services, you may be eligible for this program. To learn more, contact the OADS Intellectual Disability/Autism Services Coordinator at (207) 287-9200 or visit the OADS website.
If you are a family member or friend who provides unpaid care for someone with an intellectual disability or autism, you may also be eligible for compensation through this program. To find out if you qualify, please fill out this form, and we will get back to you as soon as possible.
