An Act to P1omore Seamless and Flexible Home and Community Supports Across the Lifespan for Individuals with Intellectual and Developmental Disabiht1es or Autism
Maine Legislature, Session 131, LD 0659
Committee Amendment CA_A_H558 (House)
Amends: 34-B MRSA §5003-B

COMMITTEE AMENDMENT "k• to HP 428, L D 659, "An Act to P1omore 
Seamless and Flexible Home and Community Supports Across the Lifespan for Individuals 
with Intellectual and Developmental Disabiht1es or Autism " 
Amend the bill by insertmg before section 1 the followmg 
'Sec. 1. 34-B MRSA §5003-B is enacted to read 
§5003-B. Services across the lifespan 
The department shall facilitate the development of a home and commumty-based 
waiver fl.om the Umted States Department of Health and Human Services, Centers for 
Medicare and Medicaid Services that provides se1 vices fo1 persons with mtellectual and 
developmental disabilities, autism or other related conditions across the lifespan, mcludmg 
smooth tiansitions f1om childhood to adulthood Upon federal appioval. the department 
shall adopt rules to implement this section Rules adopted pursuant to this section are ma101 
substantive rules as defined m Title 5, chapter 375, subchapter 2-A, except that any 
subsequent amendments to those rules are routme techmcal rules as defined m Title 5, 
chapter 3 7 5, subchapter 2-A ' 
Amend the btll by stnkmg out all of section 1 and mseitmg the followmg 
'Sec. 1. Home and community-based lifespan program. The Department of 
Health and Human Services shall estabhsh a MameCare home and commumty-based 
hfespan program for mdividuals with mtellectual and developmental disabiht1es, autism 01 
other related conditions pursuant to the Mame Revised Statutes, Title 34-B, section 5003-B, 
refened tom this Act as "the lifespan prog1am "On 01 after Apul 1, 2025, the depa1tment 
may begm enrollment m the lifespan pro gt am The depatiment may seek waivers or other 
approvals ft om the federal Department of Health and Human Services, Centers for 
Medicare and Med1ca1d Services to implement the lifespan prog1am 
The goals of the 
hfespan program are to 
1. Flexibility across the lifespan. Provide home and commumty-based supports that 
can change over the member's hfespan as a member as described m this section and the 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" A· to HP 428, L D 659 
persons who provide support to that member get older, without needing to move from one 
waive1 program to another, 
2. Seamless transitions. Expand upon the department's current childhood-to-
adulthood transition initiatives by mcludmg children begmnmg at 14 years of age and 
enable smooth transitions at later hfe stages, 
3. Early planning for independence. Emphasize in-home supports, mdependent 
hvmg skills and employment services for youth to prepare them for as much mdependence 
as possible in adulthood, 
4. Innovation. Include service innovat10ns currently under development, such as tiered 
shared hving, standardized assessment of need, enhanced medical and behav10ral health 
supports, self-direction, innovative employment supports, mdependent hving options and 
remote support technology, mcludmg models of support that can be successfully 
implemented with a smaller workforce, and 
5. Simplified and effective payment methods. Include alternative payment methods 
to promote quality and efficiency and 1 educe the admmistl ative burden for service 
providers and the department ' 
Amend the bill by msertmg after section 4 the followmg 
'Sec. 5. Appropriations and allocations. The followmg appropnat10ns and 
allocations ate made 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Lifespan Waiver Z370 
Inrt1ative P1ov1des fundmg fo1 a new MaineCrue lifespan waive1, which will offe1 the 
services currently offered under the department's rule Chaptei 101 MameCa1e Benefits 
Manual, Chapters II and ill, Sections 21 and 29 and also incorporate mnovattons such as 
self-dnected services, employment opt10ns and ttansitton services, begmnmg April 1, 
2025 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2023-24 
$0 
$0 
2024-25 
$770,908 
$770,908 
Amend the bill by ielette11ng 011enumbe11ng any nonconsecutive Pati lettei 01 sect10n 
number to read consecutively 
SUMMARY 
This amendment reqmres the Department of Health and Human Services to make maJor 
substantive rules to unplement the lifespan waiver that 1s reqmred 111 the bill Subsequent 
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am-endments to those rules are routine technical rules The amendment also changes the 
date that the department begms enrollment mto the new waiver ftom on or before January 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT A" to HP 428, L D 659 
1, 2025 to April 1, 2025 to reflect the add1t1onal tune that maJor substantive rulemakmg 
requires The amendment also adds an appropriations and allocat1ons section 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved 06/11/23 hae 
LD659 
LR 151(02) 
An Act to Prom~te Seamless and Flexible Home and Community Supports Across the Lifespan for 
Individuals with Intellectual and Developmental Disabilities or Autism 
I Fiscal Note for Bill as Amended by Committee Amendment '~" / H---5 58) 
Net Cost (Savmgs) 
General Fund 
Appropriations/ Allocat1ons 
General Fund 
Fiscal Detail and Notes 
Committee: Health and Human Services 
f1 ( Y 
Fiscal Note Required: Yes 
Fiscal Note 
FY2023-24 
FY2024-25 
$0 
$770,908 
$0 
$770,908 
ProJections 
FY2025-26 
$3,083,630 
$3,083,630 
Projections 
FY2026-27 
$3,083.630 
$3,083,630 
The bill mcludes an annual General Fund appropriation to the Department of Health and Human Services of$770,908 
beginnmg m fiscal y~ar 2024-25 for a new MameCare lifespan waiver, which will offer the services currently offered 
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under the department's rule Chapter 101 MameCare Benefits Manual, Chapters II and ill, Sections 21 and 29 and also 
mcorporate mnovati~ms such as self-d1rected services, employment opt10ns and transition services, beginnmg April 1, 
2025 
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There is fundmg m ~e currently proposed biennial budget for this new waiver program If that mitlative is part of the 
fmal budget passed ~y the legislature, this appropnation can be removed and the language can move forward 
LR0151(02)- Fiscal Note - Page 1 ofl