An Overview of Maine’s Medicaid Waivers for the Elderly

Medicaid Waivers for the Pine Tree State

By Regina Woodard for Assisted Living Directory

Regina Woodard


The 23rd state entered into the Union, Maine is mostly known for its scenery, closeness to Canada, and one of the safest states in the US. It hasn’t always been this way though, as the state was considered contested during both the American Revolution and the War of 1812. In present times, Maine boasts a population of over a million people in 2014, with a baby boomer population of 29.4% in 2010.

Maine has the largest elderly population within the US, with a national average of 25% for the rest of the country, and that percentage is expected to continue to grow to 2030. This has actually caused a bit of an issue for the state, as slow economic growth has pointed to the growing aging population and the lack of a younger generation, who would be purchasing new homes or starting families.

This has also put a focus on the types of programs that can assist those who are looking or in need of assisted living or retirement communities and facilities. Here are some of the programs Maine offers its elderly residents.

Maine's Elderly Medicaid Waivers

Community Programs

In conjunction with the federal Older Americans Act, Maine’s community programs are made up of five different areas that are listed on the aging and legal services for the elderly and include such things as health insurance counseling, home delivered meals, outreach programs, senior employment and more.

Under the community programs, seniors can ask for help in variety of forms –

  • Medicare Assistance: many individuals and family members struggle to understand and navigate their way through Medicare; Maine offers this service to help those in finding Medicare Part D plans, supplemental plans, money saving tips, legal assistance, and more.
  • Nutritional Programs: along with home delivered meals, Maine also provides nutritious mid-day meals in over a 100 different locations. Some locations also offer educational programs that discuss health and nutrition for the elderly.
  • Family Caregiver: for those family members who are taking care of loved ones who have dementia or Alzheimer’s, this program provides education, training, support groups, and respite.
  • Senior Employment: for those seniors who would like to stay in the job market or who are entering into the job market. Sponsored by Goodwill Industries and the National ABLE Network, these programs help individuals face changes in their living situation, especially after a divorce, death, or disability of a loved one.

Long Term Care

Encompassing several programs, the Long Term Care program provides support services for the elderly and disabled adults to help avoid or delay entry into a nursing facility. There are a number of different programs within this plan –

  • Assisted Housing: there are two assisted housing programs, the Assisted Living service and the independent housing with services.
    • Assisted Living Services: there are currently seven state funded assisted living facilities in the state of Maine, which allow for independent living in an apartment and receiving such services as meals, homemaking, personal care, and medical administration.
    • Independent Housing with Services: Currently, there are five IHSP programs within the state, that provide many of the same services of the Assisted Living service without medication management.
  • Adult Day Care: designed to provide older adults and those with disabilities with community based services, adult day care helps to provide structured social, recreational, and therapeutic activities, limited health services, meals, supervision, personal care services, and more.
  • In Home Care: offered to provide supportive services to elderly and disabled adults, In Home Care can be funded either through MaineCare or state funds, helping to keep individuals independent in their homes and their community.

Elderly and Adults with Disabilities Waiver

Designed to help individuals remain in their homes or communities, this waiver is also known as the Home and Community Benefits for the Elderly and Older Adults. Those who choose this waiver have the option of either having the state manage their care services or they can self-direct their care under the Family Provider Service Option (FPSO).

Individuals who decide to self-direct enter into the FPSO program and are required to use a third party financial management company to assist them, helping to manage payroll and employer taxes as an ‘employer’. Services with this program include adult day health, care coordination, environmental modifications, home health, independent living assessments, personal care, personal emergency response systems, and more.

To be eligible, individuals may be between the ages of 18 and 64 years old if disabled, while those who are 65 and older must require nursing home level of care.

Homeward Bound

Homeward Bound is Maine’s money follows the person project, funded by the Centers for Medicaid and Medicare Services. Designed to help seniors and disabled adults move from institutional care back to their community, it also examines how to best help those who are transitioning from these institutions back to the community.

Individuals who consider this program are given a choice the available community options, including homes that are owned or leased by the individual or a family member, an individual lease with an apartment, or a community based residential setting. Services include transition assistance, HCB services, Medicaid state plan services, household start up, enhanced care coordination, and more.

To be eligible for Homeward Bound, individuals must have resided in a nursing facility or hospital for at least three months, received Medicaid benefits during that stay for at least a day, and need institutional or nursing facility level of care.

These are such some of the programs the state of Maine offers its elderly population and it will continue to enhance and develop more programs as their elderly population grows.

By

Photo by m01229 Attribution 2.0 Generic (CC BY 2.0)

Resources:

Maine’s aging population hinders growth

MaineCare Elderly and Adults with Disabilities Waiver

DHHS – Long Term Care

Homeward Bound

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