Maine advances HCBS Lifespan Waiver

Maine DHHS, through OADS, OCFS, and MaineCare, is developing a single Home and Community Based Services (HCBS) Lifespan Waiver for individuals with intellectual and developmental disabilities (IDD). The waiver is designed to replace fragmented programs and support coordinated services from age 14 through adulthood under one person-centered plan. It also sets a clear direction for service delivery, emphasizing employment, community inclusion, and stable residential supports.

What the Lifespan Waiver is designed to do

The Lifespan Waiver is intended to reduce complexity for individuals who currently may need to navigate multiple programs as their needs change. A core expectation is that the waiver will reduce the need for people to move between Section 21 and Section 29 over time. The state has outlined several primary goals for the Lifespan Waiver:

• Reduce waitlists over time 

• Expand competitive integrated employment

• Strengthen community inclusion

• Improve continuity of care across the lifespan

Timeline and current rollout status

Maine is targeting a July 2026 enrollment start date. That timeline depends on CMS approval and completion of state rulemaking. Readiness work is already underway. Maine DHHS has a Provider Readiness Project in progress with support from the National Disability Institute. Provider technical assistance and readiness activities are continuing through 2025. In parallel with readiness planning, Maine DHHS has updated rate models across Sections 18, 20, 21, and 29, as well as for the upcoming Lifespan Waiver.

What providers can expect and plan for

The Lifespan Waiver is structured to begin planning earlier, including a stronger transition-to-work focus starting at age 14. Services are expected to be more integrated across residential, employment, and community-based supports, with continuity across the lifespan built into the approach.

For providers, the shift will require attention to outcomes and documentation. Agencies will need to align services and documentation to outcomes tied to employment, inclusion, and long-term stability. Maine DHHS is encouraging agencies to participate in readiness activities, assess staffing and service models, and prepare technology systems for unified care plans, documentation, EVV, and outcomes reporting. With the state moving toward a single waiver model, early preparation is positioned to help agencies remain compliant, reduce administrative burden, and better support individuals as Maine transitions to the Lifespan Waiver.