Maine opens comment on IDD Lifespan Waiver

Maine has opened a public comment period on a proposed 1915(c) home- and community-based services (HCBS) waiver designed for individuals with intellectual disability, autism spectrum disorder, or other related conditions. Maine DHHS, through the Office of MaineCare Services, posted a notice stating it plans to submit a new waiver application to CMS titled “Home and Community Based Services Across the Lifespan for Individuals with Intellectual Disabilities or Autism Spectrum Disorder” (ME.026). The proposed waiver is structured as an “across the lifespan” model and would establish eligibility beginning at age 14+.

Public comment window and waiver framing

The notice describes a service approach that would tailor delivery based on a participant’s life stage, living situation, and assessed needs. The public comment window is open until 11:59 pm on May 13, 2026. Maine’s proposed design is intended to support participants across different stages of life rather than aligning services to a single age band or setting.

Service settings and provider considerations

Under the proposal, services would be delivered primarily in private homes and integrated community settings, including employment settings. Some services would also be available in specific provider-owned or provider-operated residential settings. The notice also signals two structural choices that may shape how providers engage with the waiver. Maine states the Lifespan Waiver will operate alongside two 1915(b)(4) waivers: one for non-emergency transportation and one for selective contracting tied to Community Resource Coordination (CRC). CRC is identified in the notice as the waiver’s case management service and would be available through a limited network.

Technology supports, payment design, and new services

Maine’s notice says the waiver “incorporates innovation and technology solutions to address challenges in the direct service workforce.” It also proposes alternative payment methods “to promote quality, efficiency and economy of scale.” In the service design, Maine describes four participant groupings. Each grouping would have an annual budget cap and a defined service set. The notice lists examples of newly developed services, including Community Resource Coordination, Community Transition Case Management, Family Empowerment and Systems Navigation, Private Duty Nursing, Employment Exploration, and “Remote Monitoring and On-Call Response.”