ME Elderly and Adults with Disabilities Waiver Explained

If you are a family caregiver in Maine, you may wonder if there is a way to get paid for the care you provide to your loved one. The answer is yes, depending on your situation and eligibility. In this article, we explore one of the Medicaid waivers in Maine that offers compensation for family caregivers: the ME Elderly and Adults with Disabilities Waiver (also called the Home and Community Benefits Waiver for the Elderly and Adults with Disabilities).

Overview of ME Elderly and Adults with Disabilities Waiver

The ME Elderly and Adults with Disabilities Waiver is a Medicaid program that provides services to people ages 65 and older and those with physical disabilities ages 18 or older who require a nursing facility or hospital level of care. This waiver aims to help eligible individuals remain in their homes or other community settings instead of being institutionalized. The waiver also allows participants to choose their providers, including family members, through a self-direction option.

Eligibility requirements

To qualify for the ME Elderly and Adults with Disabilities Waiver, you must meet the following criteria:

• You must be a resident of Maine and a US citizen or legal alien.
• You must be enrolled in Medicaid or eligible for Medicaid under one of the following categories: Supplemental Security Income (SSI), SSI-related, or Medically Needy.
• You must have income below 300% of the Federal Benefit Rate (FBR), which is $2,382 monthly in 2021.
• You must have assets below $10,000 for an individual or $15,000 for a couple.
• You must have a physical disability that limits your ability to perform daily living activities, such as bathing, dressing, eating, toileting, transferring, and mobility, or you must be 65 years or older.
• You must require a hospital or nursing facility level of care, as determined by a comprehensive assessment.

Services and supports

The ME Elderly and Adults with Disabilities Waiver offers various services and supports to help participants live independently and safely in their homes or communities. Some of the services include:

• Personal care: Assistance with ADLs such as bathing, dressing, grooming, eating, toileting, transferring, and mobility.
• Respite: Temporary relief for caregivers who need a break from their caregiving duties.
• Assistive technology: Devices or equipment that help participants communicate, perform tasks, or enhance their safety and independence.
• Environmental modifications: Changes or adaptations to the home or vehicle that improve accessibility, mobility, or safety for participants.
• Transportation: Non-emergency transportation to medical appointments, social activities, or other destinations.
• Adult day health: A structured program that provides socialization, supervision, health monitoring, and therapeutic activities for participants during the day.
• Home health services: Skilled nursing, physical therapy, occupational therapy, speech therapy, or medical social services provided in the home by licensed professionals.
• Emergency response system: A device that allows participants to call for help in an emergency.

Compensation for caregivers

One of the benefits of the ME Elderly and Adults with Disabilities waiver is that it allows participants to self-direct their services. This means they can choose who provides their services, how they are delivered, and when they are scheduled. Participants can also hire and pay their family members as caregivers instead of using agency services. This option gives participants more control over their care and provides family caregivers recognition and compensation for their work.

To self-direct your services under this waiver, you must:

• Complete a self-direction orientation and training.
• Develop a person-centered plan that outlines your goals, needs, preferences, and budget.
• Hire your workers, including family members (except spouses), friends, neighbors, or other qualified individuals.
• Manage your workers’ payroll, taxes, insurance, and benefits through a fiscal intermediary.
• Monitor the quality and satisfaction of your services.

The amount of compensation that family caregivers receive depends on several factors, such as:

• The type and amount of services provided
• The rate of pay negotiated between the participant and the worker
• The budget allocated by the waiver
• The state minimum wage and labor laws

A note from Givers

If you are interested in applying for this waiver or finding out if you are eligible, please fill out this form, and we will get back to you as soon as possible. We want to support you and your loved one on your caregiving journey.