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This message provides notice of rulemaking by the Office of Aging and Disability Services.

Rules and related rulemaking documents may be reviewed at, or printed from, the OADS?website?at [link removed] [ [link removed] ]?or for a fee, interested parties may request a paper copy of rules by calling (207) 287-7055 or Maine Relay number 711.

During the comment period, please submit written comments to the agency contact person identified below for this filing. Email submissions are encouraged. Interested parties may request a paper copy of this proposed rule by calling (207) 287-7055 or Maine Relay number 711.

Additional information regarding the rulemaking process and weekly rulemaking updates can be found on the Secretary of State website. [ [link removed] ]

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*Notice of Agency Rulemaking *

AGENCY: Department of Health and Human Services, Office of Aging and Disability Services

CHAPTER NUMBER AND RULE TITLES:


* 10-149 C.M.R. Chapter 5, Introduction, Table of Contents, Rule History (AMEND)
* 10-149 C.M.R. Chapter 5, Section 63, In-Home and Community Support Services for Elderly and Other Adults (REPEAL)
* 14-197 C.M.R. Chapter 11, Consumer Directed Personal Assistance Services (REPEAL)
* 10-149 C.M.R. Chapter 5, Section 63, Home Based Supports and Services for Older and Disabled Adults (NEW RULE TO REPLACE REPEALED RULES)

TYPE OF RULE:??


* 10-149 C.M.R. Chapter 5, Introduction, Table of Contents, Rule History (ROUTINE TECHNICAL)
* 10-149 C.M.R. Chapter 5, Section 63 (In Home and Community Support Services for Elderly and Other Adults) (?HYBRID? ROUTINE TECHNICAL & MAJOR SUBSTANTIVE RULE.) This rule is Routine Technical except for ? 63.11 (Consumer Payments) which is a Major Substantive Rule provision pursuant to 34-B M.R.S. ? 5439(9)).
* 14-197 C.M.R. Chapter 11 (Consumer Directed Personal Assistance Services) (?HYBRID? ROUTINE TECHNICAL & MAJOR SUBSTANTIVE RULE.) This rule is Routine Technical except for ? 11.09 (Consumer Payments), which is a Major Substantive Rule provision pursuant to 34-B M.R.S. ? 5439(9)).
* 10-149 C.M.R. Chapter 5, Section 63 (Home Based Supports and Services for Older and Disabled Adults) (?HYBRID? ROUTINE TECHNICAL & MAJOR SUBSTANTIVE RULE.) This proposed new rule will be all Routine Technical except for ? 63.12 (Consumer Payments), which is Major Substantive rule provision pursuant to 34-B M.R.S. ? 5439(9).

BRIEF SUMMARY:

This proposed rulemaking proposes to:

(1)? AMEND 10-149 C.M.R. Ch. 5, Introduction, Table of Contents, Rule History.?

(2) REPEAL 10-149 C.M.R. Ch. 5, Section 63 (?Section 63?), In-Home and Community Support Services for Elderly and Other Adults.?

(3 REPEAL 14-197 C.M.R. Ch. 11 (?Chapter 11?), Consumer-Directed Personal Assistance Services.?

(4) REPLACE the Section 63 rule and the Chapter 11 rule with a new Section 63 rule, Home Based Supports and Services for Older and Disabled Adults.

*The Department is proposing an effective date of July 1, 2023, for the amendment of * *the Chapter 5 Introduction rule, for the repeal of the current Chapter 11 and Section * *63 rules, and for the replacement of those repealed rules with the new Section 63 * *rule. The current Chapter 11 rule and Section 63 rule will remain in effect through * *June 30, 2023.*?

_10 149 C.M.R. Chapter 5, Introduction, Table of Contents, Rule History_:? The Department is updating the Introduction, deleting the Section 63 Table of Contents from the Chapter 5 Table of Contents, and updating the Rule History.?

_Section 63 and Chapter 11 rulemakings: _

Resolves 2011, ch. 71 directed the Department to adopt a long-term services and supports plan, known as the ?Lean Implementation Plan,? and make its action items a work priority. One of the action items listed in the plan required the Department to prioritize the consolidation of two state-funded in-home care and community support services programs for elderly and other adults, currently codified as Section 63 and Chapter 11.

Stakeholder Engagement: In May 2019, the Department hosted a ?Convening on Aging and Long-Term Services and Supports? with stakeholders to establish priorities for aging and long-term services and supports (LTSS) reform. This rulemaking implements one of the priorities recommended by stakeholders which was to update LTSS policies to bring programmatic inconsistencies into alignment where appropriate.

In July 2022, the Department held a ?listening session? with various stakeholders to receive comments and suggestions on the merging of the two rules. Stakeholders included providers, consumers, the service coordination agencies, prospective sub-contractors, and the Long-Term Care Ombudsman Program. Stakeholders expressed support for the Department?s plan to merge the rules but recommended that the Department ?grandfather? Chapter 11 consumers so that these consumers would not be subject to the household asset limits in Section 63. Furthermore, stakeholders shared concerns that merging the rules could negatively impact consumers and urged the Department to maintain the same services wherever possible.

The differences between the proposed Section 63 rule and the current Section 63 and Chapter 11 rules include the following:


* Updates the title of the rule to ?Home Based Supports and Services (HBSS) for Older and Disabled Adults? to reflect current terminology;
* Updates the definition of ?Liquid Asset? in Section 63.02-25 to include revocable and irrevocable trusts;
* Updates the eligibility section of the rule, Section 63.03-1(B), to require an eligible consumer to be ?a resident of Maine?;
* Clarifies in rule that only the Department may terminate HBSS in Section 63.04-2;
* Adds Section 63.04-4 which lists the reasons that an Assessing Service Agency, Service Coordination Agency or the Department can deny or terminate the consumer from receiving Consumer-Directed Services;
* Removes diagnostic services under Section 63.05;
* Clarifies the list of non-covered services in Section 63.06;
* Creates a new subsection titled ?Limits? (Section 63.07) to outline the total monthly costs of services for consumers receiving each level of care;
* Creates a new subsection, Section 63.10, titled ?Responsibilities of the Assessing Services Agency and the Service Coordination Agency? to organize all Assessing Services Agency and Service Coordination Agency responsibilities in one subsection of the rule;
* Streamlines Section 63.10-4 to specify that program reports must align with the provisions in the contract between the Department and the Service Coordination Agencies;
* ? 63.03-1(C) continues the current Section 63 requirements for liquid assets, except that Chapter 11 Consumers who are receiving Chapter 11 services on June 30, 2023, are exempt from this liquid asset requirement.
* ? 63.12-2 (Consumer Payment Formula for Former Chapter 11 Consumers), proposes a separate consumer payment formula for those Chapter 11 Consumers who were receiving Chapter 11 services on June 30, 2023.
* ? 63.12-3(A)(1)(a) (Waiver of Consumer Payment) proposes a separate household asset amount for determining eligibility for waiver of consumer payment for those Chapter 11 Consumers who were receiving Chapter 11 services on June 30, 2023.
* Removes unnecessary and unused definitions and references to the Office of Elder Services.

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Date, time and location of PUBLIC HEARING (if any): October 13, 2022, at 1 pm. Due to the ongoing threat posed by COVID-19, DHHS has determined that its public hearings will be conducted solely remotely, via ZOOM.? This is in accordance with the DHHS Remote Rulemakings Hearings Policy issued September 10, 2021. To register, please use this link: [link removed] [ [link removed] ]

After registering, you will receive a confirmation email containing information about joining the hearing. Interpreter services will be provided during the hearing upon request.

COMMENT DEADLINE: Comments must be received by 11:59 pm on October 24, 2022

CONTACT PERSON FOR THIS FILING (include name, mailing address, telephone, fax, TTY, email):

Hilary Gove, Policy Writer Maine Department of Health and Human Services Office of Aging and Disability Services 41 Anthony Avenue????????????????????????????????????????????????????????? ???? 11 State House Station Augusta, Maine 04333-0011 EMAIL: [email protected] PHONE: (207) 446-8305 FAX: (207) 287-9915 TTY: 711 (Deaf or Hard of Hearing)

CONTACT PERSON FOR SMALL BUSINESS IMPACT STATEMENT (if different): N/A

FINANCIAL IMPACT ON MUNICIPALITIES OR COUNTIES (if any):?The Department does not anticipate a financial impact on municipalities or counties.

STATUTORY AUTHORITY FOR THIS RULE: 22 M.R.S. ? 7303(2); 34-B M.R.S. ? 5439(9); Resolves 2011, ch. 71

SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different): N/A

AGENCY WEBSITE: [link removed] [ [link removed] ]

EMAIL FOR OVERALL AGENCY RULEMAKING LIAISON: [email protected]

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