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Home & Community-Based Services: State-Only Funded Programs in Maine

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Home Based Care³,⁴,²²

Administrative Agency: Dept of Human Services (Bureau of Elder & Adult Services)

Population Served: Elderly (60+) physically disabled adults (18+)

Annual Expenditure: $12,440,000 FY01

Funding Source: General Revenue, Clients contribute

Number of People Served: 3,873 FY02

Eligibility Criteria: 1 ADL + 2 other ADLs/IADLs or nursing. Individuals who do not meet the financial &/or functional eligibility requirements of Medicaid. No income or asset limit.

Further Information: Cost caps - level I $1000/mth, level II $1250/mth, level III $1,800/mth, level IV $3,436/mth (levels based on functional need). Service limits: $3800/year respite cap. Co-pay - 3% of assets monthly, $15,000 asset disregard, 4% of monthly inc

Program Name: Home based Care: Consumer-directed²²

Administrative Agency: Dept of Human Services (Bureau of Elder & Adult Services)

Population Served: Elderly (60+) physically disabled adults (18+)

Annual Expenditure: $3,118,000 FY01

Funding Source: General Revenue, Clients contribute

Number of People Served: 203 FY01

Eligibility Criteria: 1 ADL + 2 other ADLs/IADL & ability to self-direct. No income limit, $30,000 asset disregard. Individuals who do not meet the financial &/or functional eligibility requirements of Medicaid

Further Information:

Program Name: Homemaker Services⁴,²²

Administrative Agency: Dept of Human Services (Bureau of Elder & Adult Services)

Population Served: 60+

Annual Expenditure: $2,000,000 FY02 Appropriation

Funding Source: General revenue, clients contribute

Number of People Served: 1,764 FY02

Eligibility Criteria: Need help with housekeeping, laundry groceries. No income limit, assets less than $50,000 (individual).

Further Information: Co-pay 20% service cost

Program Name: Adult Day Services⁴,²²

Administrative Agency: Dept of Human Services (Bureau of Elder & Adult Services)

Population Served: 60+

Annual Expenditure: $400,000 FY02 Appropriation

Funding Source: General revenue, clients contribute

Number of People Served: 155 FY02

Eligibility Criteria: 1 ADL or cueing with 4 ADLs. No income limit, assets less than $50,000 (individual).

Further Information: Co-pay 20% service cost

Program Name: Alzheimer's Respite⁴,²²

Administrative Agency: Dept of Human Services (Bureau of Elder & Adult Services)

Population Served: Adults (60+) with dementia

Annual Expenditure: $876,000 FY02 Appropriation

Funding Source: N/A

Number of People Served: 472 FY02

Eligibility Criteria: Dementia diagnosis. No income limit, assets less than $50,000 (individual).

Further Information: Co-pay 20% service cost. Supplements federally funded (AoA) Alzheimer's Project.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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