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: $11,677,222 FY03

Funding Source: General Revenue, Clients contribute

Number of People Served: 2,359 FY03

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 control: 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 income. Quality control: case reviews, provider audits, client satisfaction surveys. Consumer direction Can be consumer directed.

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: $2,825,710 FY03

Funding Source: General Revenue, Clients contribute

Number of People Served: 163 FY03

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: $1,928,270 FY03

Funding Source: General revenue, clients contribute

Number of People Served: 2,194 FY03

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

Further Information: Cost control 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: $371,193 FY03

Funding Source: General revenue, clients contribute

Number of People Served: 131 FY03

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

Further Information: Cost control 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: $734,443 FY03

Funding Source: N/A

Number of People Served: 1,169 FY03

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

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

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