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This bill allows
a MaineCare member approved for consumer-directed attendant services under
the MaineCare program to hire any family member, including a spouse, or a
legal guardian to provide those services in the home or community.
Consumer-Directed Attendant Services, also known as personal care attendant
(PCA) services, or attendant services under Section 12 are a State Plan
Service. State Plan Services cannot be
provided by a member of the recipient’s family per 42 CFR § 440.167 Personal
Care Services and § 441.450 Basis, Scope, and Definitions, as both include
language prohibiting Medicaid reimbursement to legally liable relatives
including: a spouse, other legally responsible relative, or the legal
guardian of the member. Thus, this bill requires the Department of Health and
Human Services to submit a waiver request to the United States Department of
Health and Human Services, Centers for Medicare and Medicaid Services no
later than January 1, 2019 allowing payment to relatives and legal guardians.
The department is required to adopt rules within 180 days of receiving
approval for the waiver.
Some members receiving services from an unrelated paid person may shift to
a related paid person, which would not increase costs to the department.
However, any members already receiving services from an unpaid relative would
be allowed to have that relative paid, creating new costs to the program. Any
increase in costs is contingent on approval of the waiver. There is not
enough information available to provide an estimate of additional cost at
this time. |