Written by Lauren Wille, Legal Director of Disability Rights Maine
Next year, DHHS will launch a new home- and community-based services waiver called the Lifespan Waiver for people with intellectual and developmental disabilities (IDD). Lifespan is a foundational reform that has extraordinary potential to support people with IDD to thrive in their homes and communities.
HCBS waivers are services designed to serve people with disabilities, including IDD, in their homes and communities instead of in institutions. (They are called “waivers” because certain Medicaid funding rules regarding institutional care are not enforced, or waived, so that people can be supported outside of institutions.)
Although Lifespan will continue to provide many of the supports that are currently offered under existing waivers, it will expand the types of services it offers. The most exciting part of Lifespan is the premise on which is it based—that people with IDD have value, that they are not simply people to be cared for, but that they are people who have something to contribute to our society. The expanded scope of services offered under Lifespan recognizes this underlying truth.
Residential supports will continue to provide options like group homes and shared living (where a person lives with their provider). However, there will be a wider scope of services to support people who want to live more independently, including both in-person and remote support in the person’s own home, independent living skills training, and even housing start-up assistance, which can help people with things like security deposits and even with furniture. Community supports will still include the center-based supports offered now but will also emphasize more individualized supports in the community, as well as supports designed to help people build relationships and connect with their communities. Lifespan will also offer an incredible array of employment supports. Too often, people with IDD are steered away from employment. Lifespan can help ensure that people have the opportunity to explore employment by offering benefits and work incentives counseling, services to build skills to pursue competitive integrated employment, support in gaining and maintaining employment, and even self-employment assistance for entrepreneurs.
Lifespan is also designed to evolve as people grow older. Unlike the current system, which serves only people age 18 or older, Lifespan begins at age 14, and the available services will depend in part on the age of the recipient. People will no longer face an abrupt service cliff as they age out of children’s services and into adult services; instead, the transition is designed to be gradual, and people remain on the same waiver.
Issues will no doubt arise as the Lifespan Waiver is implemented over the next year and beyond. DRM shares the concerns others have raised about the shortage of service providers in Maine, and we have questions about how some of the specifics of the waiver will operate. These are not problems specific to the Lifespan Waiver, and they require long-term solutions.
The Lifespan Waiver recognizes the inherent value people with IDD have, and its goals are laudable in presenting services that aim to help people live their lives with self-determination and dignity. People with IDD have waited long enough for this kind of opportunity. The time for change is now.