The Section 20 Waiver Program is for individuals with Cerebral Palsy, Epilepsy, and Other Related Conditions, and the program allows participants to choose home and community based services rather than services provided in an institutional setting.
About Section 20 Services
The goal of the Section 20 Waiver Program is to provide a comprehensive array of services to adults with Cerebral Palsy, Epilepsy, and Other Related Conditions. The benefits of this program include:
- Community integration through existing natural supports and community relationships.
- An array of service options that include: Care Coordination, Home Support, Community Support, and Work Support. It does not duplicate other MaineCare services.
- Innovative technological and clinical services to maximize independence in the most integrated community setting. This is accomplished through Assistive Technology Device Services, Home Accessibility Adaptations, and Maintenance Therapies for Occupational Therapy, Physical Therapy, and Speech Therapy.
- Other services are available and may be identified in the care planning process.
Who is Eligible?
MaineCare (Maine’s Medicaid Program) has services available for qualifying individuals age 21 or older with “other related conditions” (ORC). Other Related Conditions include:
- Cerebral Palsy or Epilepsy; or
- Any other condition, other than mental illness, found to be closely related to Intellectual Disabilities because this condition results in impairment of general intellectual functioning or adaptive behavior similar to that of persons with Intellectual Disabilities and requires treatment or services similar to these required for these persons. These conditions include but are not limited to Neurofibromitosis, Other Choreas, Anoxic Brain Damage, Cerebral Laceration and Contusion, Subarachnoid- Subdural and Extradural Hemorrhage following injury, Other and Unspecified Intracranial Hemorrhage following injury or Intracranial injury and unspecified nature.
The State of Maine requires an assessment to determine an individual’s functional and financial eligibility for services under the Other Related Conditions Waiver.
Assessments help individuals and families understand what services are available to them and to plan for service needs.
How to Apply
Step 1. Apply for Other Related Conditions Waiver services by completing and returning the required documentation:
- ORC Waiver Application (Word)
- Authorization Release (PDF)
- ORC Letter of Medical Necessity (Word)
- ORC Community Choice Letter (Word)
Step 2. An Office of Aging and Disability Services staff member will set up a face-to-face visit with you to gather information and complete the Health and Safety Assessment. You may request that a family member or other person be present at the assessment.
Step 3. If you have not already had a functional assessment by Maine's Assessing Services Agency, please contact 1-833-525-5784 (phone) or 1-844-356-7500 (fax). You will be asked questions regarding the level of support needed and the financial circumstances of the person being assessed. The Assessing Services Agency then decides if a face-to-face assessment will be needed. There is no charge, and the assessment is private. If the Assessing Services Agency determines that a face-to-face assessment is needed, you will be contacted by an assessor to schedule the assessment.
A face-to face assessment may be performed by a Registered Nurse in your home, in the hospital, or in a nursing facility. The nurse uses a laptop computer to collect the information to complete the assessment. The nurse will ask about the tasks you can do by yourself, what medications you take, what support you need, whether you have friends and family members or neighbors who can help you, what your income is, and other questions. You may request that a family member or other person be present during the assessment.