Jul 17, 2026

Maine people with intellectual and developmental disabilities (IDD) and autism deserve a service system that provides support when it is needed, helps young people prepare for adulthood, and offers meaningful choices throughout a person’s life.

Over the last five years, the Maine Department of Health and Human Services—through the Office of Aging and Disability Services (OADS) and the Office of MaineCare Services (OMS) and in partnership and consultation with hundreds of individuals with IDD and autism, families, guardians, providers, advocates, and other community partners—has developed and is now proposing the Lifespan Waiver to help build that system. This extensive stakeholder lived experience and feedback have shaped Lifespan’s design and continue to guide the Department’s work as the proposal moves forward.

Lifespan is designed to begin supporting eligible youth at age 14, strengthen the transition from school to adult services, expand options for independence and self-direction, and allow services to adapt as a person’s needs and circumstances change.

Earlier Support and Greater Choice

Individuals with IDD and autism and their families have consistently emphasized the importance of earlier access to support, sought better coordination between youth and adult services, and more choice in how and where services are provided.

The Lifespan Waiver is designed to advance those priorities by:

• Allowing eligible youth to begin receiving support at age 14;
• Improving planning for the transition from school to adulthood;
• Expanding opportunities for employment, independence, and community participation;
• Providing more options for self-directed services; and
• Allowing services to adapt as a person’s needs and circumstances change.

Beginning support at age 14 would give young people and their families more time to develop skills, explore employment, strengthen community connections, and plan for adulthood before leaving school.

Lifespan services would complement, not replace, services that schools are responsible for providing through special education.

The proposed waiver would also expand service options related to employment, technology, community participation, self-direction, and different living arrangements. Financial management services and support brokerage would be available at no cost to participants using self-directed services.

Residential and other traditional services would remain essential for many people. Lifespan is not intended to eliminate those services, but to build a broader continuum of supports that better reflects different needs, preferences, and stages of life.

Shaped by Five Years of Engagement

Lifespan has not been developed in isolation. For approximately five years, the Department has worked with individuals with IDD and autism, families, guardians, providers, advocates, and other community partners to understand what is working, where gaps remain, and how Maine’s service system can better support people throughout their lives.

That engagement has directly shaped the proposal, including its focus on earlier support, greater flexibility and self-direction, stability for current waiver participants, and gradual implementation.

Most recently, a formal public comment period on a draft of the Lifespan Waiver generated significant participation from individuals, families, guardians, providers, advocates, and other interested parties. Department staff are reviewing and responding to the comments received and making additional revisions before submitting the waiver application to the federal Centers for Medicare & Medicaid Services.

Community partners have been closely involved throughout the process, contributing perspectives and feedback that have helped shape the waiver’s design and direction:

“Maine Parent Federation has been engaged in the Lifespan Waiver development from the beginning. We are especially encouraged by its focus on supporting individuals starting at age 14, well before the transition to adulthood. We appreciate the Department’s transparency and responsiveness throughout this process and look forward to the next round of public town halls. We urge community members to stay involved, your feedback continues to shape this waiver to better meet the needs of Maine families.”

— Carrie Woodcock, Executive Director, Maine Parent Federation

Feedback received throughout the development process is also reflected in how Lifespan would be implemented. Rather than requiring an immediate systemwide transition, the Department is proposing a gradual implementation that protects stability for current participants in Sections 21 and 29 waiver programs for individuals with IDD while allowing Maine to build capacity over time.

A Thoughtful, Phased Approach

Implementing a new waiver is a significant undertaking. Individuals, families, and providers need time to understand the proposal and prepare for implementation.

During the initial implementation period, enrollment would focus primarily on eligible youth ages 14–17 and individuals with urgent health and safety needs. Adults who are not already enrolled in the Section 21 or Section 29 waivers would also be eligible for Lifespan.

People currently enrolled in Sections 21 and 29 waivers will be able to remain in those programs. They will not be required to transition to Lifespan and will not be offered enrollment during the initial implementation period.

Maintaining Sections 21 and 29 for current participants is an intentional decision that reflects feedback received throughout the development process. It provides stability for people already receiving services while allowing Maine to build Lifespan capacity over time.

Provider readiness and workforce development are also important parts of implementation planning. The Department will monitor whether authorized services are available and received and will continue working with providers to strengthen capacity as needs and preferences evolve.

Join the Lifespan State Tour

Public engagement will continue as the proposal moves forward. From July 20–24, the Office of Aging and Disability Services and the Office of MaineCare Services will hold Lifespan State Tour sessions in Bangor, Caribou, Augusta, Lewiston, and Portland.

The sessions will provide an overview of the proposed waiver, including updates made following the public comment period, and additional opportunities for individuals, families, providers, advocates, and other community members to participate in the discussion.

Morning sessions will be geared toward providers, with afternoon sessions for individuals with IDD or autism and their families. The Department particularly encourages participation by youth ages 14–17, adults who are not currently enrolled in Sections 21 or 29, and their families.

For those unable to attend in person, the July 24 sessions will also be available to view through Zoom.

Visit the Lifespan Waiver website for session times, locations, registration, and virtual participation information.

Understanding the SIS-A and Service Planning

Providing clear information about how key elements of the proposed waiver would work is also an important part of the Department’s continued engagement.

The Supports Intensity Scale-Adult, known as the SIS-A, is a standardized assessment designed to identify an individual’s support needs. It is one source of information used in a broader person-centered planning process and does not, by itself, determine the services a person will receive.

Under the proposed Lifespan Waiver, a person’s SIS-A support-needs level, along with factors including age and living arrangement, would help establish an expected annual funding range for certain services.

For people who remain enrolled in Sections 21 and 29, implementation of the SIS-A does not reduce or limit the amount of services they may receive. The SIS-A support-needs level would instead be used to inform reimbursement rates for certain services, allowing rates to better and more consistently reflect differences in the level of support individuals require.

Monitoring Implementation and System Health

Careful monitoring will be an important part of Lifespan’s implementation.

Required waiver performance measures for Lifespan will be collected and reviewed regularly, and the Department’s monitoring will extend beyond federal requirements. The Office of Aging and Disability Services and the Office of MaineCare Services are developing additional approaches to monitor access to services, provider capacity, service utilization, transitions between different types of support, and other indicators of overall system health.

The collaborative process will also continue as Lifespan moves from design to implementation. The Department is establishing a Quality Improvement Coalition to provide an ongoing avenue for stakeholder participation and input. Pending CMS approval, the Department plans to begin enrolling eligible individuals in the Lifespan Waiver in spring 2027.

The phased rollout will provide opportunities to evaluate data, learn from the experiences of individuals, families, and providers, and make adjustments when needed.

Moving Forward Together

Lifespan offers an opportunity to advance improvements that individuals and families have sought for years: earlier support, better transitions to adulthood, greater flexibility and self-direction, and a broader range of service options.

The work will continue through federal review, implementation planning, rulemaking, provider preparation, monitoring, and ongoing public engagement.

After approximately five years of planning and collaboration, the Department remains committed to moving forward thoughtfully: protecting stability for current participants, carefully phasing in enrollment, and continuing to learn from individuals, families, providers, advocates, and community partners as Maine builds a more flexible, responsive, and person-centered system.

Visit the Lifespan Waiver website for the latest updates, State Tour registration information, and additional details about the proposal.