– CDHBC is a state funded program that provides home care services to eligible Maine residents. It is also referred to as In-Home and Community Support Services for Elderly and Other Adults, Consumer-Directed Personal Assistance Services, or simply Home Based Care (HBC). There is a MaineCare (Maine Medicaid) program with a similar name. The information that follows refers to the non-Medicaid program hereafter referred to as the CDHBC Program.
The Consumer-Directed Home Based Care (CDHBC) Program, under Maine’s Office of Aging and Disability Services (OADS), provides personal assistance services delivered in a “consumer directed” model. Consumer direction means the individual receiving the care is responsible for choosing, training, and managing their own care providers. However, making payment to care providers (in this case) remains the responsibility of the administering agency.
Under the CDHBC Program, participants can receive personal care assistance, including nursing services, in their homes, as well as a budget for assistive technology, such as Personal Emergency Response Services. In general, benefits and services are limited to those that are essential to preventing the placement of the recipient in a long term, residential care facility, such as a nursing home.
In addition to applicants being residents of the state of Maine who are at least 18 years of age, the CDHBC Program has both medical and financial eligibility criteria.
Financially, the program is intended for persons who are not eligible for Maine Medicaid (MaineCare). MaineCare eligibility is a complicated subject. For the purpose of simplicity, in 2020, if an individual has less than $2,349 (300% of the Federal Benefit Rate) in monthly income and less than $10,000 in countable assets (In addition to a $2,000 asset limit, Maine allows an additional exemption of $8,000 in liquid assets), then they will be financially eligible for MaineCare. Therefore, they will be ineligible for the CDHBC Program. The CDHBC Program also has upper limits for assets, which are $50,000 and $75,000 for an individual and married couple, respectively. Finally, the program also has effective upper income limits that are vaguely defined as “Lack sufficient personal and/or financial resources for in-home services”.
Medically, applicants must require assistance with two activities of daily living (which, for this program, include bed mobility, transferring, locomotion, eating, use of a toilet, dressing, and bathing) and one instrumental activity of daily living (which, for this program, include preparing meals, day-to-day housework, shopping for groceries, and laundry). However, there are several other ways to meet medical eligibility requirements, as there are several levels of care needs. For example, applicants may require assistance with one activity of daily living and two instrumental activities of daily living OR applicants may require assistance with three activities of daily living OR applicants may require one nursing service (which for this program, include intravenous injections, tracheostomy care, wound care, oxygen administration, catheters, etc.) and assistance with two activities of daily living.
A further medical limitation is that while the person must require physical assistance, they also must be cognitively capable of directing their provider of physical assistance.
Maine Medicaid (MaineCare) also offers a consumer directed home care program, which is intended only for Medicaid beneficiaries. Therefore, persons ineligible for the CDHBC Program might wish to pursue the Consumer Directed Attendant Services Program as an alternative.
Benefits and Services
The CDHBC Program determines each participant’s care needs individually via an assessment, and a “plan of care” is established. However, the range of services that can be provided include the following for up to 40 hours per week:
- Personal assistance with the activities of daily living, such as bathing, dressing, toileting, and transferring
- Personal assistance with some instrumental activities of daily living, such as meal preparation, clean up, grocery shopping, laundry, and basic housekeeping
- Chore and handyman services
- Home health services
- Respite care, both in-home or out-of-home
- Adult day care
- Non-medical transportation
- Mental health services
- Home modifications, such as the addition of wheelchair ramps, roll-in showers, and grab bars (lifetime limit of $3,000)
- Transitional services
- Therapies (physical, occupational, speech)
- Personal emergency response systems (PERS), sometimes called Medical Alert or LifeAlert
How to Apply / Learn More
Home Based Care is under the Office of Aging and Disability Services. Very little information about this program is available on their website. For more information or to apply, call 207-287-9200. Alternatively, one might inquire with their local area agency on aging. A wait list may exist should funds not be available. If that is the case, individuals are prioritized on a first-come first-serve basis.