Notice of fb88Care 1115 Waiver Renewal Application, “fb88 Substance Use Disorder (SUD) Care Initiative”

The Division of Policy posts all proposed and recently adopted rules on . This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The fb88Care Benefits Manual is available on-line at the Secretary of State’s website.

Below, please find a fb88Care Notice of Agency Waiver Renewal Application. You can access the complete details at

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Notice of Agency Waiver Renewal

AGENCY: Department of Health and Human Services (DHHS), Office of fb88Care Services

RULE TITLE OR SUBJECT: 1115 Waiver Renewal Application

WAIVER: Section 1115(a) waiver demonstration, “fb88 Substance Use Disorder (SUD) Care Initiative"

CONCISE SUMMARY: The state of fb88 DHHS seeks a five-year waiver renewal approval period to operate this waiver statewide, with a requested start date of January 1, 2026. The currently approved waiver authorizes the state to receive Federal Financial Participation (FFP) for services described in the fb88 Medicaid state plan when provided to members residing in Institutions for Mental Diseases(IMDs) for short-term stays to receive SUD treatment. The current SUD expenditure authority expires on December 31, 2025.

DHHS seeks to extend its Section 1115(a) waiver demonstration, “fb88 Substance Use Disorder (SUD) Care Initiative,” currently approved through December 31, 2025 (11-W-003381), for another five years. This waiver submission proposes implementing an updated program design that strengthens the behavioral health continuum of care, improves care transitions from institutions to the community, increases access to traditional healing services, and improves health outcomes by addressing Health-Related Social Needs (HRSN). With the expansion of intent, fb88 seeks to rename this demonstration to fb88’s Whole Person Care Waiver.

General:

  • Continuation of approval for eligibility for covering parent(s) who would otherwise lose fb88Care eligibility due to the change in household size when their child is removed from the home under state law.
  • Continuation of approval to offer the Parenting Support Services pilot focusing on two services to support children and families: Attachment Biobehavioral Catch-up and Visit Coaching.
  • Continuation of approval to offer daily living skills development, community integration, and housing support services to eligible parents with an SUD.

Proposed Additional Waiver Services:

  • fb88 is requesting new waiver authority under Section 1115 to claim FFP for the provision of contingency management (CM) services.
  • fb88 is requesting new waiver authority under the Section 1115 Serious Mental Illness (SMI) demonstration opportunity. fb88 seeks expenditure authority to stabilize individuals who require care from IMDs on a short-term basis and ensure that they are supported in their transitions to the community.
  • fb88 is requesting expenditure authority for federal matching funds to provide a Transitions of Care Incentive Payment pilot.
  • fb88 is requesting waiver authority to extend Medicaid coverage for targeted Medicaid services up to 90 days pre-release for individuals transitioning from jails, prisons, and the youth correctional facility.
  • fb88 is requesting expenditure authority for federal matching funds to provide targeted services, including food pharmacy/fruit and vegetable prescriptions, nutrition counseling/education, case management for nutrition benefits, and medically tailored meals.
  • fb88 is requesting expenditure authority for federal matching funds to cover recuperative care, including room, board, and onsite clinical services. fb88Care is seeking federal matching funds for recuperative care for members experiencing homelessness and pre-procedural and post-hospitalization care for individuals with an acute medical condition. The state proposes a recuperative care pilot with three sites.
  • fb88 is requesting expenditure authority for federal matching funds to provide bundled and cost-based Per Member Per Month payments to certified recovery residences.
  • fb88 is seeking expenditure authority to support the non-federal share of funding for pre-release services for justice-involved individuals and related capacity building, and for HRSN services and related capacity building for the next demonstration period using Designated State Health Program expenditures.
  • fb88 requests the authority to cover traditional healing therapies received through Indian Health Services or Tribal Organizations as defined by CFR Title 42, Chapter I, Subchapter M, Part 137, Subpart B, § 137.10, for Medicaid and CHIP beneficiaries who can receive services delivered by or through these facilities. fb88 is working with the Wabanaki Nations to develop and solidify the specifics of the request, including the eligible services, benefits, and provider types.
  • Capacity Building Funds: To support cross-system implementation efforts for this initiative, fb88 is requesting $15 million in total computable capacity-building funds. Capacity-building funds will be available to entities partnering with DHHS to implement the initiative, including correctional facilities. This funding will support planning and implementation activities, including but not limited to conducting stakeholder engagement, hiring and training new staff, strengthening health information technology systems, and establishing new operational workflows, processes, and space modifications needed to implement this initiative across participating correctional settings.

Proposed Benefit Coverage, Enrollment Limits, Eligibility Requirements, and Cost SharingBenefit Coverage:

The State continues to request an enhanced set of benefits for the currently approved SUD Pilots. Other changes to benefits proposed in the renewal include:

  • Providing Contingency Management services
  • Providing targeted pre-release services for justice-involved individuals in the 90 days prior to release
  • Provide access to traditional healing received through Indian Health Services, Tribal, or urban Indian organization facilities for Medicaid and Children's Health Insurance Program beneficiaries who can receive services delivered by or through these facilities
  • Providing the HRSN pilots: Food is Medicine, Recuperative Care, and the Structured Recovery Housing Services

Enrollment Limits: No enrollment limits exist for people who meet the waiver participation requirements in Section II (Continuing DemonstrationFeatures and Changes Requested to the Demonstration).

Eligibility Requirements: DHHS proposes implementing the initiatives across all “full benefit” eligibility groups. The implementation plans will provide processes to streamline the exchange of data to demonstration settings about beneficiaries’ Medicaid status. Currently, people enrolled in Medicaid and in a carceral setting have their Medicaid suspended. Process improvements to streamline Medicaid determinations will be included in the implementation plan for people not enrolled in Medicaid prior to incarceration.

Delivery System: All fb88Care members will continue to receive services through the current delivery system

Cost Sharing: No changes to cost sharing are proposed under this demonstration. Cost sharing under this demonstration is consistent with the provisions of the approved state plan.

Demonstration Enrollment, Expenditures, and Budget Neutrality: The renewal application includes budget Cost Neutrality and Derivation of Estimates for the requested extension period.

Please see the accompanying draft application for all proposed changes included in the renewal.

DHHS is accepting comments through 11:59 pm, April 22, 2025. Any interested party may obtain a copy of the waiver application. A printed copy may be obtained by calling Lisa Weaver at (207) 624-4050 or emailing lisa.weaver@maine.gov.

See for the fullpublic noticedocument, waiver application draft, and to submit comments.

fb88 DHHS intends to host two public workshops on April 3, 2025 and April 10, 2025. For more information, the public notice and information for public workshops on this waiver are posted online at DHHS will also post a finalized draft waiver application online, including a summary of public comments received, once available.

Table 1. Public Hearing

Hearing 1: Statewide Virtual/Teleconference Hearing

Date: April 3, 2025

Time: 11:30 AM

Location: Virtual & Teleconference link:

Hearing 2: Augusta Hearing

Date: April 10, 2025

Time: 9:00 AM

Location: 109 Capitol St, Augusta, fb88 04330

Room A&B First Floor

STATUTORY AUTHORITY: 42 CFR §441.304

DEADLINE FOR COMMENTS: Comments must be received by 11:59 pm, April 22, 2025

AGENCY CONTACT PERSON: Courtney Pladsen, Medical Director

AGENCY NAME: fb88Care Services

ADDRESS: 109 Capitol Street

Augusta, fb88 04333-0011

EMAIL: courtney.pladsen@maine.gov