Self-Direction and FMS in Maine
All states: self-direction map
In short: Self-direction runs under waiver Sections 18, 20 and 29 with a choice of two FMS providers; members are the employer and can hire family.
Maine self-direction at a glance
| Self-directed programs | MaineCare Sections 18, 20 and 29 (waivers), Section 12 Consumer Directed Attendant Services, Section 19 Participant-Directed Option and the Section 96 Family Provider Service Option |
|---|---|
| FMS model | The member is the employer. An FMS provider or fiscal intermediary handles payroll, taxes and paperwork. |
| FMS vendors | Sections 18, 20 and 29: GT Independence or Palco. Sections 12 and 96: GuardianTrac LLC, SeniorsPlus or Alpha One Inc. |
| Who is the employer | The member, not an agency and not the FMS provider |
| Can family be paid | Yes in Sections 18, 20 and 29, but not the member's unpaid representative. Not confirmed for Sections 12, 19 and 96. |
| EVV for self-directed workers | Yes. The self-directed service codes are on the state EVV code list. The state does not publish whose EVV system workers use. |
| Budget authority | Yes in Sections 18, 20 and 29. Not confirmed for Sections 12, 19 and 96. |
Last verified against state sources: 2026-10-13.
Which Medicaid programs in Maine offer self-direction?
Maine offers self-direction in six parts of MaineCare, the state's Medicaid program. Three are waivers run by the Office of Aging and Disability Services (OADS) for adults with brain injury, other related conditions, and intellectual disability or autism (Sections 18, 20 and 29). The other three serve older adults and adults with physical disabilities (Sections 12, 19 and 96). Maine names its programs by their section number in the MaineCare Benefits Manual, so the section numbers are the terms to search for.
- Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder (self-direction option): a 1915(c) waiver (ME.0467) that serves adults with intellectual and developmental disability or autism. OADS runs it with the Office of MaineCare Services. The member has both employer authority and budget authority. Services that can be self-directed are Home Support (quarter hour), Community Support, Support Brokerage, FMS, Assistive Technology, Home Accessibility Adaptations, and Individual Goods and Services.
- Section 20, Home and Community-Based Services for Adults with Other Related Conditions (self-direction option): a waiver that serves adults with cerebral palsy, seizure disorder and other related conditions. OADS runs it. The member has both employer authority and budget authority. Services that can be self-directed are Home Support (quarter hour), Community Support, Support Brokerage, FMS, Assistive Technology, and Individual Goods and Services. Home Accessibility Adaptations are not offered under self-direction in this section.
- Section 18, Home and Community-Based Services for Adults with Brain Injury (self-direction option): a waiver that serves adults with brain injury. OADS runs it. The member has both employer authority and budget authority. Services that can be self-directed are Home Support (quarter hour), Support Brokerage, FMS, Assistive Technology, and Individual Goods and Services. Community Support and Home Accessibility Adaptations are not offered under self-direction in this section.
- Section 12, Consumer Directed Attendant Services: serves adults 18 or older with a physical disability who meet medical eligibility criteria and can direct their own care. OADS (Long-Term Care) runs it, and a Service Coordination Agency coordinates services. The consumer hires and manages the attendants. We did not find a clear statement on budget authority.
- Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities (Participant-Directed Option): a 1915(c) waiver (ME.0276) that serves older adults and adults with physical disabilities who meet nursing facility level of care. OADS runs it with the Office of MaineCare Services. The option lets the participant direct attendant services, and FMS is a paid waiver service. The rule text that defines the employer role could not be read for this page, and we did not find a clear statement on budget authority.
- Section 96, Private Duty Nursing and Personal Care Services (Family Provider Service Option): serves members who receive personal care under Section 96 and choose to manage their own personal care services. The state licensing page describes the option for adults 21 or older. OADS (Long-Term Care) runs it. We did not find a clear statement on budget authority.
Employer authority means the member recruits, hires, schedules and supervises the workers. Budget authority means the member also manages a set amount of money. In Sections 18, 20 and 29 the member builds a spending plan and sets each worker's hourly wage within a minimum and maximum set by MaineCare, according to the state's Employer Handbook for Self-Direction. Those wage limits usually change each January 1. The OADS self-direction page covers only Sections 18, 20 and 29. We did not find an equivalent state page for Sections 12, 19 or 96.
Who handles financial management services (FMS) in Maine?
It depends on the program. In Sections 18, 20 and 29 the member chooses between two FMS providers, GT Independence and Palco. In Section 12 and the Section 96 Family Provider Service Option the state holds agreements with three fiscal intermediaries: GuardianTrac LLC, SeniorsPlus and Alpha One Inc. In every case the member is the employer, and the FMS provider handles payroll, taxes and paperwork.
Maine uses two terms for the same kind of organization. In the OADS waivers it is an FMS provider. In Sections 12 and 96 it is a Fiscal Intermediary. Both run payroll, withhold and file taxes, and keep the member in line with tax, labor and MaineCare rules. Maine does not use the national terms fiscal/employer agent or agency with choice.
- Legal employer: the state's Employer Handbook says that in Sections 18, 20 and 29 the member is the employer of the worker, not an agency and not the FMS provider.
- Sections 18, 20 and 29: the OADS self-direction page names GT Independence and Palco as the organizations case managers refer members to. Palco says it has served Maine since 2023 and provides both FMS and support brokerage for these three waivers. Every FMS provider must be approved by OADS before it provides services, and it runs background checks, processes payroll, files taxes and issues monthly spending reports.
- Support Broker: a member in Sections 18, 20 or 29 must pick a Support Broker as well as an FMS provider. A Support Broker is a person who helps the member learn the employer role and manage the spending plan.
- Switching providers: members in Sections 18, 20 and 29 can change FMS providers once a quarter through open enrollment. Palco publishes the transfer deadline and first payday for each window on its Maine page.
- Sections 12 and 96: a Fiscal Intermediary is required. A state procurement notice lists agreements with GuardianTrac LLC, SeniorsPlus and Alpha One Inc running from July 1, 2026 to December 31, 2027. The state selects these organizations as any willing and qualified provider, and each must be enrolled with MaineCare as a Section 19 FMS provider. Alpha One runs its fiscal intermediary service under the name Attendant Services Maine.
- Section 19: FMS is a paid waiver service, and providers enroll with MaineCare as Section 19 FMS providers. We did not find a published state list of the enrolled providers. GT Independence lists the program on its own Maine page. Ask OADS for the current list.
MaineCare long term services are paid fee for service, so the FMS setup does not change by health plan. For questions about Sections 18, 20 and 29, OADS publishes a self-direction mailbox: SelfDirection.OADS@maine.gov.
Who can be a paid caregiver under self-direction in Maine?
In Sections 18, 20 and 29 a member can hire anyone as a worker, including family or friends. The worker must be at least 17, pass a background check and complete the required training. The one firm limit is the member's representative, who cannot be paid.
Important: These family rules are confirmed only for Sections 18, 20 and 29. For Section 12, the Section 19 Participant-Directed Option and the Section 96 Family Provider Service Option, we could not confirm who may be paid, including spouses, guardians and parents. Do not assume the waiver rules carry over.
- Sections 18, 20 and 29: the Employer Handbook says the member may choose family or friends as workers if they meet the age, background check and training rules.
- Representatives: a member's representative is an unpaid role. That person cannot be hired as the member's paid worker or as the support broker.
- Support brokers: a support broker cannot be a family member or the member's legal representative.
- Sections 12, 19 and 96: the rule text for these programs is in the MaineCare Benefits Manual, published as Word files that could not be read for this page. Ask the member's Service Coordination Agency, the fiscal intermediary or OADS which relatives may be paid.
We did not find a published weekly hour cap for self-directed workers in the sources reviewed. In Sections 18, 20 and 29, hours are limited in practice by the member's spending plan.
Does EVV apply to self-directed workers in Maine?
Yes. Electronic visit verification (EVV) applies to self-directed services in Maine. The self-directed service codes are on the state's EVV code list, and a claim for one of those codes without a verified visit record pends and then denies. The state does not publish whose EVV system self-directed workers use.
- Codes covered: the state EVV code list includes Home Support (T2017) under Sections 18, 20 and 29, attendant services under Section 12 (S5125 U2), and Self-directed Attendant Services (S5125 U7) and Participant-Directed Option respite (T1005 U7) under Section 19.
- What the handbook says: the Employer Handbook for Sections 18, 20 and 29 defines EVV as the electronic timekeeping system that records when a worker starts and ends a shift.
- Claims: a MaineCare provider bulletin says claims with an EVV service code and an EVV place of service pend and then deny without a verified visit.
- Live-in caregivers: live-in caregivers bill place of service 40, which is outside EVV.
Two points could not be confirmed. We did not find a state source that says whether self-directed workers record visits in the FMS provider's system or in the state's own EVV system. The vendors describe their tools in general terms: GT Independence says its Maine consumer-directed program follows state EVV rules and offers an app for logging hours, and Attendant Services Maine offers a mobile app or telephone call-in. We also did not find a statement on whether a worker's paycheck, as opposed to the MaineCare claim, depends on a verified visit. For either question, ask the FMS provider or fiscal intermediary, or OADS.
What is changing next for self-direction in Maine?
We did not find a confirmed upcoming change to self-direction in Maine as of the last check. No FMS procurement or change of vendor was found, and the state says it does not intend to issue a request for proposals for the Section 12 and Section 96 fiscal intermediary services. One proposed change is worth watching: a renewal of the Section 29 waiver that would affect which services family members can be paid for.
The Department of Health and Human Services posted a five year renewal of the Section 29 waiver (ME.0467) in July 2025. As proposed, it revises the participant direction part of the waiver and would require FMS providers to tell participants that Individual Goods and Services depend on funds accrued in the individual budget. It would also limit a legal guardian who is a family member to being paid only for Shared Living and Non-Medical Transportation, and a family member to Non-Medical Transportation, Shared Living and Respite. We did not confirm that the renewal was approved or when it would take effect, and we did not find a statement on how those limits apply to self-directed Home Support and Community Support. Until the state confirms, the Employer Handbook rules described above are the published guidance.
A few other items to keep in view:
- Section 19 and spouses: in 2019 Maine proposed a waiver amendment that would let spouses be paid as personal support specialists for extraordinary care. We did not confirm that it was approved or that it is in the current rule.
- Fiscal intermediary agreements: the current Section 12 and Section 96 agreements run through December 31, 2027.
- Already in effect: since July 26, 2024, Family Provider Service Options no longer have to register with the DHHS Division of Licensing and Certification, according to the state's licensing page.
Get notified when Maine self-direction rules change
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Who to ask about self-direction in Maine
Questions about self-direction in Maine are best put to the state. Start with Maine DHHS Office of Aging and Disability Services: Self-Direction. Published contact: SelfDirection.OADS@maine.gov.
Maine self-direction sources
- Maine DHHS Office of Aging and Disability Services: Self-Direction
- Maine DHHS: Employer Handbook for Self-Direction (June 2024)
- Maine DHHS: The Self-Direction Process in Maine, Roles and Responsibilities (March 2025)
- Maine Division of Procurement Services: notice for Fiscal Intermediary agreements (Sections 12 and 96)
- Maine DHHS: EVV service codes (October 2023)
- MaineCare provider bulletin: EVV place of service reminders (September 26, 2022)
- Maine DHHS: Notice of Section 29 waiver renewal (July 2025)
- Maine DHHS Division of Licensing and Certification: Family Provider Service Option
- Palco: Maine
Related reading
- Self-Directed Medicaid Home Care Services in 2026
- Understanding Self-Direction and FMS
- Self-Direction Fiscal Intermediary: A Guide for Participant-Directed Care
- Why Do Self-Directed Participants Choose Your FMS as Their Fiscal Intermediary?
- Self-direction in every state (map)
- Maine EVV requirements
Page history
- October 13, 2026: Page rewritten and checked against state sources.
This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.
Ankota provides software for FMS organizations and agencies that support self-direction. If you would like to talk through your program, contact Ankota or read more about Ankota's self-direction and FMS software.
