MaineCare Section 21 pays for home supports for Maine adults with an intellectual disability or autism, and it can pay a family member who provides some of them. Under the Section 21 renewal Maine posted as a draft in February 2025, a family member can be paid only for Shared Living or Non-Medical Transportation, so confirm the current rule with Maine's Office of Aging and Disability Services. A relative who becomes the paid Shared Living Provider must be certified as a Direct Support Professional and receives a stipend set by an oversight agency, not a wage.

In This Guide

Who Can Be Paid Under MaineCare Section 21?

MaineCare Section 21 is Maine's Home and Community Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder waiver (ME.0159), run day to day by the Office of Aging and Disability Services (OADS). MaineCare Section 21, a Medicaid waiver, serves Maine adults 18 or older with autism or an intellectual disability who need the level of care given in an Intermediate Care Facility for Individuals with Intellectual Disabilities.

If you've supported your adult son, daughter or sibling for years without a paycheck, the answer depends on your relationship and on which service you'd provide.

Your relationship Can you be paid under Section 21?
Parent, sibling or other relative Yes, for Shared Living and Non-Medical Transportation only; rides are paid only in limited cases (see below)
Legal guardian who is a parent, sibling or other biological relative Yes, for the same two services
Legal guardian who is a step-parent or step-sibling Named in the relatives rule, but the Shared Living limit lists only parents, siblings and other biological relatives; confirm with OADS
Legal guardian who isn't a relative No; the rule pays guardians only when they're family, and adopting an adult doesn't get around it
Spouse The relatives rule doesn't set out a spouse rule; ask OADS

A relative or guardian must meet the same qualifications as an unrelated worker, and your family member chooses their Shared Living Provider. These rules come from the Section 21 renewal application that Maine's Department of Health and Human Services posted as a draft in February 2025, with a proposed start date of July 1, 2025, so confirm them with OADS before you count on a paycheck.

How Section 21 Shared Living Works When a Family Member Is the Paid Provider

In Shared Living, your family member lives with a Direct Support Professional (DSP), or a DSP lives in your family member's home, and that DSP is the Shared Living Provider. A shared living provider may be a family member, and a provider who's related signs a residency agreement instead of a lease.

Being family doesn't change the job requirements. Regardless of relationship, a Section 21 Shared Living Provider must be certified as a DSP and must contract with an Administrative Oversight Agency, which oversees and supports the provider.

In MaineCare Section 21 Shared Living, the Administrative Oversight Agency you contract with sets your stipend, which isn't a wage. MaineCare doesn't cover your family member's rent or housing costs, so plan for those separately. We haven't found a published stipend rate, so ask each agency what it pays before you sign.

Getting Paid for Rides: Non-Medical Transportation

Under Maine's February 2025 draft Section 21 renewal, the other service a family member can be paid for is Non-Medical Transportation, which is arranged through transportation brokers. Under that Maine draft, a Section 21 relative or legal guardian can be reimbursed by the broker only if they can't transport at no charge or there's no other workable option, and the planning team recommends it.

How a Family Member Becomes a Paid MaineCare Section 21 Shared Living Provider

1
Step 1

Confirm MaineCare

Your family member must be found eligible for MaineCare and be medically eligible for waiver services, and can be enrolled in only one waiver at a time. Apply online at My Maine Connection or through the Office for Family Independence.

2
Step 2

Ask for Section 21

Talk to the case manager about applying, or, if your family member doesn't have one, email HCBS.Waiver@maine.gov for application materials. If your family member hasn't applied for adult developmental services yet, start with OADS intake: an intake coordinator contacts you within 10 days of getting a complete application packet to schedule an intake assessment.

3
Step 3

Expect a possible wait

Maine's February 2025 draft Section 21 renewal says that when Section 21 reaches its limit, applicants go on a state waitlist ranked by priority level. That wait can be hard when you're already doing the care unpaid. The same draft says that when a Section 21 opening comes up, OADS sends a letter and you have 60 days to accept, so watch the mail and confirm the deadline in that letter.

4
Step 4

Put Shared Living in the plan

Ask the case manager to add Shared Living to the Person-Centered Plan. The case manager can help you find an agency, and that agency could hire someone your family member knows, including you.

5
Step 5

Get certified and sign on

Complete DSP certification and contract with an Administrative Oversight Agency.

Questions about what MaineCare covers can go to MaineCare Member Services at 1-800-977-6740 (TTY 711). For other ways Maine families get paid, see our guide to getting paid as a family caregiver in Maine.

Frequently Asked Questions

Can I be paid to care for my husband or wife under Section 21?

Ask before you plan on it. The Section 21 relatives text names family members and guardians who are relatives, and it doesn't set out a separate rule for paying a spouse. It also notes that under Maine law a spouse is the only family member legally responsible for supporting an adult. OADS or your spouse's case manager can tell you where you stand.

Can my son hire me directly instead of going through an agency?

Plan on going through an agency. Maine's draft Section 21 renewal doesn't include the waiver section for participant-directed services, and a Shared Living Provider works under contract with an Administrative Oversight Agency., Maine's Section 19 waiver for older adults and adults with physical disabilities treats relatives differently. An adopted rule lets some spouses be paid through an agency for extraordinary care, and a 2026 draft amendment proposes rules for other relatives, but we found no sign it has been approved, so confirm with MaineCare or OADS. Our Section 19 guide covers both.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in MaineGetting paid as a family caregiver in Maine: what MaineCare Sections 19 and 21 cover, VA's PCAFC stipend for spouses and family, and Aid & Attendance limits. CaregiverMaineCare Section 19: How Family Caregivers Get Hired and PaidMaineCare Section 19 pays a spouse for extraordinary care, and Maine's proposed 2026 waiver text lets other relatives be paid, up to 40 hours a week per aide. CaregiverCaregiver Programs in Maine: A Complete DirectoryMaine caregiver programs: who MaineCare Section 19 can pay (relatives, and spouses in narrow cases), where to find respite, VA caregiver help, and how to apply. MedicaidYour Guide to Maine Medicaid HCBS WaiversMaine Medicaid HCBS waivers pay for home and community care through the Section 19 waiver. See who qualifies, what it covers, and how to apply. CaregiverAre Medicaid Waiver Payments Taxable?Are Medicaid waiver payments taxable? Usually not, if you live with the person you care for. What IRS Notice 2014-7 excludes, what it misses, how to report it.

Get help becoming a paid Shared Living Provider under MaineCare Section 21 at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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