Update to Public Statement on DDA’s Proposed Budget Cuts and Waiver Amendments
Last week, the Developmental Disabilities Administration (DDA) announced that it will be delaying implementation of several aspects of its proposed cost-containment measures, including elements of its proposed Community Pathways Waiver amendment and its proposed budget cuts for providers and participants in the Self-Directed Services Model that were slated to take effect on July 1, 2026.
Disability Rights Maryland (DRM) understands that as of June 30, 2026, the DDA had not yet submitted its proposed waiver amendment to the Centers for Medicare and Medicaid Services (CMS). Certain aspects of the DDA’s proposed cost-containment measures, including changes to rate methodology, changes to provider qualifications, such as requiring unlicensed vendors to become licensed DDA providers, and other aspects of the proposed waiver amendment require CMS approval before they can be implemented. As such, the DDA has delayed implementing these changes until CMS approves the proposed waiver amendment.
In correspondence sent to DDA participants and providers on June 29th and June 30th, the DDA shared more information about this delay, as well as its incorporation of stakeholder feedback into its proposed Community Pathways Waiver amendment, including that:
- The effective date of the new self-direction budget methodology implementation is delayed until January 1, 2027, to provide more time for planning and training.
- The effective date of DDA paying Financial Management and Counseling Services costs directly is delayed until January 1, 2027, to allow more preparation time.
- The DDA is granting unlicensed vendors a 45-day extension (until August 15, 2026) to transition to become DDA-licensed providers, in order to allow participants additional time to transition services if their current unlicensed vendor is not approved to continue providing services as required by the FY 2027 budget bill.
- The DDA has added emergency exceptions in the proposed waiver amendment to the 60/40 Rule to support continuity of services during unplanned worker departures and to protect participant health and welfare during unexpected staffing situations.
In these communications, the DDA also clarified that “CMS has 90 days to review [DDA’s] waiver amendment application” and that any changes it seeks to implement through its waiver amendment “would go into effect after CMS approval of [DDA’s] application.” The DDA has also posted a summary of its responses to stakeholder feedback and an updated version of the proposed Community Pathways Waiver amendment, which incorporates changes made in light of stakeholder feedback. Those documents are available on this website: https://health.maryland.gov/dda/Pages/Community-Pathways-Waiver-Amendment-4-2026.aspx.
DRM is reviewing the changes the DDA has made to the proposed waiver amendment in light of stakeholder feedback. We remain steadfast in our commitment to evaluating these changes and their systemic impact on Marylanders with intellectual and/or developmental disabilities (IDD). We also remain committed to ensuring that changes to the Community Pathways Waiver delivery system do not undermine the legal rights of Marylanders with IDD under the Americans with Disabilities Act (ADA) and Olmstead v. L.C., which require that services be delivered in the most integrated, least restrictive setting appropriate to each individual. Our focus will remain on collaborating with the disability community, and where possible, representing individuals to prevent unnecessary institutionalization.
The DDA has committed to hosting regional listening sessions and technical assistance webinars to help providers, participants, and support teams understand these upcoming changes, when they take effect, and what actions need to be taken and by when. The DDA must continue to work openly and collaboratively with people with disabilities, families, providers, and advocates to preserve participants’ access to necessary home and community-based services.
We urge the DDA to maintain transparency with participants, their families, providers, and organizations throughout the implementation of the proposed changes. The potential for harm to participants as a result of these changes cannot be overstated. The DDA must be vigilant to ensure that participants are not placed at risk and ensure that it has processes in place for participants to request reasonable modifications so that they can continue to receive services in the most integrated setting.
