EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb1020*
HOUSE BILL 1020
J1 2lr2037
CF SB 868
By: Delegates K. Young and Proctor, Proctor, Pendergrass, Pena –Melnyk,
Bagnall, Belcastro, Bhandari, Carr, Chisholm, Cullison, Hill, Johnson,
Kaiser, Kelly, Kerr, Kipke, Landis, R. Lewis, Morgan, Reilly, Rosenberg,
Saab, Sample–Hughes, and Szeliga
Introduced and read first time: February 10, 2022
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 13, 2022
CHAPTER ______
AN ACT concerning 1
Developmental Disabilities Administration – Self–Directed Services 2
(Self–Direction Act of 2022) 3
FOR the purpose of requiring the Developmental Disabilities Administration to establish 4
and provide training materials to coordinators of community services on 5
self–directed services; requiring coordinators of community services to educate a 6
certain recipient on self–directed services all models of services available to the 7
recipient at certain times; providing for the services and manner of delivering 8
services that the Administration provides to a recipient who receives self–directed 9
services; requiring that home– and community–based services waiver recipients 10
receive support broker services; requiring the Administration to submit a certain 11
waiver application for a certain purpose by a certain date; requiring the 12
Administration to leverage certain federal funding for a certain purpose; and 13
generally relating to Developmental Disabilities Administration services. 14
BY repealing and reenacting, with amendments, 15
Article – Health – General 16
Section 7–101 17
Annotated Code of Maryland 18
(2019 Replacement Volume and 2021 Supplement) 19
BY adding to 20 2 HOUSE BILL 1020
Article – Health – General 1
Section 7–408 through 7–410 2
Annotated Code of Maryland 3
(2019 Replacement Volume and 2021 Supplement) 4
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 5
That the Laws of Maryland read as follows: 6
Article – Health – General 7
7–101. 8
(a) In this title the following words have the meanings indicated. 9
(b) “Administration” means the Developmental Disabilities Administration. 10
(c) (1) “Admission” means the process by which an individual with an 11
intellectual disability is accepted as a resident in a State residential center. 12
(2) “Admission” includes the physical act of the individual entering the 13
facility. 14
(d) (1) “Alternative living unit” means a residence that: 15
(i) Provides residential services for individuals who, because of 16
developmental disability, require specialized living arrangements; 17
(ii) Admits not more than 3 individuals; and 18
(iii) Provides 10 or more hours of supervision per unit, per week. 19
(2) “Alternative living unit” does not include a residence that is owned or 20
rented by: 21
(i) 1 or more of its residents; or 22
(ii) A person who: 23
1. Is an agent for any of the residents; but 24
2. Is not a provider of residential supervision. 25
(e) “Claim” has the meaning stated in § 2–601 of this article. 26
(f) “Deputy Secretary” means the Deputy Secretary for Developmental 27
Disabilities. 28
HOUSE BILL 1020 3
(g) “Developmental disability” means a severe chronic disability of an individual 1
that: 2
(1) Is attributable to a physical or mental impairment, other than the sole 3
diagnosis of mental illness, or to a combination of mental and physical impairments; 4
(2) Is manifested before the individual attains the age of 22; 5
(3) Is likely to continue indefinitely; 6
(4) Results in an inability to live independently without external support 7
or continuing and regular assistance; and 8
(5) Reflects the need for a combination and sequence of special, 9
interdisciplinary, or generic care, treatment, or other services that are individually planned 10
and coordinated for the individual. 11
(h) “External support” means: 12
(1) Periodic monitoring of the circumstances of an individual with respect 13
to: 14
(i) Personal management; 15
(ii) Household management; and 16
(iii) The use of community resources; and 17
(2) Rendering appropriate advice or assistance that may be needed. 18
(i) “Fee–for–service” means a method for payment that requires a person to 19
submit a claim for payment to the Department for each service performed. 20
(j) “Group home” means a residence that: 21
(1) Provides residential services for individuals who, because of 22
developmental disability, require specialized living arrangements; 23
(2) Admits at least 4 but not more than 8 individuals; and 24
(3) Provides 10 or more hours of supervision per home, per week. 25
(k) “Habilitation” means a process by which a provider of services enables an 26
individual to acquire and maintain life skills to cope more effectively with the demands of 27
the individual’s own person and environment and to raise the level of the individual’s 28
mental, physical, social, and vocational functioning. 29
4 HOUSE BILL 1020
(L) (1) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 1
AND SERVICES ” MEANS SERVICES , EQUIPMENT, THERAPIES, TRANSPORTATION 2
ACTIVITIES, OR SUPPLIES FOR INDI VIDUALS WHO SELF –DIRECT SERVICES THAT : 3
(I) RELATE TO A NEED OR G OAL IDENTIFI ED IN THE 4
PERSON–CENTERED PLAN OF SERVICE; 5
(II) MAINTAIN OR INCREASE INDEPENDENCE ; 6
(III) PROMOTE OPPORTUNITIES FOR COMMUNITY LIVING AND 7
INCLUSION; AND 8
(IV) ARE NOT AVAILABLE UND ER A ANOTHER WAIVER SERVICE 9
OR SERVICES PROVIDED UNDER THE STATE PLAN ESTABLISHED IN SUBTITLE 3 OF 10
THIS TITLE. 11
(2) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 12
AND SERVICES ” INCLUDES ANY OTHER ALL GOODS OR SERVICES AU THORIZED 13
UNDER BY REGULATIONS ADOPT ED OR GUIDANCE ISSUED BY T HE FEDERAL 14
CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF THE 15
SOCIAL SECURITY ACT. 16
[(l)] (M) (1) “Individual support services” means an array of services that are 17
designed to increase or maintain an individual’s ability to live alone or in a family setting. 18
(2) “Individual support services” include: 19
(i) In–home assistance with meals and personal care; 20
(ii) Counseling; 21
(iii) Physical, occupational, or other therapies; 22
(iv) Architectural modification; and 23
(v) Any other services that the Administ ration considers 24
appropriate to meet the individual’s needs. 25
(3) “Individual support services” does not include full day or residential 26
services. 27
[(m)] (N) “Intellectual disability” means a developmental disability that is 28
evidenced by significantly subaverage intellectual functioning and impairment in the 29
adaptive behavior of an individual. 30
HOUSE BILL 1020 5
[(n)] (O) “Knowingly” has the meaning stated in § 2–601 of this article. 1
[(o)] (P) “Live independently” means: 2
(1) For adults: 3
(i) Managing personal care, such as clothing and medication; 4
(ii) Managing a household, such as menu planning, food preparation 5
and shopping, essential care of the premises, and budgeting; and 6
(iii) Using community resources, such as commercial establishments, 7
transportation, and services of public agencies; or 8
(2) For minors, functioning in normal settings without the need for 9
supervision or assistance other than supervision or assistance that is age appropriate. 10
[(p)] (Q) “Meaningful day services” means employment supports or home– and 11
community–based supports, other than residential services, that assist an individual in 12
developing and maintaining skills, interests, and personalized connections that may create 13
opportunities for paid employment, increased independence, or meaningful relationships 14
with other individuals in the community. 15
(R) “PERSON–CENTERED PLAN OF SERVICE ” MEANS THAT A PLAN FO R 16
SERVICES AND SUPPORTS : 17
(1) REFLECTS WHAT IS IMPO RTANT TO THE INDIVID UAL AND FOR THE 18
INDIVIDUAL’S HEALTH AND WELFARE ; AND 19
(2) IS DEVELOPED WITH INP UT FROM THE INDIVIDU AL OR THE 20
INDIVIDUAL’S REPRESENTATIVE , IF APPLICABLE. 21
(1) IS DEVELOPED WITH A F OCUS ON THE INDIVIDU AL HAVING 22
CONTROL OVER THE SER VICES AND SUPPORTS ; 23
(2) ENSURES THAT THE INDI VIDUAL IS THE PRIMAR Y CONTRIBUTOR 24
TO THE PLAN AND MAY RECEIVE SUPPORT FROM OTHER PERSONS SELECT ED BY THE 25
INDIVIDUAL IN DEVELO PING THE PLAN; 26
(3) IDENTIFIES AND ADDRES SES, TO THE EXTENT PRACTI CABLE: 27
(I) THE INDIVIDUAL ’S PREFERENCES AND IN TERESTS 28
RELATED TO ACHIEVING THE INDIVIDUAL’S DESIRED LIFESTYLE ; AND 29
6 HOUSE BILL 1020
(II) THE SUPPORTS REQUIRED TO ACHIEVE THE INDIV IDUAL’S 1
DESIRED LIFESTYLE AN D PROVIDED IN A MANN ER THAT ENABLES THE INDIVIDUAL 2
TO HAVE CONTROL OVER THE INDIVIDUAL ’S DAILY LIFE AND MAI NTAINS THE 3
INDIVIDUAL’S HEALTH AND WELFARE; AND 4
(4) ALIGNS SERVICES AND S UPPORTS TO ENSURE TH AT THE 5
INDIVIDUAL HAS ACCES S TO THE FULL BENEFI TS OF COMMUNITY LIVI NG IN A 6
MANNER THAT EMPHASIZ ES THE INDIVIDUAL ’S QUALITY OF LIFE, WELL–BEING, AND 7
INFORMED CHOICE . 8
[(q)] (S) “Provider” means an individual who is licensed or certified under 9
Subtitle 9 of this title and provides services to: 10
(1) A recipient; or 11
(2) An individual with a developmental disability who receives funding for 12
services from a source other than the Administration. 13
[(r)] (T) “Recipient” means an individual who receives services funded by the 14
Administration under this title. 15
[(s)] (U) “Release” means a permanent, temporary, absolute, or conditional 16
release of an individual from a State residential center. 17
[(t)] (V) “Residential services” means individualized support and services that 18
assist an individual in developing and maintaining skills in living in the community. 19
(W) (1) “SELF–DIRECTED SERVICES ” MEANS WAIVER PROGRAM 20
SERVICES: 21
(I) FOR WHICH PARTICIPANT S OR THEIR REPRESENT ATIVES 22
HAVE DECISION–MAKING AUTHORITY OVE R AND TAKE DIRECT RE SPONSIBILITY FOR 23
MANAGEMENT OF THE SE RVICES WITH THE ASSI STANCE OF AVAILABLE SUPPORTS 24
CHOSEN BY THE PARTIC IPANT OR THE PARTICI PANT’S REPRESENTATIVE ; AND 25
(II) THAT ARE PROVIDED IN A MANNER THAT FURTHERS: 26
1. FURTHERS THE RIGHT OF INDIVID UALS WITH 27
DISABILITIES, REGARDLESS OF THE PH YSICAL OR INTELLECTUAL CAPACIT Y OF THE 28
INDIVIDUALS, AND THEIR REPRESENTA TIVES, AS APPLICABLE , TO MAKE CHOICES 29
ABOUT AND DI RECT ALL ASPECTS OF THEIR LIVES, INCLUDING THROUGH CONTROL 30
OVER RECEIPT OF, AND FUNDING FOR , SUPPORT SERVICES BY CHOOSING AND 31
CONTROLLING THE DELI VERY OF WAIVER SERVI CES, WHO PROVIDES THE SER VICES, 32
AND HOW SERVICES ARE PROVIDED; AND 33
HOUSE BILL 1020 7
2. RECOGNIZES THAT ALL INDIVIDUALS HAVE THE 1
CAPACITY TO MAKE CHO ICES AND MAY BE SUPP ORTED IN MAKING CHOI CES. 2
(2) “SELF–DIRECTED SERVICES ” INCLUDES SERVICES TH AT: 3
(I) PROVIDE AN INDIVIDUAL WITH: 4
1. THE DECISION–MAKING EMPLOYER AUTH ORITY TO 5
RECRUIT, HIRE, TRAIN, AND SUPERVISE, AND DISMISS THE INDIVIDUALS 6
EMPLOYEES AND VENDOR S WHO FURNISH THE INDI VIDUAL’S SERVICES; AND 7
2. THE BUDGET AUTHORITY OVER HOW FUNDS IN A 8
BUDGET ARE SPENT WITHIN THE TOTAL APP ROVED ANNUAL BUDGET ; 9
(II) MAXIMIZE THE OPPORTUN ITIES OF AN INDIVIDUAL TO LIVE 10
AS INDEPENDENTLY AS POSSIBLE IN THE MOST INCLUSIVE COMMUNITY –BASED 11
SETTING OF THE INDIV IDUAL’S CHOICE; 12
(III) EMPOWER AN INDIVIDUAL TO EXERCISE CHOICE A ND 13
CONTROL OVER NEEDED LONG–TERM SERVICES AND SU PPORTS; AND 14
(IV) HELP TO MAIN TAIN AND IMPROVE THE INDIVIDUAL ’S 15
HEALTH AND QUALITY O F LIFE IN THE INDIVIDUAL’S COMMUNITY . 16
[(u)] (X) “Services” means residential, day, or other services that provide for 17
evaluation, diagnosis, treatment, care, supervision, assistance, or attention to individuals 18
with developmental disability and that promote habilitation of these individuals. 19
[(v)] (Y) “Services coordination” means a service that consists of the following 3 20
major functions that are designed to assist an individual in obtaining the needed services 21
and programs that the individual desires in order to gain as much control over the 22
individual’s own life as possible: 23
(1) Planning services; 24
(2) Coordinating services; and 25
(3) Monitoring service delivery to the individual. 26
[(w)] (Z) “State residential center” means a licensed facility operated by the 27
State that provides residential and habilitation services to individuals with an intellectual 28
disability who are at least 18 years old and meet the criteria set forth in § 7–502 of this 29
title. 30
8 HOUSE BILL 1020
(AA) “SUPPORT BROKER ” MEANS A PERSON WHO ADVOCATES ON BEHALF OF 1
AND AS DIRECTED BY WORKS AT THE DIRECTI ON OF AND FOR THE BE NEFIT OF AN 2
INDIVIDUAL WHO USES SELF–DIRECTED SERVICES , INCLUDING BY ASSISTI NG THE 3
INDIVIDUAL OR THE INDIVIDUAL ’S FAMILY OR OTHER REPRESENTATIVE ANOTHER 4
INDIVIDUAL CHOSEN BY THE INDIVIDUAL WITH: 5
(1) MAKING INFORMED DECIS IONS IN ARRANGING FO R, DIRECTING, 6
AND MANAGING SERVICE S THE INDIVIDUAL REC EIVES, INCLUDING DECISIONS 7
RELATED TO PERSONNEL REQUIREMENTS AND RES OURCES NEEDED TO MEET THE 8
REQUIREMENTS ; 9
(2) ACCESSING AND MANAGIN G IDENTIFIED SUPPORT S AND 10
SERVICES BEST SUITED FOR THE INDIVIDUAL ; AND 11
(3) PERFORMING OTHER TASK S AS ASSIGNED BY THE INDIVIDUAL 12
AND AS AUTHORIZED BY REGULATIONS ADOPTED OR GUIDANCE ISSUED B Y THE 13
FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF 14
THE SOCIAL SECURITY ACT. 15
[(x)] (BB) “Support services” means supports that assist an individual to maintain 16
or improve the individual’s functional abilities, enhance interactions, or engage in 17
meaningful relationships in the home or community. 18
[(y)] (CC) “Treatment” means any education, training, professional care or 19
attention, or other program that is given to an individual with developmental disability. 20
[(z)] (DD) “Vocational services” means a service that provides job training and 21
placement, supported employment and training in acceptable work behaviors, and 22
vocationally–related social and other skills. 23
[(aa)] (EE) “Waiver program” means each Medicaid Home – and 24
Community–Based Services Waiver funding program submitted by the Department and 25
approved by the federal Centers for Medicare and Medicaid Services in accordance with § 26
1915(c) of the Social Security Act that is overseen and administered by the Administration. 27
[(bb)] (FF) “Waiver program services” means services funded by the 28
Administration in accordance with a waiver program, including: 29
(1) Meaningful day services; 30
(2) Residential services; and 31
(3) Support services. 32
7–408. 33 HOUSE BILL 1020 9
(A) THE ADMINISTRATION , IN CONSULTATIO N WITH STAKEHOLDERS , 1
SHALL ESTABLISH AND PROVIDE TRAINING MAT ERIALS TO COORDINATO RS OF 2
COMMUNITY SERVICES SPECIFICALLY ON THE SELF–DIRECTED SERVICES MODEL OF 3
RECEIVING SERVICES , INCLUDING TRAINING MATERIALS O N SELF–DIRECTED 4
SERVICES, PROCEDURES , POLICIES, AND RESOURCES . 5
(B) AS PART OF THE PROCES S OF DEVELOPING A PE RSON–CENTERED PLAN 6
OF SERVICE FOR A REC IPIENT, A COORDINATOR OF COM MUNITY SERVICES SHAL L 7
EDUCATE THE RECIPIEN T ON THE AVAILABILITY OF SELF–DIRECTED SERVICES ALL 8
MODELS OF SERVICE AV AILABLE TO THE RECIPIENT , INCLUDING SELF –DIRECTED 9
SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES , TO 10
ASSIST THE RECIPIENT AND THE RECIPIENT ’S FAMILY OR REPRESEN TATIVE IN 11
MAKING AN INFORMED C HOICE ON WHICH SERVI CES THE RECIPIENT WO ULD LIKE 12
TO RECEIVE: 13
(1) WHEN THE INDIVIDUAL B EGINS RECEIVING SERV ICES FROM A 14
COORDINATOR OF COMMU NITY SERVICES; AND 15
(2) AT LEAST ONCE EACH YE AR THAT THE INDIVIDU AL IS RECEIVING 16
SERVICES FROM A COOR DINATOR OF COMMUNITY SERVICES. 17
(C) A COORDINATOR OF COMMU NITY SERVICES S HALL REPORT TO THE 18
ADMINISTRATION , IN THE FORM AND MANN ER REQUIRED BY THE ADMINISTRATION , 19
THAT THE COORDINATOR OFFERED PROVIDED INFORMATION ON SELF–DIRECTED 20
SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES TO AN 21
INDIVIDUAL IN ACCORD ANCE WITH THIS SECTION. 22
7–409. 23
(A) THE ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT WHO RECEIVES 24
SELF–DIRECTED SERVICES : 25
(1) INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 26
AND SERVICES IN AN A MOUNT BASED ON THE R ECIPIENT’S NEEDS AND INCLUDED IN 27
THE RECIPIENT’S PERSON–CENTERED PLAN OF SER VICE AS CALCULATED ON: 28
(I) ON AN ANNUAL BASIS ; AND 29
(II) WITHIN THE LIMITS OF THE APPROVED ANNUAL BUDGET 30
GENERATED BY THE DEPARTMENT ’S LONG TERM SERVICES AND SUPPORTS 31
SOFTWARE SYSTEM OR I TS REPLACEMENT SYSTE M; 32
10 HOUSE BILL 1020
(2) ACCESS TO THE RECIPIE NT’S PLAN OF SERVICE AN D BUDGETS 1
FOR THE PLAN OF SERV ICE THROUGH THE DEPARTMENT ’S LONG TERM SERVICES 2
AND SUPPORTS SOFTWARE SYS TEM OR ITS REPLACEMENT S YSTEM; 3
(3) UP TO 40 30 HOURS OF SUPPORT BRO KER SERVICES EACH 4
MONTH, AS NEEDED BY THE REC IPIENT AND WITHIN THE RECIP IENT’S TOTAL 5
APPROVED ANNUAL BUDG ET; 6
(4) AN OPTION FOR A FAMIL Y MEMBER OR LEGAL GU ARDIAN OF THE 7
RECIPIENT TO PROVIDE SERVICES FOR THE REC IPIENT, IF: 8
(I) THE RECIPIENT OR AN INDI VIDUAL AUTHORIZED TO MAKE 9
CARE DECISIONS ON BE HALF OF THE RECIPIEN T CHOOSES THE FAMILY MEMBER TO 10
PROVIDE THE SERVICES ; AND 11
(II) THE RECIPIENT ALSO HI RES A SUPPORT BROKER ; 12
(5) REIMBURSEMENT PAID ON A PER–MILE BASIS FOR 13
TRANSPORTATION PROVI DED TO THE RECIPIENT BY AN INDIVIDUAL WHO IS NOT 14
EMPLOYED BY THE INDI VIDUAL, IF THE TRANSPORTATIO N IS RELATED TO THE 15
OWNER OF A SPECIALIZ ED, MODIFIED, OR ACCESSIBLE VEHICL E DRIVEN BY AN 16
EMPLOYEE OF THE RECI PIENT AND FOR THE PU RPOSE OF T HE RECIPIENT 17
ENGAGING IN ACTIVITI ES SPECIFIED IN THE RECIPIENT’S PERSON–CENTERED PLAN 18
OF SERVICE; 19
(6) A BUDGET FOR SELF –DIRECTED SERVICES TH AT PROVIDES 20
SUBSTANTIALLY SIMILA R SERVICES AS THOSE PROVIDED TO A RECIPI ENT WHO 21
DOES NOT SELF –DIRECT SERVICES , INCLUDING FUNDING FOR MANAGERIAL OR 22
DIRECT SUPPORT POSIT IONS THE ABILITY TO USE F UNDS FROM THE RECIPI ENT’S 23
APPROVED ANNUAL BUDG ET FOR THE PURPOSE O F FUNDING AT LEAST O NE 24
POSITION TO ASSIST T HE RECIPIENT IN MANA GING THE RECIPIENT ’S HOME, STAFF, 25
AND OTHER ADM INISTRATIVE DUTIES A ND PAY ADMINISTRATIV E EXPENSES NEEDED 26
TO OPERATE THE RECIP IENT’S PLAN OF SERVICE , INCLUDING INTERNET SERVICE 27
AND OFFICE EQUIPMENT ; 28
(7) AN OPTION FOR A RECIP IENT WHO HAS A DEMON STRATED NEED 29
FOR OVERNIGHT SUPPOR TS PROVIDED THROUGH PERSONAL SUPPORT SER VICES 30
CARRIED OUT USING TH E RECIPIENT’S EMPLOYER OR BUDGET AUTHORITY TO 31
DIRECT AND CHOOSE TH E EMPLOYEE, VENDOR, OR PROVIDER OF THE OVER NIGHT 32
SUPPORTS, INCLUDING WHETHER TO USE FUNDING IN THE R ECIPIENT’S BUDGET 33
FOR SELF–DIRECTED SERVICES ALLOCATED FOR PERSON AL SUPPORT SERVICES 34
FOR OVERNIGHT SUPPOR TS; 35
HOUSE BILL 1020 11
(8) THE CHOICE OF A VENDO R TO PROVIDE FISCAL MANAGEMENT 1
SERVICES FROM AT LEA ST THREE OPTIONS ; 2
(9) THE OPTION TO EMPLOY A REPRESENTATIVE , SUPPORT BROKER , 3
OR TEAM OF INDIVIDUA LS TO SUPPOR T THE RECIPIENT IN D IRECTING SERVICES ; 4
AND 5
(10) TRAINING FOR A REPRES ENTATIVE, SUPPORT BROKER , OR TEAM 6
OF INDIVIDUALS ON SE LF–DIRECTED SERVICES . 7
(B) SUBJECT TO SUBSECTION (A)(3) OF THIS SECTION , THE 8
ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT OF SELF–DIRECTED SERVICES 9
ANY SUPPORT BROKER S ERVICES THAT ARE : 10
(1) AUTHORIZED UNDER BY REGULATIONS ADOPT ED OR GUIDANCE 11
ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES IN § 1915(C) OF 12
THE SOCIAL SECURITY ACT; AND 13
(2) SELECTED BY THE RECIP IENT. 14
(C) (1) THE SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE 15
ADMINISTRATION MAY NO T ESTABLISH A LIMIT ON: 16
(1) (I) THE DOLLAR AMOUNT OF INDIVIDUAL–DIRECTED FAMILY 17
AND FAMILY–DIRECTED GOODS AND SERVICES P ROVIDED TO A RECIPIE NT; OR 18
(2) (II) THE NUMBER OF HOURS O F OVERNIGHT SUPPORTS 19
PERSONAL SUPPORT SER VICES PROVIDED TO A RECIPI ENT WHO RECEIVES 20
SELF–DIRECTED SERVICES THAT: 21
1. ARE NECESSARY FOR THE HEALTH AND SAFETY OF 22
THE RECIPIENT; AND 23
2. ARE AUTHORIZED BY REG ULATIONS ADOPTED OR 24
GUIDANCE ISSUED BY T HE FEDERAL CENTERS FOR MEDICARE AND MEDICAID 25
SERVICES UNDER § 1915(C) OF THE SOCIAL SECURITY ACT. 26
(2) A RECIPIENT MAY NOT RE CEIVE SERVICES OR SU PPORTS IN 27
EXCESS OF THE RECIPI ENT’S ANNUAL APPROVED BU DGET. 28
(D) THE STATE MAY NOT REQUIRE A RECIPIENT TO DEMONSTRATE 29
COMPETENCY BEFORE TH E ADMINISTRATION AUTHOR IZES THE RECIPIENT T O 30
RECEIVE SELF–DIRECT SERVICES . 31
12 HOUSE BILL 1020
7–410. 1
(A) THE ADMINISTRATION SHALL PROVIDE UP TO 40 30 HOURS OF 2
SUPPORT BROKER SERVI CES EACH MONTH TO A RECIPIENT OF WAIVE R SERVICES, 3
AS NEEDED BY THE REC IPIENT AND WITHIN TH E RECIPIENT’S TOTAL APPROVED 4
ANNUAL BUDGET . 5
(B) SUBJECT TO SUBSECTION (A) OF THIS SECTION, THE ADMINISTRATION 6
SHALL PROVIDE TO A R ECIPIENT OF WAIVER S ERVICES ANY SUPPORT BROKER 7
SERVICES THAT ARE AU THORIZED UNDER BY REGULATIONS ADOPT ED OR GUIDANCE 8
ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 9
1915(C) OF THE SOCIAL SECURITY ACT. 10
SECTION 2. AND BE IT FURTHER ENACTED, That on or before January 1, 2023, 11
the Developmental Disabilities Administration shall submit to the Centers for Medicare 12
and Medicaid Services an amendment to the Community Pathways Waiver that includes 13
the overnight supports requirements established under Section 1 of this Act. 14
SECTION 3. AND BE IT FURTHER ENACTED, That on or before January 1 each 15
year, beginning in 2023 and ending in 2026, the Developmental Disabilities Administration 16
shall report to the General Assembly, in accordance with § 2–1257 of the State Government 17
Article, on the progress in implementing the requirements established under Section 1 of 18
this Act and the recommendations outlined in the Self–Directed Advocacy Network of 19
Maryland’s “Recommendations to Summary Study Workgroup House Bill 318 of 2021”. 20
SECTION 4. AND BE IT FURTHER ENACTED, That, to the extent authorized by 21
law, the Developmental Disabilities Administration shall leverage federal funding, 22
including funding provided by the Centers for Medicare and Medicaid Services, to pay for 23
the services established under this Act. 24
SECTION 5. AND BE IT FURTHER ENACTED, That the Maryland Department of 25
Health shall: 26
(1) collect utilization data on recipients of self–directed services and 27
determine the fiscal impact of expanding services as required under Section 1 of this Act; 28
and 29
(2) on or before January 1, 2023, provide a baseline report to the General 30
Assembly, in accordance with § 2–1257 of the State Government Article, on the utilization 31
and cost of self–directed services. 32
SECTION 6. AND BE IT FURTH ER ENACTED, That, on or before October 1, 2024, 33
the Maryland Department of Health shall report to the General Assembly, in accordance 34
with § 2–1257 of the State Government Article, on the findings and recommendations of 35
the Maryland Department of Health related to the expansion of self–directed services as 36
required under Section 1 of this Act. 37 HOUSE BILL 1020 13
SECTION 5. 7. AND BE IT FURTHER ENACTED, That this Act shall take effect 1
October 1, 2022. 2
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.