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.
*sb0868*
SENATE BILL 868
J1 2lr2038
CF HB 1020
By: Senator Lee
Introduced and read first time: February 7, 2022
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 25, 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
Article – Health – General 21
Section 7–408 through 7–410 22
Annotated Code of Maryland 23 2 SENATE BILL 868
(2019 Replacement Volume and 2021 Supplement) 1
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2
That the Laws of Maryland read as follows: 3
Article – Health – General 4
7–101. 5
(a) In this title the following words have the meanings indicated. 6
(b) “Administration” means the Developmental Disabilities Administration. 7
(c) (1) “Admission” means the process by which an indivi dual with an 8
intellectual disability is accepted as a resident in a State residential center. 9
(2) “Admission” includes the physical act of the individual entering the 10
facility. 11
(d) (1) “Alternative living unit” means a residence that: 12
(i) Provides residential services for individuals who, because of 13
developmental disability, require specialized living arrangements; 14
(ii) Admits not more than 3 individuals; and 15
(iii) Provides 10 or more hours of supervision per unit, per week. 16
(2) “Alternative living unit” does not include a residence that is owned or 17
rented by: 18
(i) 1 or more of its residents; or 19
(ii) A person who: 20
1. Is an agent for any of the residents; but 21
2. Is not a provider of residential supervision. 22
(e) “Claim” has the meaning stated in § 2–601 of this article. 23
(f) “Deputy Secretary” means the Deputy Secretary for Developmental 24
Disabilities. 25
(g) “Developmental disability” means a severe chronic disability of an individual 26
that: 27
SENATE BILL 868 3
(1) Is attributable to a physical or mental impairment, other than the sole 1
diagnosis of mental illness, or to a combination of mental and physical impairments; 2
(2) Is manifested before the individual attains the age of 22; 3
(3) Is likely to continue indefinitely; 4
(4) Results in an inability to live independently without external support 5
or continuing and regular assistance; and 6
(5) Reflects the need for a combination and sequence of special, 7
interdisciplinary, or generic care, treatment, or other services that are individually planned 8
and coordinated for the individual. 9
(h) “External support” means: 10
(1) Periodic monitoring of the circumstances of an individual with respect 11
to: 12
(i) Personal management; 13
(ii) Household management; and 14
(iii) The use of community resources; and 15
(2) Rendering appropriate advice or assistance that may be needed. 16
(i) “Fee–for–service” means a method for payment that requires a person to 17
submit a claim for payment to the Department for each service performed. 18
(j) “Group home” means a residence that: 19
(1) Provides residential services for individuals who, because of 20
developmental disability, require specialized living arrangements; 21
(2) Admits at least 4 but not more than 8 individuals; and 22
(3) Provides 10 or more hours of supervision per home, per week. 23
(k) “Habilitation” means a process by which a provider of services enables an 24
individual to acquire and maintain life skills to cope more effectively with the demands of 25
the individual’s own person and environment and to raise the level of the individual’s 26
mental, physical, social, and vocational functioning. 27
(L) (1) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 28
AND SERVICES ” MEANS SERVICES , EQUIPMENT, THERAPIES, TRANSPORTATION 29
ACTIVITIES, OR SUPPLIES FOR INDIVIDUALS W HO SELF–DIRECT SERVICES THAT : 30 4 SENATE BILL 868
(I) RELATE TO A NEED OR G OAL IDENTIFIED IN TH E 1
PERSON–CENTERED PLAN OF SERVICE; 2
(II) MAINTAIN OR INCREASE INDEPENDENCE ; 3
(III) PROMOTE OPPORTUNITIES FOR COMMUNITY LIVING AND 4
INCLUSION; AND 5
(IV) ARE NOT AVAILABLE UND ER A ANOTHER WAIVER SERVICE 6
OR SERVICES PROVIDED UNDER THE STATE PLAN ESTABLISHE D IN SUBTITLE 3 OF 7
THIS TITLE. 8
(2) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 9
AND SERVICES ” INCLUDES ANY OTHER ALL GOODS OR SERVICES AU THORIZED 10
UNDER BY REGULATIONS ADOPT ED OR GUIDANCE ISSUED BY T HE FEDERAL 11
CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF THE 12
SOCIAL SECURITY ACT. 13
[(l)] (M) (1) “Individual support services” means an array of services that are 14
designed to increase or maintain an individual’s ability to live alone or in a family setting. 15
(2) “Individual support services” include: 16
(i) In–home assistance with meals and personal care; 17
(ii) Counseling; 18
(iii) Physical, occupational, or other therapies; 19
(iv) Architectural modification; and 20
(v) Any other services that the Administration considers 21
appropriate to meet the individual’s needs. 22
(3) “Individual support services” does not include full day or residential 23
services. 24
[(m)] (N) “Intellectual disability” means a developmental disability that is 25
evidenced by significantly subaverage intellectual functioning and impairment in the 26
adaptive behavior of an individual. 27
[(n)] (O) “Knowingly” has the meaning stated in § 2–601 of this article. 28
[(o)] (P) “Live independently” means: 29
SENATE BILL 868 5
(1) For adults: 1
(i) Managing personal care, such as clothing and medication; 2
(ii) Managing a household, such as menu planning, food preparation 3
and shopping, essential care of the premises, and budgeting; and 4
(iii) Using community resources, such as commercial establishments, 5
transportation, and services of public agencies; or 6
(2) For minors, functioning in normal settings without the need for 7
supervision or assistance other than supervision or assistance that is age appropriate. 8
[(p)] (Q) “Meaningful day services” means employment supports or home– and 9
community–based supports, other than residential services, that assist an individual in 10
developing and maintaining skills, interests, and personalized connections that may create 11
opportunities for paid employment, increased independence, or meaningful relationships 12
with other individuals in the community. 13
(R) “PERSON–CENTERED PLAN OF SERVICE ” MEANS THAT A PLAN FO R 14
SERVICES AND SUPPORTS : 15
(1) REFLECTS WHAT IS IMPO RTANT TO THE INDIVID UAL AND FOR THE 16
INDIVIDUAL’S HEALTH AND WELFARE ; AND 17
(2) IS DEVELOPED WITH INP UT FROM THE INDIVIDU AL OR THE 18
INDIVIDUAL’S REPRESENTATIVE , IF APPLICABLE. 19
(1) IS DEVELOPED WITH A F OCUS ON THE INDIVIDUAL HAVING 20
CONTROL OVER THE SER VICES AND SUPPORTS ; 21
(2) ENSURES THAT THE INDI VIDUAL IS THE PRIMAR Y CONTRIBUTOR 22
TO THE PLAN AND MAY RECEIVE SUPPORT FROM OTHER PERSONS SELECT ED BY THE 23
INDIVIDUAL IN DEVELO PING THE PLAN; 24
(3) IDENTIFIES AND ADDRES SES, TO THE EXTENT PRACTI CABLE: 25
(I) THE INDIVIDUAL ’S PREFERENCES AND IN TERESTS 26
RELATED TO ACHIEVING THE INDIVIDUAL ’S DESIRED LIFESTYLE ; AND 27
(II) THE SUPPORTS REQUIRED TO ACHIEVE THE INDIV IDUAL’S 28
DESIRED LIFESTYLE AN D PROVIDED IN A MANN ER THAT ENABLES THE INDIVIDUAL 29
TO HAVE CONTROL OVER THE INDIVIDUAL ’S DAILY LIFE AND MAI NTAINS THE 30
INDIVIDUAL’S HEALTH AND WELFARE ; AND 31
6 SENATE BILL 868
(4) ALIGNS SERVICES AND S UPPORTS TO ENSURE TH AT THE 1
INDIVIDUAL HAS ACCES S TO THE FULL BENEFI TS OF COMMUNITY LIVI NG IN A 2
MANNER THAT EMPHASIZES THE INDIV IDUAL’S QUALITY OF LIFE, WELL–BEING, AND 3
INFORMED CHOICE . 4
[(q)] (S) “Provider” means an individual who is licensed or certified under 5
Subtitle 9 of this title and provides services to: 6
(1) A recipient; or 7
(2) An individual with a developmental disability who receives funding for 8
services from a source other than the Administration. 9
[(r)] (T) “Recipient” means an individual who receives services funded by the 10
Administration under this title. 11
[(s)] (U) “Release” means a permanent, temporary, absolute, or conditional 12
release of an individual from a State residential center. 13
[(t)] (V) “Residential services” means individualized support and services that 14
assist an individual in developing and maintaining skills in living in the community. 15
(W) (1) “SELF–DIRECTED SERVICES ” MEANS WAIVER PROGRAM 16
SERVICES: 17
(I) FOR WHICH PARTICIPANT S OR THEIR REPRESENT ATIVES 18
HAVE DECISION–MAKING AUTHORITY OVE R AND TAKE DIRECT RE SPONSIBILITY FOR 19
MANAGEMENT OF THE SE RVICES WITH THE ASSI STANCE OF AV AILABLE SUPPORTS 20
CHOSEN BY THE PARTIC IPANT OR THE PARTICI PANT’S REPRESENTATIVE ; AND 21
(II) THAT ARE PROVIDED IN A MANNER THAT FURTHERS: 22
1. FURTHERS THE RIGHT OF INDIVID UALS WITH 23
DISABILITIES, REGARDLESS OF THE PH YSICAL OR INTELLECTUAL CAPACIT Y OF THE 24
INDIVIDUALS, AND THEIR REPRESENTA TIVES, AS APPLICABLE , TO MAKE CHOICES 25
ABOUT AND DIRECT ALL ASPECTS OF THEIR LIV ES, INCLUDING THROUGH CONTROL 26
OVER RECEIPT OF, AND FUNDING FOR , SUPPORT SERVICES BY CHOOSING AND 27
CONTROLLING THE DELI VERY OF WAIVER SERVI CES, WHO PROVIDES THE SER VICES, 28
AND HOW SERVICES ARE PROVIDED; AND 29
2. RECOGNIZES THAT ALL I NDIVIDUALS HAVE THE 30
CAPACITY TO MAKE CHO ICES AND MAY BE SUPP ORTED IN MAKING CHOI CES. 31
(2) “SELF–DIRECTED SERVICES ” INCLUDES SERVICES TH AT: 32
SENATE BILL 868 7
(I) PROVIDE AN INDIVIDUAL WITH : 1
1. THE DECISION–MAKING EMPLOYER AUTH ORITY TO 2
RECRUIT, HIRE, TRAIN, AND SUPERVISE, AND DISMISS THE INDIVIDUALS 3
EMPLOYEES AND VENDOR S WHO FURNISH THE INDI VIDUAL’S SERVICES; AND 4
2. THE BUDGET AUTHORITY OVER HOW FUNDS IN A 5
BUDGET ARE SPENT WITHIN THE TOTAL APP ROVED ANNUAL BUDGET ; 6
(II) MAXIMIZE THE OPPORTUN ITIES OF AN INDIVIDU AL TO LIVE 7
AS INDEPENDENTLY AS POSSIBLE IN THE MOST INCLUSIVE COMMUNITY –BASED 8
SETTING OF THE INDIV IDUAL’S CHOICE; 9
(III) EMPOWER AN INDIVIDUAL TO EXERCISE CHOICE AND 10
CONTROL OVER NEEDED LONG–TERM SERVICES AND SU PPORTS; AND 11
(IV) HELP TO MAINTAIN AND IMPROVE THE INDIVIDUAL ’S 12
HEALTH AND QUALITY O F LIFE IN THE INDIVIDUAL’S COMMUNITY . 13
[(u)] (X) “Services” means residential, day, or other services that provide for 14
evaluation, diagnosis, treatment, care, supervision, assistance, or attention to individuals 15
with developmental disability and that promote habilitation of these individuals. 16
[(v)] (Y) “Services coordination” means a service that consists of the following 3 17
major functions that are designed to assist an individual in obtaining the needed services 18
and programs that the individual desires in order to gain as much control over the 19
individual’s own life as possible: 20
(1) Planning services; 21
(2) Coordinating services; and 22
(3) Monitoring service delivery to the individual. 23
[(w)] (Z) “State residential center” means a licensed facility operated by the 24
State that provides residential and habilitation services to individuals with an intellectual 25
disability who are at least 18 years old and meet the criteria set forth in § 7–502 of this 26
title. 27
(AA) “SUPPORT BROKER ” MEANS A PERSON WHO ADVOCATES ON BEHALF OF 28
AND AS DIRECTED BY WORKS AT THE DIRECTI ON OF AND FOR THE BE NEFIT OF AN 29
INDIVIDUAL WHO USE S SELF–DIRECTED SERVICES , INCLUDING BY ASSISTI NG THE 30
INDIVIDUAL OR THE INDIVIDUAL ’S FAMILY OR OTHER REPRESENTATIVE ANOTHER 31
INDIVIDUAL CHOSEN BY THE INDIVIDUAL WITH: 32
8 SENATE BILL 868
(1) MAKING INFORMED DECIS IONS IN ARRANGING FO R, DIRECTING, 1
AND MANAGING SERVICE S THE INDIVIDUAL RECEIVES , INCLUDING DECISIONS 2
RELATED TO PERSONNEL REQUIREMENTS AND RES OURCES NEEDED TO MEE T THE 3
REQUIREMENTS ; 4
(2) ACCESSING AND MANAGIN G IDENTIFIED SUPPORT S AND 5
SERVICES BEST SUITED FOR THE INDIVIDUAL ; AND 6
(3) PERFORMING OTHER TASK S AS ASSIGNED BY THE INDIVIDUAL 7
AND AS AUTHORIZED BY REGULATIONS ADOPTED OR GUIDANCE ISSUED B Y THE 8
FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF 9
THE SOCIAL SECURITY ACT. 10
[(x)] (BB) “Support services” means supports that assist an individual to maintain 11
or improve the individual’s functional abilities, enhance interactions, or engage in 12
meaningful relationships in the home or community. 13
[(y)] (CC) “Treatment” means any education, training, professional care or 14
attention, or other program that is given to an individual with developmental disability. 15
[(z)] (DD) “Vocational services” means a service that provides job training and 16
placement, supported employment and training in acceptable work behaviors, and 17
vocationally–related social and other skills. 18
[(aa)] (EE) “Waiver program” means each Medicaid Home – and 19
Community–Based Services Waiver funding program submitted by the Department and 20
approved by the federal Centers for Medicare and Medicaid Services in accordance with § 21
1915(c) of the Social Security Act that is overseen and administered by the Administration. 22
[(bb)] (FF) “Waiver program services” means services funded by the 23
Administration in accordance with a waiver program, including: 24
(1) Meaningful day services; 25
(2) Residential services; and 26
(3) Support services. 27
7–408. 28
(A) THE ADMINISTRATION , IN CONSULTATION WITH STAKEHOLDERS , 29
SHALL ESTABLISH AND PROVIDE TRAINING MAT ERIALS TO COORDINATO RS OF 30
COMMUNITY SERVICES SPECIFICALLY ON THE SELF–DIRECTED SERVICES MODEL OF 31
RECEIVING SERVICES , INCLUDING TRAINING MATERIALS O N SELF–DIRECTED 32
SERVICES, PROCEDURES , POLICIES, AND RESOURCES . 33 SENATE BILL 868 9
(B) AS PART OF THE PROCES S OF DEVELOPING A PE RSON–CENTERED PLAN 1
OF SERVICE FOR A REC IPIENT, A COORDINATOR OF COMMUNITY SERVICES S HALL 2
EDUCATE THE RECIPIEN T ON THE AVAILABILITY OF SELF–DIRECTED SERVICES ALL 3
MODELS OF SERVICE AV AILABLE TO THE RECIP IENT, INCLUDING SELF –DIRECTED 4
SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES , TO 5
ASSIST THE RECIPIENT AND THE RECIPIENT ’S FAMILY OR REPRESEN TATIVE IN 6
MAKING AN INFORMED C HOICE ON WHICH SERVI CES THE RECIPIENT WO ULD LIKE 7
TO RECEIVE: 8
(1) WHEN THE INDIVIDUAL B EGINS RECEIVING SERV ICES FROM A 9
COORDINATOR OF COMMU NITY SERVICES; AND 10
(2) AT LEAST ONCE EACH YEAR THAT THE INDIVI DUAL IS RECEIVING 11
SERVICES FROM A COOR DINATOR OF COMMUNITY SERVICES. 12
(C) A COORDINATOR OF COMMU NITY SERVICES SHALL REPORT TO THE 13
ADMINISTRATION , IN THE FORM AND MANN ER REQUIRED BY THE ADMINISTRATION , 14
THAT THE COORDINATOR OFFERED PROVIDED INFORMATION ON SELF–DIRECTED 15
SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES TO AN 16
INDIVIDUAL IN ACCORD ANCE WITH THIS SECTI ON. 17
7–409. 18
(A) THE ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT WHO RECEIVES 19
SELF–DIRECTED SERVICES : 20
(1) INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 21
AND SERVICES IN AN A MOUNT BASED ON THE R ECIPIENT’S NEEDS AND INCLUDED IN 22
THE RECIPIENT’S PERSON–CENTERED PLAN OF SER VICE AS CALCULATED ON: 23
(I) ON AN ANNUAL BASIS ; AND 24
(II) WITHIN THE LIMITS OF THE APPROVED ANNUAL BUDG ET 25
GENERATED BY THE DEPARTMENT ’S LONG TERM SERVICES AND SUPPORTS 26
SOFTWARE SYSTEM OR I TS REPLACEMENT SYSTE M; 27
(2) ACCESS TO THE RECIPIE NT’S PLAN OF SERVICE AN D BUDGETS 28
FOR THE PLAN OF SERV ICE THROUGH THE DEPARTMENT ’S LONG TERM SERVICES 29
AND SUPPORTS SOFTWARE SYS TEM OR ITS REPLACEMENT S YSTEM; 30
(3) UP TO 40 30 HOURS OF SUPPORT BRO KER SERVICES EACH 31
MONTH, AS NEEDED BY THE REC IPIENT AND WITHIN THE RECIP IENT’S TOTAL 32
APPROVED ANNUAL BUDG ET; 33 10 SENATE BILL 868
(4) AN OPTION FOR A FAMIL Y MEMBER OR LEGAL GUARDIAN OF THE 1
RECIPIENT TO PROVIDE SERVICES FOR THE REC IPIENT, IF: 2
(I) THE RECIPIENT OR AN I NDIVIDUAL AUTHORIZED TO MAKE 3
CARE DECISIONS ON BE HALF OF THE RECIPIEN T CHOOSES THE FAMILY MEMBER TO 4
PROVIDE THE SERVICES ; AND 5
(II) THE RECIPIENT ALSO HI RES A SUPPORT BROKER ; 6
(5) REIMBURSEMENT PAID ON A PER–MILE BASIS FOR 7
TRANSPORTATION PROVI DED TO THE RECIPIENT BY AN INDIVIDUAL WHO IS NOT 8
EMPLOYED BY THE INDI VIDUAL, IF THE TRANSPORTATIO N IS RELATED TO TO THE 9
OWNER OF A SPECIALIZ ED, MODIFIED, OR ACCESSIBLE VEHICLE D RIVEN BY AN 10
EMPLOYEE OF THE RECI PIENT AND FOR THE PU RPOSE OF THE RECIPIE NT 11
ENGAGING IN ACTIVITI ES SPECIFIED IN THE RECIPIENT’S PERSON–CENTERED PLAN 12
OF SERVICE; 13
(6) A BUDGET FOR SELF –DIRECTED SERVICES TH AT PROVIDES 14
SUBSTANTIALLY SIMI LAR SERVICES AS THOS E PROVIDED TO A RECI PIENT WHO 15
DOES NOT SELF –DIRECT SERVICES , INCLUDING FUNDING FO R MANAGERIAL OR 16
DIRECT SUPPORT POSIT IONS THE ABILITY TO USE F UNDS FROM THE RECIPI ENT’S 17
APPROVED ANNUAL BUDG ET FOR THE PURPOSE O F FUNDING AT LEAST O NE 18
POSITION TO ASSIST THE RE CIPIENT IN MANAGING THE RECIPIENT’S HOME, STAFF, 19
AND OTHER ADMINISTRA TIVE DUTIES AND PAY ADMINISTRATIVE EXPEN SES NEEDED 20
TO OPERATE THE RECIP IENT’S PLAN OF SERVICE , INCLUDING INTERNET SERVICE 21
AND OFFICE EQUIPMENT ; 22
(7) AN OPTION FOR A RECIP IENT WHO HAS A DEMON STRATED NEED 23
FOR OVERNIGHT SUPPOR TS PROVIDED THROUGH PER SONAL SUPPORT SERVIC ES 24
CARRIED OUT USING TH E RECIPIENT’S EMPLOYER OR BUDGET AUTHORITY TO 25
DIRECT AND CHOOSE TH E EMPLOYEE, VENDOR, OR PROVIDER OF THE OVER NIGHT 26
SUPPORTS, INCLUDING WHETHER TO USE FUNDING IN THE R ECIPIENT’S BUDGET 27
FOR SELF–DIRECTED SERVICES AL LOCATED FOR PERSONAL SUPPORT SERVICES 28
FOR OVERNIGHT SUPPOR TS; 29
(8) THE CHOICE OF A VENDO R TO PROVIDE FISCAL MANAGEMENT 30
SERVICES FROM AT LEA ST THREE OPTIONS ; 31
(9) THE OPTION TO EMPLOY A REPRESENTATIVE , SUPPORT BROKER , 32
OR TEAM OF INDIVIDUA LS TO SUPPORT THE RE CIPIENT IN DIRECTING SERVICES; 33
AND 34
SENATE BILL 868 11
(10) TRAINING FOR A REPRES ENTATIVE, SUPPORT BROKER , OR TEAM 1
OF INDIVIDUALS ON SE LF–DIRECTED SERVICES . 2
(B) SUBJECT TO SUBSECTION (A)(3) OF THIS SECTION , THE 3
ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT OF SELF–DIRECTED SERVICES 4
ANY SUPPORT BROKER S ERVICES THAT ARE : 5
(1) AUTHORIZED UNDER BY REGULATIONS ADOPT ED OR GUIDANCE 6
ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES IN § 1915(C) OF 7
THE SOCIAL SECURITY ACT; AND 8
(2) SELECTED BY THE RECIP IENT. 9
(C) (1) THE SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE 10
ADMINISTRATION MAY NO T ESTABLISH A LIMIT ON: 11
(1) (I) THE DOLLAR AMOUNT OF INDIVIDUAL–DIRECTED FAMILY 12
AND FAMILY–DIRECTED GOODS AND SERVICES P ROVIDED TO A RECIPIE NT; OR 13
(2) (II) THE NUMBER OF HOURS O F OVERNIGHT SUPPORTS 14
PERSONAL SUPPORT SER VICES PROVIDED TO A RECIPI ENT WHO RECEIVES 15
SELF–DIRECTED SERVICES THAT: 16
1. ARE NECESSARY FOR THE HEALTH AND SAFETY OF 17
THE RECIPIENT; AND 18
2. ARE AUTHORIZED BY REG ULATIONS ADOPTED OR 19
GUIDANCE ISSUED BY T HE FEDERAL CENTERS FOR MEDICARE AND MEDICAID 20
SERVICES UNDER § 1915(C) OF THE SOCIAL SECURITY ACT. 21
(2) A RECIPIENT MAY NOT RE CEIVE SERVICES OR SU PPORTS IN 22
EXCESS OF THE RECIPI ENT’S ANNUAL APPROVED BU DGET. 23
(D) THE STATE MAY NOT REQUIRE A RECIPIENT TO DEMON STRATE 24
COMPETENCY BEFORE TH E ADMINISTRATION AUTHOR IZES THE RECIPIENT T O 25
RECEIVE SELF–DIRECT SERVICES . 26
7–410. 27
(A) THE ADMINISTRATION SHALL PROVIDE UP TO 40 30 HOURS OF 28
SUPPORT BROKER SERVI CES EACH MONTH TO A RECIPIENT OF WAIVER SERVICES, 29
AS NEEDED BY THE REC IPIENT AND WITHIN TH E RECIPIENT’S TOTAL APPROVED 30
ANNUAL BUDGET . 31
12 SENATE BILL 868
(B) SUBJECT TO SUBSECTION (A) OF THIS SECTION, THE ADMINISTRATION 1
SHALL PROVIDE TO A RECIPIENT OF WAIVER SERVICES ANY SUPPORT BROKER 2
SERVICES THAT ARE AU THORIZED UNDER BY REGULATIONS ADOPT ED OR GUIDANCE 3
ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 4
1915(C) OF THE SOCIAL SECURITY ACT. 5
SECTION 2. AND BE IT FURTHER ENACTED, That on or before January 1, 2023, 6
the Developmental Disabilities Administration shall submit to the Centers for Medicare 7
and Medicaid Services an amendment to the Community Pathways Waiver that includes 8
the overnight supports requirements established under Section 1 of this Act. 9
SECTION 3. AND BE IT FURTHER ENACTED, That on or before January 1 each 10
year, beginning in 2023 and ending in 2026, the Developmental Disabilities Administration 11
shall report to the General Assembly, in accordance with § 2–1257 of the State Government 12
Article, on the progress in implementing the requirements established under Section 1 of 13
this Act and the recommendations outlined in the Self–Directed Advocacy Network of 14
Maryland’s “Recommendations to Summary Study Workgroup House Bill 318 of 2021”. 15
SECTION 4. AND BE IT FURTHER ENACTED, That, to the extent authorized by 16
law, the Developmental Disabilities Administration shall leverage federal funding, 17
including funding provided by the Centers for Medicare and Medicaid Services, to pay for 18
the services established under this Act. 19
SECTION 5. AND BE IT FURTHER ENACTED, That the Maryland Department of 20
Health shall: 21
(1) collect utilization data on recipients of self–directed services and 22
determine the fiscal impact of expanding services as required under Section 1 of this Act; 23
and 24
(2) on or before January 1, 2023, provide a baseline report to the General 25
Assembly, in accordance with § 2–1257 of the State Government Article, on the utilization 26
and cost of self–directed services. 27
SECTION 6. AND BE IT FURTHER ENACTED, That, on or before October 1, 2024, 28
the Maryland Department of Health shall report to the General Assembly, in accordance 29
with § 2–1257 of the State Government Article, on the findings and recommendations of 30
the Maryland Department of Health related to the expansion of self–directed services as 31
required under Section 1 of this Act. 32
SECTION 5. 7. AND BE IT FURTHER ENACTED, That this Act shall take effect 33
October 1, 2022. 34