MD
Maryland Senate Bill SB868

Maryland 2022 Regular Session

Maryland Senate Bill SB868 Compare Versions

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1- LAWRENCE J. HOGAN, JR., Governor Ch. 737
21
3-– 1 –
4-Chapter 737
5-(Senate Bill 868)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4+ [Brackets] indicate matter deleted from existing law.
5+ Underlining indicates amendments to bill.
6+ Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7+amendment.
8+ *sb0868*
89
9-Developmental Disabilities Administration – Self–Directed Services
10-(Self–Direction Act of 2022)
10+SENATE BILL 868
11+J1 2lr2038
12+ CF HB 1020
13+By: Senator Lee
14+Introduced and read first time: February 7, 2022
15+Assigned to: Finance
16+Committee Report: Favorable with amendments
17+Senate action: Adopted
18+Read second time: March 25, 2022
1119
12-FOR the purpose of requiring the Developmental Disabilities Administration to establish
13-and provide training materials to coordinators of community services on
14-self–directed services; requiring coordinators of community services to educate a
15-certain recipient on self–directed services all models of services available to the
16-recipient at certain times; providing for the services and manner of delivering
17-services that the Administration provides to a recipient who receives self–directed
18-services; requiring that home– and community–based services waiver recipients
19-receive support broker services; requiring the Administration to submit a certain
20-waiver application for a certain purpose by a certain date; requiring the
21-Administration to leverage certain federal funding for a certain purpose; and
22-generally relating to Developmental Disabilities Administration services.
20+CHAPTER ______
2321
24-BY repealing and reenacting, with amendments,
25- Article – Health – General
26-Section 7–101
27- Annotated Code of Maryland
28- (2019 Replacement Volume and 2021 Supplement)
22+AN ACT concerning 1
2923
30-BY adding to
31- Article – Health – General
32-Section 7–408 through 7–410
33- Annotated Code of Maryland
34- (2019 Replacement Volume and 2021 Supplement)
24+Developmental Disabilities Administration – Self–Directed Services 2
25+(Self–Direction Act of 2022) 3
3526
36- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
37-That the Laws of Maryland read as follows:
27+FOR the purpose of requiring the Developmental Disabilities Administration to establish 4
28+and provide training materials to coordinators of community services on 5
29+self–directed services; requiring coordinators of community services to educate a 6
30+certain recipient on self–directed services all models of services available to the 7
31+recipient at certain times; providing for the services and manner of delivering 8
32+services that the Administration provides to a recipient who receives self–directed 9
33+services; requiring that home– and community–based services waiver recipients 10
34+receive support broker services; requiring the Administration to submit a certain 11
35+waiver application for a certain purpose by a certain date; requiring the 12
36+Administration to leverage certain federal funding for a certain purpose; and 13
37+generally relating to Developmental Disabilities Administration services. 14
3838
39-Article – Health – General
39+BY repealing and reenacting, with amendments, 15
40+ Article – Health – General 16
41+Section 7–101 17
42+ Annotated Code of Maryland 18
43+ (2019 Replacement Volume and 2021 Supplement) 19
4044
41-7–101.
45+BY adding to 20
46+ Article – Health – General 21
47+Section 7–408 through 7–410 22
48+ Annotated Code of Maryland 23 2 SENATE BILL 868
4249
43- (a) In this title the following words have the meanings indicated.
4450
45- (b) “Administration” means the Developmental Disabilities Administration.
51+ (2019 Replacement Volume and 2021 Supplement) 1
4652
47- (c) (1) “Admission” means the process by which an individual with an
48-intellectual disability is accepted as a resident in a State residential center.
49- Ch. 737 2022 LAWS OF MARYLAND
53+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2
54+That the Laws of Maryland read as follows: 3
5055
51-– 2 –
52- (2) “Admission” includes the physical act of the individual entering the
53-facility.
56+Article – Health – General 4
5457
55- (d) (1) “Alternative living unit” means a residence that:
58+7–101. 5
5659
57- (i) Provides residential services for individuals who, because of
58-developmental disability, require specialized living arrangements;
60+ (a) In this title the following words have the meanings indicated. 6
5961
60- (ii) Admits not more than 3 individuals; and
62+ (b) “Administration” means the Developmental Disabilities Administration. 7
6163
62- (iii) Provides 10 or more hours of supervision per unit, per week.
64+ (c) (1) “Admission” means the process by which an indivi dual with an 8
65+intellectual disability is accepted as a resident in a State residential center. 9
6366
64- (2) “Alternative living unit” does not include a residence that is owned or
65-rented by:
67+ (2) “Admission” includes the physical act of the individual entering the 10
68+facility. 11
6669
67- (i) 1 or more of its residents; or
70+ (d) (1) “Alternative living unit” means a residence that: 12
6871
69- (ii) A person who:
72+ (i) Provides residential services for individuals who, because of 13
73+developmental disability, require specialized living arrangements; 14
7074
71- 1. Is an agent for any of the residents; but
75+ (ii) Admits not more than 3 individuals; and 15
7276
73- 2. Is not a provider of residential supervision.
77+ (iii) Provides 10 or more hours of supervision per unit, per week. 16
7478
75- (e) “Claim” has the meaning stated in § 2–601 of this article.
79+ (2) “Alternative living unit” does not include a residence that is owned or 17
80+rented by: 18
7681
77- (f) “Deputy Secretary” means the Deputy Secretary for Developmental
78-Disabilities.
82+ (i) 1 or more of its residents; or 19
7983
80- (g) “Developmental disability” means a severe chronic disability of an individual
81-that:
84+ (ii) A person who: 20
8285
83- (1) Is attributable to a physical or mental impairment, other than the sole
84-diagnosis of mental illness, or to a combination of mental and physical impairments;
86+ 1. Is an agent for any of the residents; but 21
8587
86- (2) Is manifested before the individual attains the age of 22;
88+ 2. Is not a provider of residential supervision. 22
8789
88- (3) Is likely to continue indefinitely;
90+ (e) “Claim” has the meaning stated in § 2–601 of this article. 23
8991
90- (4) Results in an inability to live independently without external support
91-or continuing and regular assistance; and
92+ (f) “Deputy Secretary” means the Deputy Secretary for Developmental 24
93+Disabilities. 25
9294
93- (5) Reflects the need for a combination and sequence of special,
94-interdisciplinary, or generic care, treatment, or other services that are individually planned
95-and coordinated for the individual.
95+ (g) “Developmental disability” means a severe chronic disability of an individual 26
96+that: 27
97+ SENATE BILL 868 3
9698
97- (h) “External support” means: LAWRENCE J. HOGAN, JR., Governor Ch. 737
9899
99-– 3 –
100+ (1) Is attributable to a physical or mental impairment, other than the sole 1
101+diagnosis of mental illness, or to a combination of mental and physical impairments; 2
100102
101- (1) Periodic monitoring of the circumstances of an individual with respect
102-to:
103+ (2) Is manifested before the individual attains the age of 22; 3
103104
104- (i) Personal management;
105+ (3) Is likely to continue indefinitely; 4
105106
106- (ii) Household management; and
107+ (4) Results in an inability to live independently without external support 5
108+or continuing and regular assistance; and 6
107109
108- (iii) The use of community resources; and
110+ (5) Reflects the need for a combination and sequence of special, 7
111+interdisciplinary, or generic care, treatment, or other services that are individually planned 8
112+and coordinated for the individual. 9
109113
110- (2) Rendering appropriate advice or assistance that may be needed.
114+ (h) “External support” means: 10
111115
112- (i) “Fee–for–service” means a method for payment that requires a person to
113-submit a claim for payment to the Department for each service performed.
116+ (1) Periodic monitoring of the circumstances of an individual with respect 11
117+to: 12
114118
115- (j) “Group home” means a residence that:
119+ (i) Personal management; 13
116120
117- (1) Provides residential services for individuals who, because of
118-developmental disability, require specialized living arrangements;
121+ (ii) Household management; and 14
119122
120- (2) Admits at least 4 but not more than 8 individuals; and
123+ (iii) The use of community resources; and 15
121124
122- (3) Provides 10 or more hours of supervision per home, per week.
125+ (2) Rendering appropriate advice or assistance that may be needed. 16
123126
124- (k) “Habilitation” means a process by which a provider of services enables an
125-individual to acquire and maintain life skills to cope more effectively with the demands of
126-the individual’s own person and environment and to raise the level of the individual’s
127-mental, physical, social, and vocational functioning.
127+ (i) “Fee–for–service” means a method for payment that requires a person to 17
128+submit a claim for payment to the Department for each service performed. 18
128129
129- (L) (1) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS
130-AND SERVICES ” MEANS SERVICES , EQUIPMENT, THERAPIES, TRANSPORTATION
131-ACTIVITIES, OR SUPPLIES FOR INDI VIDUALS WHO SELF –DIRECT SERVICES THAT :
130+ (j) “Group home” means a residence that: 19
132131
133- (I) RELATE TO A NEED O R GOAL IDENTIFIED IN THE
134-PERSON–CENTERED PLAN OF SERVICE;
132+ (1) Provides residential services for individuals who, because of 20
133+developmental disability, require specialized living arrangements; 21
135134
136- (II) MAINTAIN OR INCREASE INDEPENDENCE ;
135+ (2) Admits at least 4 but not more than 8 individuals; and 22
137136
138- (III) PROMOTE OPPORTUNITIES FOR COMMUNITY LIVING AND
139-INCLUSION; AND
137+ (3) Provides 10 or more hours of supervision per home, per week. 23
140138
141- (IV) ARE NOT AVAILABLE UND ER A ANOTHER WAIVER SERVICE
142-OR SERVICES PROVIDED UNDER THE STATE PLAN ESTABLISHE D IN SUBTITLE 3 OF
143-THIS TITLE.
144- Ch. 737 2022 LAWS OF MARYLAND
139+ (k) “Habilitation” means a process by which a provider of services enables an 24
140+individual to acquire and maintain life skills to cope more effectively with the demands of 25
141+the individual’s own person and environment and to raise the level of the individual’s 26
142+mental, physical, social, and vocational functioning. 27
145143
146-– 4 –
147- (2) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS
148-AND SERVICES ” INCLUDES ANY OTHER ALL GOODS OR SERVICES AU THORIZED
149-UNDER BY REGULATIONS ADOPT ED OR GUIDANCE ISSUED BY T HE FEDERAL
150-CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF THE
151-SOCIAL SECURITY ACT.
144+ (L) (1) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 28
145+AND SERVICES ” MEANS SERVICES , EQUIPMENT, THERAPIES, TRANSPORTATION 29
146+ACTIVITIES, OR SUPPLIES FOR INDIVIDUALS W HO SELF–DIRECT SERVICES THAT : 30 4 SENATE BILL 868
152147
153- [(l)] (M) (1) “Individual support services” means an array of services that are
154-designed to increase or maintain an individual’s ability to live alone or in a family setting.
155148
156- (2) “Individual support services” include:
157149
158- (i) In–home assistance with meals and personal care;
150+ (I) RELATE TO A NEED OR G OAL IDENTIFIED IN TH E 1
151+PERSON–CENTERED PLAN OF SERVICE; 2
159152
160- (ii) Counseling;
153+ (II) MAINTAIN OR INCREASE INDEPENDENCE ; 3
161154
162- (iii) Physical, occupational, or other therapies;
155+ (III) PROMOTE OPPORTUNITIES FOR COMMUNITY LIVING AND 4
156+INCLUSION; AND 5
163157
164- (iv) Architectural modification; and
158+ (IV) ARE NOT AVAILABLE UND ER A ANOTHER WAIVER SERVICE 6
159+OR SERVICES PROVIDED UNDER THE STATE PLAN ESTABLISHE D IN SUBTITLE 3 OF 7
160+THIS TITLE. 8
165161
166- (v) Any other services that the Administration considers
167-appropriate to meet the individual’s needs.
162+ (2) “INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 9
163+AND SERVICES ” INCLUDES ANY OTHER ALL GOODS OR SERVICES AU THORIZED 10
164+UNDER BY REGULATIONS ADOPT ED OR GUIDANCE ISSUED BY T HE FEDERAL 11
165+CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF THE 12
166+SOCIAL SECURITY ACT. 13
168167
169- (3) “Individual support services” does not include full day or residential
170-services.
168+ [(l)] (M) (1) “Individual support services” means an array of services that are 14
169+designed to increase or maintain an individual’s ability to live alone or in a family setting. 15
171170
172- [(m)] (N) “Intellectual disability” means a developmental disability that is
173-evidenced by significantly subaverage intellectual functioning and impairment in the
174-adaptive behavior of an individual.
171+ (2) “Individual support services” include: 16
175172
176- [(n)] (O) “Knowingly” has the meaning stated in § 2–601 of this article.
173+ (i) In–home assistance with meals and personal care; 17
177174
178- [(o)] (P) “Live independently” means:
175+ (ii) Counseling; 18
179176
180- (1) For adults:
177+ (iii) Physical, occupational, or other therapies; 19
181178
182- (i) Managing personal care, such as clothing and medication;
179+ (iv) Architectural modification; and 20
183180
184- (ii) Managing a household, such as menu planning, food preparation
185-and shopping, essential care of the premises, and budgeting; and
181+ (v) Any other services that the Administration considers 21
182+appropriate to meet the individual’s needs. 22
186183
187- (iii) Using community resources, such as commercial establishments,
188-transportation, and services of public agencies; or
184+ (3) “Individual support services” does not include full day or residential 23
185+services. 24
189186
190- (2) For minors, functioning in normal settings without the need for
191-supervision or assistance other than supervision or assistance that is age appropriate. LAWRENCE J. HOGAN, JR., Governor Ch. 737
187+ [(m)] (N) “Intellectual disability” means a developmental disability that is 25
188+evidenced by significantly subaverage intellectual functioning and impairment in the 26
189+adaptive behavior of an individual. 27
192190
193-– 5 –
191+ [(n)] (O) “Knowingly” has the meaning stated in § 2–601 of this article. 28
194192
195- [(p)] (Q) “Meaningful day services” means employment supports or home– and
196-community–based supports, other than residential services, that assist an individual in
197-developing and maintaining skills, interests, and personalized connections that may create
198-opportunities for paid employment, increased independence, or meaningful relationships
199-with other individuals in the community.
193+ [(o)] (P) “Live independently” means: 29
194+ SENATE BILL 868 5
200195
201- (R) “PERSON–CENTERED PLAN OF SERVICE ” MEANS THAT A PLAN FO R
202-SERVICES AND SUPPORTS :
203196
204- (1) REFLECTS WHAT IS IMPO RTANT TO THE INDIVID UAL AND FOR THE
205-INDIVIDUAL’S HEALTH AND WELFARE; AND
197+ (1) For adults: 1
206198
207- (2) IS DEVELOPED WITH INP UT FROM THE INDIVIDU AL OR THE
208-INDIVIDUAL’S REPRESENTATIVE , IF APPLICABLE.
199+ (i) Managing personal care, such as clothing and medication; 2
209200
210- (1) IS DEVELOPED WITH A F OCUS ON THE INDIVIDU AL HAVING
211-CONTROL OVER THE SER VICES AND SUPPORTS ;
201+ (ii) Managing a household, such as menu planning, food preparation 3
202+and shopping, essential care of the premises, and budgeting; and 4
212203
213- (2) ENSURES THAT THE INDI VIDUAL IS THE PRIMARY CONTRIBUTOR
214-TO THE PLAN AND MAY RECEIVE SUPPORT FROM OTHER PERSONS SELECT ED BY THE
215-INDIVIDUAL IN DEVELO PING THE PLAN;
204+ (iii) Using community resources, such as commercial establishments, 5
205+transportation, and services of public agencies; or 6
216206
217- (3) IDENTIFIES AND ADDRES SES, TO THE EXTENT PRACTI CABLE:
207+ (2) For minors, functioning in normal settings without the need for 7
208+supervision or assistance other than supervision or assistance that is age appropriate. 8
218209
219- (I) THE INDIVIDUAL ’S PREFERENCES AND IN TERESTS
220-RELATED TO ACHIEVIN G THE INDIVIDUAL ’S DESIRED LIFESTYLE ; AND
210+ [(p)] (Q) “Meaningful day services” means employment supports or home– and 9
211+community–based supports, other than residential services, that assist an individual in 10
212+developing and maintaining skills, interests, and personalized connections that may create 11
213+opportunities for paid employment, increased independence, or meaningful relationships 12
214+with other individuals in the community. 13
221215
222- (II) THE SUPPORTS REQUIRED TO ACHIEVE THE INDIV IDUAL’S
223-DESIRED LIFESTYLE AN D PROVIDED IN A MANN ER THAT ENABLES THE INDIVIDUAL
224-TO HAVE CONTROL OVER THE INDIVIDUAL ’S DAILY LIFE AND MAI NTAINS THE
225-INDIVIDUAL’S HEALTH AND WELFARE ; AND
216+ (R) “PERSON–CENTERED PLAN OF SERVICE ” MEANS THAT A PLAN FO R 14
217+SERVICES AND SUPPORTS : 15
226218
227- (4) ALIGNS SERVICES AND S UPPORTS TO ENSURE TH AT THE
228-INDIVIDUAL HAS ACCES S TO THE FULL BENEFI TS OF COMMUNITY LIVI NG IN A
229-MANNER THAT EMPHASIZ ES THE INDIVIDUAL ’S QUALITY OF LIFE, WELL–BEING, AND
230-INFORMED CHOICE .
219+ (1) REFLECTS WHAT IS IMPO RTANT TO THE INDIVID UAL AND FOR THE 16
220+INDIVIDUAL’S HEALTH AND WELFARE ; AND 17
231221
232- [(q)] (S) “Provider” means an individual who is licensed or certified under
233-Subtitle 9 of this title and provides services to:
222+ (2) IS DEVELOPED WITH INP UT FROM THE INDIVIDU AL OR THE 18
223+INDIVIDUAL’S REPRESENTATIVE , IF APPLICABLE. 19
234224
235- (1) A recipient; or
236- Ch. 737 2022 LAWS OF MARYLAND
225+ (1) IS DEVELOPED WITH A F OCUS ON THE INDIVIDUAL HAVING 20
226+CONTROL OVER THE SER VICES AND SUPPORTS ; 21
237227
238-– 6 –
239- (2) An individual with a developmental disability who receives funding for
240-services from a source other than the Administration.
228+ (2) ENSURES THAT THE INDI VIDUAL IS THE PRIMAR Y CONTRIBUTOR 22
229+TO THE PLAN AND MAY RECEIVE SUPPORT FROM OTHER PERSONS SELECT ED BY THE 23
230+INDIVIDUAL IN DEVELO PING THE PLAN; 24
241231
242- [(r)] (T) “Recipient” means an individual who receives services funded by the
243-Administration under this title.
232+ (3) IDENTIFIES AND ADDRES SES, TO THE EXTENT PRACTI CABLE: 25
244233
245- [(s)] (U) “Release” means a permanent, temporary, absolute, or conditional
246-release of an individual from a State residential center.
234+ (I) THE INDIVIDUAL ’S PREFERENCES AND IN TERESTS 26
235+RELATED TO ACHIEVING THE INDIVIDUAL ’S DESIRED LIFESTYLE ; AND 27
247236
248- [(t)] (V) “Residential services” means individualized support and services that
249-assist an individual in developing and maintaining skills in living in the community.
237+ (II) THE SUPPORTS REQUIRED TO ACHIEVE THE INDIV IDUAL’S 28
238+DESIRED LIFESTYLE AN D PROVIDED IN A MANN ER THAT ENABLES THE INDIVIDUAL 29
239+TO HAVE CONTROL OVER THE INDIVIDUAL ’S DAILY LIFE AND MAI NTAINS THE 30
240+INDIVIDUAL’S HEALTH AND WELFARE ; AND 31
241+ 6 SENATE BILL 868
250242
251- (W) (1) “SELF–DIRECTED SERVICES ” MEANS WAIVER PROGRAM
252-SERVICES:
253243
254- (I) FOR WHICH PARTICIPANT S OR THEIR REPRESENT ATIVES
255-HAVE DECISION–MAKING AUTHORITY OVE R AND TAKE DIRECT RE SPONSIBILITY FOR
256-MANAGEMENT OF THE SE RVICES WITH THE ASSI STANCE OF AVAILABLE SUPPORTS
257-CHOSEN BY THE PARTIC IPANT OR THE PARTICI PANT’S REPRESENTATIVE ; AND
244+ (4) ALIGNS SERVICES AND S UPPORTS TO ENSURE TH AT THE 1
245+INDIVIDUAL HAS ACCES S TO THE FULL BENEFI TS OF COMMUNITY LIVI NG IN A 2
246+MANNER THAT EMPHASIZES THE INDIV IDUAL’S QUALITY OF LIFE, WELL–BEING, AND 3
247+INFORMED CHOICE . 4
258248
259- (II) THAT ARE PROVIDED IN A MANNER THAT FURTHERS:
249+ [(q)] (S) “Provider” means an individual who is licensed or certified under 5
250+Subtitle 9 of this title and provides services to: 6
260251
261- 1. FURTHERS THE RIGHT OF INDIVID UALS WITH
262-DISABILITIES, REGARDLESS OF THE PH YSICAL OR INTELLECTUAL CAPACIT Y OF THE
263-INDIVIDUALS, AND THEIR REPRESENTA TIVES, AS APPLICABLE , TO MAKE CHOICES
264-ABOUT AND DI RECT ALL ASPECTS OF THEIR LIVES, INCLUDING THROUGH CONTROL
265-OVER RECEIPT OF, AND FUNDING FOR , SUPPORT SERVICES BY CHOOSING AND
266-CONTROLLING THE DELI VERY OF WAIVER SERVI CES, WHO PROVIDES THE SER VICES,
267-AND HOW SERVICES ARE PROVIDED; AND
252+ (1) A recipient; or 7
268253
269- 2. RECOGNIZES THAT ALL INDIVIDUALS HAVE THE
270-CAPACITY TO MAKE CHO ICES AND MAY BE SUPP ORTED IN MAKING CHOI CES.
254+ (2) An individual with a developmental disability who receives funding for 8
255+services from a source other than the Administration. 9
271256
272- (2) “SELF–DIRECTED SERVICES ” INCLUDES SERVICES TH AT:
257+ [(r)] (T) “Recipient” means an individual who receives services funded by the 10
258+Administration under this title. 11
273259
274- (I) PROVIDE AN INDIVIDUAL WITH:
260+ [(s)] (U) “Release” means a permanent, temporary, absolute, or conditional 12
261+release of an individual from a State residential center. 13
275262
276- 1. THE DECISION–MAKING EMPLOYER AUTH ORITY TO
277-RECRUIT, HIRE, TRAIN, AND SUPERVISE, AND DISMISS THE INDIVIDUALS
278-EMPLOYEES AND VENDOR S WHO FURNISH THE INDI VIDUAL’S SERVICES; AND
263+ [(t)] (V) “Residential services” means individualized support and services that 14
264+assist an individual in developing and maintaining skills in living in the community. 15
279265
280- 2. THE BUDGET AUTHORITY OVER HOW FUNDS IN A
281-BUDGET ARE SPENT WITHIN THE TOTAL APP ROVED ANNUAL BUDGET ;
282- LAWRENCE J. HOGAN, JR., Governor Ch. 737
266+ (W) (1) “SELF–DIRECTED SERVICES ” MEANS WAIVER PROGRAM 16
267+SERVICES: 17
283268
284-– 7 –
285- (II) MAXIMIZE THE OPPORTUN ITIES OF AN INDIVIDUAL TO LIVE
286-AS INDEPENDENTLY AS POSSIBLE IN THE MOST INCLUSIVE COMMUNITY –BASED
287-SETTING OF THE INDIV IDUAL’S CHOICE;
269+ (I) FOR WHICH PARTICIPANT S OR THEIR REPRESENT ATIVES 18
270+HAVE DECISION–MAKING AUTHORITY OVE R AND TAKE DIRECT RE SPONSIBILITY FOR 19
271+MANAGEMENT OF THE SE RVICES WITH THE ASSI STANCE OF AV AILABLE SUPPORTS 20
272+CHOSEN BY THE PARTIC IPANT OR THE PARTICI PANT’S REPRESENTATIVE ; AND 21
288273
289- (III) EMPOWER AN INDIVIDUAL TO EXERCISE CHOICE A ND
290-CONTROL OVER NEEDED LONG–TERM SERVICES AND SU PPORTS; AND
274+ (II) THAT ARE PROVIDED IN A MANNER THAT FURTHERS: 22
291275
292- (IV) HELP TO MAIN TAIN AND IMPROVE THE INDIVIDUAL ’S
293-HEALTH AND QUALITY O F LIFE IN THE INDIVIDUAL’S COMMUNITY .
276+ 1. FURTHERS THE RIGHT OF INDIVID UALS WITH 23
277+DISABILITIES, REGARDLESS OF THE PH YSICAL OR INTELLECTUAL CAPACIT Y OF THE 24
278+INDIVIDUALS, AND THEIR REPRESENTA TIVES, AS APPLICABLE , TO MAKE CHOICES 25
279+ABOUT AND DIRECT ALL ASPECTS OF THEIR LIV ES, INCLUDING THROUGH CONTROL 26
280+OVER RECEIPT OF, AND FUNDING FOR , SUPPORT SERVICES BY CHOOSING AND 27
281+CONTROLLING THE DELI VERY OF WAIVER SERVI CES, WHO PROVIDES THE SER VICES, 28
282+AND HOW SERVICES ARE PROVIDED; AND 29
294283
295- [(u)] (X) “Services” means residential, day, or other services that provide for
296-evaluation, diagnosis, treatment, care, supervision, assistance, or attention to individuals
297-with developmental disability and that promote habilitation of these individuals.
284+ 2. RECOGNIZES THAT ALL I NDIVIDUALS HAVE THE 30
285+CAPACITY TO MAKE CHO ICES AND MAY BE SUPP ORTED IN MAKING CHOI CES. 31
298286
299- [(v)] (Y) “Services coordination” means a service that consists of the following 3
300-major functions that are designed to assist an individual in obtaining the needed services
301-and programs that the individual desires in order to gain as much control over the
302-individual’s own life as possible:
287+ (2) “SELF–DIRECTED SERVICES ” INCLUDES SERVICES TH AT: 32
288+ SENATE BILL 868 7
303289
304- (1) Planning services;
305290
306- (2) Coordinating services; and
291+ (I) PROVIDE AN INDIVIDUAL WITH : 1
307292
308- (3) Monitoring service delivery to the individual.
293+ 1. THE DECISION–MAKING EMPLOYER AUTH ORITY TO 2
294+RECRUIT, HIRE, TRAIN, AND SUPERVISE, AND DISMISS THE INDIVIDUALS 3
295+EMPLOYEES AND VENDOR S WHO FURNISH THE INDI VIDUAL’S SERVICES; AND 4
309296
310- [(w)] (Z) “State residential center” means a licensed facility operated by the
311-State that provides residential and habilitation services to individuals with an intellectual
312-disability who are at least 18 years old and meet the criteria set forth in § 7–502 of this
313-title.
297+ 2. THE BUDGET AUTHORITY OVER HOW FUNDS IN A 5
298+BUDGET ARE SPENT WITHIN THE TOTAL APP ROVED ANNUAL BUDGET ; 6
314299
315- (AA) “SUPPORT BROKER ” MEANS A PERSON WHO ADVOCATES ON BEHALF OF
316-AND AS DIRECTED BY WORKS AT THE DIRECTI ON OF AND FOR THE BE NEFIT OF AN
317-INDIVIDUAL WHO USES SELF–DIRECTED SERVICES , INCLUDING BY ASSISTI NG THE
318-INDIVIDUAL OR THE INDIVIDUAL ’S FAMILY OR OTHER REPRESENTATIVE ANOTHER
319-INDIVIDUAL CHOSEN BY THE INDIVIDUAL WITH:
300+ (II) MAXIMIZE THE OPPORTUN ITIES OF AN INDIVIDU AL TO LIVE 7
301+AS INDEPENDENTLY AS POSSIBLE IN THE MOST INCLUSIVE COMMUNITY –BASED 8
302+SETTING OF THE INDIV IDUAL’S CHOICE; 9
320303
321- (1) MAKING INFORMED DECIS IONS IN ARRANGING FO R, DIRECTING,
322-AND MANAGING SERVICE S THE INDIVIDUAL REC EIVES, INCLUDING DECISIONS
323-RELATED TO PERSONNEL REQUIREMENTS AND RES OURCES NEED ED TO MEET THE
324-REQUIREMENTS ;
304+ (III) EMPOWER AN INDIVIDUAL TO EXERCISE CHOICE AND 10
305+CONTROL OVER NEEDED LONG–TERM SERVICES AND SU PPORTS; AND 11
325306
326- (2) ACCESSING AND MANAGIN G IDENTIFIED SUPPORT S AND
327-SERVICES BEST SUITED FOR THE INDIVIDUAL ; AND
328- Ch. 737 2022 LAWS OF MARYLAND
307+ (IV) HELP TO MAINTAIN AND IMPROVE THE INDIVIDUAL ’S 12
308+HEALTH AND QUALITY O F LIFE IN THE INDIVIDUAL’S COMMUNITY . 13
329309
330-– 8 –
331- (3) PERFORMING OTHER TASK S AS ASSIGNED BY THE INDIVIDUAL
332-AND AS AUTHORIZED BY REGULATIONS ADOPTED OR GUIDANCE ISSUED B Y THE
333-FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF
334-THE SOCIAL SECURITY ACT.
310+ [(u)] (X) “Services” means residential, day, or other services that provide for 14
311+evaluation, diagnosis, treatment, care, supervision, assistance, or attention to individuals 15
312+with developmental disability and that promote habilitation of these individuals. 16
335313
336- [(x)] (BB) “Support services” means supports that assist an individual to maintain
337-or improve the individual’s functional abilities, enhance interactions, or engage in
338-meaningful relationships in the home or community.
314+ [(v)] (Y) “Services coordination” means a service that consists of the following 3 17
315+major functions that are designed to assist an individual in obtaining the needed services 18
316+and programs that the individual desires in order to gain as much control over the 19
317+individual’s own life as possible: 20
339318
340- [(y)] (CC) “Treatment” means any education, training, professional care or
341-attention, or other program that is given to an individual with developmental disability.
319+ (1) Planning services; 21
342320
343- [(z)] (DD) “Vocational services” means a service that provides job training and
344-placement, supported employment and training in acceptable work behaviors, and
345-vocationally–related social and other skills.
321+ (2) Coordinating services; and 22
346322
347- [(aa)] (EE) “Waiver program” means each Medicaid Home – and
348-Community–Based Services Waiver funding program submitted by the Department and
349-approved by the federal Centers for Medicare and Medicaid Services in accordance with §
350-1915(c) of the Social Security Act that is overseen and administered by the Administration.
323+ (3) Monitoring service delivery to the individual. 23
351324
352- [(bb)] (FF) “Waiver program services” means services funded by the
353-Administration in accordance with a waiver program, including:
325+ [(w)] (Z) “State residential center” means a licensed facility operated by the 24
326+State that provides residential and habilitation services to individuals with an intellectual 25
327+disability who are at least 18 years old and meet the criteria set forth in § 7–502 of this 26
328+title. 27
354329
355- (1) Meaningful day services;
330+ (AA) “SUPPORT BROKER ” MEANS A PERSON WHO ADVOCATES ON BEHALF OF 28
331+AND AS DIRECTED BY WORKS AT THE DIRECTI ON OF AND FOR THE BE NEFIT OF AN 29
332+INDIVIDUAL WHO USE S SELF–DIRECTED SERVICES , INCLUDING BY ASSISTI NG THE 30
333+INDIVIDUAL OR THE INDIVIDUAL ’S FAMILY OR OTHER REPRESENTATIVE ANOTHER 31
334+INDIVIDUAL CHOSEN BY THE INDIVIDUAL WITH: 32
335+ 8 SENATE BILL 868
356336
357- (2) Residential services; and
358337
359- (3) Support services.
338+ (1) MAKING INFORMED DECIS IONS IN ARRANGING FO R, DIRECTING, 1
339+AND MANAGING SERVICE S THE INDIVIDUAL RECEIVES , INCLUDING DECISIONS 2
340+RELATED TO PERSONNEL REQUIREMENTS AND RES OURCES NEEDED TO MEE T THE 3
341+REQUIREMENTS ; 4
360342
361-7–408.
343+ (2) ACCESSING AND MANAGIN G IDENTIFIED SUPPORT S AND 5
344+SERVICES BEST SUITED FOR THE INDIVIDUAL ; AND 6
362345
363- (A) THE ADMINISTRATION , IN CONSULTATION WITH STAKEHOLDERS ,
364-SHALL ESTABLISH AND PROVIDE TRAINING MAT ERIALS TO COORDINATO RS OF
365-COMMUNITY SERVICES SPECIFICALLY ON THE SELF–DIRECTED SERVICES MODEL OF
366-RECEIVING SERVICES , INCLUDING TRAINING MATERIALS O N SELF–DIRECTED
367-SERVICES, PROCEDURES , POLICIES, AND RESOURCES .
346+ (3) PERFORMING OTHER TASK S AS ASSIGNED BY THE INDIVIDUAL 7
347+AND AS AUTHORIZED BY REGULATIONS ADOPTED OR GUIDANCE ISSUED B Y THE 8
348+FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 1915(C) OF 9
349+THE SOCIAL SECURITY ACT. 10
368350
369- (B) AS PART OF THE PROCES S OF DEVELOPING A PE RSON–CENTERED PLAN
370-OF SERVICE FOR A REC IPIENT, A COORDINATOR OF COM MUNITY SERVICES SHAL L
371-EDUCATE THE RECIPIEN T ON THE AVAILABILITY OF SELF–DIRECTED SERVICES ALL
372-MODELS OF SERVICE AV AILABLE TO THE RECIP IENT, INCLUDING SELF –DIRECTED
373-SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES , TO
374-ASSIST THE RECIPIENT AND THE RECIPIENT ’S FAMILY OR REPRESEN TATIVE IN LAWRENCE J. HOGAN, JR., Governor Ch. 737
351+ [(x)] (BB) “Support services” means supports that assist an individual to maintain 11
352+or improve the individual’s functional abilities, enhance interactions, or engage in 12
353+meaningful relationships in the home or community. 13
375354
376-– 9 –
377-MAKING AN INFORMED C HOICE ON WHICH SERVI CES THE RECIPIENT WOULD LIKE
378-TO RECEIVE:
355+ [(y)] (CC) “Treatment” means any education, training, professional care or 14
356+attention, or other program that is given to an individual with developmental disability. 15
379357
380- (1) WHEN THE INDIVIDUAL B EGINS RECEIVING SERV ICES FROM A
381-COORDINATOR OF COMMU NITY SERVICES; AND
358+ [(z)] (DD) “Vocational services” means a service that provides job training and 16
359+placement, supported employment and training in acceptable work behaviors, and 17
360+vocationally–related social and other skills. 18
382361
383- (2) AT LEAST ONCE EACH YE AR THAT THE INDIVIDU AL IS RECEIVING
384-SERVICES FROM A COOR DINATOR OF COMMUNITY SERVICES.
362+ [(aa)] (EE) “Waiver program” means each Medicaid Home – and 19
363+Community–Based Services Waiver funding program submitted by the Department and 20
364+approved by the federal Centers for Medicare and Medicaid Services in accordance with § 21
365+1915(c) of the Social Security Act that is overseen and administered by the Administration. 22
385366
386- (C) A COORDINATOR OF COMMUNIT Y SERVICES SHALL REP ORT TO THE
387-ADMINISTRATION , IN THE FORM AND MANN ER REQUIRED BY THE ADMINISTRATION ,
388-THAT THE COORDINATOR OFFERED PROVIDED INFORMATION ON SELF–DIRECTED
389-SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES TO AN
390-INDIVIDUAL IN ACCORD ANCE WITH THIS SECTI ON.
367+ [(bb)] (FF) “Waiver program services” means services funded by the 23
368+Administration in accordance with a waiver program, including: 24
391369
392-7–409.
370+ (1) Meaningful day services; 25
393371
394- (A) THE ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT WHO RECEIVES
395-SELF–DIRECTED SERVICES :
372+ (2) Residential services; and 26
396373
397- (1) INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS
398-AND SERVICES IN AN A MOUNT BASED ON THE R ECIPIENT’S NEEDS AND INCLUDED IN
399-THE RECIPIENT’S PERSON–CENTERED PLAN OF SER VICE AS CALCULATED ON:
374+ (3) Support services. 27
400375
401- (I) ON AN ANNUAL BASIS ; AND
376+7–408. 28
402377
403- (II) WITHIN THE LIMITS OF THE APPROVED ANNUAL BUDGET
404-GENERATED BY THE DEPARTMENT ’S LONG TERM SERVICES AND SUPPORTS
405-SOFTWARE SYSTEM OR ITS REPLACEMENT SYST EM;
378+ (A) THE ADMINISTRATION , IN CONSULTATION WITH STAKEHOLDERS , 29
379+SHALL ESTABLISH AND PROVIDE TRAINING MAT ERIALS TO COORDINATO RS OF 30
380+COMMUNITY SERVICES SPECIFICALLY ON THE SELF–DIRECTED SERVICES MODEL OF 31
381+RECEIVING SERVICES , INCLUDING TRAINING MATERIALS O N SELF–DIRECTED 32
382+SERVICES, PROCEDURES , POLICIES, AND RESOURCES . 33 SENATE BILL 868 9
406383
407- (2) ACCESS TO THE RECIPIE NT’S PLAN OF SERVICE AN D BUDGETS
408-FOR THE PLAN OF SERV ICE THROUGH THE DEPARTMENT ’S LONG TERM SERVICES
409-AND SUPPORTS SOFTWARE SYS TEM OR ITS REPLACEMENT S YSTEM;
410384
411- (3) UP TO 40 30 HOURS OF SUPPORT BRO KER SERVICES EACH
412-MONTH, AS NEEDED BY THE REC IPIENT AND WITHIN THE RECIP IENT’S TOTAL
413-APPROVED ANNUAL BUDG ET;
414385
415- (4) AN OPTION FOR A FAMIL Y MEMBER OR LEGAL GU ARDIAN OF THE
416-RECIPIENT TO PROVIDE SERVICES FOR THE REC IPIENT, IF:
386+ (B) AS PART OF THE PROCES S OF DEVELOPING A PE RSON–CENTERED PLAN 1
387+OF SERVICE FOR A REC IPIENT, A COORDINATOR OF COMMUNITY SERVICES S HALL 2
388+EDUCATE THE RECIPIEN T ON THE AVAILABILITY OF SELF–DIRECTED SERVICES ALL 3
389+MODELS OF SERVICE AV AILABLE TO THE RECIP IENT, INCLUDING SELF –DIRECTED 4
390+SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES , TO 5
391+ASSIST THE RECIPIENT AND THE RECIPIENT ’S FAMILY OR REPRESEN TATIVE IN 6
392+MAKING AN INFORMED C HOICE ON WHICH SERVI CES THE RECIPIENT WO ULD LIKE 7
393+TO RECEIVE: 8
417394
418- (I) THE RECIPIENT OR AN INDI VIDUAL AUTHORIZED TO MAKE
419-CARE DECISIONS ON BE HALF OF THE RECIPIEN T CHOOSES THE FAMILY MEMBER TO
420-PROVIDE THE SERVICES ; AND Ch. 737 2022 LAWS OF MARYLAND
395+ (1) WHEN THE INDIVIDUAL B EGINS RECEIVING SERV ICES FROM A 9
396+COORDINATOR OF COMMU NITY SERVICES; AND 10
421397
422-– 10 –
398+ (2) AT LEAST ONCE EACH YEAR THAT THE INDIVI DUAL IS RECEIVING 11
399+SERVICES FROM A COOR DINATOR OF COMMUNITY SERVICES. 12
423400
424- (II) THE RECIPIENT ALSO HI RES A SUPPORT BROKER ;
401+ (C) A COORDINATOR OF COMMU NITY SERVICES SHALL REPORT TO THE 13
402+ADMINISTRATION , IN THE FORM AND MANN ER REQUIRED BY THE ADMINISTRATION , 14
403+THAT THE COORDINATOR OFFERED PROVIDED INFORMATION ON SELF–DIRECTED 15
404+SERVICES, TRADITIONAL SERVICES , AND PROVIDER –MANAGED SERVICES TO AN 16
405+INDIVIDUAL IN ACCORD ANCE WITH THIS SECTI ON. 17
425406
426- (5) REIMBURSEMENT PAID ON A PER–MILE BASIS FOR
427-TRANSPORTAT ION PROVIDED TO THE RECIPIENT BY AN INDI VIDUAL WHO IS NOT
428-EMPLOYED BY THE INDI VIDUAL, IF THE TRANSPORTATIO N IS RELATED TO TO THE
429-OWNER OF A SPECIALIZ ED, MODIFIED, OR ACCESSIBLE VEHICL E DRIVEN BY AN
430-EMPLOYEE OF THE RECI PIENT AND FOR THE PU RPOSE OF THE RECIP IENT
431-ENGAGING IN ACTIVITI ES SPECIFIED IN THE RECIPIENT’S PERSON–CENTERED PLAN
432-OF SERVICE;
407+7–409. 18
433408
434- (6) A BUDGET FOR SELF –DIRECTED SERVICES TH AT PROVIDES
435-SUBSTANTIALLY SIMILA R SERVICES AS THOSE PROVIDED TO A RECIPI ENT WHO
436-DOES NOT SELF –DIRECT SERVICES , INCLUDING FUNDING FOR MANAGERI AL OR
437-DIRECT SUPPORT POSIT IONS THE ABILITY TO USE F UNDS FROM THE RECIPI ENT’S
438-APPROVED ANNUAL BUDG ET FOR THE PURPOSE O F FUNDING AT LEAST O NE
439-POSITION TO ASSIST T HE RECIPIENT IN MANA GING THE RECIPIENT ’S HOME, STAFF,
440-AND OTHER ADMINISTRA TIVE DUTIES AND PAY A DMINISTRATIVE EXPENS ES NEEDED
441-TO OPERATE THE RECIP IENT’S PLAN OF SERVICE , INCLUDING INTERNET SERVICE
442-AND OFFICE EQUIPMENT ;
409+ (A) THE ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT WHO RECEIVES 19
410+SELF–DIRECTED SERVICES : 20
443411
444- (7) AN OPTION FOR A RECIP IENT WHO HAS A DEMON STRATED NEED
445-FOR OVERNIGHT SUPPOR TS PROVIDED THROUGH PER SONAL SUPPORT SERVICES
446-CARRIED OUT USING TH E RECIPIENT’S EMPLOYER OR BUDGET AUTHORITY TO
447-DIRECT AND CHOOSE TH E EMPLOYEE, VENDOR, OR PROVIDER OF THE OVER NIGHT
448-SUPPORTS, INCLUDING WHETHER TO USE FUNDING IN THE R ECIPIENT’S BUDGET
449-FOR SELF–DIRECTED SERVICES AL LOCATED FOR PERSONAL SUPPO RT SERVICES
450-FOR OVERNIGHT SUPPOR TS;
412+ (1) INDIVIDUAL–DIRECTED FAMILY AND FAMILY–DIRECTED GOODS 21
413+AND SERVICES IN AN A MOUNT BASED ON THE R ECIPIENT’S NEEDS AND INCLUDED IN 22
414+THE RECIPIENT’S PERSON–CENTERED PLAN OF SER VICE AS CALCULATED ON: 23
451415
452- (8) THE CHOICE OF A VENDO R TO PROVIDE FISCAL MANAGEMENT
453-SERVICES FROM AT LEA ST THREE OPTIONS ;
416+ (I) ON AN ANNUAL BASIS ; AND 24
454417
455- (9) THE OPTION TO EMPLOY A REPRESENTATIVE , SUPPORT BROKER ,
456-OR TEAM OF INDIVIDUA LS TO SUPPORT THE RE CIPIENT IN DIRECTING SERVICES;
457-AND
418+ (II) WITHIN THE LIMITS OF THE APPROVED ANNUAL BUDG ET 25
419+GENERATED BY THE DEPARTMENT ’S LONG TERM SERVICES AND SUPPORTS 26
420+SOFTWARE SYSTEM OR I TS REPLACEMENT SYSTE M; 27
458421
459- (10) TRAINING FOR A REPRES ENTATIVE, SUPPORT BROKER , OR TEAM
460-OF INDIVIDUALS ON SE LF–DIRECTED SERVICES .
422+ (2) ACCESS TO THE RECIPIE NT’S PLAN OF SERVICE AN D BUDGETS 28
423+FOR THE PLAN OF SERV ICE THROUGH THE DEPARTMENT ’S LONG TERM SERVICES 29
424+AND SUPPORTS SOFTWARE SYS TEM OR ITS REPLACEMENT S YSTEM; 30
461425
462- (B) SUBJECT TO SUBSECTION (A)(3) OF THIS SECTION , THE
463-ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT OF SELF–DIRECTED SERVICES
464-ANY SUPPORT BROKER S ERVICES THAT ARE :
465- LAWRENCE J. HOGAN, JR., Governor Ch. 737
426+ (3) UP TO 40 30 HOURS OF SUPPORT BRO KER SERVICES EACH 31
427+MONTH, AS NEEDED BY THE REC IPIENT AND WITHIN THE RECIP IENT’S TOTAL 32
428+APPROVED ANNUAL BUDG ET; 33 10 SENATE BILL 868
466429
467-– 11 –
468- (1) AUTHORIZED UNDER BY REGULATIONS ADOPT ED OR GUIDANCE
469-ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES IN § 1915(C) OF
470-THE SOCIAL SECURITY ACT; AND
471430
472- (2) SELECTED BY THE RECIP IENT.
473431
474- (C) (1) THE SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE
475-ADMINISTRATION MAY NO T ESTABLISH A LIMIT ON:
432+ (4) AN OPTION FOR A FAMIL Y MEMBER OR LEGAL GUARDIAN OF THE 1
433+RECIPIENT TO PROVIDE SERVICES FOR THE REC IPIENT, IF: 2
476434
477- (1) (I) THE DOLLAR AMOUNT OF INDIVIDUAL–DIRECTED FAMILY
478-AND FAMILY–DIRECTED GOODS AND SERVICES P ROVIDED TO A RECIPIE NT; OR
435+ (I) THE RECIPIENT OR AN I NDIVIDUAL AUTHORIZED TO MAKE 3
436+CARE DECISIONS ON BE HALF OF THE RECIPIEN T CHOOSES THE FAMILY MEMBER TO 4
437+PROVIDE THE SERVICES ; AND 5
479438
480- (2) (II) THE NUMBER OF HOURS O F OVERNIGHT SUPPORTS
481-PERSONAL SUPPORT SER VICES PROVIDED TO A RECIPI ENT WHO RECEIVES
482-SELF–DIRECTED SERVICES THAT:
439+ (II) THE RECIPIENT ALSO HI RES A SUPPORT BROKER ; 6
483440
484- 1. ARE NECESSARY FOR THE HEALTH AND SAFETY OF
485-THE RECIPIENT; AND
441+ (5) REIMBURSEMENT PAID ON A PER–MILE BASIS FOR 7
442+TRANSPORTATION PROVI DED TO THE RECIPIENT BY AN INDIVIDUAL WHO IS NOT 8
443+EMPLOYED BY THE INDI VIDUAL, IF THE TRANSPORTATIO N IS RELATED TO TO THE 9
444+OWNER OF A SPECIALIZ ED, MODIFIED, OR ACCESSIBLE VEHICLE D RIVEN BY AN 10
445+EMPLOYEE OF THE RECI PIENT AND FOR THE PU RPOSE OF THE RECIPIE NT 11
446+ENGAGING IN ACTIVITI ES SPECIFIED IN THE RECIPIENT’S PERSON–CENTERED PLAN 12
447+OF SERVICE; 13
486448
487- 2. ARE AUTHORIZED BY REG ULATIONS ADOPTED OR
488-GUIDANCE ISSUED BY T HE FEDERAL CENTERS FOR MEDICARE AND MEDICAID
489-SERVICES UNDER § 1915(C) OF THE SOCIAL SECURITY ACT.
449+ (6) A BUDGET FOR SELF –DIRECTED SERVICES TH AT PROVIDES 14
450+SUBSTANTIALLY SIMI LAR SERVICES AS THOS E PROVIDED TO A RECI PIENT WHO 15
451+DOES NOT SELF –DIRECT SERVICES , INCLUDING FUNDING FO R MANAGERIAL OR 16
452+DIRECT SUPPORT POSIT IONS THE ABILITY TO USE F UNDS FROM THE RECIPI ENT’S 17
453+APPROVED ANNUAL BUDG ET FOR THE PURPOSE O F FUNDING AT LEAST O NE 18
454+POSITION TO ASSIST THE RE CIPIENT IN MANAGING THE RECIPIENT’S HOME, STAFF, 19
455+AND OTHER ADMINISTRA TIVE DUTIES AND PAY ADMINISTRATIVE EXPEN SES NEEDED 20
456+TO OPERATE THE RECIP IENT’S PLAN OF SERVICE , INCLUDING INTERNET SERVICE 21
457+AND OFFICE EQUIPMENT ; 22
490458
491- (2) A RECIPIENT MAY NOT RE CEIVE SERVICES OR SU PPORTS IN
492-EXCESS OF THE RECIPI ENT’S ANNUAL APPROVED BU DGET.
459+ (7) AN OPTION FOR A RECIP IENT WHO HAS A DEMON STRATED NEED 23
460+FOR OVERNIGHT SUPPOR TS PROVIDED THROUGH PER SONAL SUPPORT SERVIC ES 24
461+CARRIED OUT USING TH E RECIPIENT’S EMPLOYER OR BUDGET AUTHORITY TO 25
462+DIRECT AND CHOOSE TH E EMPLOYEE, VENDOR, OR PROVIDER OF THE OVER NIGHT 26
463+SUPPORTS, INCLUDING WHETHER TO USE FUNDING IN THE R ECIPIENT’S BUDGET 27
464+FOR SELF–DIRECTED SERVICES AL LOCATED FOR PERSONAL SUPPORT SERVICES 28
465+FOR OVERNIGHT SUPPOR TS; 29
493466
494- (D) THE STATE MAY NOT REQUIRE A RECIPIENT TO DEMON STRATE
495-COMPETENCY BEFORE TH E ADMINISTRATION AUTHOR IZES THE RECIPIENT T O
496-RECEIVE SELF–DIRECT SERVICES .
467+ (8) THE CHOICE OF A VENDO R TO PROVIDE FISCAL MANAGEMENT 30
468+SERVICES FROM AT LEA ST THREE OPTIONS ; 31
497469
498-7–410.
470+ (9) THE OPTION TO EMPLOY A REPRESENTATIVE , SUPPORT BROKER , 32
471+OR TEAM OF INDIVIDUA LS TO SUPPORT THE RE CIPIENT IN DIRECTING SERVICES; 33
472+AND 34
473+ SENATE BILL 868 11
499474
500- (A) THE ADMINISTRATION SHALL PROVIDE UP TO 40 30 HOURS OF
501-SUPPORT BROKER SERVI CES EACH MONTH TO A RECIPIENT OF WAIVER SERVICES,
502-AS NEEDED BY THE RECIPIENT AND WITHIN THE RECIPIENT ’S TOTAL APPROVED
503-ANNUAL BUDGET .
504475
505- (B) SUBJECT TO SUBSECTION (A) OF THIS SECTION, THE ADMINISTRATION
506-SHALL PROVIDE TO A R ECIPIENT OF WAIVER S ERVICES ANY SUPPORT BROKER
507-SERVICES THAT ARE AU THORIZED UNDER BY REGULATIONS ADO PTED OR GUIDANCE
508-ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER §
509-1915(C) OF THE SOCIAL SECURITY ACT.
510- Ch. 737 2022 LAWS OF MARYLAND
476+ (10) TRAINING FOR A REPRES ENTATIVE, SUPPORT BROKER , OR TEAM 1
477+OF INDIVIDUALS ON SE LF–DIRECTED SERVICES . 2
511478
512-– 12 –
513- SECTION 2. AND BE IT FURTHER ENACTED, That on or before January 1, 2023,
514-the Developmental Disabilities Administration shall submit to the Centers for Medicare
515-and Medicaid Services an amendment to the Community Pathways Waiver that includes
516-the overnight supports requirements established under Section 1 of this Act.
479+ (B) SUBJECT TO SUBSECTION (A)(3) OF THIS SECTION , THE 3
480+ADMINISTRATION SHALL PROVIDE TO A RECIPIE NT OF SELF–DIRECTED SERVICES 4
481+ANY SUPPORT BROKER S ERVICES THAT ARE : 5
517482
518- SECTION 3. AND BE IT FURTHER ENACTED, That on or before January 1 each
519-year, beginning in 2023 and ending in 2026, the Developmental Disabilities Administration
520-shall report to the General Assembly, in accordance with § 2–1257 of the State Government
521-Article, on the progress in implementing the requirements established under Section 1 of
522-this Act and the recommendations outlined in the Self–Directed Advocacy Network of
523-Maryland’s “Recommendations to Summary Study Workgroup House Bill 318 of 2021”.
483+ (1) AUTHORIZED UNDER BY REGULATIONS ADOPT ED OR GUIDANCE 6
484+ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES IN § 1915(C) OF 7
485+THE SOCIAL SECURITY ACT; AND 8
524486
525- SECTION 4. AND BE IT FURTHER ENACTED, That, to the extent authorized by
526-law, the Developmental Disabilities Administration shall leverage federal funding,
527-including funding provided by the Centers for Medicare and Medicaid Services, to pay for
528-the services established under this Act.
487+ (2) SELECTED BY THE RECIP IENT. 9
529488
530- SECTION 5. AND BE IT FURTHER ENACTED, That the Maryland Department of
531-Health shall:
489+ (C) (1) THE SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE 10
490+ADMINISTRATION MAY NO T ESTABLISH A LIMIT ON: 11
532491
533- (1) collect utilization data on recipients of self–directed services and
534-determine the fiscal impact of expanding services as required under Section 1 of this Act;
535-and
492+ (1) (I) THE DOLLAR AMOUNT OF INDIVIDUAL–DIRECTED FAMILY 12
493+AND FAMILY–DIRECTED GOODS AND SERVICES P ROVIDED TO A RECIPIE NT; OR 13
536494
537- (2) on or before January 1, 2023, provide a baseline report to the General
538-Assembly, in accordance with § 2–1257 of the State Government Article, on the utilization
539-and cost of self–directed services.
495+ (2) (II) THE NUMBER OF HOURS O F OVERNIGHT SUPPORTS 14
496+PERSONAL SUPPORT SER VICES PROVIDED TO A RECIPI ENT WHO RECEIVES 15
497+SELF–DIRECTED SERVICES THAT: 16
540498
541- SECTION 6. AND BE IT FURTHER ENACTED, That, on or before October 1, 2024,
542-the Maryland Department of Health shall report to the General Assembly, in accordance
543-with § 2–1257 of the State Government Article, on the findings and recommendations of
544-the Maryland Department of Health related to the expansion of self–directed services as
545-required under Section 1 of this Act.
499+ 1. ARE NECESSARY FOR THE HEALTH AND SAFETY OF 17
500+THE RECIPIENT; AND 18
546501
547- SECTION 5. 7. AND BE IT FURTHER ENACTED, That this Act shall take effect
548-October 1, 2022.
502+ 2. ARE AUTHORIZED BY REG ULATIONS ADOPTED OR 19
503+GUIDANCE ISSUED BY T HE FEDERAL CENTERS FOR MEDICARE AND MEDICAID 20
504+SERVICES UNDER § 1915(C) OF THE SOCIAL SECURITY ACT. 21
549505
550-Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.
506+ (2) A RECIPIENT MAY NOT RE CEIVE SERVICES OR SU PPORTS IN 22
507+EXCESS OF THE RECIPI ENT’S ANNUAL APPROVED BU DGET. 23
508+
509+ (D) THE STATE MAY NOT REQUIRE A RECIPIENT TO DEMON STRATE 24
510+COMPETENCY BEFORE TH E ADMINISTRATION AUTHOR IZES THE RECIPIENT T O 25
511+RECEIVE SELF–DIRECT SERVICES . 26
512+
513+7–410. 27
514+
515+ (A) THE ADMINISTRATION SHALL PROVIDE UP TO 40 30 HOURS OF 28
516+SUPPORT BROKER SERVI CES EACH MONTH TO A RECIPIENT OF WAIVER SERVICES, 29
517+AS NEEDED BY THE REC IPIENT AND WITHIN TH E RECIPIENT’S TOTAL APPROVED 30
518+ANNUAL BUDGET . 31
519+ 12 SENATE BILL 868
520+
521+
522+ (B) SUBJECT TO SUBSECTION (A) OF THIS SECTION, THE ADMINISTRATION 1
523+SHALL PROVIDE TO A RECIPIENT OF WAIVER SERVICES ANY SUPPORT BROKER 2
524+SERVICES THAT ARE AU THORIZED UNDER BY REGULATIONS ADOPT ED OR GUIDANCE 3
525+ISSUED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES UNDER § 4
526+1915(C) OF THE SOCIAL SECURITY ACT. 5
527+
528+ SECTION 2. AND BE IT FURTHER ENACTED, That on or before January 1, 2023, 6
529+the Developmental Disabilities Administration shall submit to the Centers for Medicare 7
530+and Medicaid Services an amendment to the Community Pathways Waiver that includes 8
531+the overnight supports requirements established under Section 1 of this Act. 9
532+
533+ SECTION 3. AND BE IT FURTHER ENACTED, That on or before January 1 each 10
534+year, beginning in 2023 and ending in 2026, the Developmental Disabilities Administration 11
535+shall report to the General Assembly, in accordance with § 2–1257 of the State Government 12
536+Article, on the progress in implementing the requirements established under Section 1 of 13
537+this Act and the recommendations outlined in the Self–Directed Advocacy Network of 14
538+Maryland’s “Recommendations to Summary Study Workgroup House Bill 318 of 2021”. 15
539+
540+ SECTION 4. AND BE IT FURTHER ENACTED, That, to the extent authorized by 16
541+law, the Developmental Disabilities Administration shall leverage federal funding, 17
542+including funding provided by the Centers for Medicare and Medicaid Services, to pay for 18
543+the services established under this Act. 19
544+
545+ SECTION 5. AND BE IT FURTHER ENACTED, That the Maryland Department of 20
546+Health shall: 21
547+
548+ (1) collect utilization data on recipients of self–directed services and 22
549+determine the fiscal impact of expanding services as required under Section 1 of this Act; 23
550+and 24
551+
552+ (2) on or before January 1, 2023, provide a baseline report to the General 25
553+Assembly, in accordance with § 2–1257 of the State Government Article, on the utilization 26
554+and cost of self–directed services. 27
555+
556+ SECTION 6. AND BE IT FURTHER ENACTED, That, on or before October 1, 2024, 28
557+the Maryland Department of Health shall report to the General Assembly, in accordance 29
558+with § 2–1257 of the State Government Article, on the findings and recommendations of 30
559+the Maryland Department of Health related to the expansion of self–directed services as 31
560+required under Section 1 of this Act. 32
561+
562+ SECTION 5. 7. AND BE IT FURTHER ENACTED, That this Act shall take effect 33
563+October 1, 2022. 34
564+
565+
566+