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Summary
HB1053 amends Maryland’s Health-General law governing Developmental Disabilities Administration (DDA) self-directed services. The bill clarifies that a recipient’s parent may provide services under the self-directed model, and it broadens the existing rule for family members and legal guardians who may serve as providers. Under the bill, the recipient or an authorized decision-maker must choose the parent, family member, or guardian to provide services, and the recipient must also hire a support broker.
The bill adds an additional condition: the services must be authorized for provision by a parent, another family member, or legal guardian under an Administration waiver approved by the Centers for Medicare and Medicaid Services (CMS). The act takes effect October 1, 2025, and applies to the DDA’s self-directed services framework rather than creating a new program.
Impact
HB1053 amends Section 7-409(a)(4) of the Health-General Article, changing who may be paid to provide self-directed services to a DDA recipient and under what waiver authority. It affects recipients of developmental disability services, their parents, family members, legal guardians, support brokers, and the Developmental Disabilities Administration, while tying eligibility for these provider arrangements to CMS-approved waiver authority.
Sentiment
The bill appears to have been broadly supported and noncontroversial. It was reported favorably with amendments by the House Health and Government Operations Committee, adopted by the House, and later passed third reading unanimously with 139 yeas and 0 nays. The available record suggests consensus around clarifying and expanding family-provided service options in the self-directed services system.
Contention
The main policy issue is the scope of who may serve as a paid provider in self-directed services and the safeguards attached to that role. The bill narrows potential disputes by requiring recipient choice, use of a support broker, and CMS waiver authorization, which likely addresses concerns about oversight, conflicts of interest, and compliance with federal Medicaid rules. No recorded opposition or floor debate is available in the provided materials.