Maryland DDA Budget Cuts 2026: What the Reductions Mean for Families

The Numbers Behind the Reductions

Maryland's Developmental Disabilities Administration is operating under severe fiscal pressure. The enacted state budgets for Fiscal Year 2026 and Fiscal Year 2027 include combined service reductions exceeding $290 million — approximately $164 million in FY2026 and $127 million in FY2027.

These cuts landed at a moment when the state was supposed to be reducing its DDA waiting list under the End the Wait Act of 2022. Instead, the fiscal reality has constrained the state's capacity to fund new waiver slots while simultaneously restructuring how existing services are paid for.

Here's what the reductions mean in concrete operational terms for families currently receiving or waiting for DDA services.

Self-Direction Rate Changes

The largest dollar impact falls on families using the self-directed service model, where the individual or their representative hires and manages their own support staff.

Family as Staff (FAS) sliding scale. Personal support rates for family members serving as paid staff are now calculated using BLS-indexed wage benchmarks instead of flat hourly rates. The state projects this adjustment saves $40 million. In practice, many family providers are seeing lower hourly rates than they earned previously.

Non-family staff wage cap. Rates for non-family personal support staff are capped at $30 per hour. Before this cap, some regions had approved higher rates to address recruitment challenges in high-cost-of-living areas like Montgomery County and the Baltimore corridor. The $30 cap is projected to save $6.25 million.

Unlicensed vendor rate adjustments. Payments to unlicensed vendors (individuals providing specialized services without a DDA provider license) are reduced to match the family-as-staff rates, with exceptions only for licensed nursing and support broker services. This saves an additional $16.1 million.

60/40 family hour cap. Total combined hours worked by all family members serving as paid staff for a single beneficiary cannot exceed 60 hours per week — even if each individual family member stays under their 40-hour limit. A two-parent household where both parents serve as FAS providers was previously limited only by each parent's individual 40-hour cap (80 hours combined maximum). The new rule reduces that to 60 hours. Projected savings: $1.7 million.

Elimination of the wage exception process. Previously, self-directed participants could request wage rates above the standard caps to address local staffing shortages. That administrative pathway no longer exists.

The End the Wait Act Collision

The End the Wait Act of 2022 was Maryland's legislative commitment to reducing the DDA waiting list by establishing timelines and funding commitments for new waiver enrollments. The law set targets that assumed continued budget growth — growth that the FY2026 and FY2027 budgets did not deliver.

The result is a structural disconnect: the law's targets remain on the books, but the funding to achieve them has been severely reduced. Families on the waiting list shouldn't assume the End the Wait timeline will hold — priority category and urgency of need are more likely to determine when a waiver slot becomes available than any legislated timeline.

PCP Budget Limits

The DDA has established a $500,000 annual cap on standard Person-Centered Plans. An exception process allows approvals up to $625,000 when services are documented as necessary for the individual's health and safety. These caps existed before the budget cuts but take on new significance in a fiscal environment where every service authorization is scrutinized more closely.

The 183-Day Service Requirement

A beneficiary must use at least one waiver service every 183 calendar days to maintain enrollment in the Community Pathways Waiver. A lapse in service delivery exceeding six consecutive months can result in termination from the waiver. In the context of budget cuts, this rule creates a specific risk: if staffing shortages or provider capacity issues prevent services from being delivered, the beneficiary — not the state — bears the consequence of a service gap.

If your family is experiencing service delivery gaps due to staffing or provider availability, document the gap and notify the CCS in writing. A documented failure to deliver services due to systemic capacity issues is different from a voluntary choice to decline services.

What Families Can Do

Monitor your PCP budget. If you're in self-direction, the rate changes may mean your existing budget buys fewer hours than it did previously. Request a budget review at the next annual PCP meeting and identify where adjustments are needed.

Document priority category changes. If the waiting list timeline has stretched beyond what your family can sustain — caregiver health is declining, the housing situation has changed, or behavioral needs have escalated — work with the CCS to submit a priority category reassessment. Moving from Current Request to Crisis Prevention or Crisis Resolution is often the only way to accelerate waiver funding under the current fiscal constraints.

Track LISS availability. Low Intensity Support Services grants (up to $1,000 per fiscal year for families on the waiting list) are processed through a random selection lottery with applications accepted August 1 through September 15 and selection on October 1. These grants don't replace waiver services, but they can fund adaptive equipment, respite care, or therapies while you wait.

For the complete DDA coordination framework — including waiting list strategy, priority category documentation, and the intersection with SSA and Medicaid systems — the Maryland SSI at 18 & Adult Disability Benefits Guide tracks all of these moving parts in one place.

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