Maryland DDA Self-Directed Services: Budgets, Rates, and How Self-Direction Works

What Self-Direction Means Under the DDA

When a person receives funded services through Maryland's Community Pathways Waiver, they choose between two service delivery models: Traditional (a licensed provider agency hires and manages the staff) or Self-Directed (the participant acts as the employer of record and manages their own support staff, schedule, and budget).

Self-direction gives families control. The participant — or their authorized representative — hires, trains, schedules, and supervises their own support workers. They manage a person-centered budget allocated by the DDA. They can hire family members, neighbors, or community members as paid staff rather than relying on agency-assigned workers who may rotate frequently.

That control comes with administrative responsibility. The participant handles payroll (through a fiscal intermediary like GT Independence), maintains employment records, manages scheduling, and ensures compliance with DDA regulations.

Person-Centered Plans and Budget Limits

Every Community Pathways Waiver participant, whether traditional or self-directed, must have an annual Person-Centered Plan (PCP). The CCS (Coordinator of Community Services) facilitates the planning meeting, and the plan documents the participant's goals, service needs, and the supports required to achieve them.

For self-directed participants, the PCP translates into a specific budget. The DDA reviews the plan and approves a dollar amount based on the assessed functional needs — not the participant's preferences alone. The plan must be submitted to the DDA at least 20 business days before the annual plan date to prevent a lapse in service funding.

Standard annual Person-Centered Plans are capped at $500,000. The DDA has an exception process allowing approvals up to $625,000 if the services are necessary to protect the individual's health and safety and fit within waiver parameters. Plans above $625,000 require additional layers of DDA review.

2026 Rate Changes and Budget Constraints

The FY2026 and FY2027 Maryland state budgets introduced significant changes to self-directed service delivery. These reductions account for roughly $64 million in projected savings and directly affect how families structure their staffing:

Family as Staff (FAS) Sliding Scale Rates: Personal support rates for family members working as paid staff are now calculated using revised reasonable-and-customary wage benchmarks tied to Bureau of Labor Statistics indexes. The practical effect: family members who previously negotiated higher rates may see their approved hourly rate reduced under the new benchmarks.

Non-Family Staff Wage Caps: Non-family personal support staff rates are capped at $30 per hour. Participants cannot offer higher rates to recruit or retain workers, even in high-cost-of-living areas like Montgomery County or the Baltimore metro.

Unlicensed Vendor Rate Adjustments: Payments to unlicensed vendors (individuals providing specialized services without a state license) are reduced to match the standard family-as-staff rates. Only licensed nursing services and support broker services are exempt from this reduction.

The 60/40 Family Hour Rule: Any single family member working as paid staff can work up to 40 hours per week. But the total combined hours across all family members serving as paid staff for one beneficiary cannot exceed 60 hours per week. If two parents both work as paid staff, their combined hours are capped at 60 — not 80.

Elimination of the Wage Exception Process: The administrative pathway that previously allowed participants to request wage rates above the standard caps — typically used to compete with the private job market in tight labor markets — has been eliminated entirely.

The 183-Day Service Requirement

To maintain enrollment in the Community Pathways Waiver, a beneficiary must use at least one waiver service every 183 calendar days (approximately six months). A lapse in service delivery exceeding that threshold can result in termination from the waiver.

This rule is particularly important for self-directed participants who manage their own schedules. If a support worker quits and the participant doesn't hire a replacement promptly, the service gap can accumulate. Families should track service dates and ensure at least one billable service occurs within every 183-day window.

Is Self-Direction Right for Your Family

Self-direction works best for families who have a reliable pool of potential staff, the administrative capacity to manage payroll and scheduling (or a support broker to help), and a clear picture of what supports the participant needs.

It's a poor fit when the family lacks candidates willing to work at DDA-approved rates, when the administrative overhead is unmanageable, or when the participant's needs require licensed clinical staff who typically work through agencies.

Either model can be changed. A participant in traditional services can request a switch to self-direction at their next annual PCP meeting, and vice versa. The choice isn't permanent.

For the full picture of how DDA waiver services fit alongside SSI, Medicaid, and other transition-age programs, the Maryland SSI at 18 & Adult Disability Benefits Guide covers the sequencing across all agencies.

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