RESPITE CARE SERVICES PROVIDER IN MARYLAND
PROVIDING TEMPORARY RELIEF FOR CAREGIVERS WHILE ENSURING SAFETY, CONTINUITY, AND PERSONALIZED SUPPORT FOR INDIVIDUALS WITH DISABILITIES OR COMPLEX NEEDS

Respite Care Services in Maryland are designed to give short-term relief to primary caregivers of individuals with developmental disabilities, chronic illnesses, or significant care needs. These services can be planned or provided on an emergency basis and are funded through Maryland Medicaid and the Developmental Disabilities Administration (DDA) under various Home and Community-Based Services (HCBS) Waivers, including the Community Pathways, Community Supports, and Family Supports Waivers.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Regulates Medicaid waiver programs and caregiver support services

Agency: Developmental Disabilities Administration (DDA)
Role: Oversees respite care services under DDA waivers for individuals with developmental disabilities

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Maintains documentation and billing systems for HCBS programs

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight and compliance assurance for waiver-based respite care services

2. RESPITE CARE SERVICE OVERVIEW

Respite care is temporary, substitute support for individuals who require constant supervision or assistance. The goal is to provide relief for unpaid caregivers (family, guardians, or friends) while ensuring continuity and safety of care for the individual.

Respite services may include:

In-home personal care and supervision

Short-term out-of-home respite (in certified facilities or provider homes)

Overnight or extended respite (weekend or multi-day)

Emergency or crisis-based respite

Recreational or structured social activities during care

All services must align with the person’s Person-Centered Plan (PCP) or Individual Plan (IP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business entity with the Maryland Department of Assessments and Taxation (SDAT)

Obtain an EIN from the IRS and Type 2 NPI

Apply to become a DDA-approved provider via the DDA Provider Portal

Meet staffing, facility (if applicable), and training standards

Maintain liability insurance and ensure compliance with DDA’s quality assurance measures

Note: If providing out-of-home respite, your location may require DDA inspection and approval.

4. DDA PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Business and Policy Setup

Develop business plan and P&P manual specific to respite

Hire or identify qualified Direct Support Professionals (DSPs)

Step 2: Apply via DDA Provider Application Portal

Select “Respite Care Services” under the appropriate waiver(s):

Family Supports Waiver (children under 21)

Community Supports Waiver

Community Pathways Waiver

Step 3: Submit Required Documentation

Staffing plan, background checks, staff training outlines

Emergency procedures, supervision protocols, and environmental safety plan

Step 4: Begin Services After Approval

Accept referrals through Coordination of Community Services (CCS) providers

Deliver and document respite care per authorized service hours

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC certificate (via SDAT)

IRS EIN and NPI confirmation

DDA provider approval letter

Insurance policies (general liability, professional, and auto if transporting)

Policy & procedure manual including:

Intake and emergency contact forms

Daily care logs and time tracking

Medical or behavior protocols (if applicable)

HIPAA and confidentiality policies

Abuse prevention, incident reporting, and staff supervision

Staff training records and ongoing competency evaluations

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements: Minimum high school diploma or GED, background check, CPR/First Aid certification, DDA Core Competency training

Role: Program Supervisor
Requirements: Experience in disability services, responsible for coordinating respite care schedules, staff supervision, and emergency support

Training Requirements for All Staff:

DDA Orientation and Core Competencies

Person-Centered Planning and Individual Plan implementation

Emergency response and behavior management

Abuse prevention and Mandated Reporting

Medication administration (if required, under proper delegation)

Annual refreshers and continuing education

7. MEDICAID WAIVER SERVICES

Respite care is funded under:

Family Supports Waiver – For children under 21 with intellectual/developmental disabilities

Community Supports Waiver – For individuals with lower support needs

Community Pathways Waiver – For individuals with intensive needs, including residential respite

Self-Directed Services – Families may also hire their own respite workers under a budget authority model

Approved services include:

Hourly or daily in-home care

Overnight or weekend out-of-home respite

Crisis or emergency support

Supervision for social, recreational, or medical appointment coverage

8. TIMELINE TO LAUNCH

Phase: Business Formation and Staff Hiring
Timeline: 1–2 weeks

Phase: DDA Provider Application and Documentation
Timeline: 4–8 weeks

Phase: Staff Training and Emergency Preparedness Setup
Timeline: 1–3 weeks

Phase: Referral Networking and Service Activation
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Health PAS Online (for Medicaid Provider Verification)
Website: https://mainecare.maine.gov (Note: use only for LTSS-related billing if required)

​

Maryland Board of Nursing (if CMT or nursing delegation involved)
Website: https://mbon.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND RESPITE CARE PROVIDER

We support professionals and agencies in launching licensed, DDA-compliant respite care programs to serve families across Maryland.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

DDA respite care service enrollment (Family, Community, and Community Pathways Waivers)

Policy & procedure manual development for emergency and routine respite

Templates for care logs, consent forms, and emergency response plans

Staff training schedules and credentialing trackers

Website, email, and client intake system setup

Referral outreach tools for CCS providers and family organizations

Audit-preparation tools and staff supervision documentation

RESIDENTIAL HABILITATION SERVICES PROVIDER IN MARYLAND
SUPPORTING INDEPENDENT LIVING WITH 24/7 SUPERVISION, SKILL DEVELOPMENT, AND COMMUNITY INCLUSION FOR INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES

Residential Habilitation Services in Maryland offer supervised, structured living arrangements for individuals with developmental disabilities who require ongoing support. These services are authorized under the Maryland Developmental Disabilities Administration (DDA) and funded through the Community Pathways Waiver, designed to help individuals live as independently as possible in homes they choose.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Regulates home and community-based services under Medicaid

Agency: Developmental Disabilities Administration (DDA)
Role: Oversees Residential Habilitation service delivery, compliance, and provider certification

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Hosts the platform for service tracking and Medicaid billing

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures waiver-based residential services comply with HCBS federal standards

2. RESIDENTIAL HABILITATION SERVICE OVERVIEW

Residential Habilitation supports individuals living in DDA-approved residential settings, including group homes, alternative living units (ALUs), or individually-owned homes. Services focus on:

24/7 supervision and personal care

Assistance with ADLs and IADLs

Community integration and socialization

Skill development in budgeting, cooking, hygiene, and safety

Medication administration and health monitoring

Implementation of behavioral support plans (if required)

Supports must align with each participant’s Person-Centered Plan (PCP) and Individual Plan (IP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Apply to become a DDA-approved Residential Habilitation Provider

Secure and prepare housing units that meet DDA licensure and life-safety standards

Submit floor plans, emergency procedures, and staffing plans

Hire and train Direct Support Professionals (DSPs) and residential managers

Maintain liability, property, and workers’ comp insurance

4. DDA PROVIDER ENROLLMENT & LICENSING PROCESS

Step 1: Program and Site Development

Identify residential properties and ensure ADA accessibility

Develop policies for supervision, emergency response, and skill-building routines

Step 2: Submit Application to DDA

Include Residential Habilitation as a selected service

Provide site details, ownership/lease agreements, and staffing models

Step 3: Facility Review & Pre-Licensure Inspection

DDA performs site visits to ensure fire safety, accessibility, and adequacy of space

Step 4: Provider Certification and Participant Referrals

Begin accepting residents through Coordination of Community Services (CCS) referrals

Deliver supports and document via LTSS Maryland platform

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC paperwork

IRS EIN and NPI registration

DDA provider enrollment and facility approval

Lease agreements or property ownership documentation

Policy & procedure manual including:

Daily schedule templates and shift change reports

Emergency response, evacuation, and crisis procedures

Medication administration policies (with RN delegation if needed)

Client rights, grievance resolution, and incident reporting

Hygiene, nutrition, and recreational routines

Behavioral support protocols (if applicable)

Staff onboarding and supervision tracking

Health, safety, and infection control standards

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements: High school diploma or GED, criminal background check, First Aid/CPR certification, DDA Core Competency training, medication administration (if delegated)

Role: Residential Manager / Program Supervisor
Requirements: Experience in disability services and residential supervision; oversees daily operations and compliance

Role: Registered Nurse (if required for medical oversight)
Requirements: Valid Maryland RN license; oversees health plans, medication delegation, and staff competency

Training Requirements for All Staff:

DDA Orientation and Residential Core Competencies

Emergency and disaster response

Infection control and universal precautions

Person-Centered Planning (PCP) implementation

De-escalation and behavioral support techniques

Medication administration (CMT certification if delegated)

7. MEDICAID WAIVER SERVICES

Residential Habilitation is funded through:

Community Pathways Waiver – Covers 24/7 residential habilitation and supports in licensed DDA settings

Authorized service components include:

Daily supervision and ADL/IADL assistance

Skill development and goal tracking

Nighttime staffing and sleep support

Social inclusion and leisure activities

Implementation of behavioral plans

Medication assistance and nursing oversight (as applicable)

8. TIMELINE TO LAUNCH

Phase: Business Registration and Site Acquisition
Timeline: 2–4 weeks

Phase: Policy Manual Development and Staffing
Timeline: 3–6 weeks

Phase: DDA Application and Residential Facility Approval
Timeline: 8–12 weeks

Phase: Licensing Inspection, Referral Networking, and Service Start
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

Maryland Office of Health Care Quality (for facility-related concerns)
Website: https://health.maryland.gov/ohcq

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND RESIDENTIAL HABILITATION PROVIDER

We help mission-driven professionals and organizations establish fully compliant Residential Habilitation programs that promote independence, dignity, and quality of life.

​

Scope of Work:

Business formation (LLC, EIN, NPI)

Site selection consultation and DDA facility readiness support

DDA application for Residential Habilitation approval

Full policy & procedure manual development tailored to residential operations

Staff credentialing trackers, medication delegation forms, and health logs

Intake forms, daily service notes, and incident documentation tools

Referral connections with CCS providers and local resource coordinators

Pre-inspection readiness checklists and audit prep materials

Website, HIPAA-compliant email, and communication tools setup

SUPPORTED EMPLOYMENT SERVICES PROVIDER IN MARYLAND
EMPOWERING INDIVIDUALS WITH DISABILITIES TO ACHIEVE MEANINGFUL WORK THROUGH JOB DEVELOPMENT, COACHING, AND CAREER SUPPORTS

Supported Employment Services in Maryland are designed to assist individuals with intellectual and developmental disabilities (IDD) in securing and maintaining competitive, integrated employment. These services are offered under the Maryland Developmental Disabilities Administration (DDA) through the Community Pathways Waiver, Community Supports Waiver, and the Family Supports Waiver (for transition-aged youth).

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid and waiver-based employment services

Agency: Developmental Disabilities Administration (DDA)
Role: Regulates employment service delivery, monitors outcomes, and approves provider agencies

Agency: Division of Rehabilitation Services (DORS) – MD Department of Education
Role: May provide short-term employment services prior to DDA waiver funding

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures compliance with federal HCBS rules and Employment First principles

2. SUPPORTED EMPLOYMENT SERVICE OVERVIEW

Supported Employment services are individualized and designed to:

Help participants explore, find, and maintain meaningful jobs

Promote competitive integrated employment (minimum wage or higher, in typical workplaces)

Provide job coaching, soft skills development, and career advancement support

Support transition-aged youth preparing for the workforce

Ensure coordination with DORS when applicable

Types of Supported Employment Services:

Discovery & Job Development: Assessing interests, building resumes, job matching

Job Coaching: On-site support during job training or role transition

Ongoing Supports: Regular check-ins, employer communication, and job retention strategies

Self-Employment Support: Assistance with planning, budgeting, and business coaching

All supports must align with the individual's Person-Centered Plan (PCP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Apply to become a DDA-approved provider under "Supported Employment" via the Provider Application Portal

Submit staffing plan, service descriptions, outcome tracking tools, and internal policies

Maintain general liability insurance and HIPAA-compliant documentation systems

Note: Providers must be conflict-free (not delivering case management) and comply with the Employment First policy framework.

4. DDA PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Business Formation and Program Design

Define your employment service structure (e.g., job coaching, employer engagement)

Develop a service outcome and billing documentation system

Step 2: Apply as a DDA Provider

Select “Supported Employment” under the appropriate waiver(s)

Upload required documentation (staff resumes, training plans, sample forms)

Step 3: Approval and Service Authorization

Once approved, accept participant referrals through Coordination of Community Services (CCS) agencies

Ensure employment goals are embedded in each individual’s PCP

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC certificate

IRS EIN and NPI documentation

DDA provider approval letter

Policy & procedure manual including:

Intake and vocational assessment forms

Job development and coaching plans

Attendance and progress logs

Employer communication templates

Transportation and community integration protocols

Incident reporting and grievance processes

Confidentiality and HIPAA compliance standards

Staff training and supervision logs

6. STAFFING REQUIREMENTS

Role: Employment Specialist / Job Coach
Requirements:

High school diploma (required), associate or bachelor’s degree (preferred)

Experience in employment services or disability support

Background check, CPR/First Aid certification, DDA training

Role: Program Manager / Supervisor
Requirements:

Experience in vocational services, employment law, and team leadership

Responsible for performance oversight, compliance, and community partnerships

Training Requirements for All Staff:

DDA Orientation and Employment Core Competencies

Person-Centered Planning and ISP implementation

Job coaching strategies and employer engagement

Confidentiality, safety, and behavioral support

Annual continuing education and ethics training

7. MEDICAID WAIVER SERVICES

Supported Employment is reimbursed through:

Community Pathways Waiver – Full suite of employment and day services

Community Supports Waiver – Limited job support hours

Family Supports Waiver – Transition-aged youth under 21 preparing for employment

Authorized components include:

Discovery & job development

On-site job coaching

Time-limited follow-along support

Support with navigating benefits and work incentives

Assistance with self-employment

DDA providers must collaborate with DORS to avoid duplication of services.

8. TIMELINE TO LAUNCH

Phase: Business Registration and Staff Hiring
Timeline: 1–2 weeks

Phase: Program Development and Policy Setup
Timeline: 2–3 weeks

Phase: DDA Provider Application Submission
Timeline: 4–8 weeks

Phase: Participant Referrals and Service Activation
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

Maryland Division of Rehabilitation Services (DORS)
Website: https://dors.maryland.gov

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND SUPPORTED EMPLOYMENT PROVIDER

We help employment professionals, disability advocates, and service agencies build compliant Supported Employment programs that center on empowerment, access, and real-world results.

​

Scope of Work:

Business formation (LLC, EIN, NPI)

DDA application for Supported Employment services

Policy & procedure manual tailored to employment coaching and vocational support

Templates for job logs, discovery plans, and progress tracking

Staff credentialing systems and onboarding packets

Referral networking tools for CCS and DORS connections

Website, secure communication setup, and intake system

Audit prep tools and Medicaid billing guidance via LTSS

PERSONAL ASSISTANCE SERVICES PROVIDER IN MARYLAND
SUPPORTING INDEPENDENCE AND DAILY LIVING FOR INDIVIDUALS WITH DISABILITIES AND CHRONIC CONDITIONS THROUGH IN-HOME PERSONAL CARE

Personal Assistance Services (PAS) in Maryland help individuals who need assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) to live safely and independently in their homes and communities. These services are funded under Maryland Medicaid, specifically through Home and Community-Based Services (HCBS) Waivers such as the Community First Choice (CFC) Program, Community Options Waiver, and Increased Community Services (ICS).

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid-funded personal assistance and HCBS programs

Agency: Maryland Medicaid – Office of Long-Term Services and Supports (LTSS Maryland)
Role: Administers Community First Choice (CFC), Community Options, ICS, and Medicaid provider enrollment

Agency: Maryland Developmental Disabilities Administration (DDA)
Role: Oversees personal supports under DDA waiver programs (if serving individuals with intellectual or developmental disabilities)

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Approves and ensures compliance with federal waiver requirements

2. PERSONAL ASSISTANCE SERVICE OVERVIEW

Personal Assistance Services support individuals who require help with:

Bathing, dressing, grooming, toileting, and mobility (ADLs)

Meal preparation, light housekeeping, laundry, shopping, and medication reminders (IADLs)

Accompaniment to medical appointments and community activities

Safety monitoring and supervision when medically necessary

Support with adaptive equipment or specialized care routines

Services must align with an individual's Person-Centered Plan (PCP) and be authorized through their Medicaid service plan.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain an EIN from the IRS and Type 2 NPI

Enroll as a Personal Assistance Provider through ePREP, Maryland’s Medicaid Provider Enrollment Portal

Employ or contract qualified Personal Care Aides (PCAs) or Certified Nursing Assistants (CNAs) depending on the waiver requirements

Maintain general liability insurance, workers’ comp (if applicable), and HIPAA-compliant systems

Note: Agencies do not need to be licensed as a Residential Service Agency (RSA) unless providing skilled nursing or delegating certain tasks.

4. MARYLAND MEDICAID ENROLLMENT & PROGRAM PARTICIPATION

Step 1: Business Formation and Credential Preparation

Establish entity, obtain NPI and tax documentation

Draft service descriptions and staff roles

Step 2: Apply via ePREP Portal

Select provider type: "Personal Assistance"

Choose applicable program: Community First Choice (CFC), Community Options, ICS, or DDA Personal Supports (if applicable)

Step 3: Submit Documentation

Staff qualifications, policies, insurance, and confidentiality protocols

Criminal background checks and staff training logs

Step 4: Service Authorization and Delivery

Receive referrals from Service Coordinators

Deliver supports per the participant’s plan and log service delivery electronically via LTSS Maryland

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC registration (from SDAT)

IRS EIN confirmation and NPI registration

Proof of Medicaid provider enrollment

Staff credentials (CNA license if applicable)

Policy & procedure manual including:

Intake assessments and service plan forms

ADL/IADL support logs and timesheets

Emergency preparedness and infection control protocols

Grievance policies and HIPAA compliance documentation

Staff training records and supervisory plans

Incident report forms and safety checklists

6. STAFFING REQUIREMENTS

Role: Personal Care Aide (PCA) / Direct Support Worker
Requirements: High school diploma (recommended), First Aid/CPR certification, criminal background check, PCA training per waiver guidelines

Role: CNA (for delegated tasks under nursing oversight)
Requirements: Active Maryland CNA license, if required under individual care plans

Role: Supervisor / Service Coordinator
Requirements: Experience in managing personal care services, responsible for quality assurance and documentation review

Training Requirements for All Staff:

Person-centered service delivery

ADL/IADL support techniques and infection control

HIPAA and privacy practices

Abuse, neglect, and exploitation prevention

Annual refreshers and ongoing competency checks

7. MEDICAID WAIVER SERVICES

Covered under the following Maryland Medicaid programs:

Community First Choice (CFC): PAS, supports planning, nurse monitoring

Community Options Waiver: Personal assistance as part of long-term supports

Increased Community Services (ICS): For individuals transitioning from institutions

DDA Waivers (e.g., Community Pathways, Family Supports): Personal supports for individuals with developmental disabilities

Authorized services include:

Hands-on assistance with daily routines

Supervision to prevent harm or neglect

Community engagement support and access to appointments

Monitoring and documentation of progress toward goals

8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 1–2 weeks

Phase: Policy Development and Staff Hiring
Timeline: 2–4 weeks

Phase: Medicaid Provider Enrollment via ePREP
Timeline: 30–60 days

Phase: Staff Training, Referrals, and Onboarding
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Department of Health – Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

Maryland Medicaid Office of Long-Term Services and Supports (LTSS Maryland)
Website: https://health.maryland.gov/ltss

​

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

Maryland Board of Nursing (for CNA Verification)
Website: https://mbon.maryland.gov

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND PERSONAL ASSISTANCE SERVICES PROVIDER

We help compassionate entrepreneurs and healthcare professionals launch Medicaid-approved Personal Assistance agencies in Maryland with compliance-focused tools and waiver alignment.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

Medicaid enrollment via ePREP for CFC, CO, and ICS

DDA vendor approval for personal supports (if needed)

Policy & procedure manual development for PAS delivery

Staff credentialing tools and electronic documentation templates

HIPAA-compliant systems for logging and billing through LTSS Maryland

Website, email, and intake forms setup

Referral networking with Service Coordinators and Resource Connections

Audit preparation and quality assurance tools

​

SKILLED NURSING SERVICES PROVIDER IN MARYLAND
DELIVERING PROFESSIONAL MEDICAL CARE IN HOMES AND COMMUNITY SETTINGS FOR INDIVIDUALS WITH COMPLEX HEALTH NEEDS

Skilled Nursing Services in Maryland offer clinical care by licensed nurses to individuals with medical conditions requiring assessment, treatment, and monitoring. These services are provided through Home and Community-Based Services (HCBS) waivers such as the Community Pathways Waiver, Community First Choice (CFC), and the Community Options Waiver. Services can be delivered in homes, schools, or community settings.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid, DDA, and CFC nursing services

Agency: Office of Health Care Quality (OHCQ)
Role: Licenses Residential Service Agencies (RSAs) providing skilled nursing in the community

Agency: Developmental Disabilities Administration (DDA)
Role: Authorizes skilled nursing for participants with complex needs under DDA Waivers

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures that services meet federal HCBS and clinical care standards

2. SKILLED NURSING SERVICE OVERVIEW

Skilled Nursing Services include intermittent or continuous care provided by an RN or LPN under a medical plan of care. Services may include:

Wound care and dressing changes

Medication administration and injection

Enteral (tube) feeding support

Catheter care and bowel programs

Tracheostomy or ventilator support

Chronic condition monitoring (e.g., diabetes, seizures)

Training caregivers on medical tasks

Health assessment and reporting to physicians

All services must be part of the participant’s Person-Centered Plan (PCP) and require medical necessity authorization.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

To provide skilled nursing in Maryland, agencies must:

Register with the Maryland Department of Assessments and Taxation (SDAT)

Obtain an EIN and Type 2 NPI

Apply to be a licensed Residential Service Agency (RSA) via OHCQ

Enroll as a Medicaid provider via ePREP

Meet COMAR 10.07.05 standards for staffing, documentation, and supervision

Employ or contract licensed RNs and LPNs in good standing

Maintain clinical record systems, malpractice insurance, and emergency protocols

4. OHCQ & DDA LICENSING / ENROLLMENT PROCESS

Step 1: Business Setup

Establish LLC or corporation, obtain EIN and NPI

Step 2: OHCQ Residential Service Agency (RSA) Application

Submit initial license application, program description, nurse administrator resume, policy manual, sample care plans, infection control plan

Step 3: OHCQ Inspection

Pass a site visit reviewing staff files, medical documentation, quality assurance protocols, and supervisory procedures

Step 4: Medicaid Enrollment via ePREP

Apply under “Skilled Nursing” for DDA, CFC, or CO Waiver billing

Step 5: Receive Approvals and Begin Service Delivery

Accept participant referrals and submit documentation through LTSS Maryland

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC certificate

IRS EIN and NPI documentation

OHCQ RSA license approval

Medicaid enrollment confirmation

Clinical policy & procedure manual including:

Plan of care templates and physician orders

Medication administration record (MAR) logs

RN and LPN delegation protocols

Supervision and competency review logs

Infection control and universal precautions

Incident reporting and emergency response plans

HIPAA compliance and protected health information protocols

Quality assurance/improvement procedures

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Active Maryland RN license, CPR certification, experience in community nursing, supervisory training

Role: Licensed Practical Nurse (LPN)
Requirements: Active Maryland LPN license, supervised by RN, trained in delegated care tasks

Role: Nursing Administrator / Clinical Supervisor
Requirements: RN with administrative experience; responsible for oversight of care quality and staff supervision

Training Requirements:

HIPAA and confidentiality

Infection control and PPE

Delegation, documentation, and incident response

CPR/BLS certification

Annual competency checks and continuing education

7. MEDICAID WAIVER SERVICES

Skilled Nursing is reimbursed under:

Community Pathways Waiver (DDA) – For medically complex individuals with intellectual/developmental disabilities

Community First Choice (CFC) – For adults meeting nursing facility level of care

Community Options Waiver (CO) – For seniors and adults with physical disabilities

Model Waiver for Medically Fragile Children – Pediatric in-home skilled nursing

Increased Community Services (ICS) – For individuals transitioning from institutions

Approved services include:

Nursing assessments and monitoring

In-home medical procedures and training

Short- or long-term skilled nursing support

RN supervision of delegated nursing tasks

8. TIMELINE TO LAUNCH

Phase: Business Registration and NPI/EIN
Timeline: 1–2 weeks

Phase: RSA License Application and Policy Manual
Timeline: 4–6 weeks

Phase: OHCQ Inspection and Licensing
Timeline: 6–8 weeks

Phase: Medicaid Provider Enrollment and Start of Services
Timeline: 4–6 weeks (can overlap with licensing)

9. CONTACT INFORMATION

Maryland Office of Health Care Quality (OHCQ)
Website: https://health.maryland.gov/ohcq
Phone: (410) 402-8217
Regulations: COMAR 10.07.05

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

LTSS Maryland (for waiver documentation & billing)
Website: https://ltss.health.maryland.gov

Maryland Board of Nursing
Website: https://mbon.maryland.gov

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND SKILLED NURSING PROVIDER

We assist nurses, home health agencies, and RSA operators in launching Medicaid-compliant Skilled Nursing services that ensure safe, high-quality care at home.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

OHCQ RSA license application and inspection prep

Clinical policy & procedure manual development

Staff credentialing trackers and nurse delegation templates

Care plan and documentation forms

Secure HIPAA-compliant communication system setup

LTSS billing setup and Medicaid compliance tools

Referral coordination with hospitals, CCS agencies, and MCOs

DAY PROGRAM SERVICES PROVIDER IN MARYLAND
ENRICHING LIVES THROUGH COMMUNITY ENGAGEMENT, SKILL DEVELOPMENT, AND SOCIALIZATION FOR ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES

Day Program Services in Maryland offer structured, person-centered activities during daytime hours to promote independence, build life skills, and foster community involvement for adults with intellectual and developmental disabilities. These services are funded through the Maryland Developmental Disabilities Administration (DDA) under the Community Pathways Waiver, Community Supports Waiver, and, in some cases, the Family Supports Waiver for transition-aged youth.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Regulates waiver-funded day programs under Medicaid rules

Agency: Developmental Disabilities Administration (DDA)
Role: Authorizes and oversees Day Habilitation, Employment, and Meaningful Day services

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Provides billing, service tracking, and documentation tools for DDA providers

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures compliance with federal HCBS regulations, including community integration requirements

2. DAY PROGRAM SERVICE OVERVIEW

Day Program Services may include any combination of the following “Meaningful Day” categories:

Day Habilitation: Skill-building in communication, daily living, and adaptive functioning

Community Development Services (CDS): Small group or individual community-based activities to foster engagement and independence

Employment Services: Job exploration, discovery, job coaching, and supported employment

Career Exploration: Helping participants discover vocational interests

Volunteer or pre-vocational opportunities: With community presence and staff guidance

Personal development activities: Such as cooking, budgeting, or fitness

All services are based on the participant’s Person-Centered Plan (PCP) and documented through an Individual Plan (IP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your organization with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Apply to become a DDA-approved provider through the DDA Provider Application Portal

If operating a physical program site, ensure ADA compliance, health & safety measures, and appropriate zoning

Submit organizational policies, staffing plans, supervision procedures, and community integration models

Maintain commercial general liability, workers' comp, and auto insurance (if transporting clients)

4. DDA PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Business Registration and Program Design

Define program philosophy, services offered, and outcomes tied to PCPs

Prepare staffing model, safety protocols, and daily schedules

Step 2: Apply via DDA Provider Portal

Select applicable services: Day Habilitation, CDS, Employment Services, or Career Exploration

Submit facility information, staff credentials, and service delivery model

Step 3: Facility Site Visit (if applicable)

Ensure compliance with DDA safety and accessibility standards

Be prepared to submit emergency procedures and floor plans

Step 4: Approval and Participant Enrollment

Connect with Coordination of Community Services (CCS) to receive referrals

Begin delivering authorized services with daily attendance tracking and progress documentation

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC paperwork

IRS EIN confirmation and Type 2 NPI record

DDA provider approval

Facility lease or deed and insurance documentation

Policy & procedure manual including:

Daily schedule and activity curriculum

Staffing ratios, supervision, and emergency response protocols

Attendance logs and shift documentation

PCP-driven goal tracking forms

Client rights, grievance policies, and HIPAA protocols

Transportation policies (if providing community-based services)

Staff background checks, certifications, and ongoing training records

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements: High school diploma or GED, background check, CPR/First Aid certification, DDA Core Competency training

Role: Program Supervisor or Manager
Requirements: Experience in disability services, oversees compliance, supervision, and documentation

Role: Job Coach or CDS Specialist (if offering employment/CDS)
Requirements: Knowledge of job development or community engagement; may require specialized training

Training Requirements for All Staff:

DDA Orientation and Core Competencies

Person-Centered Planning and ISP implementation

Emergency preparedness and safety

Behavioral support and de-escalation

Transportation safety (if applicable)

Documentation and Medicaid billing protocols

7. MEDICAID WAIVER SERVICES

Day Program Services are reimbursed under:

Community Pathways Waiver – Full range of Meaningful Day services

Community Supports Waiver – Limited scope of Day Habilitation and CDS

Family Supports Waiver – For youth under 21 (e.g., during summer programs or school breaks)

Authorized services include:

In-center and community-based activities

Skill-building aligned with personal goals

Employment readiness, career exploration, or volunteerism

Support with social interaction, personal hygiene during program hours

Community outings and events coordination

8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 1–2 weeks

Phase: Program Development & Staff Hiring
Timeline: 3–4 weeks

Phase: DDA Provider Application and Facility Preparation
Timeline: 6–12 weeks

Phase: Referrals, Staff Training & Service Delivery
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

LTSS Maryland (for billing and plan tracking)
Website: https://ltss.health.maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND DAY PROGRAM PROVIDER

We assist mission-driven providers in launching DDA-compliant day programs rooted in inclusion, empowerment, and measurable personal growth.

Scope of Work:

Business registration (LLC, EIN, NPI)

DDA enrollment for Day Habilitation, CDS, and Employment Services

Facility readiness checklist and policy manual development

Templates for daily logs, attendance sheets, and ISP tracking

Staff onboarding plans and competency training materials

Parent communication forms and incident response protocols

Website, secure intake forms, and digital documentation setup

Referral networking with CCS agencies and local schools

Audit preparation and Medicaid billing assistance

FAMILY SUPPORT SERVICES PROVIDER IN MARYLAND
EMPOWERING FAMILIES TO THRIVE WITH RESPITE, TRAINING, ADVOCACY, AND IN-HOME SUPPORT FOR CHILDREN AND ADULTS WITH DEVELOPMENTAL DISABILITIES

Family Support Services in Maryland are designed to strengthen families caring for individuals with developmental disabilities or autism. These supports offer relief, training, and resources to caregivers, ensuring individuals can remain at home while their families receive the help they need to reduce burnout and promote family stability. Services are authorized and funded under the Maryland Developmental Disabilities Administration (DDA) through the Family Supports Waiver, and in some cases through the Community Supports and Community Pathways Waivers.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees statewide Medicaid and waiver-funded family services

Agency: Developmental Disabilities Administration (DDA)
Role: Administers the Family Supports Waiver and regulates provider eligibility and quality

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Manages waiver billing and service documentation

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Approves waiver programs and ensures HCBS compliance and family-centered approaches

2. FAMILY SUPPORT SERVICE OVERVIEW

Family Support Services are individualized supports provided to families of children or adults with developmental disabilities. They may include:

In-home respite care

Caregiver training and consultation

Family navigation and advocacy services

Sibling support and recreational programming

Support during transitions (e.g., school to adult services)

Home-based behavioral coaching and educational guidance

Services must be documented in the participant’s Person-Centered Plan (PCP) and are designed to enhance the natural support system and avoid institutional placement.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Apply as a DDA-approved provider for Family Support Services

Submit staff qualifications, program model, and emergency protocols

Maintain general liability insurance and HIPAA-compliant records

Comply with conflict-free case management rules if offering advocacy

Note: No separate facility licensure is required unless respite is provided in a structured out-of-home setting.

4. DDA PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Prepare Your Program Model

Define services offered (e.g., respite, caregiver training, support navigation)

Create intake forms and individualized service plans

Step 2: Submit DDA Provider Application

Select “Family and Peer Support Services” or “Respite” under the Family Supports Waiver

Upload staff resumes, training plans, and documentation templates

Step 3: Approval and Referral Activation

Upon DDA approval, coordinate with Coordination of Community Services (CCS) providers to begin serving families

Enter data and track services through LTSS Maryland

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC paperwork (via SDAT)

IRS EIN and Type 2 NPI documentation

DDA provider approval

Policy & procedure manual including:

Family intake and emergency contact forms

Training consent and feedback logs

Respite scheduling and caregiver shift logs

Advocacy and navigation request forms

Incident reporting and complaint resolution procedures

Cultural competency and person-centered communication guidelines

Staff training records and supervision plans

Confidentiality and HIPAA compliance policies

6. STAFFING REQUIREMENTS

Role: Family Support Specialist / Peer Support Worker
Requirements: Experience with disability services or caregiving, background check, person-centered planning training

Role: Respite Worker (if applicable)
Requirements: High school diploma or GED, CPR/First Aid certification, background check

Role: Trainer or Advocate
Requirements: Experience with behavioral or family support models, familiarity with state services and school systems

Training Requirements for All Staff:

DDA Core Competencies and orientation

HIPAA and mandated reporting

Trauma-informed care and behavioral de-escalation

Documentation, emergency preparedness, and confidentiality

Cultural sensitivity and family dynamics

7. MEDICAID WAIVER SERVICES

Family Support Services are covered under:

Family Supports Waiver – For children under age 21 with intellectual/developmental disabilities

Community Supports Waiver – For adults with mild/moderate needs

Community Pathways Waiver – For adults with more intensive support needs

Self-Directed Services (optional) – Families may self-hire for respite and coaching

Authorized services include:

In-home or remote caregiver support

Short-term respite for family relief

Coaching on behavior, communication, or life transitions

Crisis support planning and implementation

Empowerment and skill-building for family units

8. TIMELINE TO LAUNCH

Phase: Business Formation and EIN/NPI Setup
Timeline: 1–2 weeks

Phase: Policy Manual and Program Development
Timeline: 2–3 weeks

Phase: DDA Provider Application and Approval
Timeline: 6–10 weeks

Phase: Referral Intake and Family Onboarding
Timeline: Ongoing

​

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

LTSS Maryland (for billing and documentation)
Website: https://ltss.health.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND FAMILY SUPPORT PROVIDER

We support compassionate caregivers and organizations in launching Family Support Services that reinforce dignity, resilience, and long-term community living for individuals and their families.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

DDA provider application for Family Support and Respite services

Policy & procedure manual tailored to family-focused programming

Templates for caregiver logs, training forms, and navigation tools

Staff credentialing and documentation systems

Referral networking tools with CCS agencies and schools

HIPAA-compliant intake packets and communication templates

Website, secure email setup, and audit preparation tools

​

ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN MARYLAND
ENHANCING INDEPENDENCE AND DAILY FUNCTION THROUGH INNOVATIVE TOOLS, DEVICES, AND TRAINING FOR INDIVIDUALS WITH DISABILITIES

Assistive Technology (AT) Services in Maryland are designed to help individuals with disabilities gain greater independence, communication, mobility, and access to their environment. These services are offered under Maryland Medicaid Home and Community-Based Services (HCBS) programs, especially through the Developmental Disabilities Administration (DDA) and Community First Choice (CFC) program. Assistive Technology may include both the provision of the device and the training needed to use it effectively.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid-funded HCBS services and CFC program

Agency: Developmental Disabilities Administration (DDA)
Role: Administers Assistive Technology services under DDA Waivers (Community Supports, Family Supports, and Community Pathways)

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Manages billing systems and service documentation

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures that all AT services under waivers comply with federal HCBS regulations

2. ASSISTIVE TECHNOLOGY SERVICE OVERVIEW

Assistive Technology (AT) includes both the equipment and support services needed to increase, maintain, or improve the functional capabilities of individuals with disabilities. This may involve:

Communication devices (AAC systems)

Mobility aids (walkers, standing frames, adapted strollers)

Smart home controls and environmental modifications (automated lights, door openers)

Vision or hearing supports (magnifiers, screen readers, alert systems)

Specialized software or computer access tools

Evaluation of AT needs and device recommendations

Training individuals, caregivers, and staff on AT use

Repairs, maintenance, and customization of devices

All services must be outlined in the Person-Centered Plan (PCP) or Individual Plan (IP) and approved by DDA or the relevant Medicaid waiver authority.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Enroll as a DDA-approved provider via the DDA Provider Application Portal or through the CFC Provider Enrollment process via ePREP

If providing clinical evaluations, must have qualified AT professionals (e.g., OT, PT, SLP with AT experience, RESNA-certified professionals)

Maintain HIPAA-compliant systems, liability insurance, and documentation protocols

4. DDA/CFC PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Business Formation and Staffing Setup

Develop business infrastructure, service models, and hire/train qualified staff

Step 2: Submit DDA or CFC Provider Application

Select “Assistive Technology” as a service category

Specify if your agency provides assessments, installations, repairs, or training

Step 3: Submit Supporting Documentation

Policy manual, staff credentials (licenses or certifications), evaluation tools, and service delivery forms

Step 4: Receive Approval and Begin Accepting Referrals

Work with Coordination of Community Services (CCS) agencies to begin authorized services

Submit service delivery logs and billing through LTSS Maryland or relevant portal

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC registration

IRS EIN confirmation and NPI documentation

DDA or Medicaid enrollment approval

Liability insurance, service contracts, and HIPAA/privacy policies

Policy & procedure manual including:

AT referral intake forms

AT assessment and evaluation templates

Device training logs and care instructions

Repair and maintenance tracking

Emergency back-up plans for critical AT

Confidentiality, consent, and incident reporting documentation

Staff training records and equipment handling policies

6. STAFFING REQUIREMENTS

Role: Assistive Technology Specialist
Requirements: Background in rehab engineering, special education, therapy, or AT certification (e.g., RESNA ATP)

Role: Evaluator (OT, PT, SLP, or Educational Specialist)
Requirements: Valid Maryland license, experience conducting AT assessments, and familiarity with DDA/CFC programs

Role: Technician or Installer (optional)
Requirements: Training in safe installation, device programming, and client interaction

Training Requirements for All Staff:

HIPAA and client confidentiality

Person-Centered Planning and DDA waiver principles

Safe handling and storage of equipment

Client and caregiver communication

Documentation standards for Medicaid billing

7. MEDICAID WAIVER SERVICES

Assistive Technology is reimbursable under:

DDA Community Pathways Waiver – for comprehensive AT support and services

DDA Community Supports Waiver – limited AT for non-residential services

DDA Family Supports Waiver – for children under 21 with IDD

Community First Choice (CFC) – for Medicaid enrollees requiring AT to remain in their homes

Authorized services may include:

AT evaluations and assessments

Purchase or rental of devices and software

Customization, installation, and initial setup

Training for the person and support team

Repairs and maintenance of devices

8. TIMELINE TO LAUNCH

Phase: Business Registration and Team Onboarding
Timeline: 1–2 weeks

Phase: Provider Application to DDA or CFC
Timeline: 4–8 weeks

Phase: Policy Manual Development and Staff Credentialing
Timeline: 2–3 weeks

Phase: Referral Networking and Service Activation
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP Portal)
Website: https://eprep.health.maryland.gov

​

RESNA – Assistive Technology Certification Board
Website: https://www.resna.org

​

LTSS Maryland (Billing and Documentation Portal)
Website: https://ltss.health.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND ASSISTIVE TECHNOLOGY PROVIDER

We help rehabilitation professionals, educators, and tech innovators establish Medicaid-enrolled Assistive Technology services that transform accessibility for Maryland residents with disabilities.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

DDA or CFC provider application submission

Policy & procedure manual development tailored to AT services

Templates for AT assessments, training logs, and maintenance tracking

Staff credentialing trackers for therapists and AT specialists

Website, client intake system, and documentation tools

Referral networking with schools, therapists, and CCS agencies

Audit prep and Medicaid billing support through LTSS Maryland

HOME MODIFICATION SERVICES PROVIDER IN MARYLAND
ENHANCING ACCESS, SAFETY, AND INDEPENDENCE THROUGH CUSTOMIZED MODIFICATIONS FOR INDIVIDUALS WITH DISABILITIES

Home Modification Services in Maryland involve making physical changes to a participant’s residence to support their health, independence, and ability to remain safely at home. These services are provided under the Maryland Medicaid Home and Community-Based Services (HCBS) programs, including the Community First Choice (CFC) program and the Developmental Disabilities Administration (DDA) Waivers: Community Pathways, Community Supports, and Family Supports. 

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid and CFC-funded services including home modifications

Agency: Developmental Disabilities Administration (DDA)
Role: Approves and monitors modifications under its waiver programs

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Provides billing, service tracking, and electronic documentation systems

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures compliance with federal HCBS and waiver service standards

2. HOME MODIFICATION SERVICE OVERVIEW

Home Modification services are intended to:

Increase accessibility and usability of the home

Support mobility devices and transfers

Enhance participant safety

Allow individuals to remain in their community-based residence

Common types of modifications include:

Wheelchair ramps and platform lifts

Stair lifts and grab bars

Widened doorways or hallways

Roll-in showers or accessible bathtubs

Lowered countertops and adjustable-height appliances

Visual alert systems (e.g., for doorbells, alarms)

NOTE: Modifications must be directly related to the individual’s disability, included in their Person-Centered Plan (PCP), and authorized by the appropriate agency.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN from the IRS and Type 2 NPI

Hold an active Maryland Home Improvement Commission (MHIC) license or relevant contractor certification

Apply to become a provider under DDA or Medicaid (CFC) through the ePREP portal or DDA Provider Application Portal

Maintain general liability insurance and workers’ compensation (if applicable)

Ensure compliance with ADA, state building codes, and DDA accessibility requirements

4. PROVIDER ENROLLMENT PROCESS

Step 1: Business Setup and Licensing

Finalize business registration, obtain MHIC license, and gather insurance documentation

Step 2: Apply via DDA Provider Portal or Medicaid ePREP

Choose “Environmental Accessibility Adaptation” (DDA) or “Home Modifications” (CFC)

Step 3: Submit Required Documentation

Scope of services, credentials, example proposals, safety protocols, and staff or subcontractor resumes

Step 4: Approval and Authorization

Begin services only upon PCP authorization and service plan approval

Maintain documentation and submit claims via LTSS Maryland

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC certificate

IRS EIN and Type 2 NPI documentation

Maryland contractor license (MHIC) or equivalent

DDA or CFC program approval letter

Policy & procedure manual including:

Work proposals and bid comparison forms

Pre/post photos and participant consent documentation

Contractor/subcontractor agreements and credentials

Safety inspection checklist and project logs

Emergency protocols and compliance standards

Privacy, consent, and HIPAA policies

6. STAFFING REQUIREMENTS

Role: Licensed Contractor / Home Modification Specialist
Requirements: Active MHIC license, insurance, understanding of ADA and HCBS accessibility standards

Role: Project Coordinator (optional)
Requirements: Background in accessibility services or care coordination, responsible for timelines and family communication

Training Requirements:

ADA compliance and home accessibility codes

Person-centered planning principles

Risk management and emergency planning

Confidentiality and HIPAA awareness

Infection control (for in-home work)

7. MEDICAID WAIVER SERVICES

Home Modification services are covered under:

Community First Choice (CFC) – For individuals who meet nursing facility level of care

Community Pathways Waiver – For individuals with more intensive support needs

Community Supports Waiver – For individuals with part-time or targeted support needs

Family Supports Waiver – For children under 21 living in the family home

Self-Directed Services – Participants may use their approved budget to arrange home modifications with approved vendors

Covered elements:

Assessments to determine modification needs

Equipment and material purchases

Permits and labor

Inspections, training, and follow-up (as needed)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Contractor Licensing
Timeline: 2–3 weeks

Phase: Policy Manual and Application Preparation
Timeline: 2–3 weeks

Phase: DDA or Medicaid Enrollment Review
Timeline: 6–10 weeks

Phase: Authorization for First Project and Service Delivery
Timeline: Per client referral and approval cycle

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

Maryland Home Improvement Commission (MHIC)
Website: https://www.dllr.state.md.us/license/mhic

​

LTSS Maryland (for waiver billing)
Website: https://ltss.health.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND HOME MODIFICATION PROVIDER

We support contractors, accessibility consultants, and home improvement professionals in launching fully compliant Home Modification services under Maryland Medicaid and DDA waivers.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

MHIC licensing and DDA/CFC enrollment

Policy & procedure manual tailored to accessibility work

Templates for work orders, family authorization, and safety inspection

Staff and subcontractor credentialing logs

Referral coordination tools and intake packets

Pre/post inspection checklists and before/after photo protocols

Secure billing preparation tools for LTSS Maryland

Website and client communication system setup

COMMUNITY SUPPORTED LIVING SERVICES (CSLA) PROVIDER IN MARYLAND
EMPOWERING INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES TO LIVE INDEPENDENTLY THROUGH TAILORED IN-HOME AND COMMUNITY SUPPORTS

Community Supported Living Arrangements (CSLA), also known as Community Supported Living Services (CSLS) in Maryland, are designed to help individuals with developmental disabilities live in homes they choose, either alone or with housemates, while receiving individualized support. These services focus on promoting independence, community inclusion, and person-centered care, and are primarily funded under Maryland's Developmental Disabilities Administration (DDA) Waivers, including the Community Pathways Waiver and the Community Supports Waiver.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees health and community-based service regulations for Maryland Medicaid

Agency: Developmental Disabilities Administration (DDA)
Role: Authorizes and monitors CSLA providers, administers service models under DDA Waivers

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Supports data tracking and billing for some DDA-funded services

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Approves Maryland’s DDA Waivers and ensures compliance with federal HCBS rules

2. COMMUNITY SUPPORTED LIVING SERVICE OVERVIEW

Community Supported Living Services (CSLS) offer structured, individualized supports in a person’s own home or community to help with:

Activities of Daily Living (ADLs) such as bathing, dressing, grooming

Instrumental Activities of Daily Living (IADLs) like shopping, cooking, and budgeting

Medication administration and monitoring

Home management and safety awareness

Support with accessing community resources, transportation, and social participation

Health and wellness support, when coordinated with other service providers

Services are tailored through the person’s Person-Centered Plan (PCP) and implemented via the Individual Plan (IP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Enroll as a DDA-approved provider through the Provider Application Portal

Meet Community Supported Living Services (CSLS) provider standards under DDA’s policy

Submit required policies, staffing plans, and emergency preparedness protocols

Pass DDA’s pre-approval site visit (if housing is agency-operated or supervised)

4. DDA PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Business Formation and Credential Setup

Register legal entity, obtain NPI, secure insurance, and prepare documentation

Step 2: Apply as DDA Provider

Complete the DDA Provider Application via the Maryland Developmental Disabilities Provider Portal

Select Community Supported Living Arrangement (CSLA) as a service type

Step 3: Submit Required Documentation

Organizational chart, program description, staff qualifications, P&P manual

Evidence of person-centered planning readiness and community integration model

Step 4: Approval and Service Authorization

Once approved, begin accepting referrals through Coordination of Community Services (CCS) providers

Services must align with the person’s PCP and be delivered as scheduled and documented via LTSS Maryland or provider system

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC confirmation (via SDAT)

EIN and NPI confirmation letters

DDA provider approval documentation

Commercial liability insurance and auto insurance (if transporting clients)

Policy & procedure manual including:

Person-Centered Planning and ISP implementation guidelines

ADL/IADL support plans and shift documentation logs

Medication administration and health tracking protocols

Emergency preparedness and client safety procedures

Staff training and supervision documentation

Confidentiality and rights protection policies

Incident reporting and abuse prevention

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements: Minimum high school diploma or GED, background check, First Aid/CPR, training in DDA orientation and PCP implementation

Role: Program Manager / Supervisor
Requirements: Supervisory experience in disability services, ensures service integrity and staff oversight

Role: Medication Technician (optional)
Requirements: CMT certification if assisting with meds, under RN delegation (when required)

Training Requirements for All Staff:

DDA orientation and Core Competency training

Person-Centered Planning and ISP delivery

Health and safety, infection control, and emergency procedures

Medication administration (if applicable)

Client rights, abuse prevention, and Mandated Reporting

Annual continuing education and competency checks

7. MEDICAID WAIVER SERVICES

Community Supported Living Services are covered under:

Community Pathways Waiver – For individuals with more complex support needs

Community Supports Waiver – For individuals needing a lighter support model

Self-Directed Services (optional) – CSLS can also be provided by self-directed employees under budget authority

Authorized services include:

Ongoing daily support in the home and community

Skill-building and ADL/IADL assistance

Supervision and safety planning

Employment or day program transportation support

Medication administration and health tracking

Community participation and social inclusion activities

8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 1–2 weeks

Phase: Policy Development and Staffing Plan
Timeline: 2–4 weeks

Phase: DDA Provider Application and Approval
Timeline: 6–12 weeks

Phase: Staff Hiring, Training, and Compliance Setup
Timeline: 2–4 weeks

Phase: Referral Engagement and Service Delivery
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

Maryland Board of Nursing (for CMT/RN delegation info)
Website: https://mbon.maryland.gov

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND COMMUNITY SUPPORTED LIVING SERVICES PROVIDER

We support dedicated professionals and disability advocates in launching DDA-approved Community Supported Living programs rooted in choice, dignity, and independence.

​

Scope of Work:

Business formation (LLC, EIN, NPI)

DDA provider application submission and CSLA service alignment

Policy & procedure manual specific to CSLA operations

Templates for shift logs, ISPs, medication tracking, and safety plans

Staff onboarding packets and Core Competency training tracking

HIPAA-compliant client records and communication systems

Housing and roommate matching consultation (if applicable)

Referral coordination with CCS agencies and DDA regional offices

Audit preparation, bill tools, and compliance support

CASE MANAGEMENT SERVICES PROVIDER IN MARYLAND
COORDINATING QUALITY CARE, ADVOCACY, AND PERSON-CENTERED SUPPORTS FOR INDIVIDUALS WITH DISABILITIES AND THEIR FAMILIES

Case Management Services in Maryland play a vital role in ensuring individuals with intellectual and developmental disabilities receive coordinated, person-centered, and outcome-driven services. While most traditional case management is delivered through Coordination of Community Services (CCS) agencies authorized by the Maryland Developmental Disabilities Administration (DDA), Medicaid also funds various forms of Targeted Case Management (TCM) and Supports Planning Services under programs like Community First Choice (CFC) and Community Options Waiver.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid and waiver program policy for case management across all populations

Agency: Developmental Disabilities Administration (DDA)
Role: Authorizes and regulates CCS agencies and monitors case management standards under DDA waivers

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Hosts provider portal for case documentation, service planning, and billing

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight of case management and care coordination under Medicaid HCBS Waivers

2. CASE MANAGEMENT SERVICE OVERVIEW

Case Management services help individuals:

Navigate DDA or Medicaid waiver eligibility and enrollment

Develop, update, and implement Person-Centered Plans (PCPs) or Individual Plans (IPs)

Link to medical, behavioral, and social services

Advocate for needed supports in employment, education, housing, and health care

Monitor quality of care and adjust services as needed

Prevent institutionalization by promoting natural and community supports

There are two major categories:

Coordination of Community Services (CCS): For individuals enrolled in DDA Waivers

Supports Planning/Case Management (LTSS): For Community First Choice and Community Options enrollees

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your organization with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Apply as a CCS Agency through the DDA Coordination Services Provider Application

OR apply through Medicaid’s ePREP system to deliver Supports Planning under CFC or Community Options

Maintain professional liability insurance and HIPAA-compliant documentation systems

Employ qualified Case Managers, also known as Coordinators of Community Services (CCS) or Supports Planners

Note: The DDA may issue Requests for Proposals (RFPs) for new CCS agencies based on regional demand.

4. ENROLLMENT & SERVICE AUTHORIZATION PROCESS

Step 1: Prepare Service Design and Program Structure

Define case management philosophy and team responsibilities

Create a system for tracking plans, contacts, progress, and outcomes

Step 2: Apply to Become a CCS Agency (DDA)

Submit provider application with organization chart, policy manual, staff qualifications, and supervision model

Be prepared for compliance review and background check requirements

Step 3: Enroll as a Supports Planning Agency (CFC/Community Options)

Apply through the ePREP portal

Meet staffing, credentialing, and conflict-of-interest requirements

Step 4: Start Service Delivery

Accept referrals from DDA, hospitals, or the local Area Agencies on Aging

Document all interactions and maintain person-centered planning timelines

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC paperwork

IRS EIN and NPI confirmation

DDA or Medicaid provider approval

Policy & procedure manual including:

Intake and referral forms

Person-Centered Planning (PCP) templates

Service coordination logs and contact sheets

Critical incident reporting procedures

Confidentiality and HIPAA policies

Crisis response and de-escalation policies

Supervision and quality assurance systems

Staff training documentation and annual evaluations

6. STAFFING REQUIREMENTS

Role: Case Manager / Coordinator of Community Services (CCS) / Supports Planner
Requirements:

Bachelor’s degree in human services, social work, psychology, or a related field

At least one year of experience with individuals with disabilities or vulnerable populations

Criminal background check, CPR/First Aid (recommended), and HIPAA training

Strong documentation, advocacy, and interpersonal communication skills

Role: Clinical Supervisor or Program Director
Requirements: Master’s degree or extensive case management experience, responsible for oversight and compliance

Training Requirements:

DDA Orientation and PCP development

Person-Centered Thinking and Planning tools

HCBS rights and service documentation

Crisis management and mandated reporting

Annual professional development and ethics review

7. MEDICAID WAIVER SERVICES

Case Management is reimbursed under:

DDA Waivers (Community Pathways, Community Supports, Family Supports): Through CCS model

Community First Choice (CFC): Through Supports Planning Agencies

Community Options Waiver: Case management for individuals in the community

Increased Community Services (ICS): For individuals transitioning from institutions

1915(i) State Plan Option: (if applicable for behavioral or physical disability populations)

Authorized functions include:

Intake and needs assessment

Person-Centered Plan development and review

Service referral and linkage

Monitoring and follow-up

Advocacy and crisis intervention

Documentation and Medicaid-compliant billing

8. TIMELINE TO LAUNCH

Phase: Business Registration
Timeline: 1–2 weeks

Phase: Application to DDA or Medicaid via ePREP
Timeline: 4–8 weeks

Phase: Staff Hiring and Training
Timeline: 2–3 weeks

Phase: Referral Connections and Service Initiation
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

LTSS Maryland – Medicaid Case Management Tracking
Website: https://ltss.health.maryland.gov

​

Maryland Department of Aging (Supports Planning Resources)
Website: https://aging.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND CASE MANAGEMENT PROVIDER

We help compassionate professionals and mission-aligned organizations establish DDA-approved or Medicaid-enrolled Case Management services rooted in advocacy, accessibility, and high-quality coordination.

Scope of Work:

Business registration (LLC, EIN, NPI)

DDA CCS application or Medicaid Supports Planning enrollment

Policy & procedure manual for case documentation, referral flow, and plan updates

Staff credentialing trackers and person-centered planning templates

HIPAA-compliant communication tools and recordkeeping systems

Website and professional intake packet design

Referral networking with hospitals, CCS offices, and waiver providers

Training schedules and audit preparation tools

HOME HEALTH CARE SERVICES PROVIDER IN MARYLAND
DELIVERING MEDICAL, PERSONAL, AND THERAPEUTIC SUPPORT TO INDIVIDUALS IN THEIR HOMES TO PROMOTE SAFETY, INDEPENDENCE, AND QUALITY OF LIFE

Home Health Care in Maryland involves the provision of skilled nursing, personal care, therapy, and social services to individuals in their own homes. These services are authorized through Maryland Medicaid, including programs like the Community First Choice (CFC), Community Options Waiver, and Model Waiver, and are licensed by the Office of Health Care Quality (OHCQ) as Residential Service Agencies (RSAs).

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Administers Medicaid-funded home health care under CFC and waiver programs

Agency: Office of Health Care Quality (OHCQ)
Role: Licenses and inspects Residential Service Agencies (RSAs) that provide home health services

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Regulates federal HCBS standards and supports person-centered home care delivery

Agency: Maryland Board of Nursing / Board of Physical Therapy / Other Boards
Role: Licenses clinical professionals delivering services in the home

2. HOME HEALTH CARE SERVICE OVERVIEW

Services may include any combination of the following, as authorized by a physician and documented in a Plan of Care:

Skilled nursing care (RN/LPN)

Home health aide services (personal care, grooming, toileting, feeding)

Physical, occupational, or speech therapy

Medical social work

Medication administration and monitoring

Caregiver education and coordination

Wound care, catheter care, and chronic condition management

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

To operate as a home health provider in Maryland, agencies must:

Register the business with the Maryland Department of Assessments and Taxation (SDAT)

Obtain an EIN and Type 2 NPI

Apply to become a licensed Residential Service Agency (RSA) with OHCQ

Meet staffing requirements, including hiring a Nursing Administrator (RN)

Develop and submit a policy and procedure manual, sample care plans, and staffing plans

Maintain liability and malpractice insurance

Enroll with Maryland Medicaid via ePREP for reimbursement

4. OHCQ LICENSING PROCESS

Step 1: Business Formation and Pre-Application

Register your LLC, secure an office, and obtain basic credentials

Step 2: Submit RSA Application to OHCQ

Include nurse administrator resume, operating procedures, sample forms, and clinical protocols

Select levels of care: Skilled, Unskilled, or Both

Step 3: Pass OHCQ Inspection

Includes review of clinical documentation, patient rights policies, and staff files

Step 4: Medicaid Enrollment via ePREP

Register for billing under CFC, Community Options Waiver, or Model Waiver

5. REQUIRED DOCUMENTATION

Articles of Incorporation / LLC registration

IRS EIN and Type 2 NPI documentation

OHCQ RSA application and license

Medicaid provider number and ePREP approval

Policy & procedure manual including:

Admission and discharge criteria

Physician order and care plan templates

RN supervision, home visit logs, and aide documentation forms

Infection control and emergency preparedness protocols

Medication administration record (MAR) and incident reporting

HIPAA compliance and client confidentiality standards

Staff training records and credentialing files

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Valid MD license, CPR, experience with in-home care, supervises clinical team

Role: Licensed Practical Nurse (LPN)
Requirements: Works under RN supervision, provides delegated care

Role: Home Health Aide / Certified Nursing Assistant (CNA)
Requirements: Active Maryland certification, trained in personal care, transfers, and hygiene

Role: Therapists (PT, OT, ST) – if offering rehab services
Requirements: Licensed by respective MD Boards

Role: Medical Social Worker (if applicable)

Training Requirements:

HIPAA, infection control, and emergency response

Delegation and supervision protocols

Documentation standards and incident reporting

CPR/First Aid

Annual continuing education and skills checks

7. MEDICAID WAIVER SERVICES

Home Health Care services are reimbursed under:

Community First Choice (CFC) – For individuals needing assistance with ADLs and nursing

Community Options Waiver – For adults with physical disabilities or the elderly

Model Waiver – For medically fragile children under age 22

Increased Community Services (ICS) – For those transitioning from nursing facilities

Covered services may include:

Skilled nursing (intermittent or continuous)

Home health aide support (e.g., bathing, grooming, meals)

Medication administration and IV therapy

Therapy (PT/OT/ST) services as ordered

Caregiver training and supervision

8. TIMELINE TO LAUNCH

Phase: Business Registration and Office Setup
Timeline: 1–2 weeks

Phase: RSA Application Development and Policy Manual
Timeline: 2–4 weeks

Phase: OHCQ Review and Inspection
Timeline: 6–8 weeks

Phase: Medicaid Enrollment and Participant Referrals
Timeline: 4–6 weeks

9. CONTACT INFORMATION

Maryland Office of Health Care Quality (OHCQ)
Website: https://health.maryland.gov/ohcq
Phone: (410) 402-8217
Regulations: COMAR 10.07.05

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

Maryland Board of Nursing
Website: https://mbon.maryland.gov

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND HOME HEALTH CARE PROVIDER

We assist RNs, health professionals, and mission-driven entrepreneurs in launching fully licensed and Medicaid-approved Home Health Agencies across Maryland.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

OHCQ RSA license application development

Full policy & procedure manual customized for skilled and unskilled care

Care plan templates, delegation logs, and staff supervision tools

Staff hiring and credentialing tracker

Medicaid billing prep via LTSS Maryland

Intake forms, MAR logs, and incident documentation templates

HIPAA-compliant communication system setup

Referral networking tools and outreach materials

MEAL & NUTRITION SERVICES PROVIDER IN MARYLAND
SUPPORTING HEALTH, WELLNESS, AND INDEPENDENT LIVING THROUGH MEDICALLY-TAILORED MEAL DELIVERY AND NUTRITION EDUCATION

Meal and Nutrition Services in Maryland provide individuals with disabilities, chronic health conditions, or functional limitations access to nutritious meals and dietary counseling that promote wellness and reduce health risks. These services are authorized through various Home and Community-Based Services (HCBS) programs, including the Community First Choice (CFC) program and the Developmental Disabilities Administration (DDA) Waivers: Community Pathways, Community Supports, and Family Supports.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees Medicaid HCBS programs and clinical nutrition standards

Agency: Developmental Disabilities Administration (DDA)
Role: Authorizes nutritional services and meal delivery under PCP goals

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Tracks billing and documentation for Medicaid-funded services

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures compliance with federal HCBS nutritional service requirements

2. MEAL & NUTRITION SERVICE OVERVIEW

Maryland Medicaid may authorize the following under various programs:

A. Meal Services (Home-Delivered or Congregate)

Ready-to-eat or reheat meals delivered to a participant's home

May include therapeutic diets (low-sodium, diabetic, renal-friendly)

Often authorized for individuals unable to prepare meals themselves

Meals must meet nutritional guidelines and be documented on menus

B. Nutritional Services (Dietitian-Led)

Nutritional assessments and counseling

Meal planning assistance based on medical needs

Family/caregiver education

Coordination with physicians and support teams

May involve monitoring weight, blood sugar, or dietary adherence

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Meal Services (Home-Delivered Meals):

Register business with SDAT, obtain EIN and NPI

Apply for DDA approval or enroll via Medicaid’s ePREP for CFC participants

Maintain commercial kitchen license or subcontract with licensed caterers

Comply with local health department food safety standards

Submit meal samples, menus, and delivery procedures

Nutrition Services (Professional):

Must employ or contract Licensed Dietitians (LDs) or Registered Dietitians (RDs)

Apply under DDA for "Nutrition Services" or under Medicaid for therapy/nutritional counseling

Maintain malpractice insurance and HIPAA-compliant recordkeeping

4. PROVIDER ENROLLMENT & SERVICE AUTHORIZATION

Step 1: Determine service type (Meal Delivery vs. Nutrition Counseling)
Step 2: Apply to DDA or enroll via ePREP under the appropriate waiver
Step 3: Submit required documentation (menus, credentials, policy manual)
Step 4: Receive approval and begin receiving referrals through CCS or CFC case managers
Step 5: Document services in LTSS Maryland

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC paperwork

EIN and Type 2 NPI

Local food permit or licensed commercial kitchen agreement (for meal providers)

DDA or Medicaid approval letter

Policy & procedure manual including:

Menu templates and dietary labeling

Delivery logs and temperature control protocols

RD/LD credentials and service logs

Participant intake forms and consent documentation

Nutritional assessment templates

Infection control and food safety policies

HIPAA compliance and participant communication protocols

6. STAFFING REQUIREMENTS

Role: Meal Delivery Coordinator
Requirements: Experience with food safety, background check, driver’s license (if delivering)

Role: Registered Dietitian (RD) / Licensed Dietitian (LD)
Requirements: Maryland license, experience with disabilities or chronic disease populations

Role: Food Prep Staff (if meals prepared in-house)
Requirements: Food handler certification, local health inspection compliance

Training Requirements:

HIPAA and participant confidentiality

Food safety and sanitation (ServSafe recommended)

Emergency protocols and temperature control

Cultural dietary preferences and therapeutic meal planning (for dietitians)

7. MEDICAID WAIVER SERVICES

Meal and Nutrition Services are funded under:

Community First Choice (CFC) – For adults with functional limitations who qualify for nursing facility level of care

Community Pathways Waiver – For individuals with intellectual/developmental disabilities

Community Supports Waiver – For adults needing part-time support

Family Supports Waiver – For children under 21

Examples of covered services:

Meal delivery for individuals unable to shop/cook

Diet counseling related to diabetes, heart disease, or swallowing issues

Caregiver education to support meal consistency at home

Coordinated support between RD and care team (e.g., nurse, support planner)

8. TIMELINE TO LAUNCH

Phase: Business Registration and Licensing
Timeline: 1–2 weeks

Phase: Policy Manual and Staff/Contractor Onboarding
Timeline: 2–3 weeks

Phase: Medicaid Enrollment and Approval (DDA or ePREP)
Timeline: 4–8 weeks

Phase: Service Launch and Referral Coordination
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

Maryland Board of Dietetic Practice (for RD/LD licensing)
Website: https://health.maryland.gov/bodp

​

Maryland Department of Health – Food Protection Program
Website: https://health.maryland.gov/phpa/OEHFP/OFPCHS

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND MEAL & NUTRITION SERVICES PROVIDER

We help wellness professionals, registered dietitians, and food service organizations establish compliant Medicaid-funded Meal and Nutrition Services for Maryland residents.

​

Scope of Work:

Business registration (LLC, EIN, NPI)

Local food license or dietitian credential review

Medicaid or DDA provider application support

Menu templates and nutrition assessment forms

Delivery tracking and food safety policies

Staff onboarding documents and HIPAA checklists

Referral networking with CCS and CFC case managers

Website, communication systems, and audit prep tools

THERAPEUTIC INTEGRATION SERVICES PROVIDER IN MARYLAND
FOSTERING GROWTH, SOCIALIZATION, AND SKILL-BUILDING FOR CHILDREN WITH DISABILITIES THROUGH THERAPY-DRIVEN COMMUNITY ENGAGEMENT

Therapeutic Integration Services in Maryland are structured, community-based support services for children with intellectual and developmental disabilities. These services focus on enhancing socialization, adaptive behavior, and community participation in a group setting. They are authorized under the Maryland Developmental Disabilities Administration (DDA), primarily through the Family Supports Waiver and sometimes through Community Supports and Community Pathways Waivers for transitional-aged youth.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)
Role: Oversees regulatory standards for DDA Waiver services

Agency: Developmental Disabilities Administration (DDA)
Role: Administers the Family Supports Waiver, which includes Therapeutic Integration services

Agency: Office of Long-Term Services and Supports (LTSS Maryland)
Role: Tracks data, documents service delivery, and manages Medicaid billing for DDA programs

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures compliance with federal Home and Community-Based Services (HCBS) standards

2. THERAPEUTIC INTEGRATION SERVICE OVERVIEW

Therapeutic Integration (TI) provides structured after-school or day programming for children and adolescents that:

Incorporates therapy-informed activities

Fosters communication, peer relationships, and behavior regulation

Builds community engagement skills through group activities and outings

Offers support with social-emotional learning and sensory needs

May include individual goal planning as outlined in the Person-Centered Plan (PCP)

TI programs typically operate before or after school, on weekends, and during school breaks, with staff support ratios based on individual needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your agency with the Maryland Department of Assessments and Taxation (SDAT)

Obtain EIN and Type 2 NPI

Apply to become a DDA-approved provider through the DDA Provider Application Portal

Secure a program location (site-based facility) that meets safety and accessibility requirements

Submit policies for therapeutic curriculum, behavior management, and supervision

Hire qualified staff trained in developmental disabilities, behavioral health, or child development

Obtain commercial liability insurance and ensure compliance with transportation and safety protocols (if applicable)

4. DDA PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Develop Program Design

Define therapeutic goals, daily schedules, and activity types

Include group ratios, staffing structure, and behavior support practices

Step 2: Submit DDA Provider Application

Select “Therapeutic Integration” under the Family Supports Waiver

Include location details and staffing credentials

Step 3: Site Visit & Review

Prepare for DDA pre-approval inspection if operating from a physical facility

Submit floor plans, emergency exits, and environmental safety documentation

Step 4: Receive Approval and Accept Referrals

Begin service delivery once referrals are received from Coordination of Community Services (CCS) agencies

Document attendance, outcomes, and behavioral incidents as required

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC paperwork (via SDAT)

IRS EIN and NPI confirmation

DDA provider enrollment approval

Facility lease or ownership documentation (for site-based services)

Policy & procedure manual including:

Participant intake and individualized support planning

Therapeutic activity schedule and curriculum outline

Behavior support protocols and de-escalation strategies

Incident reporting, medication management (if applicable)

Supervision policies and staff ratios

Parent communication procedures

Transportation safety plans (if providing community outings)

Staff training logs and background checks

6. STAFFING REQUIREMENTS

Role: Therapeutic Integration Specialist / DSP
Requirements: Minimum high school diploma or GED, experience with youth or disabilities, background check, CPR/First Aid, and DDA Core Competency training

Role: Clinical Supervisor or Program Manager
Requirements: Bachelor’s or Master’s degree in education, psychology, or related field; responsible for planning, supervision, and behavioral oversight

Role: Behavioral Health Consultant (optional)
Requirements: BCBA, LCSW, or similar; supports behavioral planning and training

Training Requirements for All Staff:

DDA Orientation and Core Competencies

Behavior intervention and de-escalation techniques

Trauma-informed care

Documentation and safety protocols

Parent/caregiver communication skills

Annual continuing education

7. MEDICAID WAIVER SERVICES

Therapeutic Integration is reimbursable under:

Family Supports Waiver – Children under 21 with intellectual/developmental disabilities

Community Supports Waiver – Transition-aged youth not enrolled in full-day services

Community Pathways Waiver (case-by-case for youth with high needs)

Self-Directed Services (in limited cases) – TI may be accessed through individualized arrangements

Covered services include:

Therapeutic group activities and community outings

Structured recreational engagement

Social-emotional learning support

Crisis response and behavior support (if outlined in PCP)

Transition-to-adulthood skills (as applicable)

8. TIMELINE TO LAUNCH

Phase: Business and Facility Setup
Timeline: 2–3 weeks

Phase: Staff Hiring and Curriculum Development
Timeline: 2–4 weeks

Phase: DDA Provider Application and Site Inspection
Timeline: 6–10 weeks

Phase: Service Activation and Referral Enrollment
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)
Website: https://dda.health.maryland.gov
Email: dda.providerapps@maryland.gov

​

Maryland Medicaid Provider Enrollment (ePREP)
Website: https://eprep.health.maryland.gov

​

Maryland State Department of Education (MSDE) (if providing coordination with IEPs)
Website: https://marylandpublicschools.org

​

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND THERAPEUTIC INTEGRATION PROVIDER

We help educators, behavioral specialists, and youth service providers launch impactful Therapeutic Integration programs for children with developmental disabilities across Maryland.

​

Scope of Work:

Business formation (LLC, EIN, NPI)

DDA enrollment under the Family Supports Waiver

Policy & procedure manual for therapeutic group settings

Curriculum design tools and daily schedule templates

Staff credentialing, onboarding, and Core Competency tracking

Safety and emergency procedures for site-based services

Parent consent forms, communication logs, and intake packets

Website, email, and scheduling setup

Referral networking with CCS and local IEP teams

ADULT DAY CARE SERVICES PROVIDER IN MARYLAND
PROMOTING WELLNESS, SAFETY, AND SOCIAL CONNECTIONS FOR OLDER ADULTS AND MEDICALLY FRAGILE INDIVIDUALS IN A COMMUNITY SETTING

Adult Day Care Services, formally known as Adult Medical Day Care (AMDC) in Maryland, offer structured, daytime care for adults with physical, cognitive, or medical conditions who benefit from health monitoring, social engagement, and personal care while living in the community. Services are licensed by the Office of Health Care Quality (OHCQ) and may be funded through Medicaid’s Community Options Waiver or Community First Choice (CFC).

1. GOVERNING AGENCIES

Agency: Maryland Office of Health Care Quality (OHCQ)
Role: Licenses and inspects Adult Medical Day Care centers

Agency: Maryland Medicaid / Long Term Services & Supports (LTSS)
Role: Provides reimbursement through Community Options Waiver and CFC program

Agency: Maryland Department of Health (MDH)
Role: Oversees medical eligibility and program standards

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight of Medicaid-funded adult day services

2. ADULT DAY CARE SERVICE OVERVIEW

Adult Medical Day Care (AMDC) provides:

Skilled nursing and medication administration

Personal care (bathing, toileting, grooming)

Health monitoring and chronic disease management

Therapeutic recreation and cognitive activities

Social work and case management services

Nutritious meals and snacks

Door-to-door transportation (optional but common)

Services must meet medical necessity criteria and align with the participant’s individualized service plan (ISP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

To operate legally in Maryland, Adult Day Care providers must:

Obtain licensure as an Adult Medical Day Care Center from OHCQ

Comply with COMAR 10.12.04 regulations for AMDC

Operate in a facility that meets accessibility, fire safety, and health code requirements

Employ a Registered Nurse, Program Director, and sufficient certified staff

Submit to annual inspections and quality reviews

4. OHCQ LICENSING PROCESS

Step 1: Business Registration

Register business with SDAT

Obtain EIN, NPI, and Medicaid provider number

Step 2: Facility Setup

Lease or purchase a site that meets zoning, space, and accessibility standards

Develop floor plan, meal prep area, activity space, and rest areas

Step 3: Pre-Licensure Application to OHCQ

Submit application, floor plans, fire marshal approval, staff list, and operating policies

Step 4: OHCQ Site Inspection

Schedule and pass pre-licensure survey inspection

Step 5: Begin Operations Upon Licensure

Market services to case managers and referral networks (hospitals, Area Agencies on Aging)

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC registration

IRS EIN and NPI confirmation

Lease agreement and floor plans

OHCQ application and checklist

Medicaid enrollment (ePREP)

Policy & procedure manual including:

Medical and nursing protocols

Medication administration policies (with MAR logs)

Nutrition and meal safety procedures

Behavioral support, emergency evacuation, and safety plans

Client intake, assessment, and consent forms

Staff training records and job descriptions

Transportation safety and vehicle maintenance policies (if provided)

6. STAFFING REQUIREMENTS

Role: Registered Nurse (RN)
Requirements: Onsite daily; supervises health services and medication administration

Role: Program Director
Requirements: Bachelor's degree in human services or related field and 3+ years of management experience

Role: Activity Coordinator
Requirements: Background in therapeutic recreation or group facilitation

Role: Certified Nursing Assistants (CNAs) or Geriatric Nursing Assistants (GNAs)
Requirements: Certified and trained in personal care and emergency procedures

Role: Social Worker (optional, highly recommended)**
Role: Driver (if transportation is provided)

7. MEDICAID WAIVER SERVICES

Adult Medical Day Care is funded under:

Community Options Waiver – For adults meeting nursing facility level of care

Community First Choice (CFC) – For Medicaid recipients needing personal and health services to remain in the community

Services must be pre-authorized by Medicaid and may include:

Daily nursing oversight

Personal assistance

Social work services

Structured recreation

Meals and transportation

8. TIMELINE TO LAUNCH

Phase: Business Formation & Facility Acquisition
Timeline: 2–4 weeks

Phase: Policy Development and Staff Hiring
Timeline: 3–5 weeks

Phase: OHCQ Application and Inspection
Timeline: 8–12 weeks

Phase: Medicaid Enrollment & Participant Referrals
Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Office of Health Care Quality (OHCQ)
Website: https://health.maryland.gov/ohcq
Phone: (410) 402-8217
Regulations: COMAR 10.12.04

Maryland Medicaid (ePREP Enrollment)
Website: https://eprep.health.maryland.gov

Maryland Department of Assessments and Taxation (SDAT)
Website: https://egov.maryland.gov/BusinessExpress

​

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND ADULT DAY CARE PROVIDER

We support compassionate professionals in launching licensed Adult Day Care centers that offer both medical and social care in community settings.

​

Scope of Work:

Business formation (LLC, EIN, NPI)

OHCQ Adult Day Care licensure support

Policy & procedure manual development for AMDC compliance

Staff onboarding and credentialing trackers

Participant intake forms and care plans

Fire safety compliance and inspection checklists

Medicaid billing setup and LTSS Maryland registration

Referral outreach tools for case managers and discharge planners

Website, HIPAA email, and digital documentation systems