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

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10. 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