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

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10. 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, billing tools, and compliance support