Developmental Disabilities Administration Appendix K Flexibilities Ending June 30, 2023

The federal government announced that the COVID-19 Public Health Emergency (PHE) will end on May 11, 2023. That means the temporary Appendix K flexibilities that were tied to it will also end. Effective June 30, 2023, the MDH - Developmental Disabilities Administration (DDA) will end its Appendix K flexibilities and start normal waiver operations.



The DDA was able to make a number of flexibilities permanent. Here are more details on what will change and what will remain in place:

The DDA conducted a webinar on April 21, 2023 about unwinding the remaining Appendix K flexibilities. We also highlighted flexibilities that will continue under the DDA-operated Medicaid Waivers.

Below is a brief summary of flexibilities that will end on June 30, 2023. For more information, please review the topic-specific memos on the DDA’s Appendix K webpage click below:

The flexibilities listed below, as used under Appendix K, will end on June 30, 2023. It is important to note that any flexibility with an asterisk (*) will continue in some form under the ongoing DDA waivers.

Hiring and Training Requirements

●     Hire relatives and legally responsible individuals*

●     Waive all but essential training

●     Policy on Reportable Incidents and Investigations (PORII) training provided in an expedited format

●     Sharing staff among providers

●     Cardiopulmonary Resuscitation (CPR) and First Aid standards exceptions

●     Training in MANDT®*

●     Waiver of high school or General Educational Development (GED) requirement*

●     Annual training requirement extension for DSP who have previously completed all training requirements (less than 18 months ago)

Funding and Retainer Payments

●     Meaningful Day, Personal Supports, and Residential* retainer payments

●     Increased rate (isolation)

●     Residential day time shared service hours*

●     Suspension of the minimum number of hours of Meaningful Day services to be provided during a single day. A provider may bill for the entire day only if they provide the person with, at minimum, three hours of cumulative supports

Staff Ratios

●     Staffing ratios (exceed maximum)

●     Staffing ratios — 1:1 and 2:1 exceptions

Service Flexibilities

●     Services provided any day of the week* and exceed 8 hours a day* and 40 hours per week within the person’s authorized budget

●     Self-Directed Service Delivery Model exceptions*

If you have any questions please contact your Regional Office:

●     Bianca Renwick, Central Maryland Regional Office Director at: [email protected]​

●     Kimberly D. Gscheidle Eastern Shore Regional Office Director at:

[email protected]

●     Onesta Duke, Southern Maryland Regional Office Director at:

[email protected] ​

●     Cathy Marshall, Western Maryland Regional Office Director at: [email protected]

Reference: The DDA’s Appendix K and Executive ​Orders Flexibilities chart on page 3 identifies flexibilities that will continue after June 30, 2023.

Transitioning Youth Important Reminders

As July 1 approaches, please consider the important reminders for Transitioning Youth (TY) noted below. We want to encourage Transitioning Youth and their families to work with their Coordinator of Community Services to complete and submit your Person-Centered Plan and Waiver Application.



Transitioning Youth 23

Young people who graduated or aged out of school last year in June 2022 must submit a Waiver Application before June 30, 2023 in order to be eligible for funding this fiscal year (July 1, 2022–June 30, 2023).

*Note: There are exceptions for Autism Waiver (AW) TY under the AW Appendix K. The flexibility allowed AW TY21 & 22 to temporarily remain in the AW. These youth would be considered as part of the TY23 group. They must also submit a Waiver Application before June 30, 2023.



Transitioning Youth 2024

Young people who will graduate from or age out of school this year in June 2023, may submit their DDA Waiver Application now.

If you need additional assistance, please reach out to your Regional Office.

Waiver Amendment #1 2023

The Maryland Department of Health (MDH) is seeking public comment for waiver amendments for the three home and community-based waivers operated by the Developmental Disabilities Administration (DDA):

• Family Supports Waiver
• Community Supports Waiver
• Community Pathways Waiver

The purpose of these amendments is to provide an option to exempt live-in caregivers who provide Personal Support and Respite Care Services from Electronic Visit Verification (EVV) requirements. This applies to both the traditional and self-directed services delivery models. The exemption is that live-in caregiver staff do not have to clock in and out in real time. 

Public comments can be submitted to [email protected] or mailed to the DDA Federal Program Unit at 201 West Preston Street, 4th Floor, Baltimore, MD 21201. Comments will be accepted beginning May 31 through June 30, 2023. To support the stakeholder input process and minimize or alleviate stakeholder hardship, comments for all three waivers should be submitted together under one response.

To view the proposed amendments, click on the links below:

• Family Supports Waiver - Amendment #1 2023
• Community Supports Waiver - Amendment #1 2023
• Community Pathways Waiver - Amendment #1 2023

Frequently Asked Questions Updates

The DDA is happy to share updates to the Frequently Asked Questions based on recent webinars. To view the updates click on this link.

Money Follows the Person (MFP) Stakeholder Advisory Group Meeting—June 13, 2023

The MDH’s MFP Stakeholder Advisory Group (SAG) Meeting will be held on Tuesday, June 13, 2023 from 11 a.m. to 1 p.m. The Zoom information can be found below. 

At the upcoming meeting, MDH is seeking your feedback and expertise to develop rebalancing initiatives. Please join us to answer: What rebalancing initiatives will make the biggest improvements in the health and happiness of the people we all serve?

The meetings will be "hands on" and interactive. It will include breakout sessions into virtual rooms to brainstorm and research rebalancing initiatives including:

• Housing
• Technology
• Direct support professionals/case managers workforce recruitment, training and retention 
• Behavioral health 
• MAP enhancements 
• Other/to be determined

To join the meeting click below:

For more information, contact Wayne Lee Reed III, Money Follows the Person Demonstration Grant Project Director at [email protected].

Operations Updates

Website Survey

The DDA has launched an initiative to enhance the user-friendliness and accessibility of our website. We value your input and would love to hear from you about how you use our site! Please take a moment to fill out this survey to support our improvement efforts.

Program Updates

Self-Directed Services

Save the date! 

Individual and Family Direct Goods and Services Webinar:

The DDA will be conducting a webinar on June 21, 2023 from 10-11 a.m. During the webinar, the DDA will share self-directed service updates regarding Individual and Family Direct Goods and Services (IFDGS). The webinar will share information regarding:

• The flexibilities of IFDGS.
• How to request IFDGS.
• Guidance on how to include a Day to Day Administrator in your budget.

Support Broker Services Update Webinar:

The DDA will be conducting a webinar on July 19, 2023 from 10-11 a.m. During the webinar, the DDA will share self-directed service updates regarding Support Broker Services. The webinar will share information regarding:

• The expanded role of the Support Broker.
• Support Broker requirements for people who hire family members.

Resources:

Instructional Walkthrough Videos

• How to use the SDS Budget Sheet
• Budget Modification Process
• Example Budget Sheet

NCI Staff Stability Reminder

The 2022 National Core Indicators (NCI) State of the Workforce Survey (Staff Stability Survey) unique provider links went out on March 15, 2023 and the responses are pouring in. Thank you! 

Please remember this data is important as we work together to improve the quality, longevity and sustainability of the DSP workforce. 

Surveys are due by June 30, 2023. Submit yours today! If you have any questions, please contact Leslie Thompson, Statewide Director of Provider Services, at [email protected].

Technology First 

Congratulations to Tanya Booker of Chesapeake Care for winning our Tech Tuesday Raffle! Tanya will be receiving a tech gift card for $50! 



During our May Tech Tuesday webinar, we had the pleasure of being introduced to Floreo, a virtual reality development company that demonstrated how virtual reality (VR) can assist with training people with developmental disabilities in areas of employment, public transportation and other tools to navigate safely in their community. For more information and to connect with Floreo, email them at [email protected].

Rent Subsidy Program

On Tuesday, May 30, Deputy Secretary Bernard Simons shared the DDA’s vision of people having the opportunity to live on their own in the housing of their choice.



One way we are going to realize our vision is to partner with the Maryland Department of Housing and Community Development to administer a Rent Subsidy Program. This voucher-based program will be established to assist people with IDD to live on their own in the communities of their choice. If you missed the webinar, click below to view it:

Maryland Community of Practice for Supporting Families

On May 25, the DDA Maryland Community of Practice for Supporting Families conducted a webinar titled Visiting With Your Coordinator of Community Services: In-Person Monitoring. We want to hear from you!  Are there any other potential solutions you could recommend to a CCS or other families about how to overcome the concerns some families have around in-person visits? Click below to tell us what you think.

Upcoming Events

6/6 Support Broker Initial Training

6/13 Money Follows the Person (MFP) Stakeholder Advisory Group Meeting

Missed a previous DDA Connection? 

Click here to view the archive.



Click here to view upcoming events on our DDA Training Calendar.

DDA Vision

People with developmental disabilities will have full lives in the communities of their choice where they are included, participate and are active citizens.

DDA Mission

Create a flexible, person-centered, family-oriented system of support so people can have full lives.

DDA Headquarters

201 W. Preston Street, 4th Floor

Baltimore, MD 21201

Phone: (410)767-5600

Fax: (410)767-5850

Toll Free: 1(844)253-8694

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