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Maryland Medicaid Waivers

Below is a brief description of each of Maryland’s Medicaid waivers followed by additional resources for more details.

Home and Community Options Waiver

The Community Options Waiver provides services such as assisted living facilities, medical day care, personal assistance, home-delivered meals and supports planning for Maryland residents aged 18 and over who need assistance with activities of daily living, like bathing, grooming, dressing and getting around. Individuals must meet a nursing facility level of care and financial eligibility requirements.

Medical Day Care Waiver

The Medical Day Care Services Waiver offers qualified Medicaid participant services in a community-based day care center. Medical Day Care is a structured group program that seeks to maximize health functioning and independence of eligible Medicaid participants by providing community-based health, social and related support services, as an alternative to institutional care. Individuals must be at least 16 years old and not enrolled in another home and community-based waiver. They must qualify for Medicaid in the community and meet the level of care required for nursing facility services.

Model Waiver for Disabled Children

The Model Waiver, a program started in Maryland in 1985, allows medically fragile individuals who would otherwise be hospitalized and are certified as needing either hospital or nursing facility level of care to receive medically necessary and appropriate services in the community. As a result, the Model Waiver clients can continue to live at home with their families.

Waiver for Individuals with Brain Injury

Maryland’s Home and Community Based Services Waiver for Individuals with Brain Injury provides specialized community-based services to adults with brain injuries who meet program eligibility.

Covered services include: residential habilitation, day habilitation, supported employment, individual support services, case management and medical day care. Eligible individuals must be between the ages of 22-64, have sustained a brain injury after the age of 17, require a nursing facility or chronic hospital level of care and reside in a state owned and operated nursing facility, a Commission on the Accreditation of Rehabilitation Services (CARF)-accredited chronic hospital or a state psychiatric hospital. An individual’s income and assets are reviewed to determine financial eligibility for medical assistance.

Waiver for Children with Autism Spectrum Disorder

Maryland’s Home and Community Based Services Waiver for Children with Autism Spectrum Disorder allows eligible children with Autism Spectrum Disorder to receive specific waiver services and certain Medicaid services to support them in their homes and communities. Individuals must be certified as needing services from an Intermediate Care Facility for people with Intellectual Disabilities (ICF-ID) and be between the ages of 2-21.

Community Pathways Waiver

The Community Pathways Waiver helps individuals with intellectual and developmental disabilities to live more independently in their homes and communities. The program provides a variety of Meaningful Day Services, support and residential services that promote community living, including a self-directed service model and traditional, agency-based service model.

The Community Pathways Waiver supports both children and adults. It includes various services to support assessed needs. Based on the person-centered planning process and information that comes out of focus area exploration, a coordinator will work with the person to determine the most appropriate service(s) to support their needs. Authorized services are based on an assessed need and waiver service requirements as noted in the approved waiver applications. The waiver provides a variety of services including meaningful day, support, and residential services. Support services include assistive technology services; behavioral support services; environmental assessments; environmental modifications; family caregiver training and empowerment services; family and peer monitoring supports; housing support services; individual and family-directed good and services; participant education, training and advocacy supports; personal supports; respite care services; nurse case management and delegation services; transportation; and vehicle modifications. Meaningful Day Services include supported employment; employment discovery and customization; community development services; day habilitation and medical day care. Residential services include supported living; shared living and community living – group home. Maryland has set criteria to determine eligibility for Medicaid waiver enrollment. Financial eligibility is based only on the income of the individual, not the income of the parents.

Community Supports Waiver

The Community Supports Waiver helps adults who are eligible for services through the Maryland Developmental Disabilities Administration (DDA) to live more independently in their homes and communities. The program provides a variety of Meaningful Day services and other support Services that promote community living, including a self-directed service model and traditional, agency-based service model. The services available through this waiver are less comprehensive than those provided in the DDA Community Pathways waiver.

Family Supports Waiver

The Family Supports Waiver helps participants live more independently in their homes and communities. The program provides a variety of support services that promote community living, including a self-directed service model and traditional, agency-based service model. The Family Supports Waiver supports children up to age 21 and includes various support services to support children and their families. Based on the person-centered planning process and information that comes out of focus area exploration, a coordinator will work with the family to determine the most appropriate service(s) to support their needs.

Medicaid State Plan Services and Additional Resources

The Blue Book

The Blue Book Guide to Long-Term Supports and Services provides an overview of long term supports and services available to Maryland Medicaid recipients.

Community First Choice

Maryland’s Community First Choice and Community Personal Assistance Services options provide community services and supports to enable older adults and people with disabilities to live in their own homes.

Home and Community Based Services

The Maryland Department of Health is an indispensable resource for information on Maryland’s Medicaid Waivers and other Home and Community Based Services (HACBs).

Pathfinders for Autism

A good description of Maryland waivers can also be found on the Pathfinders for Autism website.