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DLS: Community‑based waiver registries large; application processing lags
Summary
DLS highlighted long registries for home and community‑based waivers, low application return rates, and staffing bottlenecks that leave many applications pending despite expanded outreach and a contractor hire.
Department of Legislative Services analysts told the Health and Government Operations Committee that multiple Medicaid waivers have large registries and that Maryland faces persistent application‑processing delays.
Anne Braun summarized the registries: "the community options waiver having more than 20,000 individuals versus the DDA community services waiting list has just below 4,000 individuals," she said, and she noted the autism waiver—s waiting list fell by about 15 percent in the most recent year.
DLS said MDH sends substantially more applications to registry candidates than in the past (about 700 per month as of December 2024), but return and processing rates remain low. "Despite the expanded applications being sent out, only 29% or so of them were returned on average each month," Anne said, and DLS reported that about 84 percent of applications remained in pending status at month end owing largely to staffing shortages.
To address backlogs MDH began contracting in June 2024 to review plans of service, DLS said, but staffing shortages remain a limiting factor for eligibility determinations. DLS also described outreach and data‑cleanup efforts that removed deceased or relocated individuals from registries; those efforts contributed to registry declines even when enrollment did not rise.
Funding and policy context. DLS summarized funds available for end‑the‑wait activities: a dedicated purpose account created for waiver expansions initially received $30 million and other appropriations left roughly $77.3 million remaining after some expenditures and appropriations. DLS said cost containment and Board of Public Works actions reduced planned end‑the‑wait funding in FY25 and that the FY26 allowance proposes transferring $6 million from the dedicated account back to the general fund as a cost‑containment measure.
Members asked for updated processing data and for MDH impact estimates; DLS said it would follow up with more current figures and the committee requested that any updates be circulated to all members.
