Maryland aging officials warn cuts to senior-care funding would disrupt services as wait lists grow

Victoria Martinez, an analyst with the Department of Legislative Services, told the Health and Social Services Subcommittee that the Maryland Department of Aging's fiscal 2026 allowance falls about $869,000 (roughly 1%) to $90.3 million and that the department faces programmatic and spending issues that merit legislative attention.

DLS highlighted that the department's largest funding shares are federally supported Older Americans Act programs (about 28% of spending) and the state-funded senior care program (about 15%). Martinez described a pattern in recent years: participation in the senior care program has declined while the program's wait list has grown. She said the General Assembly added roughly $8.5 million to address the wait list in fiscal 2024, but MDOA reverted about $5.9 million at the close of fiscal 2024, resulting in actual spending of about $8.7 million that year. The department's fiscal 2025 appropriation was reported at about $13.9 million and the fiscal 2026 allowance at about $13.2 million; DLS recommended a $2.5 million reduction to better align the fiscal 2025 appropriation with recent spending patterns.

"DLS has asked that MDOA explain why participation in the senior care program in fiscal 2024 decreased while the wait list continued to increase and to also discuss efforts to efficiently enroll individuals from the wait list into newly opened slots," Martinez said during the committee briefing.

Carmel Roque, Secretary of the Maryland Department of Aging, told the committee the department is pressing to preserve senior-care funding and warned that the DLS-proposed midyear reduction would be destabilizing. "These state funds are more critical than ever in our current federal funding climate," Roque said, noting the department and its local area agencies on aging rely on state funds for services such as nutrition, transportation and in‑home care. She said senior-care funds at the area-agency level had already been planned and that cuts could reduce staffing and direct services.

Eloise Maine, assistant secretary for grants administration at the Department of Aging, described steps MDOA has taken on data and grants oversight since a period in which the agency lacked a senior care program manager. "Now that that issue has been fixed, we have the program manager in place and there will be consistency" in reporting, she said, adding that MDOA has instituted midyear assessments to track AAA spending and improve end‑of‑year outcomes.

DLS and department staff pointed to several causes for the apparent mismatch between allocated dollars and spending: (1) the $8.5 million was largely unplanned one‑time funding in 2024, making local AAAs reluctant to hire case managers or expand services without assurance of multi‑year funding; (2) inconsistent eligibility criteria and data‑collection practices across the 19 local area agencies on aging; and (3) administrative barriers such as lengthy authorization processes. MDOA and local AAAs said different jurisdictions saw different dynamics—Frederick County's wait list jumped after it implemented a new outreach program, while Baltimore City's wait list grew in part because of staffing shortages that delayed case management follow‑up.

Advocates and AAA representatives asked the committee to preserve funding. Megan Peters, director of government affairs at the Alzheimer's Association, urged the committee to protect funding for the state's dementia care navigation program, which she said was authorized in 2023 with a $2.4 million annual mandate that the Board of Public Works cut by $1.2 million for fiscal 2025. "Care navigation has been shown to reduce health‑care costs and improve quality of life," Peters said, and cutting the program would increase future Medicaid pressure, she argued.

Anne Secot, representing local area agencies on aging, and Carol Linehard of the Maryland Senior Citizens Action Network stressed the cost‑effectiveness of in‑home programs that keep people out of nursing homes. Linehard noted that annual nursing‑home costs in Maryland run roughly $133,502 per resident and described programs such as congregate housing services that can provide supports for a small fraction of that amount.

The committee also heard updates on MDOA initiatives beyond senior care: DLS summarized the long‑term care and dementia care navigation program (created by 2023 legislation), the Longevity Ready Maryland plan (established by executive order in January 2024, with a final report due July 2025), and the Task Force on Preventing and Countering Elder Abuse (formed under 2023 legislation, final report delivered December 2024). Martinez asked MDOA to explain plans to implement the task force recommendations.

Roque described two departmental bills introduced to consolidate and modernize state programs (senior care, senior assisted living subsidy and congregate housing services) to make the programs more flexible and accessible. She said the department has been building capacity—hiring staff, converting contractual positions and creating an IT support position—to improve oversight and data systems.

The subcommittee did not vote on funding today. MDOA officials and advocates asked legislators not to adopt the DLS‑recommended midyear reduction and to allow the department and AAAs time to implement the administrative and legislative changes intended to improve enrollment and spending.

Why it matters: the senior care program and related home‑and‑community services are the primary tools state and local agencies use to keep older Marylanders in the community and avoid higher Medicaid and nursing‑home costs. Subcommittee members asked for more detailed follow‑up on the participation decline, on the steps to move people from the wait list into slots, and on the department's proposed legislative and regulatory changes.

The department and DLS pledged follow‑up briefings and additional data. MDOA asked the committee to reject the proposed $2.5 million reduction for fiscal 2025, saying local AAAs had already planned staffing and services based on the previously allocated funding levels.