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Families, providers tell subcommittee DDA cuts would 'harm lives' and urge rejection of caps and wage cuts
Summary
Dozens of parents, self-advocates, direct support professionals and providers told the Health and Social Services Subcommittee that proposed DDA changes—wage reductions tied to BLS benchmarks, elimination of wage exceptions, and a $500,000 per-person budget cap—would undermine staffing, strip needed flexibility from individualized plans, and put people with intensive medical or behavioral needs at risk.
More than 30 witnesses — family members, people who receive services, direct support professionals (DSPs) and provider representatives — gave personal testimony at the Health and Social Services Subcommittee hearing, uniformly warning that the Department of Health’s proposed cost-containment measures would destabilize supports for people with intellectual and developmental disabilities.
Parents and guardians described how self-direction allowed them to recruit and retain consistent, highly trained staff who know complex medical and behavioral plans. Tracy Faren described how self-direction helped her adult son gain communication via augmentative and alternative communication and how stable, trained staff are essential to his safety and progress. Multiple parents testified that sudden budget cuts or wage reductions would cause staff departures, regressions in participant health and skills, and higher costs elsewhere in the system.
Provider leaders and associations (including the Maryland Association of Community Services and The Arc) explained why some individual annual PCP budgets can exceed $500,000: waiver design often results in “stacked” budget capacity that is not fully spent year-to-year but preserves flexibility for spikes in needs, crisis prevention, or service transitions. They warned a fixed cap that ignores actual expenditures could arbitrarily remove essential hours from people with sustained complex needs and cited examples where dedicated one-on-one staffing had already been reduced during FY26 implementation.
Direct support professionals and case-management organizations described operational realities: high training requirements, regulatory compliance costs for agency-operated services, and the fact that many self-directed employers lack the capacity to reliably guarantee broad-market benefits even when plans list them. Advocates asked for targeted alternatives (e.g., modest changes to glide-path rates, improved Medicaid enrollment for state-only participants, staged stakeholder implementation) instead of across-the-board budget caps or wage cuts, and for a clearer, faster appeals process for denials and redeterminations.
Why it matters: Advocates framed the proposals as not merely numerical adjustments but real-world changes that could cause people to lose staff, to experience medical or behavioral crises, or to require institutional care that is more expensive and less consistent with state policy favoring community-based services.
