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Analyst and agency spar over $542M swing in DDA budget as lawmakers press for data and safeguards
Summary
Nonpartisan analysts told the Health and Social Services Subcommittee the Developmental Disabilities Administration's fiscal 2027 allowance falls by about $542 million from the working appropriation and flagged performance gaps; Maryland Department of Health leaders defended sustainability measures and pledged further reporting while lawmakers pressed for more data on implementation and appeals timelines.
Victoria Martinez, the nonpartisan Department of Legislative Services budget analyst, opened the Health and Social Services Subcommittee’s budget hearing with a detailed review of the Developmental Disabilities Administration’s (DDA) fiscal 2027 allowance. Martinez said DDA’s fiscal 2027 allowance shows a $542 million (14 percent) decrease from the fiscal 2026 working appropriation, placing total DDA funding near $3.3 billion. DLS highlighted several drivers and performance issues: a large portion of prior spending growth tied to the LTSS transition and new rate-setting, consolidation to the Community Pathways waiver, enrollment of roughly 19,158 participants served in fiscal 2025 (about 90 percent of authorized slots), and a point-in-time waiting list of approximately 3,400—a 15 percent decline in 2025 compared with the prior year.
Martinez underscored program timeliness concerns: only 62 percent of person-centered plans (PCPs) were submitted on time in fiscal 2025, and DLS recommended narrative language requesting more information on PCP review timelines and actions to improve timeliness. DLS also recommended restricting some community services funds pending additional reporting on utilization trends and on the implementation and effects of cost-containment actions, and it recommended release of some withheld funds if no objections are raised during the hearing.
Maryland Department of Health Secretary (self-identified in testimony) and DDA Deputy Secretary Marina Hutchinson responded, framing the FY27 proposal as a sustainability package necessary to maintain federal Medicaid waiver approval and long-term program solvency. MDH said the FY27 request totals roughly $3.22 billion in total funds with about $1.7 billion in general fund support, and described efforts such as advanced-payment recoupment (DDA reported about 90 percent of an initial $468.6 million in advanced payments have been recovered or placed on payment plans) and a series of system improvements (recruitment for vacancy reduction, case-management and reporting changes, and stakeholder engagement).
Committee members pressed MDH and DLS for clarifications. Lawmakers asked for multi-year fiscal projections, questioned the drivers of the rapid spending increases in 2022–2025, probed the difference between budgeted dollars and actual spending, and sought specifics on implementation timing for FY26 cost-containment actions that were already in place (some measures took effect October 2025; others are phased in). Several members also raised appeals and redetermination delays, and requested clearer reporting to distinguish FY26 implementation effects from FY27 projections.
Why it matters: DLS’s recommendations seek greater transparency and conditionality—holding or releasing funds based on whether DDA supplies the requested monitoring data—while MDH emphasized the risk of losing federal waiver authority if the program is not demonstrably sustainable and compliant. The committee repeatedly asked for precise, auditable data showing which cost-containment measures have been fully implemented and what their measured impacts have been in FY26, so policy choices for FY27 can weigh program risk, federal compliance, and people’s health and safety.
