Moore's Budget Cuts Target Self-Directed Services: Maryland DDA Training Requirements Just Got Stricter

Moore's Budget Cuts Target Self-Directed Services: Maryland DDA Training Requirements Just Got Stricter

The Maryland developmental disabilities community thought their hardest battles were behind them when Governor Wes Moore's administration restored funding for fiscal year 2025. But the relief was short-lived. The General Assembly ultimately cut $164 million from the DDA in fiscal 2026, as part of the larger budget wrangling this year. For self-directed services, that means cuts to a program that helps families afford one-time expenses to support their family member with developmental disabilities, as well as caps on wage bonuses for some of the self-directed service care providers. These cuts arrive precisely when Maryland's self-directed services manual has introduced the most stringent documentation and training requirements in the program's history.

The timing couldn't be worse for families who've already faced unprecedented challenges. While legislators celebrated avoiding deeper cuts, the reality on the ground tells a different story. Direct support professionals are leaving the field in droves, families are struggling to find qualified caregivers, and now those who remain must navigate increasingly complex compliance requirements with reduced financial support.

The Perfect Storm: Budget Cuts Meet Regulatory Expansion

Maryland's self-directed services program serves as a lifeline for thousands of families, allowing them to hire and train their own support staff rather than rely on traditional agency services. Self-Direction provides significant cost savings to the state, while also supporting your right to self-determination and to live where and with whom you want to live—and to receive support from the people you choose. MDH data shows that in FY 2024, average Self-Directed budgets were funded $10,737 less and expenditures were $23,859 lower in comparison to the other service model.

Despite these proven cost savings, self-directed services became the primary target for budget cuts. Governor Wes Moore called for a $200 million reduction in funding for the Developmental Disabilities Administration (DDA). If you witnessed the unprecedented denials and other actions taken by the Department of Health (MDH) over the last twelve months, it will not surprise you that individuals in the Self-Directed service model (SDS) are targeted for the brunt of these cuts, with proposed reductions of Reasonable & Customary wages and a rescission of wage exceptions effectuated in new "documentation standards" in the new Self-Direction Manual.

New Documentation Requirements Create Additional Burdens

The February 2025 Self-Directed Services Manual introduces requirements that would challenge even seasoned HR professionals. Families must now navigate complex wage exception procedures that require extensive documentation for every request above standard rates. The manual mandates that participants provide detailed justifications including job advertisements spanning three months, documentation of at least five interviews, and proof that applicants either didn't attend interviews or refused reasonable offers.

For families caring for loved ones with complex needs, these requirements represent an impossible burden. Consider a family whose adult child requires overnight supervision and behavioral support. Previously, they could hire a qualified caregiver at competitive rates through a straightforward process. Now, they must document failed recruitment efforts, maintain detailed records of interview outcomes, and justify every wage decision to bureaucratic reviewers who may have never provided direct care themselves.

Training Requirements Expand While Support Systems Contract

Maryland's DDA training requirements have always been comprehensive, requiring direct support professionals to complete nine mandatory courses covering everything from aging processes to incident reporting. These COMAR-mandated trainings ensure that every caregiver understands person-centered care principles, medication administration protocols, and emergency response procedures.

The new manual expands these requirements significantly. First Aid and CPR training must now include in-person components—online-only certification no longer suffices. Electronic Visit Verification requirements have been strengthened with enhanced monitoring and corrective action protocols. Background check procedures now require more detailed documentation and sharing between Financial Management and Counseling Services providers.

Support Broker Services: More Rules, Less Help

Support brokers traditionally served as navigators, helping families understand regulatory requirements and manage their self-directed programs effectively. The new manual dramatically restricts their role while expanding their responsibilities. Support brokers can no longer process budget modifications submitted by other team members, creating potential delays in essential services. They face new billing restrictions and expanded training requirements while working within tighter hour limitations.

These restrictions come precisely when families need the most guidance. The manual's complexity has increased exponentially, yet the professional support available to navigate it has decreased. Families must now manage wage exception processes, budget modifications, and compliance monitoring with minimal professional assistance—a task that would challenge experienced HR departments.

The Real-World Impact on Families and Caregivers

The human cost of these simultaneous pressures extends far beyond bureaucratic inconvenience. Direct support professionals, already earning wages that struggle to keep pace with Maryland's cost of living, now face additional training requirements and documentation burdens. Many are choosing to leave the field entirely rather than navigate increasingly complex employment conditions for modest compensation.

Families report losing experienced caregivers who refuse to work within the new documentation requirements. Recruiting replacements becomes nearly impossible when competitive wages require extensive justification processes that can take weeks to complete. The result is a cascading crisis where those who need support most desperately are left without adequate care options.

One family member testified before legislators: "Our main caregiver just left because of the instability the DDA is causing. If you pass these cuts, you're not just balancing a budget, you're breaking families."

The Workforce Crisis Deepens

Maryland already faces a severe shortage of qualified direct support professionals. The new requirements threaten to accelerate workforce losses at the worst possible time. Experienced caregivers who've worked successfully within families for years now face additional training mandates, expanded documentation requirements, and reduced financial support for professional development.

Training providers report increased demand for DDA certification courses, but many potential caregivers are discouraged by the expanded requirements combined with wage restrictions. The result is a shrinking pool of available workers precisely when families need them most. Quality training providers find themselves overwhelmed by regulatory changes while serving a market that's increasingly difficult to enter and remain in.

Navigating the New Reality: Essential Strategies for Providers

Training providers and service organizations must adapt quickly to support families through this challenging transition. The most successful approaches focus on comprehensive education that addresses both regulatory compliance and practical implementation strategies. Families need to understand not just what the new requirements demand, but how to manage them efficiently within their daily routines.

Effective DDA training programs now must address the expanded documentation requirements alongside traditional core competencies. Participants need practical guidance on maintaining compliant records, navigating wage exception processes, and managing the increased administrative burden. Training should emphasize efficient systems that protect families' time while ensuring regulatory compliance.

Building Sustainable Support Systems

The reduced availability of professional support services makes peer networks and community resources more critical than ever. Successful families are forming informal support groups to share knowledge about regulatory navigation, recruitment strategies, and compliance management. Training providers can facilitate these connections while providing the technical foundation families need to succeed.

Technology solutions become essential tools for managing the increased administrative burden. Electronic record-keeping systems, automated compliance tracking, and digital document management can help families maintain required documentation without overwhelming their capacity for direct care. Training programs must incorporate these practical tools alongside regulatory education.

Looking Ahead: Preparing for Continued Change

Maryland's developmental disabilities community faces an uncertain future as budget pressures continue and regulatory complexity increases. The current challenges represent not a temporary adjustment but a fundamental shift in how self-directed services operate. Families and providers must prepare for ongoing changes while maintaining focus on the ultimate goal: ensuring quality support for individuals with developmental disabilities.

The successful navigation of these challenges requires sustained commitment to both regulatory compliance and innovative problem-solving. Training providers must evolve their offerings to address emerging needs while maintaining the core competencies that ensure safe, effective care. Families need comprehensive preparation for increased administrative responsibilities alongside practical strategies for maintaining quality support within constrained resources.

As Maryland's self-directed services program continues evolving, one truth remains constant: the need for knowledgeable, skilled direct support professionals who can navigate complex requirements while providing person-centered care. Training programs that address both the regulatory landscape and practical implementation challenges will prove most valuable to families working to maintain quality support within an increasingly demanding system.

The intersection of budget cuts and regulatory expansion creates unprecedented challenges, but also opportunities for innovation and community building. Families, providers, and training organizations that adapt proactively to these new realities will be best positioned to thrive despite the obstacles. The key lies in balancing regulatory compliance with practical sustainability, ensuring that increased requirements enhance rather than hinder the delivery of quality care.