Maryland Medicaid Resources:

• State Medicaid Website: Maryland
• Maryland Developmental Disabilities Council Website
• The Arc of Maryland

Maryland Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 128,000 people with disabilities covered by Medicaid in Maryland. Maryland spent $19,606 on each Medicaid recipient with a disability in 2007.

17% of all people covered by Medicaid in Maryland have a disability, while the national percentage is 15%.

The state spends 48% of all the money it spends on Medicaid on services for people with disabilities, while the national percentage of Medicaid spending on these services is 42%.

HealthChoice:

This is a statewide comprehensive benefits program that covers children and adults with disabilities, except those who are also eligible for Medicare.

• Health: chiropractic, dental, disease management, durable medical equipment, early and periodic screening, diagnosis, and treatment, family planning, hearing, hospice, hospital, immunization, mental health, substance abuse treatment, laboratory, occupational therapy, pharmacy, physical therapy, physician services, podiatry, speech therapy, vision, x-ray
• Social Services: case management

Program of All-Inclusive Care for the Elderly (PACE):

PACE programs are designed for people 55 and older who need nursing care, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed necessary.

Ages: 55 and older

Level of Care: nursing

Restrictions: You must live close enough to a PACE center to have access to care.

• Community: health-related transportation, adult day care
• Health: primary and specialty care, nursing, physical, occupational and speech, and recreation therapy, prescription drugs
• Home: home health care, home and environmental modifications
• Social Services: social services

Community Pathways:

This waiver is intended to help people with intellectual and developmental disabilities across the life span. There is no minimum or maximum age for eligibility under this waiver. This program tries to make community-based services available to people that need them.

• Community: transportation, transition services, community residential rehab, community supported living arrangements
• Health: medical day care, assistive technology and adaptive equipment, behavioral supports
• Home: environmental accessibility modifications, family and individual support, live-in caregivers, respite
• Social Services: resource coordination
• Work: expanded day habilitation including employment discovery and customization, supported employment

New Directions waiver:

The New Directions waiver allows a limited number of people with disabilities to direct their own personal care services. Normal HCBS services, such as supported employment and personal support services are covered under this program. Each client will work with a support broker and a financial management service to create a budget, hire and supervise their own staff, and make decisions about their care. The financial service will take care of taxes, paperwork, and bills.

Options for Self-Direction: This waiver allows people with developmental disabilities to work with teams of professionals who can support them in managing their money and directing their own care.

• Home: personal support
• Social Services: support broker, financial manager
• Work: supported employment

Living at Home (LAH) waiver:

This waiver is targeted at people with disabilities who live in a nursing facility but want to move back into the community, and people who need nursing services but do not want to move into a nursing home.

Ages: 18 to 64

Level of Care: nursing

• Community: transition services
• Health: nursing supervision, assistive technology, personal emergency response systems, medical day care, dietitian and nutrition services
• Home: attendant care and personal assistance, environmental accessibility modifications, individual and family training, home delivered meals
• Social Services: case management

Medical Day Care Services waiver:

Medical day care is a service that provides nursing care to people who would otherwise need to be in residential facilities in a community setting, with the goal of preventing or delaying institutional placement. All basic Maryland Medicaid state plan services are included, along with other services.

Ages: 16 and over

Level of Care: nursing

• Health: health support, rehabilitation
• Home: respite care

Model Waiver for Fragile Children:

Although this waiver is targeted at medically fragile children, it has no age restriction and so can serve older people with disabilities as well as long as they are enrolled before they turn 22. This waiver provides community-based services for people who might otherwise need to be hospitalized.

Ages: you must be enrolled before age 22

• Health: certified nursing assistants, medical day care, physician services, and private-duty nursing
• Social Services: case management, care planning

Traumatic Brain Injury waiver:

This program is for adults who have brain injuries and are eligible for Medicaid. Applicants must have had the injury after the age of 21, and must be living in a nursing home.

Ages: 22 to 64

Level of Care: nursing

• Health: day habilitation, individual support services
• Home: residential habilitation
• Social Services: case management
• Work: supported employment

Waiver for Children with Autism Spectrum Disorder:

This waiver provides community-based services for children who have been diagnosed with autism spectrum disorder.

Ages: 1 to 21

• Community: therapeutic integration
• Health: intensive individual support
• Home: residential habilitation, respite care, environmental accessibility modifications, family training
• Social Services: adult life planning