Self-Directed Services Manual - Revised Date May 11, 2026

Sep 16, 2026

Maryland Department of Health Developmental Disabilities Administration (DDA) provides a practical manual for individuals who want to self-direct their Medicaid waiver services under the Self-Directed Services Delivery Model. The guidance explains self-determination and self-direction, how to choose services, and how key authorities, budgets, and responsibilities work. Updates effective May 11, 2026 include wage exception and reasonable/customary table changes, limits on individual providers, new reporting for relatives and guardians, and related training and budgeting topics.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages209

Reading Time1 h 13 min

AccessFree to download

Introduction

Self-determination and self-direction overview

Updates to the Manual-May 11, 2026

Wage exception process and reasonable/customary standards

Individual providers and reporting form changes

Self-Directed Services

Self-directed services and training

Choosing Self-Directed Services

Financial management and counseling

Rights and Responsibilities

The person-centered plan and self-directed budget

Employees

Individual Providers and DDA Providers

Support broker services

Individual and Family Directed Goods and Services

Self-Directed Services Manual 201 West Preston Street, 4th Floor Baltimore, Maryland 21201 Issue Date: October 24, 2024 Revised Date: May 11, 2026 Effective Date: May 11, 2026, unless otherwise noted in the Manual ▶ Revised Date: May 11, 2026 ▶ Effective Date: May 11, 2026 Developmental Disabilities Administration Find Out More: 844-253-8694 [dda.health. maryland.gov](dda.health. maryland.gov) Table of Contents Introduction The Maryland Department of Health Developmental Disabilities Administration (DDA) supports participants' rights to self-determination and choice to self-direct their Medicaid waiver services. Self-determination means making your own choices, learning to effectively solve problems, and taking control and responsibility for your life. Practicing self-determination also means you are responsible for making decisions and managing your services. People with intellectual and developmental disabilities have the same right to self-determination as all people and are entitled to the freedom, authority, and supports to exercise control over the things in life that are important to them, to the degree that they desire. Self-direction, sometimes called consumer-direction or participant-direction, gives you the freedom to choose the services and supports you need to live independently. The core functions of self-direction are choice and control over how your services are provided and who is being paid to provide these services. This is a manual for people who are interested in self-directing their Medicaid waiver services using the Self-Directed Services Delivery Model. It is also a resource for people who are currently self-directing their services. This manual will help you understand the ways you can receive services and the DDA’s guidance and standards related to those services. The version of this manual was published on May 11, 2026. The most recent version of the manual can be found on the DDA’s website at [https://health.maryland.gov/dda/Pages/sdforms.aspx](https://health.maryland.gov/dda/Pages/sdforms.aspx). Click the Table of Contents headings to go to the section of your choice. If you have any questions, please contact (410) 767-5600 or (844) 253-8694 or visit: Developmental Disabilities Administration [https://health.maryland.gov/dda/Pages/home.aspx](https://health.maryland.gov/dda/Pages/home.aspx) ▶ Revised Date: May 11, 2026 ▶ Effective Date: May 11, 2026 Developmental Disabilities Administration Find Out More: 844-253-8694 [dda.health. maryland.gov](dda.health. maryland.gov) Table of Contents 1 Note: This guide is a summary with important information. There are more requirements in the Medicaid waiver program applications, laws, regulations, guidance and policies. Updates to the Manual-May 11, 2026 The Fiscal Year 2027 Budget Bill includes Self-Directed Wage, Rate, and Vendor Changes. The following updates were made to this manual. Each update below includes a link to the related page in the manual. Wage Exception Process and Reasonable and Customary Standards 1. Wage Exception Process ends: On July 1, 2026, the Wage Exception Process and the Wage Exception Form ends. 2. Reasonable and Customary Standards Updated: On July 1, 2026, the following Reasonable and Customary tables will be updated. a. Reasonable and Customary Rates for DDA Providers; b. Reasonable and Customary Rates for Individual Providers; and c. Reasonable and Customary Wages for Employees. Notes: ● There will be separate wage maximums for relatives, legally responsible persons, and legal guardians and others who are not in those categories. ● The DDA’s Self-Directed Reasonable and Customary rates can be found on DDA’s rates webpage. Using Individual Providers (formally called Vendors) On and after July 1, 2026, participants will be limited to what services individual providers can provide. 1. Individual providers can only provide the following s

FAQs

What is self-direction under Maryland’s Medicaid waiver services?

Self-direction lets participants choose the services and supports they need to live independently. It focuses on choice and control over how services are provided and who is paid to provide them.

What key updates became effective on May 11, 2026?

The manual includes updates tied to the FY 2027 budget bill, including wage and vendor changes, updated reasonable and customary tables, and changes to what individual providers can provide.

When does the Wage Exception Process end?

The Wage Exception Process ends on July 1, 2026, and the Wage Exception Form also ends on that date.

Sep 16, 2026

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