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The guidance explains self-determination and self-direction, how to choose services, and how key authorities, budgets, and responsibilities work. 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Practicing self-determination also means you are responsible for making decisions and managing your services.  \nPeople with intellectual and developmental disabilities have the same right to  \nself-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.  \nSelf-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.  \nThis 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.  \nThe 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).  \nClick the Table of Contents headings to go to the section of your choice.  \nIf you have any questions, please contact  \n(410) 767-5600  \nor  \n(844) 253-8694  \nor visit:  \nDevelopmental Disabilities Administration  \n[https://health.maryland.gov/dda/Pages/home.aspx](https://health.maryland.gov/dda/Pages/home.aspx)  \n▶ Revised Date: May 11, 2026  \n▶ Effective Date: May 11, 2026  \nDevelopmental Disabilities Administration Find Out More: 844-253-8694  \n[dda.health. maryland.gov](dda.health. maryland.gov)  \nTable of Contents  1  \nNote: This guide is a summary with important information. There are more requirements in the Medicaid waiver program applications, laws, regulations, guidance and policies.  \nUpdates to the Manual-May 11, 2026  \nThe Fiscal Year 2027 Budget Bill includes Self-Directed Wage, Rate, and Vendor Changes.  \nThe following updates were made to this manual. Each update below includes a link to the related page in the manual.  \nWage Exception Process and Reasonable and Customary Standards  \n1. Wage Exception Process ends: On July 1, 2026, the Wage Exception Process and the Wage Exception Form ends.  \n2. Reasonable and Customary Standards Updated: On July 1, 2026, the following Reasonable and Customary tables will be updated.  \na. Reasonable and Customary Rates for DDA Providers;  \nb. Reasonable and Customary Rates for Individual Providers; and  \nc. Reasonable and Customary Wages for Employees.  \nNotes:  \n● There will be separate wage maximums for relatives, legally responsible persons, and legal guardians and others who are not in those categories.  \n● The DDA’s Self-Directed Reasonable and Customary rates can be found on  \nDDA’s rates webpage.  \nUsing Individual Providers (formally called Vendors)  \nOn and after July 1, 2026, participants will be limited to what services individual providers can provide.  \n1. Individual providers can only provide the following s","cbCairpXgawoSS20","https://ap.wps.com/l/cbCairpXgawoSS20","pdf",3428795,209,"English","# Introduction\n## Self-determination and self-direction overview\n# Updates to the Manual-May 11, 2026\n## Wage exception process and reasonable/customary standards\n## Individual providers and reporting form changes\n# Self-Directed Services\n## Self-directed services and training\n# Choosing Self-Directed Services\n## Financial management and counseling\n# Rights and Responsibilities\n## The person-centered plan and self-directed budget\n# Employees\n# Individual Providers and DDA Providers\n## Support broker services\n# Individual and Family Directed Goods and Services","[{\"question\":\"What is self-direction under Maryland’s Medicaid waiver services?\",\"answer\":\"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.\"},{\"question\":\"What key updates became effective on May 11, 2026?\",\"answer\":\"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.\"},{\"question\":\"When does the Wage Exception Process end?\",\"answer\":\"The Wage Exception Process ends on July 1, 2026, and the Wage Exception Form also ends on that date.\"}]","Self-Directed Services Manual - Revised Date May 11, 2026 | PDF",73]