Baltimore, Maryland — The Self Directed Advocacy Network (SDAN), an organization that advocates for individuals with developmental disabilities who utilize self-directed services, recognizes the financial challenges facing the State of Maryland, but recent decisions impacting self-directed services are creating serious instability for people with developmental disabilities who rely on these supports every day.
Self-direction has consistently proven to be an effective and efficient model of service that allows individuals to direct their own supports while achieving meaningful, person-centered outcomes. It gives people with disabilities greater independence, flexibility, community involvement, and control over their daily lives.
At the end of April, Maryland announced a new requirement impacting self-directed service providers that will take effect July 1, 2026, giving affected individuals and providers roughly 60 days to comply. More than multiple businesses and hundreds of Marylanders with developmental disabilities are expected to be impacted by this change. At the same time, the state’s ePREP system is scheduled to shut down from June 30 through October during a system transition, creating even more uncertainty and barriers for providers and participants attempting to complete required processes.
SDAN is deeply concerned that the short implementation timeline does not provide enough time for providers and participants to successfully complete the required process and maintain uninterrupted services. As a result, many individuals risk losing critical supports beginning July 1. SDAN is urging the State of Maryland to consider the severity and real-life impact of these sudden changes on people with developmental disabilities who depend on stable, uninterrupted services every day.
These changes come at a time when workforce shortages already make it difficult to find and retain qualified direct support professionals. Wage reductions scheduled to take effect July 1, along with increased administrative requirements, further destabilize the workforce and place critical services at risk.
SDAN also recognizes the ongoing national conversation surrounding fraud prevention in Medicaid-funded programs. While accountability and oversight are important, broad policies and restrictions aimed at addressing fraud should not come at the expense of individuals with disabilities who legitimately rely on self-directed services to live safely and independently in their communities.
Self-direction is built on the belief that people with disabilities should have choice and control over who provides their care and how their supports are delivered. For individuals with significant developmental disabilities, interruptions in services can impact health, safety, independence, employment, and community involvement.
As the shortage of qualified direct support professionals continues, many individuals rely on trusted family members to help fill critical gaps in care and support. SDAN believes participants should maintain the right to choose family members as caregivers if that is what best meets their needs and preferences. Recent limits restricting family caregivers to 40 hours per week, and no more than 60 combined hours among all family members, further reduce flexibility for individuals already struggling to secure reliable staffing.
SDAN calls on state leaders to consider the severe impact these decisions will have on Marylanders with disabilities. Policies that weaken the workforce or create barriers to services destroy the stability and independence of the very people the system is meant to support.
People with disabilities deserve reliable supports, meaningful choice, and the opportunity to live full lives in their communities.
About SDAN
The Self Directed Advocacy Network (SDAN) advocates for the rights, independence, and self-determination of individuals who utilize self-directed services. SDAN works to ensure people with disabilities have a voice in the policies and decisions that affect their daily lives and long-term independence.