Disability advocates rally outside the State House in November, protesting new rules Developmental Disability Administration rules they said will create hurdles for those who self-direct disability services. (Photo by Danielle J. Brown/Maryland Matters)
Advocates are reeling at recent proposals to cut $200 million from a state agency that administers resources for people with developmental disabilities — cuts that advocates call inhumane and harmful for the people who need those services.
“We are deeply distressed by the nature of a number of these proposals,” said Laura Howell, CEO of the Maryland Association of Community Services, who said the plans “are absolutely going to hurt people.”
The fiscal 2026 budget unveiled last week by Gov. Wes Moore (D) calls for a $200 million cut from the Developmental Disabilities Administration, one of the tough choices Moore said state officials and lawmakers face as they grapple with a $3 billion budget shortfall.
“We will be advocating strenuously in the General Assembly to try to find a way to reverse some of this, if not all of it,” Howell said. “I think it’s going to be a really tall order, given the size of the cut.”
It’s not entirely clear how the cost reductions will officially come down on the DDA, but there are some cuts outlined in the budget bill. One of the larger proposed cuts would eliminate the “geographical differential” rates, which pay more to service providers in Montgomery, Prince George’s, Charles, Calvert and Frederick counties. Cutting it would save $55 million, according the budget bill.
Another proposal would eliminate the Low Intensity Support Services Program, a $5.5 million savings by cutting the program that allots up to $2,000 for certain disability-related expenses for people who do not qualify for other state supports.
While DDA cuts could affect the community as a whole, parents and advocates of the “self directed” service model feel particularly at risk.
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About 20,500 Marylanders with developmental disabilities got state support last year to help their families afford services, usually through a Medicaid waiver that also brings in federal dollars. The majority of those families, 16,827, opt for “traditional” services, meaning they join an existing program that provides day care, transportation and other services for people with disabilities.
But 3,632 families choose “self-direction,” which lets them determine how to best support their disabled relative without the guidance of a program, so long as they use those funds on accepted services such as hiring support staff to help with the disabled family member’s day-to-day activities. The person receiving those supports, or a designated representative, takes on the responsibility of organizing those services.
Alicia Wopat, president of the Self-Directed Advocacy Network of Maryland, worries how the proposed cuts will impact her son, a 30-year-old with autism who has relied on self-directed services for years.
“This particular program has resulted in a much calmer, happier, less frustrated person … self-direction has been a total game-changer for my son but also for our whole family, to be with somebody who is smiling and is joyful,” Wopat said. “It is devastating for me as an advocate to see what’s happening now, choices and decisions being made without regard for people.”
The budget bill outlines a $14.5 million reduction to self-directed services that is “contingent upon the enactment of legislation that modifies the provisions of the Self Directed Services Program.” Members of SDAN suspect some cuts will come from eliminating rate increases for people who work in self-direction, considering previous conversations they’ve had with state health officials on that front.
Currently, providers and staff who work with self-directed individuals can get a higher rate for their services compared to those who work in the “traditional models” in a community-centered facility, as people who use self-directed care will often require more intense care.
SDAN members believe that the rate increases will be cut to bring self directed and traditional provider wages closer to parity.
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Liz LaFrance, a support broker who manages the services for several clients with disabilities and is also a member of SDAN, believes there are “big cuts coming to wages” which she fears will drive away staff and workers.
“People will leave for better wages and some benefits,” LaFrance said. “This is not the time to be doing this to people, and we as a group could help solve this in a way that doesn’t hurt people — if only we could be heard, respected and treated with fairness.”
“It’s just very disheartening,” Wopat added. “And especially in this current climate with the governor’s tagline about leaving no one behind. I think many of us feel that, with these current things, we’re being left in the dust.”
Members of SDAN have already felt sidelined by the Department of Health and the DDA. In November, the developmental disabilities community rallied in Annapolis to protest new documentation requirements that they believe were created without community input, among other concerns.
Officials at the Maryland Department of Health, which oversees the DDA, say that the current self-direction program has had unsustainable growth in recent years. At a recent hearing before the Senate Finance Committee, officials said self-direction program enrollment has increased over 30% both 2024 and in 2023.
Chase Cook, communications director for the health department, noted in a statement Thursday that the governor’s budget still includes $1.3 billion for the DDA in 2026.
“As program expenses continue to rise, the budget includes various proposals to manage DDA expense growth, particularly by better leveraging federal funding and aligning Maryland’s program more closely with federal guidance and national best practices,” Cook said in the statement. “As part of that effort, we continue to remain engaged with all DDA stakeholders, including those who receive and provide self-directed services, to ensure a more inclusive and community-first approach.”
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Patti Saylor, a nurse who works with those with disabilities and whose son had Down syndrome, understands the state’s tough financial situation, but feels it is unfair to balance the budget on the DDA and the people who use its services and programs.
“It is apparent that they are in a financial crisis … and we need to take a look at that,” Saylor said. “But coming after things without including people, or without any obvious regard for how this will impact a human life, it is inhumane.”
While Saylor worries about her clients in self-directed services, she recognizes that the proposed cuts would impact a majority of the larger developmental disability community.
“We’re going to pay for disabled people wherever they are — we have to stop this conversation about it’s better here or better there, it’s more expensive here or more expensive there,” she said. “They cost money, and we commit to them.
“Of course, we have to be fiscally minded, but it cannot be wrapped around the value of this human being — or this division of community providers or self-direction. It doesn’t matter,” Saylor said.
Howell, with the Maryland Association of Community Services, agreed.
“People are deeply distressed. They are scared,” Howell said. “Whether it’s a community provider, who’s worried how they’re going to continue to support some of the people they support, or people who self-direct or families who are very scared about these changes. There is a tremendous amount of distress and fear about what this will mean if the legislature can’t turn around these cuts.”