DDA Waiver Renewal – Community Pathways and New Directions
Community Pathways and New Directions are both Medicaid programs referred to as Medicaid 1915 (c) Home and Community-Based Service (HCBS) waivers. Medicaid is a joint federal/State funding program that pays for most long-term services provided to low income, older persons, and persons with disabilities.
Medicaid waivers provide opportunities for Medicaid beneficiaries to receive services in their own home or community. Within broad Federal guidelines, States can develop home and community-based services waivers to meet the needs of people who prefer to get long-term care services and supports in their home or community, rather than in an institutional setting. These programs serve a variety of targeted populations groups, such as people with mental illnesses, intellectual disabilities, and/or physical disabilities. Persons are eligible to receive Medicaid Waiver services if they meet federal qualification criteria (i.e. eligibility or rules).
States can request to provide specific services and supports. Standard services include but are not limited to: case management (i.e. resource coordination), homemaker, home health aide, personal care, adult day health services, supported employment, habilitation (both day and residential), and respite care. States can also propose “other” types of services that may assist in diverting and/or transitioning individuals from institutional settings into their homes and community.
A state must apply to the federal government through a HCBS waiver application for permission to operate a HCBS waiver. Programs are required to be renewed every three (3) or five (5) years. Both the Community Pathways and New Directions Medicaid Waiver programs are due for renewal
Waiver Renewal Application and Stakeholder Comments
The State of Maryland submitted the following waiver application to continue the Community Pathways and New Directions waiver under one waiver.
Community Pathways Waiver Renewal Application - MD.00.23.R06.00
The following chart is a summary of public comments received on the draft waiver application and Department responses.
Waiver Application Stakeholder Comments Summary
Stakeholder Comment,Questions, And Suggestions related to the Waiver Renewal:
The DDA incorporated several suggestions, provided clarification related to questions/comments, and identified some items for further “discussion” or “no changes” due to federal requirements or Department decisions at this time. There are several items that will be further explored and referred to the advisory committee, Employment First Workgroup, and Medicaid.
In regards to our proposal related to employment and day services, there are several operational components and processes that need to be established including rates for individual versus group supported employment services. To effectively implement the supported employment and prevocational services, we plan to work with the advisory committee and will amend the waiver within the first waiver year.
All current services in both waivers will continue under the merger with the exception of resource coordination. We are committed to reviewing, on a case by case basis, current Community Pathways and New Directions waiver participant’s waiver services related to any concerns of potential loss of needed services. It is important to keep in mind that DDA has several contracts with providers for various services that are funded outside of the waiver programs.
Your thoughts should be submitted directly to: ddfeedback@hilltop.umbc.edu
Stakeholder Presentations and Resources:
- Presentation - Medicaid Waiver Renewal - Medicaid Overview, Residential, Employment and Day Time Services December 14, 2012
- Webinar Recording - December 14, 2012
- Presentation - Medicaid Waiver Renewal - Support Services and Self Directed Support Services December 17, 2012
- Webinar Recording - December 17, 2012
- Waiver Documents
To view the current federally approved programs go to Medicaid.gov - Waiver page at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/Waivers.html?filterBy=maryland
Click on either:
Maryland MD Community Pathways (0023.R05.00) 1915(c) Current
Notes: Community Pathway’s current federally approve document effective 7/1/08 to 6/30/13
Most recent amendment is still pending
CMS approval.
Maryland MD New Directions Independence Plus (0424.R01.00) 1915(c) Current
Notes: New Directions’ current federally approve document effective 7/1/08 to 6/30/13
Most recent amendment is still pending CMS approval.
- Center for Medicare and Medicaid Services
- Division of Rehabilitation Services (DORS) Resources
- Employment First Workgroup Contacts
Jade Gingerich, Maryland Department of Disabilities, Director of Employment Policy
Email: jgingerich@mdod.state.md.us
Phone: 410-767-3651
Dave Benjamin, Developmental Disabilities Administration
Email: dave.benjamin@maryland.gov
Phone: 410-572-5986