Petition against the proposed changes in the DDA Community Pathways waiver for the cap of relatives working as DSP staff 60/40 rule.
We express our total disagreement with the newly proposed waiver changes where Person Centered approach principles and Individuals’ choices of staff are severely violated by proposed service delivery hourly limits for relatives serving as paid staff. Hiring Family as Staff (FAS) is in most cases the safest, most reliable source of support for the DDA waiver participants. Developmentally disabled Individuals should be able to choose caregivers with no limitations. Many family members work 24/7 to keep their loved one healthy and safe. If the cap on the number of hours FAS can work is implemented, in many cases they will have to work without pay (and many have had to give up careers to care for their loved ones).
Per the Bureau of Labor Statistics, Maryland is experiencing a critical, ongoing shortage of Direct Support Professionals (DSPs), with high turnover rates averaging around 50% annually, mirroring national trends. The high turnover rates means that newly hired DSP staff will not know Individual specific health and safety needs. Further on, the turnover will force families to look for new providers and supports. Providers already have high staff vacancy rates and are not able to accept new referrals. The herein described situation will lead to further multiple crises for the Individuals lacking provider caregiver support and will lead to increased incident rates. The crisis and shortage of staff capacity will lead to potential Institutionalization of individuals with much higher budgets for the State.
Having relatives employed as DSPs bring staffing stability and integrity into service delivery process. All relatives as employed meet the same training & staffing requirements as outside staff. There are no exceptions.
DDA rates are the same for relatives and outside staff. There is no savings for the MDH/DDA in limiting family DSP staff hours as proposed.
Moreover, relatives DSPs have unique abilities to meet Individuals’ needs such as knowledge who Individual is, ability to communicate with Individual, availability, ability to connect Individual to the community, special skills and training. Family members DSPs help Individuals to increase their independence, community participation, integration and belonging. Moreover, family members DSPs agree to implement Individual’s Person - Centered Plan and provide services as required by the Federal and State rules, laws and regulations of the waiver program.
For the reasons stated above, we demand that the waiver amendment proposed 60/40 rules limitations for relatives be completely removed from the waiver amendment proposal. We further demand that 40 hours limitation as adopted through Waiver Amendment #3 prior be terminated.
Updates
Reached 100 supporters
May 16, 2026
57 Comments
My son has behavioral issues almost daily. We need to keep our wages and the 40 hours a week so my husband and I can help Jake with his behaviors and helping him live life to the fullest. We use our wages to house him, feed him, but him clothing and so much more.
I get there our budget short falls, but this is not the way to handle it. This is not the way you treat your most vulnerable population. If you’re concerned about fraud, create programs that address that don’t just cut funds.
Limiting ALL family to just 60 hours, including respite, seems to have no reasonable explanation behind it. My daughter is most comfortable with family and we struggle to find trusted non family DSPs.
It doesn’t make sense especially if you have family as staff who doesn’t live with the participant. Also, prohibiting family from providing administrative services doesn’t make sense.
This bill wouldn't help families that are trying to keep their loved ones protective. People with disabilities have a higher number of rapes and sexual assaults and violent crimes. My daughter is nonverbal and wouldn't be able to protect herself or tell me if she was violated. Please let us keep our loved ones with their families to insure their safe keeping.
Ann marieSiegert
I strongly oppose the proposed changes to Maryland DDA’s Community Pathways Waiver that would further limit the number of hours relatives may provide paid support services (including continuation or expansion of the 60/40 rule and prior 40-hour limitations). These restrictions undermine the fundamental principles of person-centered planning and self-direction by limiting an individual’s right to choose the caregivers who best understand and safely support their needs. For many participants with significant medical, behavioral, communication, and supervision requirements, family caregivers are not simply preferred providers—they are the safest, most consistent, and most qualified support option available. Maryland continues to experience a severe shortage of Direct Support Professionals (DSPs), high turnover rates, and provider staffing instability. Families frequently report difficulty locating qualified staff willing or able to provide services, particularly for individuals with complex support needs. Restricting family caregivers without first resolving workforce shortages places participants at substantial risk of interrupted care, increased reportable incidents, hospitalizations, emergency placements, and potential institutionalization—outcomes that directly conflict with waiver goals promoting independence and community integration. Family caregivers often leave careers, reduce employment, or provide extensive unpaid care to prevent crises and maintain health and safety. Imposing arbitrary caps on compensated hours does not reduce participant need; rather, it shifts uncompensated labor onto families while jeopardizing continuity of care. Additionally, family members employed as DSPs are required to meet training, documentation, compliance, and service standards similar to non-relative staff. The quality of care should be evaluated based on participant outcomes, health and safety, and service effectiveness—not familial relationship alone. I urge M
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Petition against the proposed changes in the DDA Community Pathways waiver for the cap of relatives working as DSP staff 60/40 rule.
We express our total disagreement with the newly proposed waiver changes where Person Centered approach principles and Individuals’ choices of staff are severely violated by proposed service delivery hourly limits for relatives serving as paid staff. Hiring Family as Staff (FAS) is in most cases the safest, most reliable source of support for the DDA waiver participants. Developmentally disabled Individuals should be able to choose caregivers with no limitations. Many family members work 24/7 to keep their loved one healthy and safe. If the cap on the number of hours FAS can work is implemented, in many cases they will have to work without pay (and many have had to give up careers to care for their loved ones).
Per the Bureau of Labor Statistics, Maryland is experiencing a critical, ongoing shortage of Direct Support Professionals (DSPs), with high turnover rates averaging around 50% annually, mirroring national trends. The high turnover rates means that newly hired DSP staff will not know Individual specific health and safety needs. Further on, the turnover will force families to look for new providers and supports. Providers already have high staff vacancy rates and are not able to accept new referrals. The herein described situation will lead to further multiple crises for the Individuals lacking provider caregiver support and will lead to increased incident rates. The crisis and shortage of staff capacity will lead to potential Institutionalization of individuals with much higher budgets for the State.
Having relatives employed as DSPs bring staffing stability and integrity into service delivery process. All relatives as employed meet the same training & staffing requirements as outside staff. There are no exceptions.
DDA rates are the same for relatives and outside staff. There is no savings for the MDH/DDA in limiting family DSP staff hours as proposed.
Moreover, relatives DSPs have unique abilities to meet Individuals’ needs such as knowledge who Individual is, ability to communicate with Individual, availability, ability to connect Individual to the community, special skills and training. Family members DSPs help Individuals to increase their independence, community participation, integration and belonging. Moreover, family members DSPs agree to implement Individual’s Person - Centered Plan and provide services as required by the Federal and State rules, laws and regulations of the waiver program.
For the reasons stated above, we demand that the waiver amendment proposed 60/40 rules limitations for relatives be completely removed from the waiver amendment proposal. We further demand that 40 hours limitation as adopted through Waiver Amendment #3 prior be terminated.
Updates
Reached 100 supporters
May 16, 2026
57 Comments
I'm a direct support professional. Our team has four members, including the mom and sister. Cutting family back to 40 hours a week means that family will have to seek outside employment and there will be shifts that will not be covered, especially when someone outside the family is on vacation. This simply does not serve the needs of the participant.
My son has behavioral issues almost daily. We need to keep our wages and the 40 hours a week so my husband and I can help Jake with his behaviors and helping him live life to the fullest. We use our wages to house him, feed him, but him clothing and so much more.
I get there our budget short falls, but this is not the way to handle it. This is not the way you treat your most vulnerable population. If you’re concerned about fraud, create programs that address that don’t just cut funds.
Limiting ALL family to just 60 hours, including respite, seems to have no reasonable explanation behind it. My daughter is most comfortable with family and we struggle to find trusted non family DSPs.
It doesn’t make sense especially if you have family as staff who doesn’t live with the participant. Also, prohibiting family from providing administrative services doesn’t make sense.
This bill wouldn't help families that are trying to keep their loved ones protective. People with disabilities have a higher number of rapes and sexual assaults and violent crimes. My daughter is nonverbal and wouldn't be able to protect herself or tell me if she was violated. Please let us keep our loved ones with their families to insure their safe keeping.
Ann marieSiegert
I strongly oppose the proposed changes to Maryland DDA’s Community Pathways Waiver that would further limit the number of hours relatives may provide paid support services (including continuation or expansion of the 60/40 rule and prior 40-hour limitations). These restrictions undermine the fundamental principles of person-centered planning and self-direction by limiting an individual’s right to choose the caregivers who best understand and safely support their needs. For many participants with significant medical, behavioral, communication, and supervision requirements, family caregivers are not simply preferred providers—they are the safest, most consistent, and most qualified support option available. Maryland continues to experience a severe shortage of Direct Support Professionals (DSPs), high turnover rates, and provider staffing instability. Families frequently report difficulty locating qualified staff willing or able to provide services, particularly for individuals with complex support needs. Restricting family caregivers without first resolving workforce shortages places participants at substantial risk of interrupted care, increased reportable incidents, hospitalizations, emergency placements, and potential institutionalization—outcomes that directly conflict with waiver goals promoting independence and community integration. Family caregivers often leave careers, reduce employment, or provide extensive unpaid care to prevent crises and maintain health and safety. Imposing arbitrary caps on compensated hours does not reduce participant need; rather, it shifts uncompensated labor onto families while jeopardizing continuity of care. Additionally, family members employed as DSPs are required to meet training, documentation, compliance, and service standards similar to non-relative staff. The quality of care should be evaluated based on participant outcomes, health and safety, and service effectiveness—not familial relationship alone. I urge M
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I'm a direct support professional. Our team has four members, including the mom and sister. Cutting family back to 40 hours a week means that family will have to seek outside employment and there will be shifts that will not be covered, especially when someone outside the family is on vacation. This simply does not serve the needs of the participant.