The FY 2027 budget for the state of Maryland includes provisions that require changes to the Community Pathways Medicaid waiver program.
To make these changes, the Maryland Department of Health is proposing a waiver amendment to the Centers for Medicare and Medicaid within the U.S. Department of Health and Human Services. The proposed amendment also includes changes to ensure the Community Pathways program can continue to provide services and supports to Marylanders with intellectual and developmental disabilities.
As part of that process, we are seeking input on the proposed amendment from our stakeholders. You can submit comments until 11:59 p.m. on Wednesday, May, 28, 2026.
The resources below provide details on the proposed changes and how you can submit feedback. We also are hosting a series of webinars to explain the changes and answer your questions. We hope you will join us!!
Overview of the Proposed Amendment
Upcoming Webinars
We are hosting a series of webinars (two in English, one in Spanish) to provide an overview of the proposed amendment and answer questions. Please join us! (We also will post a recording shortly after the first webinars.)
Webinar: Proposed Waiver Amendment
- We will walk you through the amendment proposal, the materials posted on our website and how you can provide feedback. You'll have an opportunity to share brief comments or ask questions.
- Tuesday, May 5, 2026
- Tuesday, May 12, 2026
Self-Directed Services Webinars
Changes to Reasonable And Customary Standards and Wage Exception Process - We will walk you through changes to reasonable and customary standards and the wage exception process. We are seeking your input on updates to the Self-Directed Services Manual for the changes to reasonable and customary standards and the wage exception process and ways to support participants
- Wednesday, May 6, 2026
Reasonable and Customary Rates and Wages- We will walk you through the new reasonable and customary rate and wage standards and the Financial Management and Counseling Services wages and rates change process. You'll also have an opportunity to ask questions.
Proposed Amendment Documents These are the documents that will be submitted to the federal government for approval. We have “tracked changes” in the documents so you can see what is being changed. (If you use a screen reader, select the black and and white version of each document.)
Purpose of the Amendment: A detailed description of the proposed changes and the reasons we are asking for them.
Appendix C - Participant Services: This appendix describes the home and community-based waiver services that are furnished through the waiver, including applicable limitations on such services. Each service is described in a separate document.
- Community Living - Group Home
- Appendix C - Participant Services C1 and 2-5
Appendix E - Participant-Direction of Services: Specifies the participant direction opportunities that are offered in the waiver and the supports that are available to participants who direct their services.
Appendix I - Financial Accountability: Describes the methods by which the State makes payments for waiver services, ensures the integrity of these payments, and complies with federal requirements concerning payment and federal financial participation.
Appendix J - Cost-Neutrality Demonstration: the State's demonstration that the waiver is cost-neutral.
Public Comment
Before a waiver is amended, the public has 30 days to comment on the proposed changes. You may submit comments on this proposed amendment from April 29, 2026, to May 28, 2026, as follows:
Email to: [email protected]
Send by mail to:
DDA Federal Programs Unit
201 West Preston Street, 4th Floor
Baltimore MD 21201
(Comments must be postmarked by May 28, 2026 to be considered.)
Frequently asked questions - Coming soon!
