Home and Community-Based Services (HCBS)

Maryland Medicaid offers home and community-based services for:
  • Older adults;
  • Persons with disabilities; and
  • Children with chronic illnesses.
Maryland Medicaid’s home and community-based services are offered through the regular Medicaid program and special Medicaid programs called “waivers.” Each waiver has different eligibility criteria and target a different population, such as older adults or people with a certain disability.

Request for Public Comment: Compliance with Home and Community-Based Settings Requirements (Final Rule) Heightened Scrutiny

Comments will be accepted September 29, 2022, through October 28, 2022.

​The purpose of the Home and Community-Based Settings Requirements final rule is to ensure that individuals receive Medicaid Home and Community-Based Services (HCBS) in settings that are integrated and that support full access to the greater community. These requirements maximize the opportunities for participants in HCBS programs to have access to the benefits of community living and to receive services in the most integrated setting. The Maryland Department of Health (MDH) identified provider sites that have characteristics of an institution or that appear to isolate and/or limit integration from the broader community for
individuals who receive Medicaid HCBS. These provider sites have been identified for a process referred to as a heightened scrutiny review. Heightened scrutiny means that these specific provider sites have characteristics of an institution and/or appear to isolate and/or limit integration from the broader community.
In accordance with the federal HCBS regulations found at 42 CFR Section 441.301(c)(4)(5) and Section 441.710 (a)(1)(2), the MDH will submit the following provider sites to the Centers for Medicare & Medicaid Services (CMS) for a heightened scrutiny review:

Assisted Living Facilities:
  • Adventures One, LLC T/A Norfield Acres II
  •  Caritas House
  •  Chancellor Health Care T/A Woodlands A.L. Community
  •  Fahrney-Keedy Home & Village
  •  Frostburg ALF Operator LLC dba Sterling Care at Frostburg Village
  •  Glynn Taff, Inc.
  •  New Life Healthy Living, LLC
  •  OK Family Care Assisted Living
  •  Springvale Terrace, Inc.
  •  Wintergrowth - Montgomery Center
  •  Woodmore House Assisted Living, Inc.
Autism Waiver Provider Sites:
  • The Benedictine School - Cherry Lane
  • The Benedictine School - Main Campus
Developmental Disabilities Administration Provider Sites:
  • Associated Catholic Charities, dba Gallagher Services
  • Chesapeake Group Homes, Inc.
  • Langton Green
Medical Adult Day Care Sites:
  • A Caring Hand MADC
  • A Providence Medical ADC
  • Delmarva Daybreak Hurlock
  • Evergreen Medical Adult Day Svcs.
  • Gallagher Adult Medical Day
  • Human Development Council-Frederick
  • Jarher Senior Center (JSC)
  • Jone L. Bowman AMDC
  • Joyful Adult Medical Day Care Ctr.
  • Keswick Adult Services
  • New Life AMDC
  • Paradise Adult Medical Day Care
  • Ravens Adult Day Care
  • Sagepoint Adult Day Care Services
  • Stella Maris ADC Center
  • The League For People with Disabilities
  • Washington HDC -ADC
  • We Care Adult Services
  • Winter Growth - Howard
  •  Winter Growth - Montgomery​
The MDH is posting this list of presumptively heightened scrutiny provider sites for public comment from September 29, 2022, through October 28, 2022. Public comments can be emailed to MDH.hcbssetting@maryland.gov, mailed to the MDH, Office of Long Term Services and Supports, ATTN: HCB Settings Rule Public Comment, 201 W. Preston Street, Room 135, Baltimore, MD 21201, or provided in person at the Local Health Department. Public comments can be submitted from September 29, 2022, through October 28, 2022. Any questions regarding the public comment period can be sent to Lisa Toland 410-767-5792 or Lisa.Toland@Maryland.gov.

Request for Publ​​​ic Comment:  Community Pa​thways, Community Supports, and Family Supports 1915(c) Waiver Renewal

Comments will be accepted September 6, 2022, through October 6, 2022.

The Maryland Department of Health (MDH) is renewing the 1915(c) waiver applications for its three waivers operated by the Developmental Disabilities Administration (DDA): the Community Pathways Waiver, the Community Supports Waiver, and the Family Supports Waiver. This action is to incorporate updates as needed and further align the three waivers.

Waiver programs provide various home and community-based services to support participants as they work toward individually defined life outcomes, self-determination, community living, socialization, and economic self-sufficiency. Each waiver must be renewed every five years. All renewals and requests to make changes to waiver programs are made by applying to the Center for Medicare and Medicaid Services (CMS).

Information regarding the renewals will be posted on the MDH DDA Waiver Program's page on or before September 6, 2022. Visit:

You can view a YouTube informational webinar summarizing the proposed updates​ or copies of the proposed updates are available for public review and comment at the DDA Headquarters and Regional Offices.

Public comments can be submitted to wfb.dda@maryland.gov or mailed to the DDA Federal Program Unit at 201 West Preston Street, 4th Floor, Baltimore, MD 21201. Comments will be accepted beginning September 6, 2022, through October 6, 2022. To support the stakeholder input process and minimize public burden, comments for all three waivers should be submitted together under one response.​

Public Notice​​: Statewide Transition Plan for Compliance with Home and Community-Based Settings Requirements (Final Rule)

Waiver and Service Programs

For more information, see the 2019 Bluebook Guide to Home and Community Based Programs.


The program, administered by Behavioral Health Administration (BHA),  provides opportunities for community-based services to individuals who have experienced a traumatic brain injury after the age of 17. 
Community Pathways
The Community Pathways waiver, administered by the Developmental Disabilities Administration (DDA), provides services and supports to individuals, of any age, living in the community, meet the criteria for a developmental disability.
The Community Supports program, administered by the Developmental Disabilities Administration (DDA), will provide individual and family supports for people with developmental disabilities on the DDA Waiting List.
The Family Supports program,  administered by the Developmental Disabilities Administration (DDA), will provide individual and family supports for children birth to 21 with developmental disabilities on the DDA Waiting List.
Medical Day Care Waiver
Medical Day Care is a structured group program that provides health, social, and related support services to functionally disabled adults, age 16 and older.
Model Waiver for Disabled Children
This waiver targets medically fragile individuals including technology dependent individuals who, before the age of 22, would otherwise be hospitalized and are certified as needing hospital or nursing home level of care.

Programs and Services

The Community Personal Assistance Services Program (CPAS; formerly MAPC), Community First Choice (CFC) and Community Options Waiver all offer a similar service package. Services vary based on eligibility. The core services are personal assistance, supports planning, and nurse monitoring. The Community Options Waiver also offers services in assisted living.
Employed Individuals with Disabilities (EID
The EID Program provides Medical Assistance to working Marylanders with disabilities who meet the program’s eligibility criteria. 

Hospice Services
The provision of hospice care is generally in the home to avoid an institutional setting and to improve the individual’s quality of life during the end of a participants' terminal illness. However, individuals eligible for Medicaid may choose to reside in a nursing facility and receive hospice care in that setting.

Maryland Health Homes
The program targets populations with behavioral health needs who are at high risk for additional chronic conditions, including those with serious persistent mental illness, serious emotional disturbance, and opioid substance use disorders. 
Program of All-Inclusive Care for the Elderly (PACE)
PACE is a voluntary health program designed to provide and coordinate all needed preventive, primary, acute and long-term care services so that older individuals can continue living in the community.

Rare and Expensive Case Management (REM)
The Rare and Expensive Case Management (REM) Program is a case management program for recipients with specified rare and expensive conditions.

HCBS Forms


Help Leaving a Nursing Facility
Community Resources
Medical Equipment, Supplies or Transportation

CO Advisory Council Meeting Archive

Public comment is closed. Documents for reference only.