Maryland · children's waiver
DDA Waivers (Community Pathways Waiver) in Maryland
Maryland's Developmental Disabilities Administration (DDA) runs Medicaid waivers for children and adults with intellectual and developmental disabilities. Starting October 6, 2025, the Family Supports Waiver (birth to 21) and Community Supports Waiver were folded into the Community Pathways Waiver. Through Personal Supports and self-directed services, relatives, legal guardians and legally responsible persons, including parents of minors, can be paid as staff, with new hour caps in the FY2027 budget.
Also called: DDA waiver · Community Pathways Waiver · Family Supports Waiver · Community Supports Waiver · Maryland DDA self-directed services · family as staff
Who do you care for?
Quick facts
- Pay
- Set by self-directed budget or provider — not published
- Adult children & other relatives
- Yes
- Spouse
- Sometimes
- Parent of a minor child
- Sometimes
- Waitlist
- long
Who qualifies for DDA Waivers (Community Pathways Waiver)
- Found eligible by DDA as having a developmental disability, through the DDA eligibility application, documents and interview.
- Eligible for Maryland Medical Assistance (Medicaid), which you must apply for before DDA can fund services.
- Meets the waiver's level-of-care rules; children were served from birth through 21 under the former Family Supports Waiver.
- Is offered a waiver slot from the DDA Waiting List, which is prioritized by need.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- relatives can be paid as staff, now capped at 40 hours a week per relative and 60 hours a week total across all family caregivers; in-laws now count as relatives.
- Spouse Sometimes
- spouses count as legally responsible persons and fall under the same family-as-staff limits.
- Parent of a minor child Sometimes
- legally responsible persons, including parents of minors, can be paid for waiver services, subject to the 40-hour-per-person and 60-hour-total weekly caps.
- Living together
- family staff may live with the participant.
Who employs the caregiver: Either. Self-Directed Services (participant is the employer, with a fiscal management service) or the Community Provider-Managed model through a DDA-licensed agency; family-as-staff limits apply in both.
Spouse rules differ by program — see spouse pay in Maryland.
How much DDA Waivers (Community Pathways Waiver) pays
Set by self-directed budget or provider — not published. In self-directed services the participant sets staff wages within an approved budget; the FY2027 budget created a separate self-directed rate that removes agency indirect costs. Agency staff are paid what the agency sets, and the FY2027 budget cut provider rates 2%. No single family-caregiver wage is published.
Hours and budget: A Coordinator of Community Services builds a person-centered plan and DDA authorizes services and a budget. Family-as-staff hours are capped at 40 per week per relative, guardian or legally responsible person and 60 per week total for the participant.
Compare with other Maryland programs on the Maryland caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
DDA cannot meet all requests, so it keeps a Waiting List prioritized so people with the greatest need are helped first. People who will not need services within three years go on the Future Needs Registry.
How to apply for DDA Waivers (Community Pathways Waiver)
- Apply for Medical Assistance (Medicaid) for the person with a disability.
- Complete the DDA Application for Eligibility through the DDA regional office for your county, with supporting documents and an interview.
- If found eligible, you are placed on the DDA Waiting List by priority; a Coordinator of Community Services can help while you wait.
- When a waiver slot is offered, build the person-centered plan, choose self-directed or provider-managed services, and add family members as staff within the hour limits.
- Developmental Disabilities Administration · 844-253-8694 · official site
- DDA Regional Offices (eligibility teams) · not published on this page · official site
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DDA Waivers (Community Pathways Waiver) questions
Can parents get paid to care for a child with a disability in Maryland?
Yes, through the DDA Community Pathways Waiver. Legally responsible persons, including parents of minors, can be paid as staff, but each family member is capped at 40 hours a week and all family staff together at 60 hours a week.
What happened to the Family Supports Waiver?
On October 6, 2025 DDA combined the Family Supports and Community Supports Waivers into the Community Pathways Waiver. Participants were moved automatically and kept their services.
What is the 60/40 rule?
A FY2027 budget policy that caps paid hours at 40 per week for each relative, guardian or legally responsible person, and 60 per week total for the participant across all family caregivers.
Is there a waiting list for DDA services?
Yes. The DDA Waiting List is prioritized by need. People who do not need services in the next three years go on the Future Needs Registry.
Can I hire my sibling under self-directed services?
Yes. Relatives can be hired as staff in self-directed services, within the family-as-staff hour limits. In-laws now count as relatives for those limits.
Sources: health.maryland.gov · health.maryland.gov · health.maryland.gov · health.maryland.gov · health.maryland.gov · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Maryland caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Maryland — pick yours for the local picture.
Across the line
States that border Maryland
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.