MDH faces backlash for new caregiving documentation requirements

A state senator has called for the Maryland Department of Health to clear up confusion about new reporting requirements for those caring for someone with a developmental disability.

In a recent letter to Health Secretary Laura Herrera Scott, Republican Sen. J.B. Jennings wrote that his office has been “inundated” with messages from people with developmental disabilities, their families and caregivers who felt thrown by the department’s new requirement for more documentation to continue getting paid for care services.

“These issues are not only unacceptable but run counter to Maryland’s commitment to ensuring dignity and opportunity for all residents, especially for our most vulnerable citizens,” Jennings wrote.

Last Thursday, the department began requiring more documentation for certain caregiving services, like allowing family members providing care to work overtime or paying caregivers more than a certain amount, that are part of one of the Medicaid waiver programs operated in Maryland.

The programs allow states to waive certain Medicaid rules so that people who would otherwise live in institutional settings can receive care and services in their homes and communities, according to the department.

The new requirements apply to the roughly 3,600 people who rely on the Medicaid waiver program for “self-directed” services, through which families determine how to support their disabled relative and use government funding to hire support staff members and pay for other accepted services.

There were no changes to the service options available, and department officials said that more documentation would reduce processing delays to get providers their payments quicker and increase oversight of the services.

Health department spokesman Chase Cook said in a recent statement that improving the services will be “an ongoing process” and that “engagement with our provider and participant communities” is a core value for the state Developmental Disabilities Administration.

But people with disabilities and their caregivers felt blindsided by the changes when the department announced them on Oct. 24, with plans to implement them on Nov. 7.

On Nov. 6, the state Developmental Disabilities Administration decided to hold off on the new documentation requirements until Nov. 21, citing the confusion felt by those relying on the program.

Despite the delay and a recent virtual community meeting, concerns remained. A group of disabilities advocates held a rally at the State House last week to protest the changes, and Jennings sent his letter on Nov. 22.

Jennings wrote that caregivers were having issues with backpay, people were dropped from critical services for exceeding a reduced income threshold by as little as $34, and family members had lost their roles as caregivers.

The senator called for Department of Health officials to reevaluate the income thresholds and policies or offer people the chance to reduce their income within a reasonable time frame to meet the new requirements.

He also called for officials to develop a plan to ensure that caregivers are compensated fairly and promptly, “as a small business would be held liable for a situation of not paying employees,” and to clarify how family members can continue serving as caregivers when it’s in the best interest of the person receiving care.