In this subtitle the following words have the meanings indicated. “Eligible child” means an individual with developmental disability under the age of 22 years who is: In an out-of-home placement; or At immediate risk of out-of-home placement. “Family” means an eligible child’s natural, adoptive, or foster parents. “Family” includes: A guardian; A person acting as a parent of a child; or A relative or stepparent with whom a child lives. “Family support services” means a program designed to enable a family to provide for the needs of a child with developmental disability living in the home. “Family support services” includes: Individual and family counseling; Personal care; Day care; Specialized equipment; Health services; Respite care; Housing adaptations; Transportation; and Other necessary services. “Program” means the Family Support Services Program.

The General Assembly finds and declares that: There are over 2,500 disabled children placed outside of their homes by State agencies; Because of a lack of support services within the community, families are often forced to place their disabled children outside the home and excessive costs are associated with certain residential placements; The family support services project sponsored by the Maryland State Planning Council on Developmental Disabilities has demonstrated that disabled children can be returned to the community and new residential placements prevented when support services for families are available; Family support services enable families to provide for the needs of their disabled children in the least restrictive setting; and Maintaining disabled children with their families has been demonstrated to be cost effective. The General Assembly declares that it is the policy of this State to enhance the quality of life for children with developmental disability and their families, to preserve family unity, and to promote family stability by: Providing essential family support services to assist families in caring for children with developmental disability in the home; and Diminishing the use of residential placements for children with developmental disability.

There is a Family Support Services Program. The Administration shall contract with private nonprofit community-based organizations for the provision of family support services in each county of the State. The Administration shall base the amount of a grant to a county upon the needs of the eligible families in each locality in accordance with the data available through the Family Support Services Consortium Project for localities of comparable size. The Administration shall implement a sliding payment scale for reimbursement from families financially able to pay for all or part of the services under the Program. Before using Program funds, the Program shall coordinate and assist any eligible child and family in receiving services available under existing programs including: Respite care under Title 7, Subtitle 2 of the Human Services Article; Day care services; Homemaker services; Personal care; Services to families with children under § 4–402 of the Family Law Article; Children’s medical services under § 15–125 of this article; Attendant care services under Title 7, Subtitle 4 of the Human Services Article; and Other applicable federal and local programs. The Program shall assist in providing family support services that are not otherwise available.

Beginning July 1, 1986 and each fiscal year thereafter, the Secretary shall request budget support that is sufficient to operate the Program and shall continue to provide family support services at least for the level in effect on June 30, 1986. The Secretary shall request budget support that is sufficient to operate the family support services project initiated by the Maryland State Planning Council on Developmental Disabilities and serving Baltimore County and Anne Arundel County by July 1, 1988, and shall assume financial responsibility to the extent that funds are provided by the Governor in the budget. By July 1, 1990, the Secretary shall request budget support sufficient to provide family support services in every county of the State and Baltimore City. The Department shall assume financial responsibility for the Program to the extent that funds are provided in the budget by the Governor.

For day habilitation and vocational services, the Administration shall also use local funds. The local funds shall be limited to the amount paid by each jurisdiction in fiscal year 1984.

In this part the following words have the meanings indicated. “Eligible person” means an individual with a developmental disability that is likely to continue indefinitely or an individual with a severe chronic disability that is attributable to a physical or mental impairment, other than the sole diagnosis of mental illness, or to a combination of mental and physical impairments that is likely to continue indefinitely. “Individual support services” means a program designed to assist eligible persons in developing their maximum potential and in maintaining themselves in the community. “Individual support services” includes: Identification services; Training and support for self–advocacy; Therapeutic services; Individual and family counseling; Medical equipment purchase, rental, and repair; Crisis intervention and follow–up; Attendant care; Respite services; Barrier removal; Transportation assistance; Community integration services; Employment related services; and Other services to maximize independence, productivity, and integration within the community. “Program” means the Individual Support Services Program.

The General Assembly finds and declares that: Persons with disabilities should be afforded the opportunity to achieve their maximum potential through increased independence, productivity, and integration into the community. Services provided to persons with disabilities should be provided within a natural home setting in a manner that is responsive to the person’s needs and does not overly intrude into the person’s life. Individual support services are flexible, creative services provided in accordance with unique individual needs. Individual support services promote the development of the individual’s inner strengths and encourage informal support networks consisting of family, friends, and the community. The provision of individual support services is cost effective because reliance upon more expensive day and residential services is diminished. Although the focus of the Individual Support Services Program is upon the adult with a disability, the provision of individual support services may begin with young adults in adolescence. The General Assembly declares that it is the policy of this State to promote the independence, productivity, and integration within the community for individuals with severe disabilities by providing an array of individual support services.

There is an Individual Support Services Program. The Administration shall enter into grant agreements for the provision of individual support services in all counties of the State. Eligible persons selected for services by the Administration shall be informed of individual support services and encouraged to use them, as appropriate, prior to being offered full day or residential services.

In this Part IV the following words have the meanings indicated. “Community supported living arrangements services” means services to assist an individual with developmental disabilities in activities of daily living necessary to permit the individual to live in the individual’s own home, apartment, family home, or rental unit with no more than 2 other individuals who are recipients of these services. “Community supported living arrangements services” includes: Personal assistance; Training and habilitation services necessary to assist the individual in achieving increased integration, independence, and productivity; 24–hour emergency assistance; Assistive technology; Adaptive equipment; Support services necessary to enable the individual to participate in community activities; Case management services; and Other services, as approved by the Secretary. “Eligible individual” means an individual who: Has a developmental disability as defined in § 7–101(g) of this title; or Is eligible only for individual support services, as provided in § 7–403(c) of this title. “Program” means the Community Supported Living Arrangements Services Program. “Support services” means individual support services and family support services as defined in this title.

The General Assembly finds and declares that: The Developmental Disabilities Administration has funded individuals with developmental disabilities in successful residential programs in the communities of the State; Recipients of services are capable and eager to determine the services and homes they desire to a greater degree than allowed under the present system; Currently, to obtain residential service, individuals with developmental disabilities must fit into “slots” available in existing service delivery systems, rather than being supported in their own homes; Support services can be tailored to the needs of individuals with developmental disabilities, regardless of the nature or severity of their disability, to enable them to live in homes of their own choosing that may include homes owned or rented by the recipient or supplied by parents, relatives, or trusts; and The provision of community supported living arrangements services promotes the integration and independence of individuals with developmental disabilities and enhances their quality of life. The General Assembly declares that it is the policy of the State to promote the integration and independence of individuals with developmental disabilities and to enhance the quality of life of these individuals by: Providing essential community supported living arrangements services to eligible individuals to enable them to: Receive services from providers of their own choosing; and Live in their own home or homes of their own choosing in their own community; Making community supported living arrangements services available to eligible individuals no matter how severe or profound their disability may be; and Tailoring community supported living arrangements services to the needs of the individual recipients, rather than requiring individuals to fit into a preexisting residential service delivery system.

The Secretary shall adopt regulations for the licensing of persons who provide community supported living arrangements services to eligible individuals that include standards for: Licensing providers that include grievance procedures for recipients of community supported living arrangements services; and The inspection of licensees at least once each year. The regulations shall ensure that community supported living arrangements services to an eligible individual are provided in accordance with an individual support plan as required by regulation.

The Secretary shall establish and implement a Quality Assurance Program for the Community Supported Living Arrangements Services Program. The Quality Assurance Program shall include: A system of external monitoring of providers of community supported living arrangements services by recipients, family members, and other interested parties that focuses on the recipient’s quality of life; Reporting procedures to make information available to the public as required by federal regulations; and Provisions for the ongoing monitoring of the health and well-being of each recipient. Any State plan amendment affecting the State Medical Assistance Program regarding community supported living arrangements services, including the Quality Assurance Program, shall be reviewed by the Maryland Developmental Disabilities Council and the Maryland Disability Law Center.

The Secretary shall develop a plan for community supported living arrangements services that addresses: How services will be structured to meet the needs and preferences of eligible individuals; The number of eligible individuals estimated to need services and the number of individuals actually provided services sufficient to meet their needs under the Program; A recipient-based evaluation system on which to base individual and State policy changes to the Program that includes recipient satisfaction with provided services; Technical assistance and information on how to access and to utilize the Program to recipients, family members of recipients, advocacy organizations, and other interested persons; and Technical assistance and information to service providers on how to structure services to meet the needs and preferences of recipients. Community advocacy and provider organizations shall be involved in the development of the State plan for community supported living arrangements services. In order to offer eligible individuals creative housing alternatives, the Administration shall include in the State plan for community supported living arrangements services a provision for collaboration with the Department of Housing and Community Development and other appropriate agencies and organizations. In addition to any other provisions required under this section, the State plan for community supported living arrangements services shall provide, to the extent that funds are available, that the first 500 individuals to receive community supported living arrangements services shall be: Eligible individuals who have applied for community-based residential or support services under this title and are not currently receiving these services; or In equal numbers, eligible individuals who are currently receiving residential services and eligible individuals who have applied for community residential or support services and are not currently receiving these services. After the first 500 individuals have received community supported living arrangements services under paragraph (1) of this subsection, to determine the distribution of available funds, the Secretary shall review: The needs of eligible individuals who have applied for community-based residential or support services under this title and are not receiving these services; and The needs of eligible individuals currently receiving community-based residential or support services.

By December 31, 1991, the Secretary shall adopt regulations necessary to implement the provisions of this part.

In this part, “low intensity support services” means a program designed to: Enable a family to provide for the needs of a child or an adult who is living in the home and has a severe chronic disability that: Is attributable to a physical or mental impairment, other than the sole diagnosis of mental illness, or to a combination of physical and mental impairments; and Is likely to continue indefinitely; or Support an adult who is living in the community and has a severe chronic disability that: Is attributable to a physical or mental impairment, other than the sole diagnosis of mental illness, or to a combination of physical and mental impairments; and Is likely to continue indefinitely. “Low intensity support services” includes the services and items listed in §§ 7–701(d) and 7–706(c) of this subtitle. There is a Low Intensity Support Services Program in the Administration. Low intensity support services shall be flexible to meet the needs of individuals or families. Through fiscal year 2025, the Administration shall establish a cap of no less than $2,000 of low intensity support services per individual per fiscal year to a qualifying individual. For fiscal year 2026 and each fiscal year thereafter, the Administration shall establish a cap of no less than $1,000 of low intensity support services per individual per fiscal year to a qualifying individual. The Administration may waive the cap on low intensity support services provided under paragraph (1) of this subsection. An individual seeking low intensity support services is not required to: Submit an application to the Department as provided in § 7–403 of this title; or Complete an application for the Medical Assistance Program if the low intensity support services will be provided to a minor. The Department may develop a simplified application process for low intensity support services. The Administration shall deliver services to an eligible individual seeking low intensity support services dependent on the availability and allocation of funds provided by the Administration.