MD Family Supports Waiver

Published on
August 22, 2023
Last updated
February 29, 2024
Written by
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Katie Wilkinson
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The Family Supports Waiver is a Medicaid program that provides services and supports to individuals with developmental disabilities who live with their families or in their homes.
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See If You're Eligible

If you are a family caregiver of a person with developmental disabilities in Maryland, you might qualify for financial assistance or other benefits through the Family Supports Waiver. This waiver is a Medicaid program that provides services and supports to individuals with developmental disabilities who live with their families or in their homes. Here, we explore the Family Supports Waiver, how it works, and how it can help you as a caregiver.

Overview of Family Supports Waiver

The Centers for Medicare and Medicaid Services approved the Family Supports Waiver as a Medicaid program in 2017. The waiver aims to support individuals with developmental disabilities and their families by providing them with services and supports that promote independence, community integration, and quality of life. The waiver also seeks to prevent or delay institutionalization and reduce the waiting list for other waivers.

The Family Supports Waiver serves individuals with developmental disabilities who are eligible for Medicaid and meet the following criteria:

  • They are between 0 and 21 or between 22 and 64 years old and have been enrolled in the waiver before turning 22.
  • They are diagnosed with an intellectual disability or related condition that occurred before 22 and is expected to last indefinitely.
  • They require an intermediate care facility for individuals with intellectual disabilities (ICF/IID) level of care, which means they need ongoing supervision, training, or support to perform daily living activities.
  • They live with their families or in their own homes.

The Family Supports Waiver has an annual budget of $25 million and serves up to 400 individuals annually.


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Services and supports

The Family Supports Waiver offers a range of services and supports that are tailored to the needs and preferences of each individual and family. Some of the services and supports available under the waiver are:

  • Personal support: This service assists with personal care, household tasks, community activities, and other needs. The service can be provided by an agency or a self-directed worker chosen by the individual or family.
  • Respite care: This service temporarily relieves caregivers who need a break from their caregiving duties. The service can be provided in the individual’s home, the provider’s home, or another setting approved by the waiver.
  • Environmental modifications: This service offers adaptations or improvements to the individual’s home or vehicle necessary to ensure their health, safety, or accessibility. Examples include ramps, grab bars, lifts, alarms, etc.
  • Family caregiver training and empowerment services: This service provides education, training, counseling, support groups, and other resources to help caregivers enhance their skills, knowledge, and well-being.
  • Additional services: The waiver also offers other services such as assistive technology, behavioral support services, nursing services, transition services, etc.

Who are you caring for?

Compensation for caregivers

One of the benefits of the Family Supports Waiver is that it allows individuals and families to self-direct some of the services they receive. Self-direction means they can choose who provides the service, how it is provided, when, and where it is delivered. Self-direction also means that they can hire and pay their workers, including family members or friends.

The Family Supports Waiver offers two options for self-direction: self-directed personal support and self-directed respite care. Under these options, individuals and families can hire workers to provide personal assistance or respite care. The workers can be family members (except spouses or legal guardians), friends, neighbors, or anyone else who meets the qualifications and passes a background check.

The workers are paid through a fiscal intermediary agency that handles payroll, taxes, insurance, and other administrative tasks. The workers are paid at an hourly rate determined by the state. The current rate for self-directed personal support is $13.50 per hour, while the current rate for self-directed respite care is $14.00 per hour. These rates are subject to change based on state regulations.

Individuals and families can have more control over their services and support by choosing self-direction. They can also compensate their caregivers for the valuable work that they do.

A note from Givers

If you are interested in applying for this waiver or finding out if you are eligible for compensation as a caregiver, please fill out this form. We will get back to you as soon as possible with more information. 

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