Developmental Disabilities Administration
March 2021
Message from the Deputy Secretary
There is a renewed sense of hope for brighter and healthier days ahead with the arrival of spring and our statewide COVID-19 vaccination efforts. While March marks the one year onset of the COVID-19 pandemic, it also marks Developmental Disabilities Awareness Month. Declared in 1987, Developmental Disabilities Awareness Month raises awareness about the inclusion of people with developmental disabilities in all areas of community life. Developmental Disabilities Awareness Month also serves as another opportunity to celebrate your advocacy, tenacity and determination that has removed barriers to push forward as strong contributing members of our communities. These same attributes will help us emerge from this pandemic and restore our community connections and connectedness.
As we move forward, I pause to pay tribute to those lives lost during this pandemic and again offer gratitude to those who stepped up during such challenging and uncertain times. Individuals with developmental disabilities, families, staff and providers adapted and innovated in new and exciting ways. You challenged yourselves to find new interests and hobbies to fill your days, new skills and routines were developed, and new precautions to keep ourselves and others healthy and safe. We quickly learned to use technology to bridge the distance and saw the potential to continue virtual supports into the future. Your ability to adapt to these changes with determination, creativity and flexibility continues to make me proud of our resilient community. I know none of this was easy but my hope for the DDA coming out of this pandemic is that this perseverance strengthens the foundation of our person-centered practice and inspires our transformation goal -- access to a flexible, person-centered, family-oriented system of support so people can have full lives. 
With your continued partnership and with the support of Governor Hogan and the Maryland legislature, our transformation work is advancing. Earlier this year, the DDA received approval of our waiver amendments and we are aligning our policies and guidance to these new opportunities and services including virtual support delivery models. We are continuing to work across the system to provide clear and supportive pathways to promote self-direction and our Community of Practice for Supporting Families is advising and contributing to these efforts. We are expanding our LTSSMaryland billing pilot to further test our new processes. We are guided by your experiences and we look forward to continuing ahead, together, with all of you

Thank you for your commitment and support!
Professional photo of Deputy Secretary Bernard Simons
Bernard Simons
Deputy Secretary
2021: Our First Quarter
Resilience, Collaboration, Partnership and Innovation
The Developmental Disabilities Administration remains grateful for your partnership and contributions to our state of emergency response and transformation efforts. This newsletter highlights several top priorities and areas of focus in this first quarter of the new year.
COVID-19 Update
DDA’s highest priority is the health, safety, and wellbeing of people with intellectual and developmental disabilities, their families, staff, and providers. With the roll-out of the COVID-19 vaccination in January, individuals with developmental disabilities were given prioritization in Maryland. To reach individuals, their families and our valued direct support professionals statewide, this effort is relying on the close collaboration and partnership between State agencies, local health departments, providers and our regional DDA staff. DDA Deputy Secretary Bernard Simons continues to host bi-weekly webinars to provide access to accurate, clear and timely information. These recorded webinars are available, along with other COVID-19 resources at the DDA dedicated website page, DDA COVID-19 Information Page. In addition, the staff in your regional DDA office also remain available to help you navigate the resources for vaccination. You may also want to learn more about vaccine safety, efficacy, and eligibility: covidLINK | Maryland Department of Health

Pre-register for an appointment at a state mass vaccination site:
As more and more people we serve are becoming fully vaccinated, our providers are leading discussions for the ‘how and when’ to reopen and resume in-person community services. Their careful planning is guided by a number of factors including individual and family interests and readiness, program and staffing capacity, transportation, and early provider experiences with scaled back openings this spring. 

To shape these plans and timelines, please consider participation in a brief survey similar to last fall. The DDA recognizes that with the passing of time and with the COVID-19 vaccination roll-out, individual and family preferences may have changed. Thank you for your participation in this reopening survey which can be accessed here.
Maryland Community of Practice for Supporting Families 
The MD Community of Practice for Supporting Families has a deep appreciation for the invaluable support of families and their unique challenges and impacts during COVID-19. We remain focused on webinars to share critical information, ideas and to offer support and connectedness to each other. 

In January, following the successful implementation of the Electronic Visit Verification (EVV) for individuals accessing Personal Supports, an EVV Check-in was hosted. This webinar used a panel discussion to answer questions and to address challenges. Also, this quarter, Person-Centered Planning: The Challenges and Gifts of COVID-19 was supported by an inspiring self-advocate and her amazing mother who shared their personal experiences, perspectives and learnings. Through the challenges and disruptions of COVID-19, they maintained a positive outlook and offered practical strategies and encouragement Person-Centered Planning: The Challenges and Gifts of COVID-19.  
With the arrival of COVID-19 vaccines our communities are reopening. People with developmental disabilities and families are beginning to plan and live their lives again. In early March, the webinar Maryland ABLE: Achieving A Better Life Experience provided information about how they, through an ABLE account, can save money without jeopardizing their state or federal benefits, such as SSI, Medicaid, and waiver services. Information on the Economic Stimulus Payments was included too.

And in late March, families learned about DDA’s Behavioral Support Services and how to access them. Followed by a compelling presentation on how Creative Options, Inc., a DDA provider and a parent/family, utilizing Behavioral Support services, work together to support the family member with developmental disabilities to live his best life. See the MD Community of Practice Webinar Series #20 – Behavior Supports – March 24, 2021.

Please contact Mary Anne Kane Breschi, Director of Family Supports, for any additional questions you might have at  
LTSSMaryland Implementation
LTSSMaryland is a software system that houses Person Centered Plans (PCPs) and Service Authorizations. This system will enhance and support the coordination, delivery, and payment for services provided through DDA’s programs.  

The DDA is transitioning its prospective payment and billing processes from the current legacy system Provider Consumer Information System (PCIS2) to LTSSMaryland fee for service payment through a planned and phased approach. This will enable controlled testing of the system ahead of a full transition. Progress is ongoing and building off successful implementation of the initial pilot.

To continue to ensure fiscal payment strategies used within LTSSMaryland are functional, the DDA is expanding the pilot to a small group of five providers who have volunteered to transition all of their billing to LTSSMaryland. This group is referenced as the Early Adopter Group (EAG). 

Participants supported by these agencies will work with their Coordinator of Community Services, providers and the DDA to have their annual plan updated, renewed or revised to develop current budgets and authorizations in LTSSMaryland. These agencies will begin billing services in LTSSMaryland on July 1, 2021 or October 1, 2021. 

Earlier this year, Senate Bill 796 - which had previously been vetoed by Governor Hogan - was overridden. The newly passed legislation will require additional steps be taken by the DDA prior to fully implementing LTSSMaryland for all participants. The DDA is actively planning for the impacts of this and looks forward to engaging with stakeholders to define the next phases of going live in LTSSMaryland.  
Person-Centered Planning  
As the foundation of our work and the guiding principle behind our transformation, person-centered planning (PCP) remains one of DDA’s highest priorities. With our partners in person-centered planning, the DDA has worked to revise processes to ensure timely access to services.  

The DDA Regional Offices review all Initial, Annual, and Revised PCPs using a PCP checklist. This checklist is used to ensure the PCP meets the person's needs, addresses health and safety risks, and follows State and federal requirements. The checklist was shared with the Coordination of Community Services (CCS) providers to enhance the quality of the PCPs they submitted and to decrease the need for clarification from the regional office.  

Recently, the DDA updated the checklist to streamline the process and increase the number of PCPs reviewed by regional staff. We are already seeing an increase in the number of PCPs being approved per day. 

The DDA has also issued a Coordinator of Community Services PCP Checklist, which they will now complete for every PCP. Use of the CCS PCP Checklist will help to guide and enhance the submission of a quality and complete PCP and reduce the timeframe for the Regional Office reviews.  

The DDA will also be sharing a Provider PCP Checklist tool to further support the coordination and communication between the participant’s selected service Providers and the CCS in the development of the PCP. Please remember that the PCP development is a collaborative process and these checklists will help the region, CCS, and agency providers ensure the PCP process is reflective of each person’s individual needs. Every PCP has equal value and importance to the DDA.  

To support the development of PCPs through the use of the PCP Checklist, the DDA will be hosting a webinar for all DDA Providers on Friday, April 9, 2021 at 10 AM. You can register here for this webinar.
Value Based Payment for Employment Services
In February of 2021, the Developmental Disabilities Administration alongside the National Association of State Directors of Developmental Disability Services (NASDDDS) presented a webinar on the alternative payment structure known as Value Based Payments. The DDA will take the next 18 months to meet with internal and external stakeholders, including people supported by DDA and their families, to develop a value based payment model for employment services. 
As an Employment First state, Maryland’s guiding principle is that all individuals who want to work can work and contribute to their community when given opportunity, training, and support that build upon their unique talents, skills and abilities. Everyone of working age, and those supporting them, should consider employment as the first option prior to any other service options. As fully participating members of their community, individuals with developmental disabilities will be afforded the opportunity to earn a living wage and engage in work that makes sense to them.

The goal of value based payments is to promote value through financial incentives to providers for meeting a person’s stated goals, desired outcomes, or milestones. This will enable the DDA to promote high quality supports and use metrics to measure and improve the intended outcome of the value based payment. By implementing this payment structure, we will shift the focus away from volume of support to incentivizing providers to improve coordination of support efforts. 

The DDA and NASDDDS will invite other national experts, including state agencies, that have implemented value based payments to gather information on strategies and lessons learned prior to implementation. We want to make sure we get this right and we are in no rush. To learn more about value based payments and DDA’s timeline, please click here.
Upcoming Events
The Deputy Secretary will continue his biweekly webinar series, sharing new information and providing time for your questions and responses. The series continues on April 2nd at 1 PM, and will repeat every two weeks. Register here.

The DDA continues to offer training for providers, Support Brokers, and CCS agencies. Learn about these and other upcoming training opportunities and register through the DDA training calendar.
Regional Office Contact Information

Central Maryland: Nicholas Burton
Southern Maryland: Onesta Duke
Eastern Shore: Kimberly Gscheidle
Western Maryland: Cathy Marshall
Maryland Department of Health
Developmental Disabilities Administration
201 W. Preston St. | Baltimore, MD 21201