BALTIMORE — It took Matt Masone and his family six months to assemble a team of caregivers to look after his 15-year-old son with Down syndrome and mood disorders.
The three caregivers hired over the past year gave Masone’s family an element of freedom, allowing it to attend family functions or other events and generally leave the house without fearing a crisis.
Now, with sweeping cuts to Maryland’s developmental disabilities system taking effect on July 1, Masone, a Severna Park businessman, worries his carefully selected team may not stay intact.
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“The only thing we know for certain is the consistency we need for (our son) to succeed is compromised,” said Masone, who asked that his minor son’s name not be disclosed for privacy reasons.
Gov. Wes Moore and lawmakers approved a package of spending reductions this spring that includes about $126 million in cuts to Maryland’s Developmental Disabilities Administration.
Masone’s concerns are shared by as many as 4,000 Maryland families enrolled in the state’s self-directed services program, which allows people with intellectual and developmental disabilities to hire and manage their own caregivers. The caregivers can be family members or — as in the Masones case — providers from outside the home.
“These self-directed services are what make independent living possible,” said Denise Stokes, director of marketing and communications for The Arc Prince George’s County, a nonprofit group supporting people with various disabilities.
Under the changes, the maximum hourly rate for caregivers from outside the home is being reduced even as “basic living expenses continue to increase,” said Mary Beth Janczak, a caregiver who lives near Bel Air. Janczak is the mother of a 31-year-old daughter with cerebral palsy and also a caregiver for other people with disabilities.
A DDA-issued schedule of rate changes shows that the maximum rate for caregivers like Janczak will drop about 25% from $32.18 to $24.14. “A caregiver who loses one-quarter of their income isn’t experiencing a budget adjustment — they’re experiencing a financial crisis,” said Janczak, who is also a paramedic.
The cuts, she said, “will make it more difficult to recruit and retain qualified caregivers at a time when the direct support workforce is already experiencing significant shortages nationwide.”
Maryland entered the legislative session facing a roughly $3 billion budget deficit, and state health officials said the DDA cuts were geared specifically to rein in escalating costs and keep the program in compliance with federal Medicaid requirements.
The agency’s service costs have grown more than 144% over the last five years — a period in which enrollment in its self-directed program has “stagnated,” according to a written response from the Maryland Health Department to Baltimore Sun questions.
“Maryland remains committed to supporting individuals with developmental disabilities in community-based settings and ensuring participants have access to services that promote independence, choice, and community integration,” the department statement said.
In March, more than 100 people stood outside the State House in sleet and cold temperatures listening to testimony from people with developmental disabilities who said they were worried about losing support services.
Budget cuts to the program were originally designed to be steeper. Under Moore’s proposed budget, the DDA would have lost roughly $150 million. The proposal included several cost-containment measures aimed at slowing spending growth, including a $500,000 cap on individual care-plan budgets.
The General Assembly removed the cap, which advocates said would have meant significant reductions in care for the people with the most complex and high-support needs. Lawmakers also lessened the overall cuts to about $126 million, although the impact will be higher because the federal government matches money allocated to the program.
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