Developmental Disabilities Administration
December 2020
Message from the Deputy Secretary
As I reflect upon this year, which has brought all of us unprecedented challenges, I want to express my gratitude for each of you, our shared grief for the people we have lost to the coronavirus, and my hope for the future for Marylanders with developmental disabilities.   

First, and foremost, I would like to thank each and every one of you for your partnership in helping to keep people as safe and healthy as possible through the pandemic. 

To the people we support and families, thank you for your grace as we rapidly redesigned services. Your creativity and innovative ways of staying connected as we stayed safe at home reminds us all of the deep strength of relationships. Your resilience is inspiring.

To the Direct Support Professionals, you are our front-line heroes. You show up, day after day, to make sure the people we support are not only cared for but also cared about. Your commitment has never been more visible. Thank you.

To the Coordinators of Community Services, you have been our first line of communications, providing wellness checks and amending person-centered plans to ensure that people and families have the information, services, and support they need during this time. We appreciate you.  

To our provider network, you have risen to the challenge, innovated, and continued to provide necessary services to support people with developmental disabilities even as the ground changed underneath us all. Thank you for your partnership. 

And, to the staff here at the DDA, thank you for your ongoing leadership, vision, and commitment to our shared mission. We could not do this without you.

This year has been a difficult one and all of us have been impacted by COVID-19. Some of us have lost those close to us, others have seen the world change in uncertain ways. While this pandemic is not over, like all of you, I am looking forward to a vaccine and overcoming this pandemic. Until then, please stay safe. 

Finally, as we close out 2020, I want to say that I am hopeful about what next year will bring. If there can be a silver lining to the pandemic, it has shown us that our community and the services provided to people with developmental disabilities can adjust in challenging times. Through this pandemic, we learned that we can be more innovative in the ways in which services and supports are provided through the use of technology. Through my biweekly webinar series, I have heard from more of you directly than ever before. You have shared stories and examples of how providing support to people remotely has given people new independence during this time. People who have spent their days in congregate settings have tried new activities out of necessity, and some have discovered new interests and abilities. Families have stepped in as direct support staff, and for people and families who prefer this new arrangement, we will grow our self-direction service model. And, perhaps most importantly, we have navigated this new world collaboratively. Working together we will continue to create a flexible, person-centered, family-oriented system of supports so people can have full lives. 

I wish you happy holidays and a healthy new year. 
Professional photo of Deputy Secretary Bernard Simons
Bernard Simons
Deputy Secretary
2020: A Year in Review
Resilience, Collaboration and Innovation
The Developmental Disabilities Administration kicked off 2020 with bold goals for our continued systems transformation. As we quickly discovered, the COVID-19 pandemic would change the way all of us operate and shift our focus for the year. Nonetheless, working through uncharted waters, the DDA, people and families, Coordinators of Community Services (CCS), and provider network had many accomplishments in 2020. First and foremost was our shared commitment to the health, safety and wellbeing of people with intellectual and developmental disabilities, their families, staff and providers. This is and will continue to be our top priority as we move into 2021.

This newsletter highlights some of our accomplishments in 2020 and shares a look ahead at some of our goals for 2021. We appreciate your continued collaboration, partnership and commitment to our shared mission.
COVID-19 Response
Graphic representing DDA’s COVID-19 response including icons for “Webinars”, “Memos, Guidance and Considerations”, “PPE Distribution”, and “Appendix K”.
In March, a national public health emergency was declared. The DDA and our provider network changed our service structure to allow people to stay safe at home, provide new flexibilities for families, make innovative use of technology, and provide financial support to services impacted by the pandemic. The DDA worked with the Centers for Medicare and Medicaid Services on an emergency Appendix K waiver to respond to the pandemic. 

Understanding the critical nature of communications during an emergency, the DDA increased and expanded its communication with people in services, families, provider agencies and Direct Support Professionals to provide them with updated information related to its changes in policies and services, and the knowledge and skill of tools to assist people and families to problem-solve and plan during this challenging time. The DDA began a weekly live webinar series, issued COVID-19 topic specific memos, guidance, and directives, and Appendix K detailed guidance on new processes and more than 25 easy to read At A Glance documents that described these changes. The DDA partnered with Dr. Kenneth Feder, an epidemiologist from the Centers for Disease Control and Prevention (CDC), to provide real time information, guidance, and to answer practical questions. 

Some people with intellectual and developmental disabilities working in competitive integrated jobs were classified as essential workers and continue to perform their critical work with support services as needed. In addition, new job opportunities arose during this time for others.

As Personal Protective Equipment (PPE) became available, the DDA partnered with sister agencies to distribute six rounds of PPE to participants in self-direction, microboards, and providers throughout the state. The DDA also shared Reopening Framework Considerations, informed by guidance from the CDC. Understanding the varying impact of COVID-19 across the state, Regional Offices have put together teams of families and providers to have these conversations at the local level. 

To guide our thinking about reopening and reenvisioning the future of services, the DDA surveyed people with intellectual and developmental disabilities, their families and providers. The information we received has already resulted in new waiver amendments to expand virtual services, provide support to people in the hospital, and expand staffing flexibilities. This work will continue into the new year, as we support people, families, providers, and direct support professionals through a difficult winter and, with the vaccine, begin a safe, slow, and steady reopening. 
Program Innovations
Diverse group of people with and without developmental disabilities, using varying forms of technology such as tablets and computers.
While COVID-19 has slowed the implementation of new Meaningful Day and Employment services, it also provided an opportunity to move to a technology first approach. This approach allowed us to look at how to enhance access to technology for people with intellectual and developmental disabilities, with the ultimate goal of supporting them to live as independently as possible in their community. The DDA has already begun to braid this learning into our services, with the option of virtual and remote supports through our Waiver Amendment #3. We look forward to continuing to build upon the use of technology in 2021. We will also continue our conversations on tiered standards for HCBS Community Settings Rule compliance and a values-based payment model for employment services. 
Maryland Community of Practice for Supporting Families 
The DDA launched the MD Community of Practice for Supporting Webinar Series to bring together people with intellectual and developmental disabilities, families and community partners to share critical information and ideas to support each other and build knowledge, skill and resiliency within themselves and the community during COVID-19. Subject matter experts (inclusive of family members and self-advocates) and invited guests discuss and address the challenges and concerns confronting people and families related to COVID -19 through the lens of the Charting the LifeCourse (CtLC) framework. Participants in the webinar learned about the principles and tools of CtLC and how they can be employed to problem solve and plan now and beyond.

The first webinar Connecting with Family Members During COVID-19,  explored the different ways families and their family member(s) with developmental disabilities residing with a community provider and unable to visit with their family could stay connected while remaining safe at home. Others included Lessening the Trauma of COVID -19, Transition, Q & A with DDA, Employment and many more. The December webinars helped families plan for a healthy and happy holiday and think about how to find the joy as they celebrate the holiday season in ways that may be very different this year.

The webinar series will continue throughout the new year and we are pleased to continue to welcome Marylanders with intellectual and developmental disabilities and their families to offer their expertise as presenters in the webinars, or to participate and connect with the DDA using the chat box
Person-Centered Planning  
Person-centered planning is the foundation of the work that the DDA does and is the guiding principle behind our transformation, ensuring people with developmental disabilities are central to all of our efforts. As part of our commitment to a robust planning process, the DDA is continuously reviewing its processes and looking for opportunities to improve policies and practices to help drive the most robust planning process possible.

This year, as we are transitioning to LTSSMaryland, the DDA recognized that the paperwork for our person-centered planning and revision process was too complex and set about to streamline it. With support and feedback from CCS and providers, the DDA issued new guidance that clarified expectations, eliminated paperwork, and developed new forms that more closely align with the LTSSMaryland system.

To support this approach, the DDA is working with the National Association of State Directors of Developmental Disabilities Systems and other national experts on a review of our person-centered planning process and targeted case management. We expect to receive reports and recommendations in the Spring and will share them with stakeholders for feedback and implementation. 
Electronic Visit Verification  
Collaborating with Coordinations of Community Services agencies and providers, the DDA has successfully implemented Electronic Visit Verification (EVV) for more than 4,300 people with intellectual and developmental disabilities who receive Personal Supports through a provider agency. This was a big lift and the DDA team worked diligently and collaboratively with providers and CCS agencies to execute the EVV Go-Live implementation. We know change can be difficult, but together we have achieved an important step forward not just for federal compliance, but also in our move toward LTSSMaryland. In 2021, we will continue this implementation for the people who self-direct their Personal Supports services. 
LTSSMaryland Implementation
In March, in response to the national public health emergency, DDA Deputy Secretary Simons announced a delay to LTSSMaryland implementation to focus on health and safety. This meant that beginning in July 2020, the DDA and our providers began operating in dual systems -- both PCIS2 and LTSSMaryland -- until the transformation is completed. We recognize that this added administrative tasks and applaud the CCS, providers and DDA Regional Office flexibility and adaptability during this time. 
Through EVV implementation, we successfully transitioned Personal Supports to LTSSMaryland. At the same time, building off of the lessons learned from the first wave of EVV implementation, we also moved Supported Living services into LTSSMaryland. In 2021, the DDA will work with a group of Early Adopters -- providers who have raised their hands and offered to go all in to LTSSMaryland and share their learning -- to further test full system implementation. 
Policy Development 
Policies provide standards and guidance for practice, and create expectations and accountability both for the DDA and our system of services. The DDA has made significant progress in publishing policies this year, using the PolicyStat system. Working with the Policy Review Team and the Technical Work Group, as well as sister agencies, the DDA has published policies related to Meaningful Day, Competitive Integrated Employment, Personal Supports, Transportation, Organized Health Care Delivery Systems, and Provider Billing.

Policies include easy to understand guidance, as well tools like At a Glance overviews and Integrated Support Stars, to help place services in the context of integrated, community-based support. The DDA will be publishing policies regarding Residential Services, Contribution to Care, and Room and Board within the month, with policies on Person-Centered Planning in 2021. 
This has been a year of rapid and unexpected change. Together we have supported people with intellectual and developmental disabilities, their families, and staff to be as healthy and safe as possible, while innovating and advancing our shared mission.  
Moving forward, 2021 will undoubtedly provide new challenges and opportunities. Building upon the collaboration and lessons learned this year, we will accomplish our goals together. 
Upcoming Events
Calendar with January 2021 showing. Dates 1/6 and 1/8 are circled.
The Deputy Secretary will continue his biweekly webinar series, sharing new information and providing time for your questions and responses. The series continues on January 8th at 1 PM, and will repeat every two weeks. Register here.

The Community of Practice for Supporting Families will also continue its webinar series for families. Next up is a roundtable discussion on Electronic Visit Verification to hear directly from people with intellectual and developmental disabilities and their families about their experiences. Join the conversation on January 6th at noon by registering here

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

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