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*hb1593*
HOUSE BILL 1593
J1, O3 6lr3666
CF SB 583
By: Delegate Guyton Delegates Guyton, Alston, Bagnall , Cullison, Guzzone, Hill,
Hutchinson, S. Johnson, Kaufman, Kipke, Lopez, Martinez, M. Morgan,
Reilly, Rosenberg, Ross, Taveras, White Holland, and Woorman
Introduced and read first time: February 15, 2026
Assigned to: Rules and Executive Nominations
Re–referred to: Health, February 26, 2026
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 9, 2026
CHAPTER ______
AN ACT concerning 1
Developmental Disabilities Administration – Self–Directed Services Manual – 2
Public Comment 3
Community Pathways Waiver – Adoption of Regulations 4
FOR the purpose of requiring the Deputy Secretary for Developmental Disabilities to 5
provide notice to the public before making changes to the Self –Directed Services 6
Manual; requiring the Deputy Secretary to receive and consider comments on the 7
proposed changes from the public for at least a certain period; prohibiting the Deputy 8
Secretary from adopting the proposed changes until the public comment period has 9
ended; and generally relating to the Self–Directed Services Manual the Secretary of 10
Health to adopt regulations governing the Community Pathways Waiver, including 11
regulations pertaining to the delivery of self–directed services; and generally relating 12
to the Community Pathways Waiver. 13
BY repealing and reenacting, without amendments, 14
Article – Health – General 15
Section 7–101(a), (b), (f), and (w), and (x) 16
Annotated Code of Maryland 17
(2023 Replacement Volume and 2025 Supplement) 18
BY adding to 19
Article – Health – General 20
2 HOUSE BILL 1593
Section 7–409.1 1
Annotated Code of Maryland 2
(2023 Replacement Volume and 2025 Supplement) 3
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 4
That the Laws of Maryland read as follows: 5
Article – Health – General 6
7–101. 7
(a) In this title the following words have the meanings indicated. 8
(b) “Administration” means the Developmental Disabilities Administration. 9
(f) “Deputy Secretary” means the Deputy Secretary for Developmental 10
Disabilities. 11
(w) (1) “Self–directed services” means waiver program services: 12
(i) For which participants or their representatives have 13
decision–making authority over and take direct responsibility for management of the 14
services with the assistance of available supports chosen by the participant or the 15
participant’s representative; and 16
(ii) That are provided in a manner that: 17
1. Furthers the right of individuals and their 18
representatives, as applicable, to make choices about and direct all aspects of their lives, 19
including by choosing and controlling the delivery of waiver services, who provides the 20
services, and how services are provided; and 21
2. Recognizes that all individuals have the capacity to make 22
choices and may be supported in making choices. 23
(2) “Self–directed services” includes services that: 24
(i) Provide an individual with: 25
1. The decision–making employer authority to recruit, hire, 26
train, supervise, and dismiss the employees and vendors who furnish the individual’s 27
services; and 28
2. The budget authority over how funds in a budget are spent 29
within the total approved annual budget; 30
HOUSE BILL 1593 3
(ii) Maximize the opportunities of an individual to live as 1
independently as possible in the most inclusive community –based setting of the 2
individual’s choice; 3
(iii) Empower an individual to exercise c hoice and control over 4
needed long–term services and supports; and 5
(iv) Help to maintain and improve the individual’s health and quality 6
of life in the individual’s community. 7
(x) “Services” means residential, day, or other services that provide for 8
evaluation, diagnosis, treatment, care, supervision, assistance, or attention to individuals 9
with developmental disability and that promote habilitation of these individuals. 10
7–409.1. 11
(A) THE DEPUTY SECRETARY SHALL PROVI DE NOTICE TO THE PUB LIC 12
BEFORE MAKING CHANGES TO TH E SELF–DIRECTED SERVICES MANUAL 13
DEVELOPED BY THE ADMINISTRATION. 14
(B) IF THE DEPUTY SECRETARY PROPOSES TO MAKE CHANGES TO THE 15
SELF–DIRECTED SERVICES MANUAL, THE DEPUTY SECRETARY SHALL RECEI VE 16
AND CONSIDER COMMENTS ON THE PROPOSED CH ANGES FROM THE PUBLIC F OR A 17
PERIOD OF AT LEAST 90 DAYS AFTER THE DATE NOTICE IS PROVIDED TO THE PUBLIC 18
UNDER SUBSECTION (A) OF THIS SECTION. 19
(C) THE DEPUTY SECRETARY MAY NOT ADO PT THE PROPOSED CHAN GES 20
UNTIL AFTER THE PUBLIC COMMENT PERIOD REQUIRED UNDER SUBSECTION (B) OF 21
THIS SECTION HAS END ED. THE SECRETARY SHALL ADOPT REGULATIONS 22
GOVERNING THE COMMUNITY PATHWAYS WAIVER, INCLUDING REGULATION S 23
PERTAINING TO THE DELIVERY OF SELF–DIRECTED SERVICES. 24
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall ta ke effect 25
October 1, 2026. 26
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.