The recent revisions to the Developmental Disabilities Administration (DDA) Manual—implemented in November 2024—are sending shockwaves through Maryland’s self-directed care community. Following the bait-and-switch tactics on funding we exposed earlier in Maryland’s Bait-and-Switch on Disability Funding: Don’t Be Fooled, it now appears that drastic cost-saving measures are not limited to short-term budget gimmicks but extend to the very core of service delivery: the wages and working conditions of self-directed services (SDS) staff, particularly the Direct Support Professionals (DSPs) who deliver daily care.
A Cost-Cutting Playbook That Endangers Quality of Care
Under the Moore-Miller administration’s agenda, the latest changes to the DDA Manual threaten to reduce wages for DSPs as part of a broader cost-saving strategy. These DSPs are not unskilled, minimum-wage workers; they are highly trained professionals essential to maintaining the quality and continuity of care for individuals with developmental disabilities.
A recent letter from a respected law firm on behalf of the Self-Directed Advocacy Network of Maryland (SDAN) laid bare the risks inherent in these measures. The letter detailed how reducing wages and curbing cost-of-living adjustments (COLAs) could lead to:
Catastrophic Staff Loss: If wages are cut below the dollar amounts noted below, there will be a sudden, severe exodus of experienced and skilled caregivers, undermining service continuity for thousands of Marylanders with developmental disabilities.
Threats to Health and Safety: With fewer resources to recruit and retain well-trained staff, the safety and well-being of individuals relying on these services are at risk.
Increased Operational Costs: Short-term savings may lead to higher long-term expenses through increased turnover, repeated training, and diminished care quality.
What Do These Wage Cuts Mean in Real Terms?
For many DSPs, a “living wage” isn’t just a number—it’s the baseline required to cover housing, food, transportation, healthcare, and other essentials. According to the MIT Living Wage Calculator for a family of one adult with two children, the estimated hourly living wages in Maryland’s most populous jurisdictions are approximately:
Montgomery County: $32.00 per hour
Howard County: $31.00 per hour
Baltimore County: $30.00 per hour
Baltimore City: $30.00 per hour
Prince George’s County: $30.50 per hour
Frederick County: $29.00 per hour
Assuming full-time work at 40 hours per week (2,080 hours per year), these rates translate into annual incomes of roughly:
Montgomery County: $66,560 per year
Howard County: $64,480 per year
Baltimore County: $62,400 per year
Baltimore City: $62,400 per year
Prince George’s County: $63,440 per year
Frederick County: $60,320 per year
These figures starkly illustrate that DSPs require wages significantly above current baselines to meet the true cost of living for a family. Failure to maintain these levels means risking not only financial insecurity for caregivers but also a catastrophic loss of the skilled workforce essential for quality, self-directed care.
The Real Faces Behind the Numbers
It is crucial to recognize that a significant portion of the caregiving staff are immigrant mothers of color — many of whom are raising one to two children while working these demanding jobs. These women are not only the backbone of self-directed care—they are also striving to support their own families under challenging economic circumstances. The undervaluation of their labor, combined with Maryland’s high cost of living, underscores the profound injustice of any wage cuts. Such reductions directly threaten their ability to provide for their children and themselves while continuing to deliver essential, round-the-clock care.
Comparing Workloads: DSPs vs. State Legislators
In stark contrast, Maryland state legislators have historically earned modest salaries relative to the intensive, full-year work of DSPs. For example, between 2010 and 2014, the base annual salary for a legislator was $43,500—with the Senate President and House Speaker earning $56,500 in 2010. Following recommended increases, from 2015 through 2018, legislator salaries rose incrementally—from $45,207 to $50,330 for general legislators, and from $58,718 to $65,371 for the Senate President and House Speaker. For the period 2019 through 2023, salaries have remained at these 2018 levels, as detailed in the Maryland Manual: General Assembly Compensation
Importantly, these legislative salaries are awarded for a very stressful and demanding yet still part-time role: Maryland’s legislators are in session full time for only about three months each year, with the remaining nine months involving much lighter (yet still significant) duties. Meanwhile, DSPs and caregivers work 12 months a year. Their roles extend far beyond a short legislative session, encompassing round-the-clock care that is both physically and emotionally taxing. DSPs routinely handle:
Complex Health Challenges: Managing conditions such as severe allergies, seizures, and communication impairments.
Essential Daily Support: Providing assistance with mobility, transportation, meal preparation, personal hygiene (including showering and grooming), and household tasks.
Emotional and Crisis Management: Addressing emergencies and unexpected changes in a client’s health or behavior without backup.
This continuous, intensive workload—often under significant personal risk and with limited support—demonstrates that the value of DSPs far exceeds that of any part-time public service role. While legislators face extraordinary pressure during their short sessions, caregivers, including many immigrant mothers of color, shoulder unrelenting demands every day of the year.
A Manual Without a Public Mandate
The changes in the DDA Manual were introduced without the proper stakeholder engagement mandated by Maryland’s Administrative Procedure Act. Instead of a collaborative review, these revisions—ranging from budget allocation inflexibility to unauthorized restrictions on DSPs’ employer authority—were pushed through with little to no public input. The result is a policy document that not only contravenes the spirit of the Self-Direction Act of 2022 but also places participants and their support teams in a precarious position.
Key issues outlined in the letter include:
Unilateral Policy Shifts: The DDA abandoned established practices, such as objective criteria for personal supports enhanced (PSE), replacing them with opaque, subjective measures.
Erosion of Participant Autonomy: By limiting the ability to adjust budgets or set competitive wages, the revisions strip away the fundamental principle of self-directed care: the participant’s right to control their own services.
Lack of Transparency: Participants are now left in the dark about critical changes affecting their Long Term Services and Supports (LTSS) plans, undermining trust in an already strained system.
The Human Toll of Cost-Saving Measures
Behind every policy revision are real people facing real consequences. The threatened wage cuts are not merely a fiscal maneuver; they represent a direct assault on the dignity and quality of life for those who depend on self-directed care. Families and caregivers are already feeling the impact—when a program director recently broke down on the phone while explaining to a client that services would soon be curtailed, it underscored that these are not abstract numbers on a budget, but lifelines for vulnerable citizens.
The administration’s approach—favoring short-term cost savings over comprehensive, participant-driven solutions—reflects a dangerous prioritization of political expediency over long-term care quality. With the looming risk of losing skilled DSPs, the very infrastructure of community-based care is at stake.
A Call for Accountability and Immediate Action
It is time for the DDA to reverse course. The agency must:
Engage Stakeholders: Reinstate a transparent, collaborative process that involves all affected parties—participants, DSPs, and advocacy groups—in policy revisions.
Reaffirm Participant Rights: Restore full budgetary and employer authority to participants, ensuring that wage decisions reflect both market realities and the high cost of living in Maryland.
Maintain the Current Wage Structure: Under no circumstances should the DDA consider any modifications to the established wage structure for DSPs.
Clarify and Retract Harmful Policies: Provide clear, objective criteria for service determinations and eliminate any practices that resemble unauthorized competency assessments.
Despite repeated attempts to engage the DDA—most notably through the detailed letter from SDAN’s legal team—the agency has yet to respond. This silence, in the face of clear evidence of harm, is unacceptable and must be met with immediate accountability from state leadership.
Conclusion
Maryland’s self-directed care model is under assault. The DDA’s unilateral revisions to the November 2024 Manual, coupled with threatened wage cuts for SDS staff, are not just bureaucratic missteps; they are a direct threat to the autonomy, dignity, and quality of life for Marylanders with developmental disabilities. As we continue to hold the Moore-Miller administration accountable, the disabilities community and its advocates stand united in demanding fair treatment, transparent governance, and, above all, the preservation of a system designed to empower its most vulnerable citizens.
We can do better, Maryland. Contact your state legislators and ask them to protect Maryland’s most vulnerable citizens from the Moore-Miller administration’s money grab tactics.