Medical Day Care Services from Maryland Medicaid

Waiver Description

Medical day care combines social activities and health-related support. Maryland Medicaid operates Medical Day Care Services both for individuals participating in Home and Community Based Services and for persons enrolled in the traditional Medicaid state plan. Under the program, licensed daycare centers provide daytime supervision and care to help several thousand functionally disabled adults and seniors in Maryland. 

It may be referred to as simply Medical Day Care or by the acronyms MDCS and MDC. The program is under the administration of Maryland’s Developmental Disabilities Administration (DDA), which operates under the direction of the Department of Health and Mental Hygiene.

What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services outside of the nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of the care outside of a nursing home needs to be less than the cost of care in a nursing home.

 

Eligibility Guidelines

The Medical Day Care Waiver serves adults ages 16 and over; there is no age maximum. To qualify, an individual must be a Maryland resident who is functionally disabled and financially eligible for Medicaid.

Applicants already enrolled in a similar waiver, such as Community Pathways or  Community Options (formerly Older Adults) automatically qualify for the program.

Disability Requirements: Applicants must be under the care of a physician, be frail elderly, disabled or chronically ill and must require hands-on assistance with at least one activity of daily living.  They must be at-risk of placement in a nursing home if care cannot be delivered to the home. In other words, applicants must have a demonstrated need for an institutional level of care to enroll in MPAC.

Financial Requirements: Applicants must be Categorically Needy for this program which means that they must have income below the Supplemental Security Income level.  In 2017, this means his/her monthly income cannot exceed $755. All income streams in the applicant’s name are counted for this limitation, even if there are received annually or quarterly.

Maryland also allows individuals to qualify, if their income is below $350 per month after deducting all the unreimbursed medical expenses. This is called the Medically Needy pathway to enrollment.

In terms of assets, excluding the value of the home and other personal items, Maryland allows individuals to retain countable assets valued up to $2,500, slightly higher than in most states. 

Persons uncertain about their financial eligibility should contact a planning professional before making an application to Medicaid.

 

 

Benefits and Services

The Medical Day Care Services Waiver Program offers many types of services from nursing and nutrition work to rehabilitation therapy and other health services that require medical supervision. 

While not specifically stated as a benefit, the program also relieves a primary caregiver by offering daytime respite for caregiving responsibilities.  Personal care and supervision are, of course, provided during the time in which the individual is present at the Medical Day Care center.

How to Apply / Learn More

The program has a limited number of spaces available to applicants who qualify. In 2016, Maryland increased the available slots to approximately 6,000 with corresponding increases. Space is limited.

Non-Medicaid Applicants
To apply to receive Medical Day Care Services, interested parties can begin the process by contacting their representative of AERS (Adult Evaluation and Review Services) operated by local health departments. More information about AERS in Maryland.

Current Medicaid Beneficiaries 
If an individual is already enrolled in either the Living At Home Waiver, the Older Adults Waiver, Traumatic Brain Injury Waiver, or the Model Waiver, the state directs inquiries to the individual’s case manager.

If an individual is enrolled under the New Directions Waiver or Community Pathways, officials recommend contacting the individual’s service coordinator.

Some limited additional information about the program is available here.