AT Funding Guide

What's Covered

• Communication and AAC devices
• Speech-generating devices (separate SLP assessment path)
• Visual and hearing support devices
• Environmental controls (voice-activated lights, alarms)
• Computer applications and adaptive equipment
• Adapted toys and recreation devices
• Weighted utensils and daily living aids
• Video magnifiers and telephone access devices

One-time AT costs were excluded from the former Family Supports annual individual cost limit, meaning AT had effective priority in budget calculations.

How to Get AT Through This Waiver

1. 1

   Work with your Coordinator of Community Services (CCS)

   Your CCS guides the process, helps determine what's needed, and coordinates with providers. You must have a CCS to access DDA services.

2. 2

   Determine if an AT assessment is required

   Items under $1,000: no AT Professional assessment required (but one can be requested). Items $1,000 and above: an AT Professional assessment IS required before acquisition.

3. 3

   Get the assessment (if needed)

   An AT Professional evaluates needs and produces a list of all recommended devices, supplies, software, and equipment. For speech-generating devices, an SLP handles the assessment instead. AT assessments are a separately billable waiver service.

4. 4

   Get 3 estimates

   Before purchase, submit 3 vendor estimates to DDA for review. This is required to ensure reasonable pricing.

5. 5

   Document in the Person-Centered Plan

   The CCS ensures the AT is documented in your Person-Centered Plan with justification for how it maintains or improves functional abilities.

6. 6

   DDA authorizes and provider delivers

   Once approved, the AT is procured through a licensed or DDA-Certified Provider. Under self-direction, you can direct the purchase through your FMCS provider.

What's Happening

Maryland's DDA budget grew from approximately $1 billion to over $3 billion in five years. The state now faces cost-neutrality pressure, operating 18% below the federal threshold, with $1.7 billion in federal support at risk if that threshold is exceeded.

FY2027 cuts of $126M in state funds trigger loss of matching federal Medicaid dollars, creating an effective ~$252M reduction. Geographic differential rates are being capped at 10% above rest-of-state rates, affecting providers in the Baltimore-DC corridor.

How This Affects AT

• No AT-specific carve-outs from cuts. AT competes with all other services
• Reduced funding may slow authorization approvals
• Provider capacity may shrink as reimbursement rates tighten
• Waitlist times may increase

Device Lending Library

Borrow from over 500 AT devices for a 1–4 week trial period. Available by appointment. Inventory includes screen readers, AAC devices, magnifiers, Braille displays, adaptive keyboards and mice, and environmental controls.

AT Reuse Center

Free refurbished and gently-used equipment including wheelchairs, walkers, hearing aids, and communication devices. Priority is income-based. A critical resource during budget cuts.

Low-Interest Loan Program

Apply at onestop.md.gov or email a fillable PDF to mdtap.atloan@maryland.gov. Credit requirements are less stringent than traditional lenders.

3D Printing Lab / Makerspace

MDTAP operates an on-site fabrication lab that can create custom AT solutions, including prosthetic grips, switch adapters, and other custom devices through 3D printing. Funded through a 2026 TEDCO Makerspace Initiative grant.

What DORS Funds

• Hand controls for vehicles
• Ramps and stair glides
• Alternative keyboards and mice
• Screen magnification and screen readers
• AAC devices for workplace communication
• Cognitive aids (task reminder apps, prompting systems)
• Voice recognition software
• Noise-canceling headphones
• Ergonomic and specialized work equipment

How to Access

1. 1

   Apply to DORS

   Contact your local DORS office. You need a documented disability that impedes employment.

2. 2

   Eligibility determination

   DORS confirms your disability and that you can benefit from VR services. People with IDD qualify. Cognitive disabilities are the largest group DORS serves.

3. 3

   Vocational assessment identifies AT needs

   May include evaluation by a rehab engineer or AT specialist, and a trial period with specific devices.

4. 4

   AT included in your IPE

   Your Individualized Plan for Employment specifies the AT, tied directly to your employment goal.

5. 5

   DORS funds the AT

   DORS procures the technology directly. Must be related to getting, keeping, or advancing in a job.

What's Covered

• Wheelchairs (manual and power)
• Hospital beds and patient lifts
• Walkers, canes, and crutches
• Oxygen equipment and CPAP machines
• Prosthetics and orthotics
• Hearing aids (primarily children under 21)

What's NOT Covered

• Most home modifications
• Non-medical AT (iPads for communication unless deemed medically necessary)
• Environmental controls and smart home devices

Prior Authorization

Most DME requires prepayment authorization. Prosthetics/orthotics over $1,000 and medical supplies over $500 must be pre-approved. Submit: prescription from a Medicaid-enrolled provider, medical justification, and proof of medical necessity. Decisions typically take 5–14 days.

Your Rights

Under IDEA, IEP teams must consider assistive technology for every student with a disability. If the team determines AT is needed for FAPE, the school district provides it at no cost to parents.

County AT Programs with Lending Libraries

How It Works

Maryland's Self-Directed Services model gives you two authorities:

• Budget Authority: Control how your authorized funds are spent, including directing purchases toward AT
• Employer Authority: Hire and manage your own support staff

You work with your CCS and a required Financial Management and Counseling Services (FMCS) provider. AT must be provided by licensed or DDA-Certified Providers, not vendors, employees, relatives, or guardians. Rates must be “reasonable and customary” per DDA standards.

Kennedy Krieger AT Clinic (MCDD)

Maryland's federally funded UCEDD offers comprehensive AT evaluations for AAC, power mobility, computer/phone access, and environmental controls. SLP and OT team serves children and adults.

The Arc Baltimore: AT Program

Offers AT assessments ($250), configuration and training ($75/hr), and device demonstrations across 10 categories including communication, computer access, eating, environmental control, hearing, home safety, memory/cognition, phone, recreation, and vision.

Contact: Kelly Bell, kbell@thearcbaltimore.org

The Arc Prince George's County: MD AT Co-op

Trainings and discounted AT purchasing through the Maryland AT Co-op at matcoop.org.

Advocacy & Legal