Left Directionless: State policies for those directing their own disability care are hindering people's independence

Sam Silverman, a 23-year-old man who is autistic and has two chromosome disorders, hires support staffers to help him every day in his apartment in Frederick using funds the state has allocated to him. The life that Sam’s built for himself is made possible through self-directed services. In November, the Maryland Developmental Disabilities Administration (DDA) officially implemented some policy changes for self-directed services, codifying the processes and challenges participants were facing for months beforehand, advocates said. Now, the governor’s office is proposing millions in cuts to the DDA for fiscal year 2026 — including cuts to some valuable disability care services. This is part 1 of a 2-part series about the challenges of navigating self-directed services, a disability care model.