Facebook-f Linkedin
Client Portal

Remote Support in Maryland: Every Service It Fits, and How It Is Paid

Any Maryland provider agency can get Vista Enterprise™, with VistaLink™ and Vista’s team behind it, and like an EHR or payroll system, it needs no state approval. Billing is separate. Maryland’s Developmental Disabilities Administration lists Remote Support Services in the Community Pathways Waiver, based on each person’s assessed need. Your own trained staff respond and decide.

Can any Maryland agency buy a remote support solution?

Yes. Any Maryland provider or agency can get Vista Enterprise™, which includes VistaLink™ and Vista’s team behind the agency. Like an EHR or payroll system, getting it does not need approval from the Maryland Department of Health (MDH), the Developmental Disabilities Administration (DDA), or anyone else.

Billing Medicaid for Remote Support Services is a separate question. It follows the DDA’s waiver rules, your agency’s licensing or certification, and each person’s Person-Centered Plan (PCP).

Where does remote support fit in Maryland?

Setting or programHow technology is usually paidWhat to know
DDA Community Pathways WaiverRemote Support Services, per person, plus technology and monthly fees through AT and ServicesDDA authorization and consent from everyone in the home
Community First Choice and the Home and Community-Based Options Waiver (older adults and people with disabilities)Personal emergency response systems and technology that substitutes for human help, preauthorized in the planNo remote support staffing service
ICF/IIDThe facility’s own costFederal staffing floor stays; quality and privacy use
Nursing homes and assisted livingThe facility’s own costPrivacy and fall prevention
Home care (residential service agencies)The agency’s own cost, or the person’s program where it appliesFills the gaps between visits
Any agency, any settingAgency gets Vista Enterprise™, with Vista’s team behind itNo approval needed to buy

What are Maryland’s waiver rules for remote support?

The DDA runs one Medicaid waiver for people with developmental disabilities: the Community Pathways Waiver (CPW). In October 2025, Maryland folded its Family Supports and Community Supports waivers into CPW, so CPW now covers everyone the DDA serves through a waiver.

Remote Support Services is a CPW service. According to the DDA, it:

  • Supports the person’s independence and can reduce the amount of in-person staff a person needs.
  • Includes off-site system monitoring staff and stand-by supports to notify police, fire and backup support staff as needed.
  • Is based on assessed need and the technology that may work best for the person.
  • Covers more than devices: installation, repair and maintenance, a backup system, and training and technical assistance for the person and their team.
  • Can be self-directed under Budget Authority.

Since October 2025, the service must give the person control over the equipment, including the ability to turn off the remote monitoring device/equipment, unless a Behavioral Support Plan or Nursing Care Plan says otherwise.

Maryland is also a Technology First state. The Governor proclaimed it on August 15, 2022, and the DDA set up a task force so technology is considered in every person’s plan.

What has to happen before remote support starts in Maryland?

The CMS-approved Community Pathways Waiver amendment, MD.0023.R08.06, effective October 6, 2025 (DDA copy of the approved waiver, checked Oct 25, 2026), sets these steps:

  1. A preliminary assessment. The person’s team considers their goals, support needs, health, benefits, risks, and the other people who live in the home, and documents it in the PCP.
  2. Adults only, with DDA authorization. The service is for people 18 and older and must be authorized by the DDA.
  3. Informed consent from everyone in the home. Each person living in the home, and their legal guardians, learn the benefits and risks, how to control the equipment, and that they can turn off the remote monitoring device/equipment. Consent is obtained from each of them.
  4. Placement that respects privacy. Cameras and sensors are typically located in common areas. Other areas of the home are considered based on assessed need, privacy and rights considerations, and informed consent. A person living alone may choose more.
  5. Set hours if the person wants them. Use can be limited to certain hours in the PCP.

Families and people supported can ask their Coordinator of Community Services (CCS) whether Remote Support Services is right for them.

Who can deliver and bill Remote Support Services in Maryland?

According to the DDA, Remote Support Services must be provided by a licensed or DDA-certified provider. Under self-direction, it is available through Budget Authority, but it cannot be provided by vendors, the person’s own employees, relatives, legally responsible persons or legal guardians.

The approved waiver also expects the provider to have written policies, approved by the DDA, on privacy, information security and privacy law, and to have the system preauthorized by the DDA.

How does Maryland pay for remote support?

Maryland has several paths, and they work together.

1. Remote Support Services in the person’s plan. A licensed or DDA-certified provider delivers and bills Remote Support Services under CPW, based on the person’s assessed need and DDA authorization. The DDA expects the service to be delivered in a cost-neutral way compared with in-person direct support, with time limited direct supports from the existing services available during transition to remote monitoring.

2. Technology for the person. CPW’s AT and Services covers a technology assessment, help choosing and using technology, and, since October 2025, monthly service fees. Environmental Modifications can now cover attached smart home devices. Personal emergency response systems moved to Maryland’s Community First Choice program in October 2025.

3. Your agency gets Vista Enterprise™, with Vista’s team behind it. Any agency can get Vista Enterprise™ as its own remote support solution, paid from its own budget, whether or not it bills Remote Support Services.

4. Alongside residential services. Remote Support Services is not available to people receiving Community Living-Enhanced Supports or Shared Living. As with any use of the service, the system must be preauthorized by the DDA and delivered in a cost-neutral way.

What about older adults and people with physical disabilities in Maryland?

Remote support is not only for disability services. Maryland’s Medicaid program runs Community First Choice (CFC), and people in the Home and Community-Based Options Waiver can also receive CFC services. CFC covers two kinds of technology:

  • Personal emergency response systems, including installation and monthly costs. Since October 6, 2025, the DDA waiver no longer covers them under AT and Services; the DDA’s October 2025 waiver guide (checked Oct 25, 2026) says they are covered by CFC, and the person’s coordinator helps with the CFC application or finds other ways to pay.
  • Items or services that substitute for human assistance, such as environmental controls and other technology, when they increase the person’s independence and replace help that would otherwise be paid for. Each item must be preauthorized in the person’s plan of service.

These programs do not include a remote support staffing service. Agencies that serve CFC and waiver participants, including home care and assisted living providers, can still get Vista Enterprise™ for their own staff, with Vista’s team behind them.

What if our staffing stays the same, as in an ICF or a fully staffed group home?

Many Maryland agencies keep every in-person shift and still use remote support, because technology raises quality even with full staff.

It holds in every setting, since even a fully staffed overnight shift cannot be in every room at once, stay fully alert through every hour of the night, or carry every detail from one shift to the next, and when nothing answers those human limits, they quietly become limits on the outcomes people supported can reach.

That is a limit of people, not a failing of staff.

Enabling technology for human services fills those gaps without replacing anyone, giving trained people better information and more of their time for the moments that need a person in the room.

  • Fewer night bed checks that wake people up. For people who do not need repositioning, in-person checks through the night interrupt sleep and privacy. Staff go in when it matters, because VistaLink™ lets overnight staff know when something needs a person.
  • Closing gaps in data. A steady record across shifts, so handoffs rest on more than memory.
  • Closing gaps in judgment. Even with staff in the building, a change can be easy to miss or hard to read in the middle of the night. A clear record helps staff make the call.

Know the limits.

  • Federal ICF rules set the staffing floor. In an intermediate care facility for individuals with intellectual disabilities (ICF/IID), federal rules require a responsible direct care staff person on duty around the clock when people are present, awake in some living units, plus minimum direct care staff ratios. Remote support adds to on-site staff; it does not replace them.
  • Privacy comes first. Federal rules require ICFs to give each person the opportunity for personal privacy. Federal survey guidance limits cameras and audio in ICFs to common areas, never bedrooms or bathrooms, and says they cannot be used in place of staff. Non-wearable sensors in the home fit that approach.
  • The facility pays. An ICF/IID is paid as a facility, not through a person’s waiver plan, so an ICF that uses Vista Enterprise™ pays for it as its own operating cost.
  • In Maryland, ICF/IID programs are licensed under COMAR 10.07.20. Remote Support Services is a DDA waiver service, so an ICF does not bill it.
  • Group homes and privacy. Federal home and community-based settings rules give each person privacy in their sleeping or living unit. In shared homes, the DDA expects equipment mostly in shared areas and consent from everyone who lives there.

Can nursing homes and assisted living in Maryland use remote support?

Yes. Nursing homes and assisted living communities get Vista Enterprise™ the same way any agency does, with Vista’s team behind them, and their own staff respond and decide.

  • Nursing homes. Federal rules give each resident a right to personal privacy and require the facility to provide adequate supervision and devices to prevent accidents. Technology that helps staff see who needs them, without waking everyone, supports both goals. Nursing homes are paid as facilities, so Vista Enterprise™ is the facility’s own purchase. In-person staffing rules do not change.
  • Assisted living. Assisted living residents live in their own units, with their own rights to privacy and choice. Technology placed with each resident’s consent gives staff better information between scheduled visits.
  • In Maryland, nursing homes are licensed under COMAR 10.07.02, and assisted living programs under COMAR 10.07.14, which was revised effective April 28, 2025. The Home and Community-Based Options Waiver also covers assisted living services under COMAR 10.09.54.13 (both checked Oct 25, 2026).

How does remote support help home care agencies in Maryland?

Home care agencies send aides into people’s homes for set hours. Between visits, no one is there. Remote support fills that gap: the person keeps their privacy, and the agency’s trained staff can see when something needs attention and decide who should go.

  • Better visits. Aides arrive knowing how the night went.
  • Earlier warning. Changes in routine show up before they become a crisis.
  • Support for family caregivers, who can rest knowing someone trained will respond.
  • In Maryland, most home care agencies are licensed as residential service agencies under COMAR 10.07.05. For participants in Community First Choice, the agency can also look at whether a personal emergency response system or technology that substitutes for human help belongs in the plan.

Who else can remote support help in Maryland?

Remote support is enabling technology for human services as a whole, and it works for people with intellectual and developmental disabilities (IDD), older adults, people with physical disabilities, people recovering from an illness or injury, and the staff and families who support them.

Why does remote support fit in Maryland?

  • Technology First by proclamation, with a DDA task force so technology is considered in every plan.
  • One waiver for everyone the DDA serves, so Remote Support Services is open to more people than before.
  • Choice and control in the rules, including the person’s right to turn the equipment off.
  • Funding for the whole picture: the service itself, technology and monthly fees for the person, and smart home changes.

How does VistaLink™ fit Maryland’s rules?

VistaLink™ uses non-wearable sensors and a display in the home to send events to your agency’s own trained remote support staff, and it never acts alone.

Your agency stays the provider. It confirms that its full setup meets Maryland’s rules for the service it bills, or for its license if it bills nothing. Vista runs implementation and staff onboarding with your team. For DDA Remote Support Services, that includes any DDA preauthorization and written policies the DDA requires.

For states and government agencies

Vista can also work directly with Maryland’s Developmental Disabilities Administration (DDA), and with other state and government agencies, for example through a procurement, a contract or a state-mandated program. A state can adopt Vista Enterprise™ as its statewide remote support solution, with one solution across providers and Vista’s team behind every agency, while any single agency can already get it with no state approval.

Remote support for states and government agencies

What does remote support look like for a Maryland agency? (composite example)

This is a composite example built from common situations. It is not a real person.

A young man who shares an apartment with a roommate wants his nights to himself, without staff in the apartment overnight. His team completes a preliminary assessment, he and his roommate both give informed consent, and sensors go in the shared hallway and kitchen. He knows how to turn the system off. Overnight, the agency’s remote support staff handle events and call the on-call staff member when his plan says to.

Questions and answers

Can any Maryland agency buy a remote support solution?

Yes. Any Maryland provider or agency can get Vista Enterprise™, which includes VistaLink™ and Vista’s team behind the agency. Like an EHR, it needs no MDH or DDA approval. Billing Remote Support Services is separate and follows DDA rules.

Which Maryland waiver covers Remote Support Services?

The Community Pathways Waiver, run by the DDA. Since October 2025, the Family Supports and Community Supports waivers are part of Community Pathways.

Who can provide Remote Support Services in Maryland?

A licensed or DDA-certified provider. Under self-direction it is available through Budget Authority, but it cannot be provided by vendors, the person’s employees, relatives, legally responsible persons or legal guardians.

Can a person turn off remote support equipment in Maryland?

Yes. Since October 2025, the service must give the person control over the equipment, including the ability to turn off the remote monitoring device/equipment, unless a Behavioral Support Plan or Nursing Care Plan says otherwise.

Does Maryland pay monthly technology fees?

Since October 2025, CPW’s AT and Services covers monthly service fees, and Environmental Modifications can cover attached smart home devices. Personal emergency response systems moved to Community First Choice.

Can remote support be used in Maryland Shared Living?

No. Remote Support Services is not available to people receiving Shared Living or Community Living-Enhanced Supports.

Can a Maryland ICF, nursing home or assisted living program use remote support?

Yes, as its own tool alongside on-site staff. Federal staffing rules still apply in full, an ICF does not bill the waiver service, and the facility pays for Vista Enterprise™ as its own cost.

Is remote support in Maryland only for disability services?

No. It fits any human service where staff cannot be everywhere at once: disability services, older adults through Community First Choice, assisted living, nursing homes and home care.

How does a family ask about remote support in Maryland?

Talk with the person’s Coordinator of Community Services (CCS). The team decides together whether Remote Support Services fits the person’s needs and plan.

Book a demo

See how your Maryland agency could run its own remote support with Vista Enterprise™ and VistaLink™.

See how Vista Enterprise™ is priced for agencies: Vista Enterprise™ pricing.

Book a demo

Related pages