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Maryland Developmental Disabilities Administration (DDA)
Low Intensity Support Services (LISS) Program
Applicant and Family Guide
Fiscal Year 2023
Information in this guide is subject to change at the discretion of the Developmental Disabilities
Administration (DDA) to ensure the provision of quality service. This guide does not represent a guarantee or
commitment of funding.
Page 2 of 33
TABLE OF CONTENTS
WELCOME...............................................................................................................................3-4
PART 1: COVERSHEET: LISS PROGRAM………………………………………………5
a) APPLICANT ELIGIBILITY (page 6-7)
b) RANDOM SELECTION and APPLICATION (page 8-9)
LISS PROGRAM CONTRACTORS…………………………………………………………10
PART 2: COVERSHEET: CONSIDERATION FOR PROGRAM FUNDING………….11
a) SELECTION NOTIFICATION (page 12)
b) SELECTION APPLICATION PACKET CHECKLIST (page 12)
I. Proof of Identity including Parent’s ID if applicable (page 13)
II. Proof of Residency (page 13)
III. Proof of Developmental Disability and/or Intellectual Disability (page 14)
IV. Proof of Attestation Form (page 14)
V. Services Eligibility Application (page 15-16)
VI. Invoices, Receipts for Services or Online Printouts
VII. Insurance Information: Coverage or Non-coverage including Co-pay, (If applicable)
VIII. Professional Letter of Recommendation (If applicable)
IX. W-9 Form from company/independent contractor (If applicable)
c) SERVICES ELIGIBILITY APPLICATION (page 15-16)
d) LISS SERVICES, SUPPORTS OR ITEMS FOR PURCHASE and REQUIRED DOCS (page 16-28)
➢ Adapted Items Category
1) Aids for daily living and/or Devices
2) Specialized Equipment
3) Clothing/Shoes
➢ Assistive Technology Category
➢ Caregiving Services Category
1) Attendant Care+
2) Childcare
3) Respite (In-home and Agency)
➢ Educational Services Category
1) Training and Support
2) Tuition
3) Tutoring
4) Items for Learning
➢ Home Modification/Barrier Removal Category
➢ Identification Services Category
➢ Recreational Services Category
1) Camp
2) Community Integration (Non-Therapeutic) Services
➢ Transportation Category
➢ Wellness: Physical and Mental Health Services or Items Category
1) Behavior Support Services
2) Medical/Dental Health Services or Items
3) Therapeutic Services
INELIGIBLE SERVICES AND ITEMS……………………………………………………28
ADDITIONAL FUNDING OPTION: REIMBURSEMENT……………………………....29
CANCELLATIONS and RETURNS PROCESS …………………………………………..30
MD DDA REGIONAL OFFICES…………………………………………………………...31
GLOSSARY…………………………………………………………………………………..32-33
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WELCOME
The Developmental Disabilities Administration (DDA) thanks you for your interest in its Low Intensity
Support Services (LISS) Program. The DDA is committed to supporting children, adults with
developmental and/or intellectual disabilities and their families. The mission of the DDA is to create a
flexible, person-centered, family-oriented system of support for children and adults to have a full, happy,
healthy, life while being integrated into their communities across their lifespan.
The DDA’s LISS Program serves children living at home with their family and adults with developmental
and /or intellectual disabilities living in their own home in the community, who are not receiving any
supports or services from the DDA.
Below are highlights of what the LISS Program offers:
• It is flexible to meet the needs of children as they grow and adults as they mature across their
lifespan.
• Provides up to $2000 to assist children and adults with purchasing eligible services and/or items
to address their needs.
• Enhances or improves a child or adult’s quality of life, promotes independence and community
integration.
The LISS Program has a two-part application process to apply for possible LISS Program funding. The
first application is the Random Selection, and the second application is the Services Eligibility. Both
applications are required to apply to this program.
Please note: Hard copy Random Selection Applications are longer be accepted. All submissions
must be done online.
To promote equality and access to those with an eligible developmental and/or intellectual disability, the
LISS Program utilizes an automated system called Random Selection. Because funding is limited; the use
of the Random Selection allows all applicants to be considered for possible LISS Program funding. For
reference, the Random Selection process is outlined on page (8-9) of this guide.
The access links to the electronic Random Selection Application are located on the Maryland
Developmental Disabilities Administration’s website in two locations: the DDA web homepage and the
LISS Program home page. This access link will only be available during each Round and will close to the
public after each Round.
Please note: The DDA LISS Program requires that both the Random Selection Application and the
Service Eligibility Application be completed only by the applicant (or their parent, if the applicant is
under 21, or their legal guardian, as applicable).
SEE NEXT PAGE >>>>>>>>
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It is the responsibility of the applicant and/or parent/legal guardian to complete and submit each
application and all required supporting documentation to the LISS Program Contractors. For reference,
both applications are discussed on pages (8-9) and pages (15-16) of this guide. Please see the
“Glossary” section concerning the meaning of “LISS Program Contractors”.
This Applicant and Family Guide is an instructional tool that provides potential and actual applicants with
information they need to complete their application. It is critical that this guide be reviewed in its entirety.
The accessibility of this guide has changed. This guide will not be printed and mailed out to “Selected”
applicants unless there is a special request; instead, this guide will be located on the LISS Provider’s
website and the DDA LISS web home page. Please refer to page (10) “LISS Program Contractors”, to
obtain the website addresses.
For more information about the DDA, please visit dda.health.maryland.gov or contact DDA’s Regional
Office that services the county in which you live. See page (31) for the listing of the DDA regional
offices.
If you have any questions or need assistance in completing forms, please contact the LISS Program
Contractors that service your county. They are happy to assist you!
Page 5 of 33
COVERSHEET
PART 1: LISS PROGRAM
A) APPLICANT ELIGIBILITY
B) RANDOM SELECTION AND APPLICATION INFORMATION
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APPLICANT ELIGIBILITY
Set forth in the Maryland Annotated Code, Health-General Article § 7-717(a) and Code of
Maryland Regulations (COMAR) 10.22.14.05.
Please note: If there is a conflict between this guide and COMAR 10.22.14, COMAR 10.22.14 will
control whether, you, or the item or service you request, are eligible for LISS Program funding.
➢ An applicant may be ELIGIBLE for LISS funding if he or she meets the following criteria:
1. The applicant is a Maryland resident, providing proof of address within the calendar year and
proof of identity.
2. The applicant has an eligible diagnosis by meeting the criteria set forth in 7-717(a) of the
Health-General Article as follows:
A. Is either:
- A child or an adult who is living in the home; or
- An adult who is living in the community; And
B. Has a severe, chronic, disability that:
- Is attributable to a physical or mental impairment, other than the sole diagnosis
of a mental illness, or to a combination of physical and mental impairments.;
and
- Is likely to continue indefinitely.
3. At the time of the Random Selection, the applicant is not enrolled in any Maryland
Medicaid Home and Community-Based Services Waiver program or currently receiving any
services funded by the DDA (except Coordination of Community Services (CCS),
Maryland Medicaid Home and Community Based Waiver programs include but are not
limited to:
a. DDA’s Community Pathways Waiver
b. DDA’s Community Supports Waiver
c. DDA’s Family Supports Waiver
d. Medicaid’s Community Options Waiver
e. Maryland State Department of Education’s Autism Waiver
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APPLICANT ELIGIBILITY
The applicant may be on the DDA’s Waiting List for its Medicaid Waiver programs and ONLY receiving
Coordination of Community Services (CCS). However, an applicant is not required to be on the DDA
Waiting List or to be receiving CCS services.
Please note: This restriction does not apply to applicants enrolled in the Maryland Model Waiver
Program or Medicaid’s Rare & Expensive Case Management (REM) Program at the time of the Random
Selection process.
4. The applicant was selected through Random Selection process.
5. The applicant has submitted a fully, completed, LISS Program application by the due dates
established by the DDA LISS Program.
6. The applicant did not receive LISS Program funding in Round 1 of the Random Selection process in
the same Fiscal Year.
Please note: If an applicant does not meet any of the above criteria, then he or she is not eligible for
LISS Program funding.
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RANDOM SELECTION AND APPLICATION INFORMATION
The LISS Program uses an automated system called the Random Selection to determine which applicants
may receive LISS Program funding provided the applicant meets all applicable eligibility criteria and
requirements to receive funding. Because funding is limited, the use of the Random Selection allows the
DDA to promote equality and access for everyone.
The access link to the electronic Random Selection Application will be located on the Maryland
Developmental Disabilities Administration’s website in two locations: the DDA web homepage and the
LISS Program home page. This access link will only be available during each Round and will close to the
public after each Round.
Please note: Hard copy Random Selection Applications will no longer be accepted. All submissions must
be done online.
For Round 1 and Round 2, applicants and/or parent/legal guardians can only submit ONE electronic
Random Selection Application through the DDA web portal. This submission will then be assigned to the
LISS Program Contractor who covers their county.
Who can complete the Random Selection Application?
(1) If the individual applicant is under the age of 21 (but does not have a court-ordered legal guardian),
then a natural or adoptive parent must complete the application.
(2) If the individual applicant has a court-ordered legal guardian (regardless of the applicant’s age), then
the legal guardian must complete the application; and
(3) If the individual applicant is over the age of 21, does not have a legal guardian, and only requires
physical assistance in completing the application, then a parent, relative, friend, or case manager or
social worker may help under the individual applicant’s direction.
To: Parents/legal guardians:
When submitting a Random Selection Application. Please do not enter your demographic
information (name, address, date of birth, social security etc.) in the Random Selection Application. It
is the child and/or adult’s demographic’s information that must be entered into the application.
To: Applicant: The DDA LISS Program requires that both the Random Selection Application and the
Service Eligibility Application be completed and signed only by the applicant (or their parent, if the
applicant is under 21, or their legal guardian, as applicable). It is the responsibility of the applicant and/or
parent/legal guardian to complete and submit each application and all required supporting documentation
to the LISS Program Contractors.
To: Applicant: If you require assistance with completing the Random Selection Application,
there two (2) options:
1) A Vendor may help the applicant with completing the Random Selection Application but may not
complete the Random Selection Application on behalf of an applicant. Please see the “Glossary”
section concerning the meaning of “Vendor” on page (33).
2) The LISS Program Contractors can provide application assistance. Please see the list of “LISS
Program Contractor” on page. Please see the “Glossary” section concerning the meaning of a
“LISS Program Contractor” on page “(33).
SEE NEXT PAGE >>>>>>>>>>
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RANDOM SELECTION AND APPLICATION INFORMATION
Steps to LISS Program Funding:
1. The Randomization process takes place twice in the fiscal year-once in the summer (July)
and once in the winter (December).
A. For Round 1 and Round 2, applicants and/or parent/legal guardians can only submit ONE
electronic Random Selection Application through the DDA web portal. This submission
will then be assigned to the LISS Program Contractor who covers their county.
Random Selection and Application Submission Schedule for FY 2023
FY 2023- Round 1
1) The online access link will open on May 1, 2022.
2) The online access link will close on June 30, 2022.
3) Random Selection will take place on July 15, 2022.
FY 2023-Round 2
1) The online access link will open on July 16, 2022.
2) The online access link will close on November 30, 2022.
3) Random Selection will take place on December 15, 2022.
➤PLEASE: If an applicant is not selected in Round 1, their application will not be automatically
rolled over into Round 2 randomization process. The applicant will need to submit a new Random
Selection Application during “Open Season” for Round 2 via the online public Random Selection
Application access link. Please see the schedule above for Round 2 for FY 2023.
2. Based on the outcome of the Random Selection for each Round, Random Selection Lists
are generated for each region. These lists are then distributed to the LISS Providers for
notification purposes.
3. Within twenty (20) business days after Random Selection has occurred, LISS Providers will
notify applicants in writing regarding the status of their application.
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LISS PROGRAM CONTRACTORS
The LISS Program Contractors who operate this program across the State of Maryland are listed below.
When applying to the LISS program, please submit your application and/or documentation to the
contractor that covers your county.
Penn Mar Human Services
310 Old Freeland Road
Freeland, MD 21053
Toll Free: 1.877.282.8202
TTY: 711; Fax: 410.357.4767
E-mail: LISS@Penn-Mar.org
Website: http://www.penn-mar.org/liss
Counties served: Allegany, Anne Arundel, Baltimore City, Baltimore County, Carroll, Frederick,
Garrett, Harford, Howard, and Washington
Maryland Community Connection
4401 Nicole Drive
Lanham, MD 20706
Phone: 301.583.8880; Toll Free: 1.877.622.6688
E-mail: LISS@marylandcommunityconnection.org
Website: https://bit.ly/LISSMCC
Counties served: Calvert, Charles, Montgomery, Prince George’s, St. Mary’s, Caroline, Cecil,
Dorchester, Kent, Queen Anne’s, Somerset, Talbot, Wicomico and Worcester
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COVERSHEET
PART 2: CONSIDERATION FOR PROGRAM FUNDING
A) SELECTION NOTIFICATION
B) SELECTION APPLICATION PACKET CHECKLIST
C) SERVICES ELIGIBILITY APPLICATION
D) REQUIRED DOCUMENTS FOR APPLICATION PACKET
E) LISS SERVICES AND DOCUMENTATION
➢ Adapted Items Category
1) Aids for daily living and/or Devices
2) Specialized Equipment
3) Clothing/Shoes
➢ Assistive Technology Category
➢ Caregiving Services Category
1) Attendant Care
2) Childcare
3) Respite (In-home and Agency)
➢ Educational Services Category
1) Training and Support
2) Tuition
3) Tutoring
➢ Home Modification/Barrier Removal Category
➢ Identification Services Category
➢ Recreational Services Category
1) Camp
2) Community Integration (Non-Therapeutic) Services
➢ Transportation Category
➢ Wellness: Physical and Mental Health Services or Items Category
1) Behavior Support Services
2) Medical/Dental Health Services or Items
3) Therapeutic Services
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SELECTION NOTIFICATION
The written notification of selection will include instructions on next steps of the process, accessing the
LISS Program Applicant and Family Guide and other pertinent documents. The written notification will
also include a deadline date to submit the Services Eligibility Application and supporting documentation.
Written notifications will be sent to applicants and/or parents/legal guardians via mail.
FOR APPLICANTS SELECTED: APPLICATION PACKET CHECKLIST
➢ Please: When submitting your Services Eligibility Application and required documents for each
eligible service category, you must also submit Proof of Identity, of the Applicant and if
applicable, Parent/Legal Guardian, Proof of Residency and Proof of a Developmental or
Intellectual Disability, with your packet.
Proof of Identity including, if applicable, Parent or Legal Guardian identification
(For applicants under the age of 21).
Proof of Residency
Proof of Developmental Disability and/or Intellectual Disability
Attestation Form: there are two pages to complete, sign and date
LISS Program Services Eligibility Application
Invoices, Receipts or Online Printouts for Services
➢ Please: For any Health or Mental Health Related services eligible for LISS Program funding, the
invoices must indicate the license number of the professional who is licensed by the respective
State of Maryland Licensing Board.
Health Insurance Information: Coverage or Non-coverage including Co-pay, (e.g., Explanation of
Benefits from health insurance provider, If applicable)
Professional Letter of Recommendation (If applicable)
➢ Please: The Letter of Recommendation form must be completed and signed by a Maryland
licensed Professional in the medical/mental health field. All LISS eligible health, mental health
or specialized item service categories requested, i.e., prescription drugs, therapies, must be
recognized and/ or approved by a governing authority, i.e., U.S. Food and Drug
Administration. The completer of this form must be the Maryland licensed medical/mental
health that recommends the eligible LISS service, support or specialized item. This form must
not be completed, signed or dated by the applicant/parent/legal guardian. Incomplete or
missing information may result in a denial of funding for the LISS eligible service, support or
item.
W-9 Form from the Vendor (If applicable)
➢ Please: If the above documents are not submitted with your application packet, your application
will be delayed as the LISS Program Contractor waits for the required documentation. Your
application will be placed with the applications received and /or completed until the date the
provider receives the documentation. If the LISS Program Contractor does not hear back from
you after requesting additional information or does not receive the required documents, then your
application will be denied.
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REQUIRED DOCUMENT: TO APPLY FOR LISS PROGRAM FUNDING
The following are a list of required documents to be submitted with your Services Eligibility Application
packet. These documents are needed to determine whether the applicant meets the applicable eligibility
criteria. Providing the following documentation does not mean you automatically qualify for LISS
Program funding. However, failure to provide the required documentation may result in denial of LISS
Program funding.
1. Proof of Identity: The proof of the applicant’s identity must contain the applicant's legal first,
middle, and last name, without the use of initials or nicknames.
A copy of ONE of the following is acceptable:
A. Valid social security card issued by the U.S. Social Security Administration;
B. Legal birth certificate;
C. Valid passport issued by the U.S. Department of State;
D. A valid green card or student Visa, issued by the U.S. Citizenship and
Immigration Services;
E. Valid military identification card issued by the U.S. Department of Defense;
F. Current driver’s license or identification card issued by Maryland.
Please note: Parents and/or legal guardians of the underage (21 and under) applicant who
signs the Services Eligibility Application on behalf of the underage (21 and under) applicant,
must provide proof of identity.
A copy of ONE of the following is acceptable for the parent/legal guardian to submit:
A. A current driver’s license or identification card issued by Maryland
B. A valid Military identification card issued by the U.S. Department of Defense
C. Valid passport issued by the U.S. Department of State;
D. A valid green card or student Visa, issued by the U.S. Citizenship and Immigration
Services;
E. Valid military identification card issued by the U.S. Department of Defense;
2. Proof of Maryland Residency: To qualify for the LISS Program, the applicant must live in the
State of Maryland. The following documentation, dated within the last 12 months, is acceptable
for proof of residence.
A copy of ONE of the following is acceptable.
A. A current household utility statement (e.g. Water bill or Gas/Electric bill);
B. A current lease agreement; or
C. A mortgage statement or proof of home ownership
(e.g. Deed, Title, Bill of Sale, or Statement from Maryland Assessment and Taxation).
Please note: If the applicant, parent and/or legal guardian cannot produce any of the above
documents because another individual owns the property in which the applicant resides, then the
applicant, parent and/or legal guardian will need a written statement from the owner of the property,
as well as one of the above documents in the property owner’s name. SEE NEXT PAGE>>>>>>>
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TO APPLY FOR LISS PROGRAM FUNDING-REQUIRED DOCUMENTS
Please note: Bank statements or Individual Education Plans (IEP) will no longer be
acceptable as verifiable proof of identification or residency.
3. Proof of Developmental and/or Intellectual Disability: The following documentation is acceptable
to prove whether the applicant has a qualifying disability. Please submit one of the following:
A. A statement written by a Maryland licensed medical/mental health professional, listing all the
applicant’s diagnoses including the confirmation of an eligible developmental and/or
intellectual disability. If the letter is unclear as to what is the actual primary disability, the
LISS Program Provider will request additional proof of disability reports, completed by a
Maryland licensed medical/mental health professional.
B. An approved Individualized Educational Program (IEP) within the last 3 years that
identifies an eligible diagnosis.
C. A Maryland Department of Health (MDH)-Developmental Disabilities Administration
(DDA) Eligibility Determination letter of an eligible developmental and/or intellectual
disability or support-only status.
►Please note: A Learning Disability, Developmental Delay, Global Delay, or ADHD diagnosis, by itself,
may not meet program requirements. Additional documentation will be requested by the LISS Program
Provider if the above diagnoses are indicated within the proof of disability documentation.
4. Attestation Form: This is a two-page form that must be signed and dated, upon receipt, and submitted
back to the LISS Provider that is processing your LISS Program application. If this entire form is not
received or completed per the instructions, then, your LISS Program application packet will be
considered incomplete.
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SERVICES ELIGIBILITY APPLICATION
Services Eligibility Application is a one-page document that LISS Program applicants and their families
are given to apply for possible LISS Program funding for eligible services and/or items that are under the
DDA’s regulations set forth at COMAR 10.22.14. The following information is collected within this
application:
• Applicant’s Demographic Information and Contact Information
• Service/Item Information
• Reason/Purpose for requests
• Amount of Funding requested
• Applicant Declaration
• Signature of Applicant and/or Representative
This application is required after the applicant has been notified by the LISS Program Contractor that he
or she was selected for consideration under the Random Selection process. To be approved for LISS
Program funding, the applicant and/or parent/legal guardian, must fill out this application in its entirety;
listing requested services or items and pricing amounts of each service or item.
Who can complete the Services Eligibility Application?
(1) If the individual applicant is under the age of 21 (but does not have a court-ordered legal
guardian), then a natural or adoptive parent must complete the application;
(2) If the individual applicant has a court-ordered legal guardian (regardless of the applicant’s
age), then the legal guardian must complete the application; and
(3) If the individual applicant is over the age of 21, does not have a legal guardian, and only
requires physical assistance in completing the application, then a parent, relative, friend, or
case manager or social worker may help under the individual applicant’s direction.
To: Applicant: The DDA LISS Program requires that the Service Eligibility Application be completed
and signed only by the applicant (or their parent, if the applicant is under 21, or their legal guardian, as
applicable). It is the responsibility of the applicant and/or parent/legal guardian to complete and submit
the application and all required supporting documentation to the LISS Program Contractors.
To: Applicant: If you require assistance with completing the Services Eligibility Application,
there two (2) options:
1) A Vendor may help the applicant with completing the Random Selection Application but
may not complete the Random Selection Application on behalf of an applicant. Please
see the “Glossary” section concerning the meaning of “Vendor” on page (33).
2) The LISS Program Contractors provide application sessions. The applicant can reach out to the
LISS Program Contractors to seek help with completing the Random Selection Application.
Please see the “Glossary” section concerning the meaning of a “LISS Program Contractor”
on page (33).
The service requests on the Services Eligibility Application must fall within the current fiscal year which
for Fiscal Year 2023, is July 1, 2022, through June 30, 2023. Except for camps, any requests that fall
outside of the current fiscal year will not be approved. For camps, requests will be accepted
through August 31, 2023.
SEE NEXT PAGE >>>>>>>>>>
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Please note: If you are Services Eligibility Application and your packet of documents are deemed
incomplete during the time of review, you will receive a written notification. If the packet is not
completed by a certain timeframe, your application and packet will be denied. For your information,
the LISS Program Provider will request additional required documents based on LISS Program guidelines
to complete your application packet.
Please note: For any requests to change the original requests of services, supports or items to be
purchased indicated on the original Services Eligibility Application, the LISS Program requires that you
contact the LISS Program Contractor about submitting a change request. If approved, a new Services
Eligibility Application and new supporting documentation can be submitted for consideration.
The original amount requested cannot be increased by adding a new request for new services, supports or
items to be purchased, indicated in the new Services Eligibility Application.
The Services Eligibility Application is no longer included in this guide. Please go to the LISS
Program Contractor’s website to access this application. Please refer to page (10), “LISS Program
Contractors” to obtain their website addresses.
LISS PROGRAM SERVICES, SUPPORTS OR ITEMS FOR PURCHASE
LIST OF REQUIRED DOCUMENTATION
Below is the list of eligible services, supports and/or items for purchase that may be considered for LISS
Program funding (in accordance with COMAR 10.22.14), including what documentation is required to
process the requests. When completing the Services Eligibility Application please identify the services
and/or items that you are requesting.
Please note: If there is a conflict between this guide and COMAR 10.22.14, COMAR 10.22.14 will
control whether, you, or the item or service you request, are eligible for LISS Program funding.
Please note: The “Required Documents” must accompany your Services Eligibility Application to be
considered complete. Each service category listed in this section has the same or different document
requirements.
Providing the following documentation does not mean you automatically qualify for LISS Program
funding. However, failure to provide the required documentation may result in denial for consideration
for LISS Program funding. The LISS Program Contractor may request additional documentation if the
services/supports or requested items are in question.
I. Adapted Items (Aids and/ or Devices, Specialized Equipment, Clothing) Category
a) Adapted Items: Aids and/or Devices
Are daily living aids and/or devices that have been modified or tailored to help the individual with
a developmental and/ or intellectual disability while functioning in the home and/or community.
Adapted items enhance an individual’s environment, daily living, mobility or recreational activities.
Adapted items may include the following:
• Aids for daily living or improving the individual’s environment.
• Aids for self-help activities such as eating, bathing, cooking, dressing, toileting, cleansing of
oneself with the aid of wipes and home maintenance.
• Sensory Items
SEE NEXT PAGE >>>>>>>>>>
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b) Adapted: Specialized Equipment
Adapted: Specialized Equipment must be modified or tailored to help the individual with a
developmental and/ or intellectual disability while functioning in the home and/or community.
Adapted items enhance an individual’s environment, daily living, mobility or recreational activities.
Adapted: Specialized Equipment may include the following:
• The equipment can be acquired commercially.
• Can be a modification to the individual's or family's automotive vehicle for personal
transportation. Examples are adaptive driving aids, hand controls, wheelchair lifts, adaptive car
seat, adaptive stroller, adaptive bikes, etc.
• Specialized equipment for medical, recreational or home use.
Please note: Under Adapted Items: Devices or equipment used on land, in the air or on water are not
considered Adapted: Specialized Equipment. There must be safety alterations incorporated within the
device or equipment to be considered “Adapted-Specialized Equipment”. For example, Trampolines
should have a safety net that surrounds the entire Trampoline and/or safety bar. This protects the
individual while using the Trampoline.
REQUIRED DOCUMENTS for Adapted Item requests excluding Clothing/Shoes:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page (32) of this guide OR a copy of online shopping cart, shipping, handling & tax included
(required for payment).
• Letter of Recommendation by a Maryland licensed medical/mental health professional. If a
blank Letter of Recommendation is needed, please go to the LISS Program
Contractor’s website.
• Form W-9 for the business selling the product. The form W-9 is not needed for online
vendors like Apple.com or Amazon.com. If a blank W-9 form is needed, please go to
the LISS Program Provider’s website.
c) Adaptive Clothing/Shoes
Garments that increase independence by simplifying self-dressing and offering solutions to meet a
variety of physical challenges. To be approved, clothing/shoe requests must be “Adapted” meaning
modified, altered or tailored to meet the personal care needs of the Individual.
Clothing/shoe items may include the following:
1. Soft, tag less, or seamless clothing for sensory sensitivity
2. Open back, side-zip, cut away, items with Velcro, snap, zipping or magnet closures
3. Adaptive footwear
4. Adaptive clothing for people using wheelchairs
REQUIRED DOCUMENTS for Clothing/Shoes:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide OR a copy of online shopping cart, shipping, handling & tax included
(required for payment).
• Form W-9 for the business selling the product. The form W-9 is not needed for online
vendors. If a blank W-9 form is needed, please go to the LISS Program Contractor’s
website.
• Letter of Recommendation by a licensed professional. If a blank Letter of
Recommendation is needed, please go to the LISS Program Contractor’s website.
SEE NEXT PAGE >>>>>>>>>>
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II. Assistive Technology Category
Assistive Technology means a type of device which enables an individual to live, learn and function in
the community and participate in community activities without restriction. Examples: Computers
and Computer accessories, I-pad, headphones, educational software. Printers are considered a
computer accessory.
Assistive technology may include the following:
• This type of technology can be acquired commercially, modified or customized.
• Environmental control units for participants' homes to allow spontaneous or programmed control
of household appliances and other home devices.
• Devices with web-based operating systems, software, and computer accessories that enable
participants to function more independently.
• Training, maintenance and repair of the covered assistive technology device and/or equipment.
• Augmentative communication and communication-enhancement devices.
REQUIRED DOCUMENTS for Assistive Technology requests:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page (32) of this guide OR a copy of online shopping cart, shipping, handling & tax included
(required for payment).
• Form W-9 for the business selling the product. The form W-9 is not needed for online vendors
like Apple.com or Amazon.com. If a blank W-9 form is needed, please go to the LISS
Program Contractor’s website.
III. Caregiving Services (Attendant Care, Child Care and Respite) Category
a) Attendant Care
Attendant Care involves aiding with activities of daily living. A person who is a parent or a
person who may be legally/financially responsible for the LISS Program applicant cannot be
paid by LISS Program funding to provide this service.
The Vendor must submit completed timesheets after rendering the service, to the
parent/legal guardian. The parent/legal guardian is responsible for reviewing the timesheet,
approving, signing and dating. The parent/legal guardian is then responsible for submitting the
completed timesheets to the LISS Program Contractor for payment. Payment to the Vendor will
be remitted after the service has been completed and all required documents have been
submitted. Vendors are not paid in advance for services.
Examples of activities of daily living:
1. Eating, bathing, cooking, dressing, and toileting
2. Shopping
3. Providing transportation services to medical or mental health appointments
4. Medication management
SEE NEXT PAGE >>>>>>>>>>
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REQUIRED DOCUMENTS:
• The invoice(s) should contain all minimum information as stated in the “Glossary”
section on page (32) of this guide.
• State registered Vendor invoice must indicate State license number of the person or
business is authorized to operate in the State of Maryland.
• For Independent Contractors (non-State registered) Vendors: the following must
accompany the invoice:
a) Must provide a copy of a current Maryland Driver’s License or photo ID, OR
Other state driver’s licenses or photo ID.
b) Completed Independent Contractor Agreement (Supplied by the LISS Program
Contractor)
c) Copy of Social Security Card
Please see the “Glossary” section on page 33 of this guide on the meaning of “Independent
Contractor”.
• Form W-9 for the Business/Individual selling or providing the service. If a blank W-9
form is needed, please go to the LISS Program Contractor’s website.
b) Childcare
The care or supervision of an individual under age 21 with a disability, by a licensed provider,
received during specific times of the day to supplement the care provided by the child's parents or
legal guardians. A person who is a parent or legally/financially responsible for the LISS applicant
cannot be paid by LISS funding to provide this service.
REQUIRED DOCUMENTS for Child Care:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• State registered Vendor invoice must indicate State license or registration number from the
Maryland State Department of Education, of the person or business authorized to operate in the
State of Maryland.
• Form W-9 for the business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
c) Respite (in-home and via agency)
Respite provides a break to both the child and/or adult with developmental disabilities and the
caregiver from daily routines and responsibilities. It is short term and can take place in or outside
of the home. Respite can be planned and/or provided during emergency situations. A person who is a
parent or legally/financially responsible for the LISS applicant cannot be paid by LISS funding to
provide this service.
►Please note: The parent/legal guardian chooses the Vendor to provide respite services. The
individual will be considered a Vendor of the parent/legal guardian and not of the LISS Program
Contractor. The LISS Program Contractors are only responsible for disbursing LISS Program
funding and are not responsible for paying un-employment insurance or worker’s compensation.
If respite services are being provided by an independent contractor, the independent contractor
shall submit timesheets indicating hours worked at the agreed upon rate to the applicant and/or
parent/legal guardian for review. The applicant and/or parent/legal guardian will then submit the
documented timesheets to the LISS Program Contractor upon application approval. The LISS
Program Contractor will pay the service as it occurs. The LISS program cannot approve more than 45
days or 1080 hours of respite in a fiscal year.
SEE NEXT PAGE >>>>>>>>>>
Page 20 of 33
REQUIRED DOCUMENTS:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section
on page 32 of this guide.
• State registered Vendor invoice must indicate State license number of the person or business is
authorized to operate in the State of Maryland.
• For Independent Contractors (non-State registered) Vendors: the following must
accompany the invoice:
a) Must provide a copy of a current Maryland Driver’s License or photo ID OR
Other state driver’s licenses or photo ID.
b) Completed Independent Contractor Agreement (Supplied by the LISS Program
Contractor)
c) Copy of Social Security Card
Please see the “Glossary” section on page 33 of this guide on the meaning of “Independent
Contractor”.
• Form W-9 for the business/Individual selling or providing the service. If a blank W-9 form is
needed, please go to the LISS Program Contractor’s website.
IV. Educational Services (Training and Support for Self-Advocacy, Tutoring, Tuition for
Post-Secondary Academic and Vocational Services and Items for Learning)
a) Training and Support for Self-Advocacy
Training and supports for self-advocacy mean activities related to self-enhancement, higher
education, gaining knowledge of community and governmental resources and learning ways to
advocate for oneself. This service cannot be provided by a parent or legal guardian, or a person who
is otherwise legally responsible for the LISS Program applicant. Please see the “Glossary” section
concerning the meaning of Vendor. Please see the “Glossary” section concerning the meaning
of parent or legal guardian.
Training and Support services may include the following:
• Conference fees (i.e., the cost to register, enroll, or sign up), but not including food,
lodging, or travel costs;
• IEP Preparation fees including attendance to IEP Meetings, but not including costs associated
with food or lodging;
• Advocacy Training for Parents, Students and Adults with developmental and/or intellectual
disabilities;
• Pre-vocational Training (e.g., habilitative assistance with résumé writing, interview, and
employment skills);
• Job Training and Job Placement
Please note: IEP Preparation and/or Advocacy Training service requests: The DDA LISS Program will
require verification of attendance (i.e., documentation verifying that the services were rendered to the
recipient), that shows that there was, an actual appointment/meeting/training or IEP meeting in which the
LISS recipient attended, and the service(s) were rendered. It is the responsibility of the applicant
and/or parent/legal guardian to submit the Vendor invoice and verification of attendance for IEP
and/or Advocacy type services with their LISS Program Selection Packet. If the verification of
attendance is not included in the selection packet, the packet will be considered incomplete.
The documentation requirements will likely include, but are not limited to:
1) Identification of which services were provided to each recipient for which a person received
LISS Program funding; And
2) Identification of the date on which the services were provided; And
3) Identification of the number of hours the services were provided on each of those date(s) of
services SEE NEXT PAGE >>>>>>>>>>
Page 21 of 33
REQUIRED DOCUMENTS for Training and Support Services:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section
on page 32 of this guide.
• For Independent Contractors (non-State registered) Vendors: the following must
accompany the invoice:
a) Must provide a copy of a current Maryland Driver’s License or photo ID OR
Other state driver’s licenses or photo ID.
b) Completed Independent Contractor Agreement (Supplied by the LISS Program
Contractor)
c) Copy of Social Security Card
Please see the “Glossary” section on page 33 of this guide on the meaning of “Independent
Contractor”.
• FORM W-9 for the business selling or providing the service. If a blank W-9 form is needed, please
go to the LISS Program Contractor’s website.
b) Tuition for Post-Secondary Academic and Vocational Services
Tuition means a financial obligation for educational services provided by an academic institution,
technical/trade school or agency. A person who is a parent or legally/financially responsible
for the LISS applicant cannot be paid by LISS funding to provide this service.
Tuition services may include the following:
• Post-secondary academic courses
• Vocational or Job training
• Community College or Technical School
REQUIRED DOCUMENTS for Tuition Services:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section
on page 32 of this guide.
• Form W-9 for the Business/Individual providing the service. If a blank W-9 form is
needed, please go to the LISS Program Contractor’s website.
c) Tutoring for Post-Secondary Academic and Vocational Services
Tutoring means educational services that provide assistive learning skills and abilities to enhance a
child or adult with developmental disabilities overall capabilities. A person who is a parent or
legally/financially for the LISS applicant cannot be paid by LISS funding to provide this service.
Tutoring services may include the following:
• Academic Tutoring
• Vocational Tutoring
• Tutoring for Testing Purposes
REQUIRED DOCUMENTS for Tutoring
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• For Independent Contractors (non-State registered) Vendors: the following must
accompany the invoice:
a) Must provide a copy of a current Maryland Driver’s License or photo ID OR
Other state driver’s licenses or photo ID.
b) Completed Independent Contractor Agreement (Supplied by the LISS Program
Contractor)
c) Copy of Social Security Card
• Form W-9 for the business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
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d) Items for Learning
This category is for items of an educational nature and should not be a duplicate of what's available in
the school system or included in homeschooling curriculums.
Examples would be:
Flash Cards, Word Building, Registers, sight word builders, calendars, letter matching games,
counting/sorting (color/type) objects, books for parent support (about disabilities/learning/etc.),
books/workbooks to help with home study of topics learned in school, sign language courses or
items of a similar nature.
REQUIRED DOCUMENTS for Items for Learning
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide OR a copy of online shopping cart, shipping, handling & tax included
(required for payment).
• Form W-9 for the business selling the product. The form W-9 is not needed for online vendors
such as Apple.com or Amazon.com or similar business. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
V. Home Modification/Barrier Removal
This refers to the modification or removal of obstructive environments and/or items in order to
promote independence, privacy, or safety for the child or adult with developmental disabilities.
A person who is a parent or legally/financially responsible for the LISS applicant cannot be paid by LISS
funding to provide this service. Home modification and barrier removal must be provided by a Maryland
licensed contractor.
►Please note: The applicant or the applicant’s family must own the property requiring modification.
Home Modification/Barrier Removal may include the following:
• Widening of doorways
• Installation of grab bars or railing
• Specialized plumbing or electrical work
• Fencing for a yard to prevent wandering
• Installation of locks or buzzers to notify and prevent wandering
• Modification of bathroom or kitchen facilities to make them physically accessible.
• (Ref: COMAR 10.22.14.03.)
• Modification of an existing structure that extends from the home which has no roof or is
• considered a paved area situated directly on the ground. (Ref: COMAR 10.22.14.03b-ix)
Home Modification/Barrier Removal may not include the following:
• Major structural components such as adding additional rooms to the home which adds square
footage to the home.
REQUIRED DOCUMENTS for Home Modification/Barrier Removal:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• Invoice must indicate State license number of the person or business is authorized to operate in
the State of Maryland.
• Form W-9 for the business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
• Proof of home ownership (Deed, Title, Bill of Sale, or Statement from MD Assess and Tax)
Page 23 of 33
VI. Identification Services
These services include costs for:
a) Obtaining Maryland State Identification Card (Reimbursement Only)
b) Fingerprinting for a job (Reimbursement Only)
c) Identification bracelets or cards.
REQUIRED DOCUMENTS:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section
on page 32 of this guide OR a copy of online shopping cart with shipping, handling & tax
included and date(s) of service.
• Please review the section called “Reimbursement” to submit the “required” documents for
reimbursement.
VII. Recreational Services (Camp, Community Integration: Non-Therapeutic, Therapeutic Summer
Programs)
a) Camp
Camp is defined in COMAR 10.22.14 as an entity that operates on private property, or private
facilities, whether leased or owned. It provides primarily recreational activities or has a substantial
recreational component. Types of camps that are covered under the LISS regulations are:
i. Day Camps: Camps that are conducted during day hours during the winter or summer. Day
Camps must be licensed or certified by the State in which the camp is located. Camp license
or certification must come from one of the entities listed below. If the camp is in the summer
only, LISS funding can be made available to pay for services until August 31
st
of the
current fiscal year.
➢ Accredited by Maryland or Out of State Department of Education
➢ Accredited by the American Camping Association
➢ Approved by the Maryland Developmental Disabilities Administration or the
State Government entity where the camp is located.
ii. Overnight Camps: Camps that are conducted overnight during the winter or summer.
Overnight camps must be licensed or certified by the State in which the camp is located.
Camp license or certification must come from one of the entities listed below. If the camp is
in the summer only, LISS funding can be made available to pay for services until
August 31
st
of the current fiscal year.
➢ Accredited by the Maryland or Out of State Department of Education
➢ Accredited by the American Camping Association
➢ Approved by the Maryland Developmental Disabilities Administration or the
State Government entity where the camp is located.
REQUIRED DOCUMENTS Camps:
• The invoice(s) should contain all minimum information as stated in the “Glossary”
section on page 32 of this guide.
• Invoice must indicate the camp license or certification from one of the accreditations listed above.
• Dates of service for Camps can occur outside the current fiscal year, which for FY 2023,
would be July 1, 2022, through August 31, 2023.
• Form W-9 for the business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
➢ Please contact the LISS Program Contractor if the Camp has not made a registration form
available. See Next Page >>>>>>>>>
Page 24 of 33
b) Community Integration (Non-Therapeutic) Services
These services promote and increase community involvement. A person who is a parent or
legally/financially responsible for the LISS Program applicant cannot be paid by LISS Program
funding to provide this service.
Community Integration may include the following:
1. Leisure activities include, but are not limited to, the following:
a) Recreational membership, within the current fiscal year, for the applicant +1
(Parent, guardian, spouse, or support person), when applicable.
b) Art/Music Lessons
c) Karate Lessons
d) Swimming Lessons
e) Therapeutic horseback riding (not hippo-therapy**)
f) Bicycles and accessories
Please note: Therapeutic horseback riding is defined as adapted recreational horseback riding
lessons for individuals with disabilities; it is not the same as Hippo-therapy.
2. Driving lessons
3. Training in navigation of individual’s community
4. Mentoring
REQUIRED DOCUMENTS:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• Dates of service must occur within the current fiscal year which for FY 2023 is July 1, 2022, to
June 30, 2023.
• Form W-9 for the business/Individual selling the service. If a blank W-9 form is needed, please
go to the LISS Program Contractor’s website.
Please: Non-Therapeutic programs are services that focus on community integrated activities
such as dance, karate, or swimming and are operated throughout the year which includes the summer
months. These services would be covered as an eligible LISS service under the Community
Integration-Non-Therapeutic Service category. Please see Community Integration service category
below for the required documents needed. Non-Therapeutic programs must occur within the fiscal
year, which for FY 2023, is July 1, 2022 to June 30, 2023.
c) Therapeutic Summer Programs are a set of services designed to provide medical, behavioral or
psychological therapies, such as speech, applied behavior analysis and occupational, through a
variety of activities in a safe environment. Therapeutic summer programs are offered under the
licensure of a medical or mental health professional and provided by clinical staff with clinical
oversight.
SEE NEXT PAGE >>>>>>>>>>>>
Page 25 of 33
REQUIRED DOCUMENTS Therapeutic Summer Programs:
For Therapeutic Summer Programs:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• Invoice must indicate license number of the medical/mental health professional licensed by the
respective Maryland Licensing Board.
• Dates of service for Therapeutic Summer Programs can occur, which for FY 2023, from
July 1, 2022 through August 31, 2023.
• Form W-9 for the Business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
• A Letter of Recommendation from a Maryland Licensed Professional. If a blank Letter of
Recommendations is needed, please go to the LISS Program Contractor’s website.
VIII. Transportation
Transportation services means the travel services used to assist an applicant to access and navigate the
community. A person who is a parent or legally/financially responsible for the LISS applicant cannot
be paid by LISS funding to provide this service.
Transportation services may include the following:
• Metro Access, Taxi Vouchers, Uber, and Lyft.
• The hiring of a company or person to provide transportation.
• Wheelchair or Scooter Loaders
➤Please note: Ride sharing services such as Uber and Lyft are reimbursable services only.
REQUIRED DOCUMENTS:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• Form W-9 for the Business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
• For Independent Contractors (non-registered) Vendors: the following must accompany
the invoice:
a) Must provide a copy of a current Maryland Driver’s License or photo ID, OR
Other state driver’s licenses or photo ID.
b) Completed Independent Contractor Agreement (Supplied by the LISS Program
Contractor)
c) Copy of Social Security Card
Please see the “Glossary” section on page 33 of this guide on the meaning of “Independent
Contractor”.
IX. Wellness (Behavior Support Services, Medical and/or Dental Services or Items, and
Therapeutic Services)
See Next Page >>>>>>>>>>>>>>>>
Page 26 of 33
a) Behavior Support Services
Behavior Support Services (BSS) assist individuals with challenging behaviors to acquire
skills to integrate and participate in the community. A person who is a parent or legally
responsible for the LISS Program applicant cannot be paid by LISS Program funding to
provide this service. BSS services must be provided by a licensed Psychologist, Psychology
Associate under the supervision of a licensed Psychologist, licensed Physician, Licensed,
Certified Social Worker, Licensed or Certified professional Counselor, who shall have
training and experience in applied behavior analysis. (DDA Regulation: COMAR 10.22.10.
Behavior Support Services (BSS) include, but are not limited to, assessments, behavioral
intervention, and monitoring.
Please note: Behavior Support Services does not include Applied Behavior Analysis (ABA)
therapy. For ABA therapy requests, please see “Therapeutic Services” service category.
REQUIRED DOCUMENTS for Behavior Support Services:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section
on page 32 of this guide.
• Invoice must indicate license number of the medical/mental health professional licensed by the
respective Maryland Licensing Board.
• Form W-9 for the business/Individual offering the service. If a blank W-9 form is needed, please
go to the LISS Program Contractor’s website.
• A Letter of Recommendation by a licensed professional. If a blank Letter of Recommendation
is needed, please go to the LISS Program Contractor’s website.
b) Medical and/or Dental Services or Items
Medical and/or Dental services or items requested must be recognized by a respective healthcare
professional who licensed by the State of Maryland’s licensing board and must be recognized and/
or approved by a governing authority, e.g., US Food and Drug Administration. This service category
requires a Letter of Recommendation form completed and signed by the Maryland licensed
medical and/or dental health professional who has given the recommendation. State license number
of the healthcare professional to practice, must be indicated on the form.
Medical and/or Dental Services or Items may include the following:
• Dietician and nutritionist counseling
• Feeding programs
• Protective undergarments (diapers and under pads)
• Disposable gloves
• Catheters
• Dental exams, treatments and orthodontia (such as braces and retainers)
• Vision exams, treatment and eyeglasses
LISS funding cannot purchase services or items that are:
• Covered by an existing health plan
• Constitute or are a part of experimental or prohibited treatments.
➢ Please note: For insurance purposes, if you are choosing to use a provider that is out-of-network,
LISS may not fund the requested service or item.
See Next Page >>>>>>>>>>
Page 27 of 33
REQUIRED DOCUMENTS for Medical and Dental Services/Items:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• License number of the medical/mental health professional licensed by the respective Maryland
Licensing Board.
• Form W-9 for the business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
• Proof of coverage or non-coverage from health insurance, including co-pay info (For example: An
Explanation of Benefits, Denial Letter, or Coverage Summary).
• If the applicant is uninsured (without medical, dental, or vision insurance) a written statement from
the licensed provider can be submitted as proof of the applicant’s uninsured status.
• A Letter of Recommendation by a licensed professional. If a blank Letter of Recommendation is
needed, please go to the LISS Program Contractor’s website.
c) Therapeutic Services
Therapeutic Services include a broad range of treatments such as Speech, Occupational,
Physical, Behavioral, Art, Hippo-Therapy, and Individual/Family Therapy. These therapies are
intended to improve, increase, or maintain an individual’s well-being. A person who is a parent or
legally/financially responsible for the LISS applicant cannot be paid by LISS funding to provide
this service. This service category requires a Letter of Recommendation form completed and signed
by the Maryland licensed healthcare/mental health professional who has given the recommendation.
State license number of the healthcare professional to practice, must be indicated on the form.
Please note: LISS funding cannot purchase services or items covered by an existing health
plan or fund experimental or prohibited treatments. If you are choosing to use a provider that
is out-of-network for your insurance, LISS may not fund the requested service.
Please note: Therapeutic horseback riding is defined as adapted recreational horseback riding lessons
for individuals with disabilities; it is not the same as Hippo-therapy.
Therapeutic Services may include the following:
• Speech, Occupational, Physical, Behavioral, Art and Hippo-Therapy, Individual and Family
Therapy, Applied Behavioral Analysis (ABA) Therapy and items related to non-experimental and
permitted therapies.
• Music Therapy: Music Therapy is the clinical and evidence-based use of music interventions to
accomplish individualized goals within a therapeutic relationship by a credentialed professional
who has completed an approved music therapy program.
REQUIRED DOCUMENTS:
Therapeutic Services requests:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• Invoice must indicate license number of the medical/mental health professional licensed by the
respective Maryland Licensing Board.
• Proof of coverage or non-coverage from health insurance, including co-pay info (For example: An
Explanation of Benefits, Denial Letter, or Coverage Summary). This is not required for Music
Therapy service requests.
• Letter of Recommendation by a licensed professional. If a blank Letter of Recommendation
is needed, please go to the LISS Program Contractor’s website.
See Next Page >>>>>>>
Page 28 of 33
REQUIRED DOCUMENTS:
For Music Therapy requests:
• The invoice(s) should contain all minimum information as stated in the “Glossary” section on
page 32 of this guide.
• Invoice must indicate license/ certification number of the Music Therapist – Board Certified
(MT-BC) by the certification board for Music Therapists.
• Form W-9 for the business/Individual providing the service. If a blank W-9 form is needed,
please go to the LISS Program Contractor’s website.
• Letter of Recommendation by a licensed professional. If a blank Letter of Recommendation is
needed, please go to the LISS Program Contractor’s website.
INELIGIBLE SERVICES AND ITEMS
In accordance with COMAR 10.22.14.08D- (1)-(3), the LISS Program excludes the following services
and items from being paid for by LISS Program’s funding.
1. All experimental or prohibited treatments by the Health Occupations Licensing Boards and the
Federal Drug Administration are excluded services.
2. The program does not provide funding for or otherwise cover the following:
A. Housing adaptations or improvements to an individual’s home that adds to the home’s
total square footage;
B. Adaptations or modifications that restrict an individual’s movement or jeopardize
the individual’s welfare;
C. Cash;
D. Case management;
E. Gift cards;
F. Housing assistance, including eviction assistance, utility disconnection and deposits
G. Presents;
H. Toys, except for therapeutic purposes;
I. Vacations; or
J. Vehicles, vehicle gas, tires, registration, or violations such as tickets and fines.
Please note: Neither DDA nor LISS Providers cannot directly purchase items from a vendor
that requires a membership. This includes Costco, Sam’s Club, and B.J.’s.
Page 29 of 33
ADDITIONAL FUNDING OPTION:
Reimbursement, using LISS Program funding, is only available for purchased, eligible services or items
received within the current, fiscal year, which for FY 2023 is July 1, 2022 to June 30, 2023. The only
exception is Camps and Therapeutic Summer Programs. For information on Camps, please see page (23)
and for information on Therapeutic Summer Programs, please see pages (24-25).
For Non-Therapeutic Programs, please see page (24).
The request for Reimbursement should be indicated on the Services Eligibility Application under the
service/item request column and should be labeled “Reimbursement and name of service category”. For
example, Reimbursement-Adaptive Equipment.
Please note: LISS Program cannot reimburse items and/or services purchased with cash or gift cards.
REQUIRED DOCUMENTS:
1) Please refer to the section “LISS Program Services, Supports and Items for Purchase, List of
Required Documentation” pages (16-28) to determine the documentation required for each
service/item to be submitted for reimbursement consideration.
2) If the proof of payment is from the parent, family member or legal guardian, then the document
must show the payment was completed. The proof of payment should be a paid, bank check
drawn from a person’s personal bank account, credit card statement or bank statement.
3) For Reimbursements: W-9 Forms are to be completed by the account holder indicated on the
“proof” of payment document(s).
4) If the proof of payment is from a vendor or service provider, the invoice or online shopping cart
must show the payment amount and type of payment (Personal Bank Check, Credit Card, PayPal
or Venmo etc.), was completed by the applicant, parent and/or legal guardian. Dates of service
must be indicated on the paid invoice or on the online, confirmation, receipt from the vendor or
service provider.
Page 30 of 33
CANCELLATIONS AND RETURNS PROCESS
Cancellations:
If a requested service, approved and paid by State funding, is cancelled, the applicant and/or parent/legal
guardian is responsible for notifying the LISS Program Contractor. The LISS Program Contractor will
need to know when the service started and when it ended. The Service Provider or Vendor will be
notified, and arrangements made to recoup payments sent to provide the service to the LISS Program
applicant.
Please be aware that this process will take time to complete, and the payments originally made to the
Service Provider or Vendor will not be readily available to be used for another service or item purchase
until the payment has been returned and processed.
Returns:
The LISS Program has established a “Return Item” procedure for eligible LISS Program items requested
to be purchased and paid with State LISS Program funding. The procedure is as follows:
If an item(s) requested, approved, paid and purchased within the current fiscal year, is found to be
defective, the item is the wrong color or size, not as described in the online store website etc., and needs
to be returned. The LISS Program applicant or parent/legal guardian must:
1) Notify the LISS Program Contractor upon discovering the defect or issue with the item.
2) The LISS Program applicant and/or parent/legal guardian will be asked to submit a picture of the
item(s) with the defect via email to the LISS Program Contractor.
3) Upon review, the LISS Program Contractor will contact the LISS Program applicant and/or
parent/legal guardian to discuss options to return the item(s). The applicant and/or parent/legal
guardian will be responsible for returning the item(s) back to the online vendor for proper credit
back to the LISS Program.
4) The LISS Program Return Item process will follow the Vendor/Seller Return Policy. Restocking
fees are not the responsibility of the LISS Program. The restocking fee will be subtracted from
the LISS Program award.
The LISS Program applicant and/or parent/legal guardian is not to return any item(s) purchased with
State funding, back to a physical store for a refund but must contact the LISS Program Contractor to make
plans to have the item(s) returned. All refunds must be returned to the LISS Program and not the LISS
Program applicant and/or parent/legal guardian.
For reference, please review both pages of the two-page Attestation Form agreement which all LISS
Program applicants and/or parent or legal guardians are required to complete, sign and date. The
second agreement states the following:
“Any LISS funding that I am awarded will only be used for covered services, as provided in COMAR
10.22.14.07, and not for an impermissible use or purpose, as provided in COMAR 10.22.14.08.
http://www.dsd.state.md.us/COMAR.”
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`
DDA REGIONAL OFFICES
Central Maryland Regional Office
Address: DDA - Central Maryland Regional Office, 1401 Severn St., Baltimore, MD 21230
Telephone: (410) 234-8200; TOLL FREE: 1-877-874-2494
TDD: (410)363-9430; FAX: (410)234-8397
Counties served: Anne Arundel, Baltimore City, Baltimore, Harford and Howard
Eastern Shore Regional Office
Address: DDA - Eastern Shore Regional Office, 926 Snow Hill Road, Salisbury, Maryland 21804
Telephone: (410) 572-5920; Toll Free: 1-888-219-0478
TDD Line: 1-800-735-2258; FAX: (410)572-5988
Counties served: Caroline, Cecil, Dorchester, Kent, Queen Anne's, Somerset, Talbot, Wicomico, and
Worcester
Southern Maryland Regional Office
Address: DDA - Southern Maryland Regional Office,
312 Marshall Ave., 7th Floor, Laurel MD 20707
Telephone: (301) 362-5100; TOLL FREE: 1-888-207-2479
TDD: (301)362-5131; FAX: (301)362-5130
Counties served: Calvert, Charles, Montgomery, Prince George's, and St. Mary's
Western Maryland Regional Office
Address: DDA - Western Maryland Regional Office,
1360 Marshall Street, Hagerstown, Maryland 21740
Telephone: (301) 791-4670; TOLL FREE: 1-888-791-0193
FAX: (301)791-4019; Maryland Relay: 1-800-735-2258
Counties served: Allegany, Carroll, Frederick, Garrett and Washington
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GLOSSARY
Applicant: An individual who has submitted a LISS Random Selection application to a LISS Program
Provider for LISS Program funding.
Approval: The application was selected, reviewed, and met the criteria for eligibility to receive funding
for the requested service or item.
Completed Registration Form: A completed form to register for camp or class or other time limited
events or sessions. The form must specify the event, the applicant’s name, dates of service and the cost.
Denial: The application was not approved for LISS Program funding.
Estimate or Quote: An approximation of the cost of a program, project, or operation that includes the
name and address of the business, dates of service, and the cost from a vendor.
Family: A “Family Member" who resides with the eligible individual and can be any of the following:
(a) Spouse;
(b) Biological, adoptive, or foster parent;
(c) Guardian;
(d) Sibling;
(e) Grandparent; or
(f) Other related next of kin.
Fiscal Year: The State government operates on a fiscal year calendar that runs from July 1 of the current
year through June 30
th
of the next year. LISS Program follows this fiscal year calendar.
Form W-9: The IRS form used to verify a business or person’s name, address and taxpayer identification
number.
Invoice: A document that describes the goods and services that have been, or will be, rendered to
the LISS program applicant/parent or legal guardian, and the cost thereof and contains certain
minimum information as required by this LISS Program Guide. Except as otherwise provided for
each description of covered LISS Program services categories and required documentation listed
therein (see pages 16-28), the invoice should generally contain the following information:
(1) The full name of the LISS Program applicant receiving the service or support.
(2) The full name of individual assuming responsible for payment (if LISS Program
funding is denied), if different from the LISS Program applicant.
(3) Date the invoice was generated and Invoice number.
(4) Clear indication whether the invoice is an initial proposal or estimate of services (i.e.,
generated before services are rendered after an initial consultation) or a final invoice (i.e.,
after services have been rendered) as follows:
a. If initial invoice, it must clearly indicate that it is “Proposed,” “Quote,” or “Estimate”; or
b. If final invoice, it must clearly indicate that it is “Final.”
(5) Description of services that have been or will be rendered. The description of services must
be detailed enough to clearly identify specific components of the services that has been, or
will be, rendered to the LISS Program applicant by the Vendor.
(6) Proposed or actual date(s) on which services have been or will be rendered.
(7) Proposed or actual hour(s) services have been or will be rendered.
(8) Rate of pay: total amount of proposed or actual cost of services to be paid and term in which
to pay the service if LISS Program funding is denied.
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Independent Contractors: A person who is hired by the applicant/parent/legal guardian to
provide a service and may not be a state registered Vendor. Example: Neighbor or friend.
Legal Guardian: means a person who has been appointed as guardian of the person or property of the
LISS Program applicant by an order of a court of competent jurisdiction.
Letter of Recommendation: The document completed by a Maryland licensed medical/dental/mental
health professional who recommends a specific medical/dental/mental health related service,
prescription drugs, therapies, or item. A blank form is located on the LISS Provider’s website.
LISS Program Contractor: means an entity contracted with the DDA to administer the LISS Program,
including issuing notices of random selection, reviewing Service Eligibility Applications, determining
whether the individual applicant and/or the requested goods or services are eligible for LISS Program
funding, and distributing LISS Program funds in accordance with applicable requirements.
Not Selected: The Random Selection did not choose an applicant’s application for further review.
Online Shopping Cart: An Internet printing listing that identifies the items chosen for purchase from a
specific website. The printout must contain the final cost including tax, shipping and handling fees.
Parent: means natural or adoptive persons who have a legal responsibility to the LISS Program applicant.
Random Selection: The electronic system that randomly selects applicants for possible funding.
Reimbursement: The dollar amount provided to the applicant that he or she spent out of pocket to pay
for an eligible service and/or item.
Selected: The Random Selection chooses an applicant’s application for further review. Selection does not
mean the applicant is approved.
Services Eligibility Application: The application is used to identify the services and items requested.
The applicant or his or her family must submit this application by the date identified on the applicant’s
selected letter. A blank form is located on the LISS Provider’s website.
Timesheets: When requesting Respite and/or Attendant Care, this form is required to remit payment. This
form is supplied by the LISS Provider if the service is approved. It must be completed by the independent
contractor. It must include the rate of pay (such as hourly or daily) and the total number of hours or days
being requested.
For example: 40 days at $50/day = $2,000 or 100 hours at $12/hour = $1200.
Vendor means an Individual or entity, selected by an Individual applicant, to provide goods or services
funded by LISS Program. Neither the DDA nor its LISS Program specifically list or endorse individuals
or entities to serve as Vendors. Vendors are not paid in advance for services by the LISS Program. Costs
must be responsible and customary.
