THERAPEUTIC INTEGRATION SERVICES PROVIDER IN MARYLAND

Fatumata Kaba
Sep 2
4 min read

FOSTERING GROWTH, SOCIALIZATION, AND SKILL-BUILDING FOR CHILDREN WITH DISABILITIES THROUGH THERAPY-DRIVEN COMMUNITY ENGAGEMENT

Therapeutic Integration Services in Maryland are structured, community-based support services for children with intellectual and developmental disabilities. These services focus on enhancing socialization, adaptive behavior, and community participation in a group setting. They are authorized under the Maryland Developmental Disabilities Administration (DDA), primarily through the Family Supports Waiver and sometimes through Community Supports and Community Pathways Waivers for transitional-aged youth.

1. GOVERNING AGENCIES

Agency: Maryland Department of Health (MDH)

Role: Oversees regulatory standards for DDA Waiver services

Agency: Developmental Disabilities Administration (DDA)

Role: Administers the Family Supports Waiver, which includes Therapeutic Integration services

Agency: Office of Long-Term Services and Supports (LTSS Maryland)

Role: Tracks data, documents service delivery, and manages Medicaid billing for DDA programs

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures compliance with federal Home and Community-Based Services (HCBS) standards

2. THERAPEUTIC INTEGRATION SERVICE OVERVIEW

Therapeutic Integration (TI) provides structured after-school or day programming for children and adolescents that:

Incorporates therapy-informed activities
Fosters communication, peer relationships, and behavior regulation
Builds community engagement skills through group activities and outings
Offers support with social-emotional learning and sensory needs
May include individual goal planning as outlined in the Person-Centered Plan (PCP)

TI programs typically operate before or after school, on weekends, and during school breaks, with staff support ratios based on individual needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your agency with the Maryland Department of Assessments and Taxation (SDAT)
Obtain EIN and Type 2 NPI
Apply to become a DDA-approved provider through the DDA Provider Application Portal
Secure a program location (site-based facility) that meets safety and accessibility requirements
Submit policies for therapeutic curriculum, behavior management, and supervision
Hire qualified staff trained in developmental disabilities, behavioral health, or child development
Obtain commercial liability insurance and ensure compliance with transportation and safety protocols (if applicable)

4. DDA PROVIDER ENROLLMENT & SERVICE APPROVAL

Step 1: Develop Program Design

Define therapeutic goals, daily schedules, and activity types
Include group ratios, staffing structure, and behavior support practices

Step 2: Submit DDA Provider Application

Select “Therapeutic Integration” under the Family Supports Waiver
Include location details and staffing credentials

Step 3: Site Visit & Review

Prepare for DDA pre-approval inspection if operating from a physical facility
Submit floor plans, emergency exits, and environmental safety documentation

Step 4: Receive Approval and Accept Referrals

Begin service delivery once referrals are received from the Coordination of Community Services (CCS) agencies
Document attendance, outcomes, and behavioral incidents as required

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC paperwork (via SDAT)
IRS EIN and NPI confirmation
DDA provider enrollment approval
Facility lease or ownership documentation (for site-based services)
Policy & procedure manual including:
- Participant intake and individualized support planning
- Therapeutic activity schedule and curriculum outline
- Behavior support protocols and de-escalation strategies
- Incident reporting, medication management (if applicable)
- Supervision policies and staff ratios
- Parent communication procedures
- Transportation safety plans (if providing community outings)
- Staff training logs and background checks

6. STAFFING REQUIREMENTS

Role: Therapeutic Integration Specialist / DSP

Requirements: Minimum high school diploma or GED, experience with youth or disabilities, background check, CPR/First Aid, and DDA Core Competency training

Role: Clinical Supervisor or Program Manager

Requirements: Bachelor’s or Master’s degree in education, psychology, or related field; responsible for planning, supervision, and behavioral oversight

Role: Behavioral Health Consultant (optional)

Requirements: BCBA, LCSW, or similar; supports behavioral planning and training

Training Requirements for All Staff:

DDA Orientation and Core Competencies
Behavior intervention and de-escalation techniques
Trauma-informed care
Documentation and safety protocols
Parent/caregiver communication skills
Annual continuing education

7. MEDICAID WAIVER SERVICES

Therapeutic Integration is reimbursable under:

Family Supports Waiver – Children under 21 with intellectual/developmental disabilities
Community Supports Waiver – Transition-aged youth not enrolled in full-day services
Community Pathways Waiver (case-by-case for youth with high needs)
Self-Directed Services (in limited cases) – TI may be accessed through individualized arrangements

Covered services include:

Therapeutic group activities and community outings
Structured recreational engagement
Social-emotional learning support
Crisis response and behavior support (if outlined in PCP)
Transition-to-adulthood skills (as applicable)

8. TIMELINE TO LAUNCH

Phase: Business and Facility Setup

Timeline: 2–3 weeks

Phase: Staff Hiring and Curriculum Development

Timeline: 2–4 weeks

Phase: DDA Provider Application and Site Inspection

Timeline: 6–10 weeks

Phase: Service Activation and Referral Enrollment

Timeline: Ongoing

9. CONTACT INFORMATION

Maryland Developmental Disabilities Administration (DDA)

Website: https://dda.health.maryland.gov Email: dda.providerapps@maryland.gov

Maryland Medicaid Provider Enrollment (ePREP)

Website: https://eprep.health.maryland.gov

Maryland State Department of Education (MSDE) (if providing coordination with IEPs)Website: https://marylandpublicschools.org

Maryland Department of Assessments and Taxation (SDAT)

Website: https://egov.maryland.gov/BusinessExpress

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — MARYLAND THERAPEUTIC INTEGRATION PROVIDER

We help educators, behavioral specialists, and youth service providers launch impactful Therapeutic Integration programs for children with developmental disabilities across Maryland.

Scope of Work: