Peggy Lauer, a Baltimore resident living with Parkinson’s disease, was told she would start receiving 48 hours of nursing care on April 1. At the last moment, she learned that the financial approval for her Medicaid waiver had not gone through. Her sister, who has cared for her for years, says they let go of a private caregiver to prepare for the new schedule and are now staring at months of uncertainty, paying out of pocket or going without help, as they say Lauer clearly needs. Their situation is one very personal example of a larger backlog that advocates say is stranding families who depend on in-home services.
As reported by WMAR-2 News, Lauer’s care plan itself was approved, but the "financial piece" was not. She and her sister were told on March 31 that the final green light could take almost another year. WMAR reports that Lauer had been getting eight hours of home help a week and had planned to ramp up to 48 hours of nursing care starting April 1, a shift that led them to release their previous aide. According to the station, the Maryland Department of Health declined to provide an on-camera interview when asked about the backlog.
"Other than sleeping, she needs 24 hour care," Lauer's sister, Kathy Sweat, told WMAR2 News, adding, "Oh, yeah, absolutely, we feel forgotten. We absolutely do." Lauer told the station she was "very disappointed" and wants relief for her sister as soon as possible. Their frustration mirrors what many families say they feel as they wait for home- and community-based services to actually materialize.
Advocates Say Delays Are Widespread
Advocates and provider groups have warned for more than a year that eligibility reviews, staffing shortages, and the flood of redetermination work since the pandemic have led to long waits for waiver decisions, sometimes stretching six months to a year, according to reporting by WTOP. Providers told reporters they are delivering large amounts of "uncompensated care" while clients temporarily fall off waivers, a financial hit that some nonprofits say reaches into the hundreds of thousands or even millions of dollars. Disability advocates say the backlog has been made worse by leadership churn and administrative cuts that left critical eligibility work short-staffed.
State Report Lays Out Goals and Bottlenecks
The Maryland Department of Health's "End the Wait" report, submitted in December 2024, confirms that six of eight home- and community-based waiver programs have registries and outlines staffing and provider-capacity steps intended to reduce those lists by half by FY 2028, according to the Maryland Department of Health. The report notes that the shared waitlist for Developmental Disabilities Administration-operated waivers was about 4,130 people in August 2024 and identifies the Eligibility Determination Division as a choke point for financial reviews. Officials included funding proposals and rate increases aimed at strengthening provider capacity, but families and advocates say paperwork backlogs and slow processing are still getting in the way of care.
Lawmakers Passed the End the Wait Act, Now Comes Implementation
Lawmakers approved the End the Wait Act in 2022, directing the Maryland Department of Health to produce plans for cutting waitlists and to set funding targets, according to the Maryland General Assembly. Advocates and some providers say that while the law created a roadmap, on-the-ground problems such as hiring logjams, complex redeterminations, and aging IT systems have left many applications stuck in limbo. Families like the Lauers say they need realistic timelines and faster follow-through from the agency that runs the program.
State officials are also dealing with a broader Medicaid workload, including redeterminations and new eligibility rules that add to already heavy caseloads. Public radio reporting notes that the department is trying to keep people enrolled as new requirements approach and that staffing turnover makes timely processing harder, according to WYPR. Advocates argue the state should move financial reviews for already-approved service plans to the front of the line so care can start sooner. Some provider groups are also pressing officials to reimburse agencies for uncompensated care when gaps stem from administrative failures rather than any change in a client’s needs.
For now, Lauer and her sister are still waiting, a daily reminder of how an administrative backlog can turn into a full-blown care crisis. State leaders say they are working on solutions, but advocates are calling for faster fixes that move people out of a paperwork queue and into the home care they were told they would receive. Until processing speeds and staffing levels improve, more Maryland families are likely to face the same hard choice between costly private help and essential needs going unmet.
