Who Increased Community Services in Maryland is for
Picture a parent who went into a nursing facility after a hospital stay and has been there for months. They’re stable now and want to come home to Baltimore. Their pension is too high for the Community Options Waiver.
That’s the gap Increased Community Services was built for. MDH lists these rules:
- Age 18 or older, needing a nursing facility level of care.
- Six months or more in a nursing facility, while Medicaid-eligible for at least 30 days in a row.
- Not eligible for an HCBS waiver or PACE.
- Monthly income above 300% of the SSI benefit. Calculated from SSA’s 2026 rate of $994, that’s about $2,982 a month (3 × $994).
- Countable assets of no more than $2,500.
- Only the applicant’s own income and assets count.
ICS is small. A June 2025 MDH demonstration notice says it is authorized to enroll up to 100 people.
For the wider picture of Maryland programs, see our Medicaid home care overview and the Maryland Medicaid eligibility guide.
Increased Community Services vs the Community Options Waiver
Both programs serve adults who need a nursing facility level of care. The main split is income: the CO Waiver caps it at 300% of SSI, and ICS starts above that line.
| Community Options Waiver | Increased Community Services | |
|---|---|---|
| Age | 18+ | 18+ |
| Medical test | Nursing facility level of care | Nursing facility level of care |
| Where the person lives | At home or in the community; nursing facility residents with 30+ Medicaid-paid days can apply without waiting | Nursing facility for at least 6 months, Medicaid-eligible 30+ days in a row |
| Monthly income | No more than 300% of SSI (about $2,982, calc.) | More than 300% of SSI |
| Countable assets | $2,000 or $2,500, by eligibility category | No more than $2,500 (applicant’s own) |
| How to get in | Join the registry through MAP, wait for an invitation | Referral from Medicaid’s Eligibility Determination Division only |
| Size | 6,348 slots, 4,477 enrolled in FY25 (MDH, Feb. 2026) | Up to 100 people (June 2025 notice) |
| Spouse as paid provider | No rule in our sources; ask MDH | Barred by COMAR 10.09.81.13B |
The CO Waiver includes all Medicaid benefits, Community First Choice among them, plus assisted living, case management, medical day care and other services. Its registry held 23,461 people on June 30, 2025. Read more on our Community Options Waiver page.
ICS has its own list, built around the move home: personal assistance, respite, supports planning, home-delivered meals, PERS, environmental adaptation, family training and Money Follows the Person transition services.
How to get a referral to Increased Community Services
You can’t apply to ICS directly. MDH says the referral must come from Medicaid’s Eligibility Determination Division.
A sensible first move is two conversations:
- The nursing facility social worker. Ask about the resident’s length of stay and Medicaid history, both central to ICS.
- Maryland Access Point. Options counselors explain which programs fit. In the city, call MAP of Baltimore City at 410-396-CARE (2273). In the county, call the Department of Aging in Towson at 410-887-2594.
Ask both whether an ICS referral is realistic, or whether the CO Waiver, Community First Choice or PACE fits better. Our step-by-step guide to applying covers the assessment, supports planner and plan of service.
The ICS spouse rule under COMAR 10.09.81.13B
This is the question families ask most. Under COMAR 10.09.81.13B, an ICS provider may not be:
- the participant’s spouse,
- the parent of a dependent child, or
- a person with full and unrestricted guardianship powers.
This bar is written for ICS. Don’t assume it carries over to other Maryland programs, and don’t assume it doesn’t. For CFC questions, call the Community First Choice Program at 410-767-1739.
Coming home from a nursing facility to Baltimore
The first weeks at home after a long facility stay can be hard. Stairs in a Canton rowhouse, a bathroom on the second floor, medications that changed during the stay.
Personal assistance is on the ICS service list. At home, that looks like personal care: bathing, dressing and moving around safely. For people who need someone present most of the day, families also look at 24-hour home care or live-in care.
We serve families in Canton, Highlandtown, Fells Point and across Baltimore County. Our care coordinators can explain the steps and what to ask. We don’t decide eligibility or make ICS referrals.
To talk about a return home, call our in-home care team in southeast Baltimore at 410-421-1041, or send a message.
This page is general information, not legal or benefits advice. Rules change, so confirm details with Maryland Medicaid or Maryland Access Point.