Before the State will take you seriously, you need a real business entity. Register your LLC with SDAT, get your EIN, open a business bank account, and set up workers' compensation and unemployment insurance — you'll need proof of both as application attachments. The DDA application requires you to demonstrate financial capability and submit a budget and fiscal verification. If you don't know your numbers, you can't pass this step.

This is the single most common reason applications die. The DDA requires CJIS background checks for you and your first-line managers before approval. Two hard rules:

• Request checks at least two weeks before you submit your application
• A check is only "current" if the DDA receives it within 45 days of the request — and if it's not at DDA headquarters within 30 days of receiving your application, your application will not be approved

The DDA's Agency Authorization # is 1500001484 and the ORI # is MD003105Y. On the Livescan form, check "Government Licensing or Certification." If serving children, you also need Child Protective Services clearances.

Submit electronically to providerapplications.dda@maryland.gov with your target Regional Office in the subject line. As an agency, complete pages 1–11 plus the Agency Questionnaire (pages 14–17). Required attachments include:

• Program Service Plan
• Quality Assurance (QA) Plan
• Budget and Fiscal Verification Form
• Governing Body (Board of Directors) Form
• Staff Training Form & Staff Criminal History Form
• Policies and Procedures Form
• Resumes for CEO, Directors, and all managers/supervisors overseeing waiver services
• Signed Provider Agreement to Conditions of Participation
• Completed Application Checklist (mandatory)

Required attachments are numbered and listed in the application. Miss one, and you're waiting.

Your Policies and Procedures manual is not boilerplate you can copy off the internet. COMAR 10.22.02 requires specific policies, and OHCQ surveyors check them line by line. This is where most new operators burn weeks — and where a structured builder pays for itself.

Once your provider application is moving, OHCQ inspects your physical site. They check the building, safety, required postings, resident rights, staff files, resident records, and — critically — HCBS Settings Final Rule compliance, which is the first thing surveyors evaluate during a residential visit.

Approval to provide services means nothing until you can get paid. That means LTSSMaryland billing setup, understanding MCO vs. Medicaid fee-for-service paths, and Electronic Visit Verification (EVV) compliance.

First resident intake, EVV activation, your ongoing compliance calendar, license renewal tracking, and incident logging. Launching is the start, not the finish.