Direct support professional training in Maryland is regulated by the Developmental Disabilities Administration (DDA) within the Maryland Department of Health. Licensed community providers operate under COMAR Title 10, Subtitle 22, and the staff training rule — COMAR 10.22.02.11 — applies across DDA-funded services: residential, meaningful day, employment, personal supports, and nursing supports delivered under the Community Pathways and related HCBS waivers. The DDA consolidates every requirement into its Provider Training Matrix, which maps each curriculum to its COMAR or federal citation, the services and audience it applies to, its deadline, and the CMS direct-service-workforce core competencies it fulfills — making the matrix the single most useful compliance document a Maryland training coordinator can keep on hand.

Initial training runs on two clocks. Under COMAR 10.22.02.11C, staff must receive adequate training to perform their assigned duties — including specialized topics such as seizure disorders and behavior support where relevant to the people served — before assuming independent duties, and the DDA's audit form (DH Form DD.APP.1.1) is blunt about the stakes: staff must meet all required training before providing services independently, and training and qualification must be initially and continually met for payments. Under COMAR 10.22.02.11D, the core curriculum must be completed within three months of hire (the DDA matrix operationalizes this as 90 days): community integration and inclusion under the HCBS Community Settings Rule (D)(1); individual-directed, outcome-oriented person-centered planning (D)(2); general characteristics and needs of the people served, including seizure disorders (D)(3) and (C)(2)(a); CPR and First Aid (D)(4); fundamental rights and supporting choice (D)(5); communicable diseases and bloodborne pathogens (D)(6), aligned to OSHA 29 CFR 1910.1030; and supporting individuals and families in making choices, communication skills, and principles of behavior change (D)(7)–(8), which Maryland providers deliver through the Mandt System curriculum adopted under the DDA Behavior Support Services Policy. The matrix adds incident reporting (PORII) within 90 days under COMAR 10.22.02.03(D)(2), HIPAA basics, and the aging process for staff supporting people across the lifespan.

Ongoing requirements are topic-based rather than an aggregate hour count. Bloodborne pathogens retrains annually per OSHA; DSPs complete an annual Mandt refresher — the first recertification in person, after which providers may use blended online learning for Chapters 1–5 while Chapters 6–8 (required for staff supporting people with restrictive behavior plan techniques) must be tested out in person; CPR and First Aid renew every two years to American Red Cross or equivalent national standards; and sexual behavior awareness training for meaningful day services renews annually under COMAR 10.01.18.04. There is no state DSP registry or certification in Maryland — compliance is demonstrated through provider training records, which DDA reviews against the COMAR requirements, so an accurate, per-staff training ledger is effectively the compliance artifact. Providers running annual cycles across dozens of staff typically manage this in an LMS that flags each person's 90-day window, annual retraining dates, and two-year renewals automatically.

Medication administration is Maryland's most tightly gated item. Unlicensed staff may administer medications only after completing the Maryland Board of Nursing's approved 20-hour Medication Technician Training Program (MTTP) and becoming a Certified Medication Technician (CMT) under COMAR 10.39.04.06, working under the delegating authority of a registered nurse. CMT certification renews every two years in the technician's birth month, requiring a Board-approved clinical update completed within 90 days before expiration and 100 hours of CMT practice in the preceding two years — miss the update past the 30-day grace period and the full 20-hour program must be repeated. Staff must also clear a criminal history records check before employment under COMAR 10.22.02.11B and Health-General § 19-1902 et seq., with Child Protective Services checks added for staff serving participants under 18.

Maryland is an open-market training state. The DDA does not run a state training platform, license a single vendor, or operate a course-approval gate for the core curriculum: providers choose their own training sources, and the Provider Training Matrix itself points to a range of them — the American Red Cross and National Safety Council for CPR/First Aid, the Mandt System for behavior support, CDC seizure training, and Training and eTracking Solutions, which the matrix lists by name as a training resource on core curriculum rows including the aging process, general characteristics and needs, fundamental rights and supporting choice, and communicable diseases/bloodborne pathogens. The gated exceptions are the hands-on items: MBON-approved CMT training, in-person Mandt certification components, and CPR skills verification.

As a Maryland-based company listed on the DDA's own Provider Training Matrix, Training and eTracking Solutions provides online DSP training built for Maryland's requirements — courses mapped to the COMAR 10.22.02.11C and D topic areas and the CMS DSP core competencies the matrix tracks, automatic monitoring of each staff member's 90-day initial window, annual bloodborne pathogens retraining, and two-year CPR and CMT renewal dates, and per-staff records formatted to answer DDA licensing reviews and the DH Form DD.APP.1.1 attestation without a spreadsheet scramble. TeTS also tracks the pieces that must happen in person — Mandt recertification, CPR skills checks, MBON clinical updates — so Maryland providers hold one complete training record per DSP.