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Maryland, a fairly small mid-Atlantic state with about 5 million people in 1999, has 12 home and community services programs for older persons and adults with physical disabilities. Marylands Medicaid program provided home and community services to approximately 5,100 beneficiaries through the optional personal care benefit and 4,600 beneficiaries through its optional medical day care program in fiscal year 1999. The state has one currently operating Medicaid waiver for older adults with 135 slots, which will be expanded to 1,135 slots in 2001. The state will implement another waiver in 2001 with 150 slots in the first year for non-elderly adults with physical disabilities. The state also has eight small, state-funded home and community services programs designed to serve adults who are not eligible for Medicaid. The state has a complex administrative structure for its home and community services programs, with several state and local agencies involved.