Maryland Administrative Code

.09 Grievance Procedure Stage 4: Central Review Committee Response. A. The Central Review Committee: (1) Shall meet within 10 working days of receipt of an appeal; (2) Shall review all prior information concerning the grievance; (3) May perform an investigation of the grievance w…

.10 Resident Grievance System Reports. A. The Director of the RGS shall ensure that RGS reports: (1) May not be released to other persons except as provided within this chapter; and (2) Identify the alleged violations, the decision, and the remedy. B. With the identity of those i…

.11 Personnel Provisions. A. A facility may not place the reports of the RGS in an employee's personnel file. B. The rights advisor may not be a witness in an agency proceeding against an employee, unless the rights advisor is a first-hand witness to events being reviewed. C. If …

.12 External Legal Action. A. This chapter does not modify the resident's: (1) Legal rights; (2) Access to seek private legal counsel from attorneys not receiving funding for legal assistance from the Maryland Department of Health; or (3) Access to a court. B. The Resident Grieva…

.01 Scope. These regulations govern payment for specific emergency services, as defined in Health-General Article, §10-628, Annotated Code of Maryland, rendered as a direct consequence of a petition for emergency evaluation.

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Consultant” means a physician, licensed by the State, who is not a salaried staff member of the emergency facility and who is authorized by the emergency facility to perfo…

.03 Conditions for Payment. The Department shall pay for emergency service only if: A. As determined according to Health-General Article, §16-202, Annotated Code of Maryland, the emergency evaluee cannot pay the charge for the service; and B. The emergency evaluee does not have h…

.04 Payable Services. The Department shall limit services payable under this chapter to the following emergency services: A. The basic emergency room fee in a designated emergency facility; B. The initial examination performed in the emergency room of a designated psychiatric eme…

.05 Billing Procedures. A. The provider shall submit the following documents: (1) A request for payment on a form designated by the Department; (2) A bill that specifies the: (a) Name of the emergency evaluee; (b) Date of service; and (c) Description of service; (3) A copy of the…

.06 Payment Rates. The Department shall pay: A. Hospitals, at rates approved by the Health Services Cost Review Commission; B. Physicians, the lesser of the: (1) Amount billed; or (2) The Statewide average of prevailing charges for an examination by a physician consultant based o…

.07 Subrogation by the Department. A. Before billing the Department, the provider shall: (1) Take all reasonable steps to collect the charge from the emergency evaluee and, if applicable, from insurers, including Medicare and Medical Assistance; or (2) Make and document a determi…

.08 Patients' Rights. A. Access to Care. Providers of emergency services shall give an emergency evaluee equal access to treatment and services that are available or medically indicated, regardless of diagnosis, handicap status, race, age, sex, national origin, religious or polit…

.01 Scope. A. This chapter outlines the process for application for, denial of, and disciplinary action on, the approval for a program to be eligible to receive State or federal funds for providing community mental health services. B. This chapter does not apply to programs appro…

.02 Definitions. In this chapter, terms have the meanings indicated in COMAR 10.21.17.

.03 Approval Requirements. To be eligible for approval under this chapter, a program shall: A. Meet the requirements of: (1) This chapter; (2) COMAR 10.21.17; (3) The chapter under this subtitle that outlines the requirements for the specific program; and (4) Medical Assistance r…

.04 Application Process. A. Consultation. Before submitting an application, an applicant for approval of a program may request assistance from the Department's designated approval unit or the appropriate core service agency (CSA) director regarding the proper compilation of appli…

.05 Program Service Plan (PSP). On the forms approved by the Administration as part of the application required under Regulation .04C of this chapter or COMAR 10.21.04.05B, a program shall submit a PSP that includes a description of: A. The range of services that the program will…

.06 Evaluation of Application. A. The Department's designated approval unit shall evaluate the application to determine whether the applicant adequately documents that the: (1) Proposed program has met all approval requirements; (2) Applicant has reviewed and is knowledgeable reg…

.07 Temporary Approval. A. If the Department's designated approval unit determines that the program meets all approval requirements, the Secretary shall: (1) Issue temporary approval according to the provisions of §B of this regulation; and (2) Forward copies of the approval to t…

.08 Approval of a Program. A. Approval Without Conditions. (1) The Secretary shall grant approval without conditions to a program if, based on an on-site review, the Department's designated approval unit determines that the program complies with the requirements for approval. (2)…

.09 Waivers and Variances. A. Waivers. The Secretary may not waive the requirements of any regulation adopted under: (1) This chapter; (2) COMAR 10.21.17; or (3) The chapter under this subtitle that outlines the requirements for a specific program. B. Variances. (1) A program tha…

.10 Deemed Status. A. Initial Request for Deemed Status. If a program is approved under Regulation .08 of this chapter and is accredited under relevant behavioral health care standards of the Joint Commission on the Accreditation of Health Care Organizations (JCAHO) or the Rehabi…

.11 Program Inspection and Investigation by the Department. The Department, its designees, the Administration, the Administration's ASO, CSA, and federal funding agents may: A. Make announced and unannounced visits to a program; and B. Inspect and copy all records, including, but…

.12 Denial, Emergency Suspension of Approval, and Disciplinary Action. A. Denial of Approval. (1) If the Secretary proposes to deny approval to an applicant under the provisions of this chapter, the Secretary shall give written notice of the proposed denial to the: (a) Applicant;…

.13 Program Request for Discontinuation of Operations. A. If a program intends to discontinue operation, the program director shall, no less than 60 calendar days before the program intends to discontinue operation, submit to the Department's approval unit, the Administration, an…

.14 Program Request for Discontinuation of Approval. A. If a program wishes to discontinue approval, the program director shall, not less than 60 calendar days before the date the program wishes to discontinue approval: (1) Submit to the Department's designated approval unit a le…

.15 Initiation of Receivership. The Secretary may take action to initiate receivership under the provision of Health-General Article, §§19-333 — 19-339, Annotated Code of Maryland.

.16 Procedures for Hearings. A. If the Secretary proposes to deny approval or initiate disciplinary action, the Secretary shall give the program director written notice of the proposed action, according to the provisions outlined in Regulation .12A — C of this chapter. B. Within …

.01 Scope. This chapter delineates the administrative requirements for a community mental health program.

.02 Definitions. A. In COMAR 10.21.16 and subsequent community mental health program chapters, the following terms have the meanings indicated. B. Terms Defined. (1) “Ability to pay” means the individual's ability to pay for mental health services, as determined according to the …

.03 Authorization and Payment. A. Authorization for Services. (1) The program shall comply with the provisions of this regulation when the program provides services to: (a) A Medicaid recipient; or (b) An individual for whom, because of the severity of the mental illness and, bas…

.04 Consent for Services, Orientation, and Advance Directive for Mental Health Services. A. Consent for Services. (1) Before initiating services to an individual, a program shall: (a) Obtain consent from the individual to: (i) Render services to the individual; and (ii) Involve, …

.05 Advisory Committee. A. Membership. A provider that is approved by the Department under this subtitle to operate a program shall have an advisory committee that is composed of members: (1) That reflect the cultural and ethnic profile of the community or communities being serve…

.06 Collaboration with Core Service Agency (CSA). The program director shall: A. Submit annually to the CSA, or, when providing services in multiple jurisdictions, the lead CSA, and the Community Services Reimbursement Rate Commission, an annual summary that, at a minimum, includ…

.07 Program Model. A. A community mental health program shall develop a program model that promotes recovery and resiliency as required according to the chapter under this subtitle for the specific program. B. The program director shall ensure that information and services are pr…

.08 Records. A. General Requirements. (1) The program shall, either manually or electronically: (a) Establish a record for an individual who receives services from the program; and (b) Ensure that entries in the record are dated, signed, and include the signer's degree or license…

.09 Policies and Procedures. A. The program shall have and maintain written policies that, at a minimum include: (1) The program's mission and goals; (2) A description of the organizational structure of the program; (3) Identification of the duties of the program director and, if…

.10 Discharge from Services. A. When an individual has attained the goals identified in the individual's service plan, the individual's program coordinator shall begin the process for discharge planning. B. Discharge Policy. The program shall have and maintain written policies an…

.11 Human Services Development. A. Supervision. The program director shall: (1) Establish a system to ensure ongoing supervision of staff; and (2) Determine the need for staff supervision on the basis of: (a) Credentials, competencies, experience, education, and training; (b) Per…

.12 Quality Management (QM). A. A program shall establish and maintain a QM process in accordance with the requirements of this regulation. B. QM Plan. The program director shall develop and, at least every 3 years, review a written QM plan that: (1) Provides for an internal, ong…

.13 Reports of Death. Upon notification of the death of any individual in a State funded or operated program or facility, the administrative head of the program or facility shall: A. Report the death according to the provisions of Health-General Article, §10-714(a), Annotated Cod…

.14 Staff Credentials, Competencies, and Privileges. A. The program director shall ensure that staff and consultants perform only those duties for which the staff and consultants have the appropriate credentials and competencies according to the provisions of this regulation. B. …

.15 Rights. A. A program shall: (1) Explain to an individual enrolled in a program the individual's rights as set forth in Health-General Article, Title 10, Subtitle 7, and Title 4, Subtitle 3, Annotated Code of Maryland; (2) Provide, in writing, information regarding an individu…

.16 Complaints. A. A program shall develop and implement an internal process for the prompt and objective resolution of complaints related to services provided that may be presented by an individual. B. The program shall prominently display, in accessible centralized locations, t…

.17 Grievances. If an individual has a grievance regarding the denial of services based on eligibility or medical necessity criteria, the individual may file the grievance according to the procedures outlined in COMAR 10.09.70.08.

.01 Scope. A. This chapter applies to clinical programs that provide a combination of developmental and mental health services in a preschool setting, made accessible and available to children and the families of children who are at risk for or who are emotionally disturbed, who …

.02 Definitions. A. In this chapter, terms have the meanings stated in COMAR 10.21.17 and this regulation. B. Terms Defined. (1) “Individualized family service plan (IFSP)” means the plan defined in COMAR 10.09.40. (2) “Learning center” means a designated area of a classroom that…