Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 01 - PROCEDURES
Chapter 10.01.18 - Sexual Abuse Awareness and Prevention Training
Section 10.01.18.02 - Definitions
Universal Citation: MD Code Reg 10.01.18.02
Current through Register Vol. 51, No. 19, September 20, 2024
A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Admission" means the process by which an
individual is accepted as a resident or patient in a State facility and
includes the physical act of the individual entering the State
facility.
(2) "Central coordinator"
means an individual or individuals designated by the Deputy Secretary for the
unit of the Department responsible for the operations of each State facility
to:
(a) Oversee development of policies and
materials;
(b) Monitor compliance;
and
(c) Identify and make
recommendations for improving a State facility's prevention and detection of,
and response to, inappropriate sexual behavior in State facilities.
(3) "Covered program" means any of
the following facilities and programs:
(a) A
State facility as defined in §B(22) of this regulation;
(b) Non-State operated residential treatment
centers for emotionally disturbed children and adolescents, licensed under
COMAR 10.07.04;
(c) Vocational and
day services programs, licensed by the Developmental Disabilities
Administration under COMAR 10.22.02 and 10.22.07; and
(d) The following programs licensed by the
Behavioral Health Administration:
(i)
Psychiatric rehabilitation programs for adults licensed under COMAR
10.63.03.09;
(ii) Residential rehabilitation programs
licensed under COMAR
10.63.04.05;
(iii) Supported employment programs licensed
under COMAR
10.63.03.16; and
(iv) Psychiatric rehabilitation programs for
minors licensed under COMAR 10.63.03.10.
(4) "Department" means the Maryland
Department of Health.
(5) External
Law Enforcement Agency.
(a) "External law
enforcement agency" means the Department of State Police or a police agency of
a county or municipal corporation.
(b) "External law enforcement agency" does
not include the police force of the Maryland Department of Health.
(6) "Inappropriate sexual
behavior" means:
(a) Sexual abuse as defined
in §B(17) of this regulation; and
(b) Any sexual act, as defined in §B(18)
of this regulation, between a staff member of a covered program and an
individual receiving services at the covered program.
(7) "Individual" means a person receiving
services or treatment at a State facility.
(8) "Initial plan of care" means the first
plan of care created for an individual by the treatment team and is created at
the first treatment team meeting.
(9) "Internal complaint process" means a
written policy and procedure for a covered program 's handling and
investigation of reports of inappropriate sexual behavior, as defined in
§B(3) of this regulation, and appropriate actions in response to verified
incidents of inappropriate sexual behavior, occurring within the covered
program.
(10) "Licensed" means
being licensed by the Department or approved by the Department to receive
funding to provide services in Maryland.
(11) "Peer training" means awareness and
prevention training regarding inappropriate sexual behavior that is provided by
a peer of the individual receiving services.
(12) "Plan of care" means a written document
addressing the needs of the individual receiving services from a covered
program, and the covered program's plan for provision of services and treatment
to meet those needs, developed in accordance with applicable State and federal
laws and regulations.
(13) "Program
director" means the individual who is responsible for the daily operations of a
covered program as outlined in the chapter under the appropriate subtitle that
delineates the requirements for a specific program.
(14) "Protection plan" means a document
created to address the individual's needs, with respect to the individual's:
(a) Risk of being subjected to the
perpetrator of inappropriate sexual behavior at the facility; and
(b) Treatment team's plan for mitigating the
individual's risk.
(15)
Reasonable Safety Precautions.
(a) "Reasonable
safety precautions" means an established set of measures, procedures, and
protocols taken in order to maintain the safety of individuals upon admission
to the State facility.
(b)
Reasonable safety precautions may include but are not limited to:
(i) Unit restriction, including dining on the
unit;
(ii) Increased nursing
contacts or more frequent observation by nurses;
(iii) Restrictions on activities;
(iv) Increased staffing assigned to the
individual; and
(v) Similar or
additional measures implemented.
(c) The type of reasonable safety precautions
implemented and the reason for the reasonable safety precautions shall be
documented in the individual's records.
(16) "Risk assessment screen" means a uniform
tool, developed by the Department, used by a facility to:
(a) Screen an individual for a history of
being subjected to, or perpetrating, inappropriate sexual behavior, and related
trauma; and
(b) Assess an
individual's risk of being subjected to, or perpetrating, inappropriate sexual
behavior while at the facility.
(17) Sexual Abuse.
(a) "Sexual abuse" means any sexual act, as
defined in §B(18) of this regulation, that is made or threatened to be
made without the consent of an individual who is the recipient of the action,
or without the consent of an individual solicited to take the action, which
occurs on the premises of a covered program or at any off-premises activity
sponsored by the covered program.
(b) "Sexual abuse" includes sexual harassment
and sexual assault.
(c) "Sexual
abuse" does not include an action taken reasonably related to the provision of
care, treatment, or services to an individual including:
(i) The performance of an accepted medical or
behavioral procedure pursuant to and in accordance with orders of an
appropriately qualified licensed health care professional; and
(ii) An action taken by a staff member that
complies with applicable laws and policies on the use of physical
intervention.
(18) "Sexual act" means any of the following,
if it can reasonably be construed to be for sexual arousal or gratification, or
for the abuse of either party, and not for an accepted medical or behavioral
purpose:
(a) An act in which an object or part
of an individual's body penetrates, however slightly, into another individual's
genital opening or anus;
(b)
Intentional physical contact, or an attempt to make physical contact, either
directly or through clothing, between the genitals, finger or fingers, hand or
hands, or mouth of one individual and the genitals, groin, inner thigh,
buttocks, anus, breast, or mouth of another individual;
(c) Intentional physical contact, or an
attempt to make physical contact, between the tongue or mouth of one individual
and any part of the body of another individual;
(d) The following nonphysical contacts:
(i) The intentional exposure by an individual
to another of the individual's naked genitals, groin, inner thigh, buttocks,
anus, or breast;
(ii) The
intentional exposure by an individual to another of photographs of an
individual's naked genitals, groin, inner thigh, buttocks, anus, or
breast;
(iii) The intentional
observation by an individual of another individual's naked genitals, groin,
inner thigh, buttocks, anus, or breast;
(iv) Verbal or written description of,
questions or suggestions regarding, or requests for any of the physical
contacts described in §B(18)(a)-(c) of this regulation;
(v) Photographing, drawing, transmitting an
image of, saving an image of, or recording the naked body or body parts of
another individual;
(vi)
Intentionally exposing an individual to photographs, pictures, drawings,
diagrams, or other graphic depictions of naked body or body parts of an
individual; and
(vii) Intentionally
causing another individual to make or attempt any of the physical contacts
described in §B(18)(a)-(c) of this regulation; and
(e) Other intentional acts directed to
another individual and performed for the purpose of arousing sexual thoughts or
feelings and not for purposes related to the provision of care.
(19) "Sexual assault" means any of
the following:
(a) A sexual offense as defined
in Criminal Law Article, Title 3, Annotated Code of Maryland; and
(b) Any other sexual act that is a crime
under State or federal law.
(20) "Sexual harassment" means intimidation,
bullying, or coercion of a sexual nature or unwelcome sexual advances, requests
for sexual favors, and other verbal or physical conduct of a sexual nature that
tends to create a hostile or offensive environment.
(21) "Staff member" means any individual
employed by a covered program, whether contractually or permanently and any
individual who volunteers with, is a contractor for or consultant to, works as
an intern or resident for, or otherwise is engaged by, the covered program at
any facility or location in which services are provided to
individuals.
(22) "State facility"
means the following institutions operated by the Department:
(a) A psychiatric hospital, licensed pursuant
to COMAR 10.07.01;
(b) An
intermediate care facility for individuals with developmental disabilities
licensed pursuant to COMAR 10.07.20;
(c) A forensic residential center, licensed
pursuant to COMAR 10.07.13; and
(d)
Regional institutes for children and adolescents licensed and operated pursuant
to COMAR 10.07.04 and COMAR 10.21.06.
(23) "Treatment team" means the group of
individuals at the covered program who, in accordance with applicable State and
federal law and regulations, are responsible for the development and
implementation of a plan of care for an individual receiving services from the
covered program.
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