Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.20 - Community Personal Assistance Services
Section 10.09.20.01 - Definitions
Universal Citation: MD Code Reg 10.09.20.01
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) "Activities of daily living" means tasks
or activities that include, but are not limited to:
(a) Bathing and completing personal hygiene
routines;
(b) Dressing and changing
clothes;
(c) Eating;
(d) Mobility, including:
(i) Transferring from a bed, chair, or other
structure;
(ii) Moving, turning,
and positioning the body while in bed or in a wheelchair; and
(iii) Moving about indoors or outdoors;
and
(e) Toileting,
including:
(i) Bladder and bowel
requirements;
(ii) Routines
associated with the achievement or maintenance of continence; and
(iii) Incontinence care.
(2) "Applicant" means an
individual who is applying to receive services under this chapter.
(3) "Assistance" means that another
individual:
(a) Physically performs the
activity for the participant;
(b)
Physically helps the participant to perform the activity;
(c) Monitors the participant's performance of
the activity in order to ensure health and safety; or
(d) Cues or encourages the participant to
perform the activity.
(4) "Certified medication technician (CMT)"
means an individual, regardless of title, who:
(a) Completes a course in medication
administration approved by the Maryland Board of Nursing;
(b) Is certified by the Maryland Board of
Nursing under COMAR 10.39.04; and
(c) Performs medication administration tasks
delegated by a nurse in accordance with COMAR 10.27.11.
(5) "Certified nursing assistant (CNA) "
means an individual, regardless of title, who:
(a) Is certified by the Maryland Board of
Nursing under COMAR 10.39.01; and
(b) Routinely performs delegated nursing
tasks delegated by a nurse in accordance with COMAR 10.27.11.
(6) Community Setting.
(a) "Community setting" means the area,
district, locality, neighborhood, or vicinity where a group of people live
which provides participants with opportunities to:
(i) Seek employment and work in competitive
integrated settings;
(ii) Engage in
community life;
(iii) Control
personal resources; and
(iv)
Receive services.
(b)
"Community setting" does not mean:
(i)
Hospitals;
(ii) Nursing
facilities;
(iii) Institutions for
mental diseases;
(iv) Intermediate
care facilities for individuals with intellectual disabilities; or
(v) Other institutions.
(7) "Conflicts of interest" means
real or seeming incompatibility between one's private interests and one's
public or fiduciary duties.
(8)
"Delegated nursing functions" means nursing services provided to a participant
by an enrolled personal assistance worker under the supervision of a:
(a) Registered nurse in accordance with COMAR
10.27.11; or
(b) Nurse practitioner
in accordance with COMAR 10.27.07.
(9) "Department" means the Maryland
Department of Health and Mental Hygiene or its authorized agent acting on
behalf of the Department.
(10)
Home.
(a) "Home" means the participant's
place of residence in a community setting.
(b) "Home" does not mean:
(i) An assisted living program as defined in
COMAR 10.07.14;
(ii) A residential
rehabilitation program licensed as a therapeutic group home under COMAR
10.21.07;
(iii) An alternative
living unit, group home, or individual family care home as defined in COMAR
10.22.01;
(iv) Community-based
residential facilities for individuals with intellectual or developmental
disabilities licensed under COMAR 10.22.02; or
(v) Any other provider-owned or controlled
residence.
(11) "Institution" means an establishment
that furnishes, in single or multiple facilities, food, shelter, and some
treatment or services to four or more individuals unrelated to the
proprietor.
(12) "Instrumental
activities of daily living" means tasks or activities that include, but are not
limited to:
(a) Preparing meals;
(b) Performing light chores that are
incidental to the personal assistance services provided to the
participant;
(c) Shopping for
groceries;
(d) Nutritional
planning;
(e) Traveling as
needed;
(f) Managing finances and
handling money;
(g) Using the
telephone or other appropriate means of communication;
(h) Reading; and
(i) Planning and making decisions.
(13) "Medicaid" means the Program,
administered by the State of Maryland under Title XTK of the Social Security
Act, which provides comprehensive medical and other health-related care for
categorically eligible and medically needy participants.
(14) "Medically necessary" means that the
service or benefit is:
(a) Directly related to
diagnostic, preventive, curative, ameliorative, palliative, or rehabilitative
treatment of an illness, injury, disability, or health condition;
(b) Consistent with current accepted
standards of good medical practice;
(c) The most cost-efficient service that can
be provided without sacrificing effectiveness or access to care; and
(d) Not primarily for the convenience of the
participant, the participant's family, the provider, or the worker.
(15) "Nurse " means an individual
who is currently licensed to practice nursing in the State under COMAR
10.27.01.
(16) "Nurse monitor"
means a registered nurse who completes nursing assessments on participants and
evaluates the delivery of care.
(17) "Participant" means an individual who:
(a) Has been determined to meet the
qualifications for participation in Community Personal Assistance Services as
specified in Regulation .03 of this chapter; and
(b) Is enrolled with the Department to
receive Medicaid services.
(18) "Personal assistance provider agency"
means a public or private agency that:
(a)
Employs or contracts with personal assistance workers; and
(b) Has been enrolled by the Program as a
provider of personal assistance services.
(19) Personal Assistance Services.
(a) "Personal assistance services" means
assistance specific to the functional needs of a participant with a chronic
illness, medical condition, or disability.
(b) "Personal assistance services" includes:
(i) Assistance with activities of daily
living and instrumental activities of daily living; and
(ii) The performance of delegated nursing
functions.
(20) "Plan of service" means the support plan
that:
(a) Reflects what is important to the
individual and what is important for the individual's welfare; and
(b) Is developed with support from the
supports planner with input from the individual and, when applicable, the
individual's representative.
(21) "Preauthorized" means approved by the
Department or its designee before services can be rendered.
(22) "Program" means the Maryland Medicaid
Program.
(23) "Provider" has the
same meaning as defined in COMAR 10.09.36.
(24) "Provider agreement" means a contract
between the Department and the provider for rendering the services under this
chapter.
(25) "Recommended plan of
care" means the recommended service plan developed by a nurse after a
face-to-face evaluation of an applicant or participant.
(26) "Representative" means:
(a) The person authorized by the individual
to serve as a representative in connection with the provision of personal
assistance services and supports;
(b) The individual who signs the plan of
service on the participant's behalf;
(c) Any individual who makes decisions on
behalf of the participant related to the participant's plan of
service;
(d) A legal guardian of
the individual for the participant; or
(e) The parent or foster parent of a
dependent minor child.
(27) "Supports planner" means an individual
who coordinates services, including:
(a)
Supporting development of apian of service;
(b) Interacting with third parties on behalf
of, or in conjunction with, the applicant or participant; and
(c) Ensuring an accurate plan of service is
provided to the Department.
(28) "Telephonic time-keeping system" means a
system developed by the Department for workers to time stamp the start and
finish of services provided to a participant.
(29) "Worker" means an individual who is
employed by or contracts with a personal assistance provider agency to provide
personal assistance services.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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