Current through Register Vol. 51, No. 19, September 20, 2024
To provide Autism Waiver services, the provider:
A. Shall be approved in accordance with the
requirements specified in this chapter;
B. Shall have a provider agreement in effect,
signed with the Program;
C. Shall
meet all the conditions for participation specified in COMAR 10.09.36, except
as otherwise specified in this chapter;
D. Shall assure that professional employees
who render or delegate services under this chapter have the appropriate
experience and health-related license or professional certification to meet the
participant's needs, including equivalency review by an accredited agency for
credentials obtained outside of the United States, before rendering services to
any Autism Waiver participant;
E.
Shall assure that direct care workers who render services under this chapter:
(1) Have at least a high school degree or
GED, including equivalency review by an accredited agency for credentials
obtained outside of the United States, before rendering services to any Autism
Waiver participant;
(2) Receive
adequate and appropriate training, within 60 days of employment and annually
thereafter, pertaining to care for children with autism spectrum disorder
including:
(a) Training concerning abuse,
neglect, and exploitation;
(b)
Positive behavioral interventions and restraints rendered by a MSDE approved
trainer,
(c) Reportable event
policy; and
(3) Work under the ongoing
supervision of a qualified professional employee of the provider who has annual
training in:
(a) Abuse, neglect,
exploitation;
(b) Positive
behavioral interventions and appropriate use of restraints rendered by a
MSDE-approved trainer,
(c)
Reportable event policy; and
(4) Are approved
by the provider as qualified to meet the participant's needs;
(5) Are approved by the participant's
parents; and
(6) Have volunteer or
employment experience working with children with autism spectrum disorder or
other developmental disabilities as a service provider or as a family member
for a minimum of 100 hours, that may include:
(b) Post high school educational experience
with developmental disabilities;
(c) Shadowing experienced staff;
(d) Employment with a developmental
disabilities agency; or
(e)
Fulfilling the community service requirement through volunteering with a child
with autism or another developmental disability;
F. Shall be required to have a
professional on-call at all times, and employ or contract with certain
professionals for consultation as needed when providing:
(1) Residential habilitation
services;
(2) Intensive individual
support services; and
(3)
Therapeutic integration services;
G. Shall employ on-call professionals and
professional consultants:
(1) Who are:
(a) Board-certified behavior
analysts;
(b) Certified school
psychologists;
(c) Certified
special educators;
(d) Individuals
with a masters or doctorate degree in special education or a related field and
5 years experience in providing training or consultation in autism spectrum
disorder or other developmental disabilities;
(e) Licensed certified social
workers;
(f) Licensed professional
counselors;
(g) Nurse
psychotherapists;
(j) Occupational
therapists;
(l) Registered nurses;
or
(m) Speech therapists;
and
(2) Who have:
(a) Experience providing services to children
with autism spectrum disorder or other developmental disabilities;
(b) A background in behavior management
techniques; and
(c) Knowledge of
the specific children being served by the provider.
H. Shall verify the licenses,
credentials, and references of all individuals who render or delegate services
on the provider's behalf under this chapter, and have a copy of the licenses,
credentials, and at least three written references available for
inspection;
I. Shall maintain
current, written, and signed contracts with all contractors providing waiver
services on behalf of the provider that include:
(1) The scope of services to be
performed;
(2) The requirement to
comply with all applicable Medicaid regulations;
(3) The requirement to complete and maintain
written documentation of service delivery, individualized for each participant
on each day that the participant receives services;
(4) A clause that no monies shall be sought
from the waiver participant or the participant's family if the contract is
breached by either the provider or contractor; and
(5) A current copy of a provider license or
certification and insurance as required in this chapter;
J. With the exception of environmental
accessibility adaptation providers, shall submit to a preemployment criminal
background investigation;
K. With
the exception of respite care and environmental accessibility adaptations
providers, shall submit separate, written treatment plans to service
coordinators within 30 calendar days of the initiation of services in
accordance with State guidelines for each individual service and at least once
in each 12-month period thereafter, or more frequently if the treatment plan
changes;
L. If an agency, shall
require supervisory and direct care employees of provider agencies to:
(1) Submit an application for a child care
criminal history record check to the Criminal Justice Information System
Central Repository, Department of Public Safety and Correctional Services, in
accordance with Family Law Article, §5-561, Annotated Code of
Maryland;
(2) Request the
Department of Public Safety and Correctional Services to send the child care
criminal history report to the agency of employment; and
(3) Not have been convicted of, received
probation before judgment for, or entered a plea of nolo contendere to, a
felony or crime involving moral turpitude or theft, or have other criminal
history that indicated behavior that is potentially harmful to
participants;
M. If an
agency, shall:
(1) Pay for the criminal
background check;
(2) Maintain the
original child care criminal history report for all agency and contracted
employees as well as any updated criminal history reports from the Department
of Public Safety and Correctional Services in the employee's personnel record;
and
(3) Submit monthly Criminal
Justice Information System's update reports to the Maryland State Department of
Education;
N. If
self-employed, shall:
(1) Submit an
application for a criminal history record check to the Criminal Justice
Information System Central Repository, Department of Public Safety and
Correctional Services;
(2) Request
the Department of Public Safety and Correctional Services to send the child
care criminal history report to the Department;
(3) Pay for the criminal background
check;
(4) Not have been convicted
of, received probation before judgment for, or entered a plea of nolo
contendere to, a felony or crime involving moral turpitude or theft, or have
other criminal history that indicated behavior that is potentially harmful to
participants; and
(5) Submit
monthly Criminal Justice Information System's update reports to the State
Department of Education.
O. Shall have the option to request the
Department to waive the provisions of §§L(3) and N(4) of this
regulation if the applicant demonstrates that:
(1) The conviction, probation before
judgment, or plea of nolo contendere for a felony or any crime involving moral
turpitude or theft was entered more than 10 years before the date of the
provider's or prospective employee's application; and
(2) The criminal history does not indicate
behavior that is potentially harmful to participants;
P. Shall have adequate liability
insurance;
Q. Shall provide
services in accordance with the requirements of the Autism Waiver plan of care,
this chapter, the Autism Waiver, and all relevant federal, State, and local
laws and regulations;
R. Shall
agree to submit claims for payment by the Program for only those services
covered under this chapter which have been identified and documented in a
participant's Autism Waiver plan of care;
S. Shall agree to maintain and have available
to the Department or the State Department of Education personnel records and
written documentation describing waiver services rendered, including dates and
hours of services provided to participants, for a period of 6 years, in a
manner approved by the Department or its designee;
T. Shall agree not to suspend, increase, or
reduce services for a participant without a waiver plan of care or plan of care
addendum from the service coordinator for that participant;
U. Unless a risk to health and safety exists,
shall agree not to terminate services for a participant without providing:
(1) 30 days written notice to the
participant, parent or guardian, and service coordinator; and
(2) Assistance in the discharge planning
process;
V. Is not
eligible to participate in the waiver if the provider or any of its principals
were previously program providers, or if its principals were principals in
program providers, that have overpayments that remain due and owing to the
Department;
W. Is not eligible if
the provider or its principals within the past 24 months have:
(1) Had a license or certificate suspended or
revoked as a health care provider, health care facility, or provider of direct
care services;
(2) Been suspended
or removed from participating as a Medicaid provider;
(3) Undergone the imposition of sanctions
under COMAR
10.09.36.08H;
(4) Been subject to disciplinary action
including actions by providers or any of its principal's licensing
board;
(5) Been cited by a State
agency for deficiencies which affect a participant's health and safety;
or
(6) Experienced a termination of
a reimbursement agreement with or been barred from work or participation by a
public or private agency due to:
(a) Failure
to meet contractual obligations; or
(b) Fraudulent billing practices;
X. Shall maintain
written quarterly records documenting face-to-face supervision of direct care
employees and direct observation of the participant that includes:
(1) Date and location of
supervision;
(2) Review, feedback,
and oversight of the implementation of treatment plan goals;
(3) Review, feedback, and oversight of the
implementation of positive behavior intervention;
(4) Review, feedback, and oversight of the
scope of activities during service;
(5) Review, feedback, and oversight of data
collection;
(6) Date and name of
supervisor, name of employee, and name of the participant; and
(7) Signature of supervisor;
Y. Shall agree to keep all records
available for inspection or audit by the Department or the Department's
designee at any reasonable time during business hours;
Z. Shall implement and follow the Reportable
Event policy in accordance with the Department's established policy by:
(1) Reporting incidents and complaints to the
participant's service coordinator within 24 hours;
(2) Submitting a written report within 7
calendar days on a form designated by the Department; and
(3) Notifying the local department of social
services immediately if the provider has a reason to believe that the
participant has been subject to abuse, neglect, self-neglect, or exploitation,
in accordance with COMAR 07.06.04;
AA. May not:
(1) Render direct services to the provider's
own child; or
(2) Render
supervision to the direct care worker of the provider's own child;
BB. With the exception of
environmental accessibility adaptations providers and residential habilitation
providers, shall submit to the service coordinator monthly service tracking
forms for each participant served within 20 calendar days of the end of each
month;
CC. With the exception of
environmental accessibility adaptations providers, shall attend at least one
Autism Waiver training conducted by the State each year and shall participate
in:
(1) One training annually regarding the
prevention, identification, and reporting of abuse, neglect, and
exploitation;
(2) One training
annually regarding positive behavioral intervention and restraints;
and
(3) All statewide Autism Waiver
trainings during any year in which the provider is under recommendation for
disenrollment from the waiver or has had Medicaid payments suspended;
DD. Shall satisfactorily complete
all aspects of the Autism Waiver provider applications process;
EE. Shall notify the Program within 15 days
of occurrence of any change to contact information;
FF. Shall maintain communications with the
program by maintaining a working telephone and answering machine, facsimile
machine, and e-mail account;
GG.
Shall have status as a Maryland Medicaid Autism Waiver provider, including the
Medicaid provider number, terminated if no services have been provided for 24
consecutive months;
HH. Shall, when
transportation is provided:
(1) Implement the
provider's transportation policy;
(2) Identify the driver in daily contact
notes or a transportation log;
(3)
Document the start and stop times transportation is provided for each day that
a participant is transported;
(4)
Maintain a copy of the current automobile liability coverage and documentation
of payment for the vehicle transporting a participant; and
(5) Maintain a current copy of the valid
State driver's license and driving record for staff transporting a waiver
participant; and
II.
Shall comply with all administrative policies, procedures, transmittals, and
guidelines issued by the Department or its designee.