Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 22 - DEVELOPMENTAL DISABILITIES
Chapter 10.22.01 - Definitions
Section 10.22.01.01 - Definitions
Universal Citation: MD Code Reg 10.22.01.01
Current through Register Vol. 51, No. 19, September 20, 2024
A. In this subtitle, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Administration" means the Developmental
Disabilities Administration of the Department of Health and Mental
Hygiene.
(2) "Alternative living
unit (ALU)" means a residence owned, leased, or operated by a licensee that:
(a) Provides residential services for
individuals who, because of a developmental disability, require specialized
living arrangements;
(b) Admits not
more than 3 individuals; and
(c)
Provides 10 or more hours of supervision per unit, per week.
(3) "Assistive technology" means
the technology necessary to enable the individual to live successfully in the
community.
(4) "Aversive technique"
means the use of painful or noxious stimuli to the body, which is intrusive to
the individual's physical, mental, or emotional well-being, used to terminate
challenging or maladaptive behavior.
(5) "Barrier" means an obstacle preventing or
inhibiting an individual from receiving services and supports in the most
integrated setting appropriate to meet the individual's needs.
(6) "Behavior plan (BP)" means a plan
designed to modify behavior through the use of clinically accepted
techniques.
(7) Behavioral
Consultation.
(a) "Behavioral consultation"
means on-site observation, assessment, and evaluation of the interaction
between the individual and the individual's caregiver in the context of the
individual's existing programs.
(b)
"Behavioral consultation" includes:
(i)
Recommendations regarding the structure of the program and appropriate
activities and services; and
(ii)
Consultation, as needed, with clinical professionals.
(8) "Behavioral emergency" means a
situation in which an individual's behavior appears to present imminent danger
to the individual or to others.
(9)
"Behavioral respite" means relief services provided by a community residential
licensee to meet an individual's behavioral needs.
(10) "Care provider" means an individual who
is responsible for the daily operation of an individual family care home as
defined in §B(26) of this regulation.
(11) "Challenging behavior" means those
behaviors exhibited by an individual which:
(a) Are harmful, destructive, or socially
unacceptable; and
(b) Necessitate
being addressed in the individual's individual plan.
(12) "Chemical restraint" means the use of an
injectable medication as an intervention in a behavioral emergency.
(13) "Community supported living arrangement
home" means a residence:
(a) Which is rented
or owned by an individual or the individual's family or proponent or held in
trust for an individual;
(b) Where
an individual lives as a roommate without the individual's name appearing on
the lease or title; or
(c) Where
the licensee is the guarantor of rental or mortgage payments for an individual
receiving CSLA services.
(14) Community Supported Living Arrangements.
(a) "Community supported living arrangements
(CSLA)" means services to assist an individual in nonvocational activities
necessary to enable that individual to live in the individual's own home,
apartment, family home, or rental unit, with
(i) No more than two other nonrelated
recipients of these services; or
(ii) Members of the same family regardless of
their number.
(b)
"Community supported living arrangements (CSLA)" includes personal support
services, as defined under the Administration's Home and Community-Based
Services Waiver with the Centers for Medicare and Medicaid Services, including
but not limited to the following services:
(i) Personal assistance services;
(ii) Supports that enhance the individual's
opportunity for community participation and to exercise choice and control over
the individual's own life;
(iii)
Training, habilitation, and other services necessary to assist the individual
in achieving and maintaining increased integration, interdependence, and
productivity; and
(iv) 24-hour
emergency assistance.
(c) "Community supported living arrangements
(CSLA)" also includes other services set forth in the Administration's Home and
Community-Based Services Waiver with the Centers for Medicare and Medicaid
Services as distinct from personal support services, including but not limited
to the following:
(i) Assistive
technology;
(ii) Adaptive
equipment;
(iii) Resource
coordination;
(iv) Environmental
modifications;
(v) Respite;
and
(vi) Other services as approved
by the Secretary or the Secretary's designee.
(15) "Department" means the Department of
Health and Mental Hygiene.
(16)
"Developmental disability" means a severe chronic disability of an individual
that:
(a) Is attributable to a physical or
mental impairment, other than the sole diagnosis of mental illness, or to a
combination of mental and physical impairments;
(b) Is likely to continue
indefinitely;
(c) Is manifested in
an individual younger than 22 years old;
(d) Results in an inability to live
independently without external support or continuing and regular assistance;
and
(e) Reflects the need for a
combination and sequence of special, interdisciplinary, or generic care,
treatment, or other services that are individually planned and coordinated for
the individual.
(17)
"Director" means Director of the Developmental Disabilities Administration or
the Director's designee.
(18)
"Eligible for individual support services" means an individual with a severe
chronic disability that is:
(a) Attributable
to a physical or mental impairment other than the sole diagnosis of mental
illness, or to a combination of mental and physical impairments; and
(b) Likely to continue
indefinitely.
(19)
"Environmental modification" means physical adaptations to an individual's home
that are provided to enable the individual to live safely at home.
(20) "Foreign corporation" means an entity
that is properly organized, chartered, and incorporated under the laws of a
state other than Maryland.
(20-1) "Forensic residential center (FRC)" means a facility that is:
(a) Licensed to provide a
continuum of integrative services to individuals with intellectual
disabilities:
(i) Ordered by the court for an
evaluation or to be confined;
(ii)
Court-committed for care or treatment to the Department as incompetent to stand
trial or not criminally responsible who are dangerous as a result of
intellectual disabilities; or
(iii)
On conditional release and returned to the facility either voluntarily or on
hospital warrant;
(b) A
related institution as defined in Health-General Article, §19-301(o),
Annotated Code of Maryland; and
(c)
Not an extended care or comprehensive rehabilitation facility.
(21) "Functional analysis" means a
method of investigation which involves the systematic, experimental
manipulation of analogue conditions, and precise measurement of challenging
behavior, in order to determine the behavioral consequences which maintain the
challenging behavior.
(22)
"Functional assessment" means a nonexperimental method, such as systematic
observations and questionnaires, designed to assist in the formulation of an
educated guess concerning the behavioral consequences which maintain
challenging behavior.
(23) "Generic
services" means services which are available to the community at
large.
(24) "Goal" means measurable
supports or training to achieve an outcome.
(25) "Group home" means a residence owned,
leased, or operated by a licensee that:
(a)
Provides residential services for individuals who, because of a developmental
disability, require specialized living arrangements;
(b) Admits at least four, but not more than
eight individuals; and
(c) Provides
10 or more hours of supervision per week.
(26) "Individual" means a person eligible to
receive services from the Developmental Disabilities Administration.
(27) "Individual family care (IFC) home"
means a private, single family residence which provides a home for up to three
individuals with developmental disabilities, who are unrelated to the care
provider.
(28) "Individual plan
(IP)" means a plan that specifies assessments, services, supports, and training
required by the individual.
(29)
"Integrated work setting" means an environment in which individuals with
developmental disabilities and individuals without developmental disabilities
work together.
(30) "Licensed
capacity" means the number of individuals for whom a licensee is authorized to
provide services at a single site.
(31) "Licensed certified social worker" means
a person authorized to practice social work under Health Occupations Article,
Title 19, Annotated Code of Maryland.
(32) "Licensed health care practitioner"
means a person licensed to provide health care within the scope of Health
Occupations Article, Annotated Code of Maryland.
(33) "Licensed or certified professional
counselor" means a person who is authorized to practice professional counseling
under Health Occupations Article, Title 17, Annotated Code of
Maryland.
(34) "Licensed physician"
means a person who is authorized to practice medicine under Health Occupations
Article, Title 14, Annotated Code of Maryland.
(35) "Licensed psychologist" means a person
who is authorized to practice psychology under Health Occupations Article,
Title 18, Annotated Code of Maryland.
(36) "Licensee" means an agency that has been
granted a license by the Administration to provide services to
individuals.
(37) "Management of
disruptive behavior" means the Administration-approved curriculum for managing
challenging or aggressive behavior.
(38) "Mechanical restraint" means a
mechanical device which restricts the free movement of an individual, such as a
safety coat or posey mittens.
(39)
"Mechanical support" means a mechanical device used to:
(a) Support an individual's proper body
position, balance, or alignment, such as splints, wedges, bolsters, or lap
trays; or
(b) Protect an individual
with a continuing medical condition from sustaining an injury, for example, the
use of protective head gear for an individual with epilepsy.
(40) "Most integrated setting"
means a setting that enables an individual with a disability to interact with
nondisabled individuals other than staff to the fullest extent
possible.
(41) "Natural supports"
means family, friends, co-workers, and community members who provide informal
assistance to the individual to enable the individual to live and work in the
community.
(42) "Outcome" means
tangible results of goals that reflect the desired quality of life as defined
by the individual.
(43) "Personal
assistance" means help with activities of daily living which does not have an
habilitation objective.
(44)
"Physical restraint" means a manual method used to restrict the free movement
of an individual, such as therapeutic hold.
(45) "Plan of correction (POC)" means the
licensee's proposed response to findings of noncompliance identified by the
Licensing and Certification Administration or the Administration.
(46) "PRN orders" means a preauthorized order
to administer a specific behavior management technique or medication to modify
behavior which is administered on an as-needed basis when a challenging
behavior is exhibited.
(47)
"Program service plan (PSP)" means the document submitted as part of the
licensure application that delineates the rationale, scope, staffing, training,
setting, and location for the services or supports to be provided.
(48) "Proponent" means a person who has a
legitimate interest in the welfare of an individual receiving services from a
licensee.
(49) "Psychology
associate" means a person who may perform psychological services under certain
conditions as specified in Health Occupations Article, Title 18, Annotated Code
of Maryland.
(50) "Record" means
the cumulative body of information the licensee has on file regarding an
individual.
(51) "Resource
coordinator" means a professional:
(a)
Designated by the Developmental Disabilities Administration;
(b) Not employed by a direct service
provider;
(c) Who has knowledge and
experience in community supports for individuals with developmental
disabilities; and
(d) Who meets the
requirements of COMAR 10.22.09.
(52) "Respite" means relief services provided
to the family or care provider to meet planned or emergency
situations.
(53) "Restrictive
technique" means a technique that is implemented to impede an individual's
physical mobility or limit free access to the environment, including but not
limited to physical, mechanical, or chemical restraints or medications used to
modify behavior.
(54) "Seclusion"
means the involuntary placement of an individual alone in a room.
(55) "State residential center (SRC)" means a
State owned and operated facility for individuals with intellectual
disabilities.
(56) "Supports" means
the assistance provided to individuals or their families to enable greater
participation in the community and enhanced quality of life.
(57) "Target behaviors" means those behaviors
identified by the team to be changed by implementing a behavior plan.
(58) "Team" means those persons, including
the individual, proponent, licensee representatives, resource coordinator, and
others involved in the development of the IP.
(59) "Temporary augmentation of staff" means
supplemental staff utilized on a time-limited basis to work with an individual
exhibiting challenging behavior.
(60) "Treating professional" means an
individual designated by the facility director who is involved in the
implementation of the IP.
(61)
"Verbal abuse" means disrespectful shouting, screaming, swearing, name calling,
or other verbal activity directed toward an individual.
(62) "Vocational assessment" means a method
of determining an individual's job and career preferences and the skills and
training necessary to accomplish these preferences.
(63) "Volunteer work" means work performed by
an individual without pay.
(64)
"Written plan of habilitation" means, for State residential centers, a
component of the IP as described in COMAR
10.22.05.02B(14)
and .03C.
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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