Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 3
Subtitle 22 - DEVELOPMENTAL DISABILITIES
Chapter 10.22.02 - Administrative Requirements for Licensees
Section 10.22.02.14 - Quality Assurance
Universal Citation: MD Code Reg 10.22.02.14
Current through Register Vol. 51, No. 19, September 20, 2024
A. The licensee shall submit a quality assurance plan and any subsequent substantive changes to the plan to the Administration for approval.
B. The licensee shall develop and implement a system of internal quality assurance which at a minimum:
(1) Is focused on the individual's choices,
preferences, and satisfaction, and includes personal contact with the
individuals being served;
(2) Has
outcomes and results that are measurable and may be incorporated into future
IPs for the individuals being served;
(3) Has outcomes and results that are
measurable and may be incorporated into systemic changes in a licensee's
operation;
(4) Collects and
evaluates data and analyzes trends identified through quality assurance
activities including:
(a) The name of the
individual with a behavior plan,
(b) The medication or other restrictive
technique used,
(c) The date and
time the restrictive technique was used,
(d) Whether the medication or other
restrictive technique was used as an emergency or as part of a behavior plan,
and
(e) Whether the medication or
other restrictive technique used is meeting the goals and objectives
established in the behavior plan;
(5) Provides for prompt and appropriate
response when an individual's health or safety is at risk; and
(6) Includes proactive strategies to improve
the quality of services, including health and safety.
C. The licensee shall:
(1) Establish goals and standards to measure
the quality of services being delivered and define how the standards are
measured;
(2) Maintain records to
demonstrate the effectiveness of its quality assurance activities;
(3) Implement changes based on the results of
the evaluated data; and
(4) Be held
accountable by the Administration for accomplishing the goals and standards
that are established as part of the licensee's system of quality
assurance.
D. The Administration may request documentation from a licensee to verify that the licensee is accomplishing the goals and standards set forth in the licensee's quality assurance plan.
E. Standing Committees.
(1) The licensee shall establish
a committee or committees to perform the following functions:
(a) Perform the quality assurance functions
set forth in this regulation;
(b)
Review the licensee's protocol for identifying, reporting, documenting,
investigating, and reviewing of incidents to ensure compliance with
Administration procedures;
(c)
Monitor whether the licensee's protocol identified in §E(2) of this
regulation is being properly implemented by reviewing all incidents in an
effort to identify deficient practices and recommend necessary corrective
action;
(d) Approve all behavior
plans which use restrictive techniques to ensure that the behavior plan
complies with the requirements of COMAR
10.22.04.03AA and
10.22.10;
(e) Review, approve, and
establish the time frame for the restriction of a right if it is not related to
a challenging behavior, in accordance with COMAR
10.22.04.03A;
and
(f) Review the licensee's
policies and procedures, and implementation of them, to ensure that they
adequately protect the legal and human rights of each individual served by the
licensee.
(2) The
committee or committees may be organized to perform the functions set forth in
§A of this regulation for one or more licensees.
(3) The committee or committees shall include
an equal number of licensee staff, and individuals, proponents, or members of
the community who are not employed by the licensee. For a committee member who
is remunerated only to serve as a member of the committee, that member is not
counted as staff or as a member of the community.
(4) The committee or committees may consult
with a licensed health professional such as a psychologist, physician,
physician's assistant, nurse practitioner, or board-certified clinical
pharmacist, as needed.
(5) A
committee member may not participate in the decision making process of any:
(a) Incident in which the committee member
was involved; or
(b) Behavior plan
the committee member has developed.
(6) The committee or committees shall meet as
needed to perform the functions identified in §E(1) of this regulation,
with, at least, a majority of members present.
(7) The committee or committees shall ensure
confidentiality for the individual in accordance with Health-General Article,
§7-1010, Annotated Code of Maryland.
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