Capitol Building Maryland Register

Issue Date:  January 13, 2023

Volume 50 •  Issue 1  • Pages 1 — 40

IN THIS ISSUE

Division of State Documents

Regulations

Special Documents

General Notices

Pursuant to State Government Article, §7-206, Annotated Code of Maryland, this issue contains all previously unpublished documents required to be published, and filed on or before December 23, 2022 5 p.m.
 
Pursuant to State Government Article, §7-206, Annotated Code of Maryland, I hereby certify that this issue contains all documents required to be codified as of December 23, 2022.
 
Gail S. Klakring
Acting Administrator, Division of State Documents
Office of the Secretary of State

Seal

Information About the Maryland Register and COMAR

MARYLAND REGISTER

   The Maryland Register is an official State publication published every other week throughout the year. A cumulative index is published quarterly.

   The Maryland Register is the temporary supplement to the Code of Maryland Regulations. Any change to the text of regulations published  in COMAR, whether by adoption, amendment, repeal, or emergency action, must first be published in the Register.

   The following information is also published regularly in the Register:

   • Governor’s Executive Orders

   • Attorney General’s Opinions in full text

   • Open Meetings Compliance Board Opinions in full text

   • State Ethics Commission Opinions in full text

   • Court Rules

   • District Court Administrative Memoranda

   • Courts of Appeal Hearing Calendars

   • Agency Hearing and Meeting Notices

   • Synopses of Bills Introduced and Enacted by the General Assembly

   • Other documents considered to be in the public interest

CITATION TO THE MARYLAND REGISTER

   The Maryland Register is cited by volume, issue, page number, and date. Example:

• 19:8 Md. R. 815—817 (April 17, 1992) refers to Volume 19, Issue 8, pages 815—817 of the Maryland Register issued on April 17, 1992.

CODE OF MARYLAND REGULATIONS (COMAR)

   COMAR is the official compilation of all regulations issued by agencies of the State of Maryland. The Maryland Register is COMAR’s temporary supplement, printing all changes to regulations as soon as they occur. At least once annually, the changes to regulations printed in the Maryland Register are incorporated into COMAR by means of permanent supplements.

CITATION TO COMAR REGULATIONS

   COMAR regulations are cited by title number, subtitle number, chapter number, and regulation number. Example: COMAR 10.08.01.03 refers to Title 10, Subtitle 08, Chapter 01, Regulation 03.

DOCUMENTS INCORPORATED BY REFERENCE

   Incorporation by reference is a legal device by which a document is made part of COMAR simply by referring to it. While the text of an incorporated document does not appear in COMAR, the provisions of the incorporated document are as fully enforceable as any other COMAR regulation. Each regulation that proposes to incorporate a document is identified in the Maryland Register by an Editor’s Note. The Cumulative Table of COMAR Regulations Adopted, Amended or Repealed, found online, also identifies each regulation incorporating a document. Documents incorporated by reference are available for inspection in various depository libraries located throughout the State and at the Division of State Documents. These depositories are listed in the first issue of the Maryland Register published each year. For further information, call 410-974-2486.

HOW TO RESEARCH REGULATIONS

An Administrative History at the end of every COMAR chapter gives information about past changes to regulations. To determine if there have been any subsequent changes, check the ‘‘Cumulative Table of COMAR Regulations Adopted, Amended, or Repealed’’ which is found online at http://www.dsd.state.md.us/PDF/CumulativeTable.pdf. This table lists the regulations in numerical order, by their COMAR number, followed by the citation to the Maryland Register in which the change occurred. The Maryland Register serves as a temporary supplement to COMAR, and the two publications must always be used together. A Research Guide for Maryland Regulations is available. For further information, call 410-260-3876.

SUBSCRIPTION INFORMATION

   For subscription forms for the Maryland Register and COMAR, see the back pages of the Maryland Register. Single issues of the Maryland Register are $15.00 per issue.

CITIZEN PARTICIPATION IN
THE REGULATION-MAKING PROCESS

   Maryland citizens and other interested persons may participate in the process by which administrative regulations are adopted, amended, or repealed, and may also initiate the process by which the validity and applicability of regulations is determined. Listed below are some of the ways in which citizens may participate (references are to State Government Article (SG),

Annotated Code of Maryland):

   • By submitting data or views on proposed regulations either orally or in writing, to the proposing agency (see ‘‘Opportunity for Public Comment’’ at the beginning of all regulations appearing in the Proposed Action on Regulations section of the Maryland Register). (See SG, §10-112)

   • By petitioning an agency to adopt, amend, or repeal regulations. The agency must respond to the petition. (See SG §10-123)

   • By petitioning an agency to issue a declaratory ruling with respect to how any regulation, order, or statute enforced by the agency applies. (SG, Title 10, Subtitle 3)

   • By petitioning the circuit court for a declaratory judgment

on the validity of a regulation when it appears that the regulation interferes with or impairs the legal rights or privileges of the petitioner. (SG, §10-125)

   • By inspecting a certified copy of any document filed with the Division of State Documents for publication in the Maryland Register. (See SG, §7-213)

 

Maryland Register (ISSN 0360-2834). Postmaster: Send address changes and other mail to: Maryland Register, State House, Annapolis, Maryland 21401. Tel. 410-260-3876. Published biweekly, with cumulative indexes published quarterly, by the State of Maryland, Division of State Documents, State House, Annapolis, Maryland 21401. The subscription rate for the Maryland Register is $225 per year (first class mail). All subscriptions post-paid to points in the U.S. periodicals postage paid at Annapolis, Maryland and additional mailing offices.

Lawrence J. Hogan, Jr., Governor; John C. Wobensmith, Secretary of State; Gail S. Klakring, Administrator; Mary D. MacDonald, Senior Editor, Maryland Register and COMAR; Elizabeth Ramsey, Editor, COMAR Online, and Subscription Manager; Tami Cathell, Help Desk, COMAR and Maryland Register Online.

Front cover: State House, Annapolis, MD, built 1772—79.

Illustrations by Carolyn Anderson, Dept. of General Services

 

     Note: All products purchased are for individual use only. Resale or other compensated transfer of the information in printed or electronic form is a prohibited commercial purpose (see State Government Article, §7-206.2, Annotated Code of Maryland). By purchasing a product, the buyer agrees that the purchase is for individual use only and will not sell or give the product to another individual or entity.


 

Closing Dates for the Maryland Register

Schedule of Closing Dates and Issue Dates for the
Maryland Register .........................................................................  4

 

COMAR Research Aids

Table of Pending Proposals ...............................................................  5

 

Index of COMAR Titles Affected in This Issue

COMAR Title Number and Name                                                  Page

08        Department of Natural Resources .......................................  10

09        Maryland Department of Labor ...........................................  11

10        Maryland Department of Health ..........................................  11

11        Department of Transportation ................................................  8

12        Department of Public Safety and Correctional Services .......  28

14        Independent Agencies .........................................................  30

26        Department of the Environment ............................................  9

30        Maryland Institute for Emergency Medical Services
Systems (MIEMSS) .........................................................  37

 

 

PERSONS WITH DISABILITIES

Individuals with disabilities who desire assistance in using the publications and services of the Division of State Documents are encouraged to call (410) 974-2486, or (800) 633-9657, or FAX to (410) 974-2546, or through Maryland Relay.

 

 

The Division of State Documents

DEPOSITORIES FOR DOCUMENTS INCORPORATED BY
   REFERENCE
.  7

 

Final Action on Regulations

11 DEPARTMENT OF TRANSPORTATION

MARYLAND TRANSPORTATION AUTHORITY

Electronic Toll Collection and Toll Violation
   Enforcement
 8

MOTOR VEHICLE ADMINISTRATION — VEHICLE
   INSPECTIONS

Vehicle Emissions Inspection Program ...................................  8

MOTOR VEHICLE ADMINISTRATION—DRIVER
   LICENSING AND IDENTIFICATION DOCUMENTS

Proof of Age, Full Name, Identity, Maryland Residence, and
   Lawful Status
. 8

26 DEPARTMENT OF THE ENVIRONMENT

AIR QUALITY

Control of Agriculturally Related Installations .  9

 

 

Proposed Action on Regulations

08 DEPARTMENT OF NATURAL RESOURCES

BOATING—SPEED LIMITS AND OPERATION OF
   VESSELS

Susquehanna River ...................................................................  10

09 MARYLAND DEPARTMENT OF LABOR

DIVISION OF LABOR AND INDUSTRY

Elevator, Escalator, and Chairlift Safety .  11

10 MARYLAND DEPARTMENT OF HEALTH

MEDICAL CARE PROGRAMS

Physicians’ Services .  11

Early Intervention Service Coordination .  13

Service Coordination for Children with an IEP or Enrolled
   in the Autism Waiver
 13

School-Based Health Centers (SBHC) ....................................  13

Urgent Care Centers .................................................................  21

BOARD OF PHYSICAL THERAPY EXAMINERS

Telehealth .  22

ALCOHOL AND DRUG ABUSE ADMINISTRATION

Prescription Drug Monitoring Program ..  24

BOARD OF ENVIRONMENTAL HEALTH SPECIALISTS

General Regulations .  26

Licensing Procedures .  26

Continuing Education .  26

Fee Schedule .  26

12 DEPARTMENT OF PUBLIC SAFETY AND
   CORRECTIONAL SERVICES

POLICE TRAINING AND STANDARDS COMMISSION

Police Complaint Mediation Program ......................................  28

14 INDEPENDENT AGENCIES

WORKERS’ COMPENSATION COMMISSION

Legal Representation and Fees ................................................  30

COMMISSION ON CRIMINAL SENTENCING POLICY

General Regulations .................................................................  32

Criminal Offenses and Seriousness Categories .......................  32

30 MARYLAND INSTITUTE FOR EMERGENCY
   MEDICAL SERVICES SYSTEMS (MIEMSS)

DESIGNATION OF TRAUMA AND SPECIALTY
   REFERRAL CENTERS

Trauma Center Designation and Verification Standards .  37

 

 

Special Documents

DEPARTMENT OF THE ENVIRONMENT

WATER AND SCIENCE ADMINISTRATION

Water Quality Certification 22-WQC-0029 .  38

Water Quality Certification 22-WQC-0037 .  38

Water Quality Certification 22-WQC-0038 .  39

 

 

General Notices

COMMISSIONER OF FINANCIAL REGULATION

Bank Merger ............................................................................  40

DEPARTMENT OF THE ENVIRONMENT

Public Meeting .........................................................................  40

Public Hearing — Correction .  40

SPORTS WAGERING APPLICATION REVIEW
   COMMISSION

Public Meeting .  40

BOARD OF WELL DRILLERS

Public Meeting .........................................................................  40

 

 

COMAR Online

        The Code of Maryland Regulations is available at www.dsd.state.md.us as a free service of the Office of the Secretary of State, Division of State Documents. The full text of regulations is available and searchable. Note, however, that the printed COMAR continues to be the only official and enforceable version of COMAR.

        The Maryland Register is also available at www.dsd.state.md.us.

        For additional information, visit www.dsd.maryland.gov, Division of State Documents, or call us at (410) 974-2486 or 1 (800) 633-9657.

 

Availability of Monthly List of
Maryland Documents

        The Maryland Department of Legislative Services receives copies of all publications issued by State officers and agencies. The Department prepares and distributes, for a fee, a list of these publications under the title ‘‘Maryland Documents’’. This list is published monthly, and contains bibliographic information concerning regular and special reports, bulletins, serials, periodicals, catalogues, and a variety of other State publications. ‘‘Maryland Documents’’ also includes local publications.

        Anyone wishing to receive ‘‘Maryland Documents’’ should write to: Legislative Sales, Maryland Department of Legislative Services, 90 State Circle, Annapolis, MD 21401.

 

 

CLOSING DATES AND ISSUE DATES THROUGH
DECEMBER 2023

Issue
Date

Emergency

and Proposed

Regulations

5 p.m.*

Notices, etc.

10:30 a.m.

Final

Regulations

10:30 a.m.

2023

January 27

January 9

January 13**

January 18

February 10

January 23

January 30

February 1

February 24

February 6

February 13

February 15

March 10

February 17**

February 27

March 1

March 24

March 6

March 13

March 15

April 7

March 20

March 27

March 29

April 21

April 3

April 10

April 12

May 5

April 17

April 24

April 26

May 19

May 1

May 8

May 10

June 2

May 15

May 22

May 24

June 16

May 26**

June 5

June 7

June 30

June 12

June 16 **

June 21

July 14

June 26

July 3

July 5

July 28

July 10

July 17

July 19

August 11

July 24

July 31

August 2

August 25

August 7

August 14

August 16

September 8

August 21

August 28

August 30

September 22

September 1**

September 11

September 13

October 6

September 18

September 25

September 27

October 20

October 2

October 6**

October 11

November 3

October 16

October 23

October 25

November 17

October 30

November 6

November 8

December 1

November 13

November 20

November 22

December 15

November 27

December 4

December 6

December 29

December 11

December 18

December 20

 

   Please note that this table is provided for planning purposes and that the Division of State Documents (DSD) cannot guarantee submissions will be published in an agency’s desired issue. Although DSD strives to publish according to the schedule above, there may be times when workload pressures prevent adherence to it.

*   Also note that proposal deadlines are for submissions to DSD for publication in the Maryland Register and do not take into account the 15-day AELR review period. The due date for documents containing 8 to 18 pages is 48 hours before the date listed; the due date for documents exceeding 18 pages is 1 week before the date listed.

NOTE:  ALL DOCUMENTS MUST BE SUBMITTED IN TIMES NEW ROMAN, 9-POINT, SINGLE-SPACED FORMAT. THE PAGE COUNT REFLECTS THIS FORMATTING.

** Note closing date changes.

The regular closing date for Proposals and Emergencies is Monday.

 

RegCodificationSystem
Cumulative Table of COMAR Regulations
Adopted, Amended, or Repealed

   This table, previously printed in the Maryland Register lists the regulations, by COMAR title, that have been adopted, amended, or repealed in the Maryland Register since the regulations were originally published or last supplemented in the Code of Maryland Regulations (COMAR). The table is no longer printed here but may be found on the Division of State Documents website at www.dsd.state.md.us.

Table of Pending Proposals

   The table below lists proposed changes to COMAR regulations. The proposed changes are listed by their COMAR number, followed by a citation to that issue of the Maryland Register in which the proposal appeared. Errata pertaining to proposed regulations are listed, followed by “(err)”. Regulations referencing a document incorporated by reference are followed by “(ibr)”. None of the proposals listed in this table have been adopted. A list of adopted proposals appears in the Cumulative Table of COMAR Regulations Adopted, Amended, or Repealed.

 

03 COMPTROLLER OF THE TREASURY

 

03.02.01.03—.07,.09,.11—.22 • 49:21 Md. R. 954 (10-7-22)

03.02.03.01—.08 • 49:21 Md. R. 954 (10-7-22)

03.02.05.01—.12 • 49:21 Md. R. 954 (10-7-22)

03.02.06.01—.05 • 49:21 Md. R. 954 (10-7-22)

 

05 DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT

 

05.20.05.01—.12 • 49:25 Md. R. 1054 (12-2-22)

 

07 DEPARTMENT OF HUMAN SERVICES

 

07.02.01.10 • 49:9 Md. R. 532 (4-22-22)

 

08 DEPARTMENT OF NATURAL RESOURCES

 

08.02.04.11 • 49:15 Md. R. 742 (7-15-22)

             49:18 Md. R. 855 (8-26-22) (err)

08.18.12.05 • 49:27 Md. R. 1113 (12-30-22)

08.18.26.06 • 50:1 Md. R. 10 (1-13-23)

 

09 MARYLAND DEPARTMENT OF LABOR

 

09.09.03.03 • 49:25 Md. R. 1057 (12-2-22)

09.12.32.01—06 • 49:21 Md. R. 953 (10-7-22)

09.12.81.02 • 50:1 Md. R. 11 (1-13-23) (ibr)

09.32.12.01—.05 • 49:17 Md. R. 798 (8-12-22)

09.37.05.01—.08 • 49:26 Md. R. 1083 (12-16-22)

 

10 MARYLAND DEPARTMENT OF HEALTH

 

     Subtitle 09 (2nd volume)

 

10.09.02.01,.03—.05,.07—.09,.11 • 50:1 Md. R. 11 (1-13-23) (ibr)

10.09.05.01,.03—.07 • 49:27 Md. R. 1113 (12-30-22)

10.09.31.01,.03—.06 • 49:22 Md. R. 982 (10-21-22)

10.09.40.01—.06 • 50:1 Md. R. 13 (1-13-23)

10.09.41.04,.07 • 49:16 Md. R. 762 (7-29-22)

10.09.49.03—.10 • 49:24 Md. R. 1028 (11-18-22)

10.09.52.01—.06 • 50:1 Md. R. 13 (1-13-23)

10.09.55.03,.06 • 49:27 Md. R. 1115 (12-30-22)

10.09.76.01,.03,.05 • 50:1 Md. R. 13 (1-13-23)

10.09.77.01,.03—.07,.10 • 50:1 Md. R. 21 (1-13-23)

10.09.95.05 • 49:23 Md. R. 999 (11-4-22)

10.09.96.01,.02,.05,.06 • 49:24 Md. R. 1028 (11-18-22)

 

     Subtitles 10—22 (3rd volume)

 

10.15.07.01 • 49:27 Md. R. 1116 (12-30-22) (ibr)

10.21.01.04,.08 • 49:23 Md. R. 1000 (11-4-22)

 

     Subtitles 23—36 (4th volume)

 

10.28.01.01—.06 • 49:26 Md. R. 1084 (12-16-22)

10.32.01.03 • 49:16 Md. R. 768 (7-29-22)

10.32.02.03 • 49:16 Md. R. 768 (7-29-22)

10.32.02.10 • 49:16 Md. R. 769 (7-29-22)

 

     Subtitles 37—52 (5th volume)

 

10.37.10.26 • 49:18 Md. R. 822 (8-26-22)

10.38.13.01—.06 • 50:1 Md. R. 22 (1-13-23)

10.40.12.01—.06 • 49:26 Md. R. 1085 (12-16-22)

10.41.06.01—.06 • 49:26 Md. R. 1087 (12-16-22)

10.42.10.01—.06 • 49:26 Md. R. 1088 (12-16-22)

10.46.08.01—.06 • 49:27 Md. R. 1116 (12-30-22)

10.47.07.02—.05-1,.07—.09 • 50:1 Md. R. 24 (1-13-23)

 

     Subtitles 53—68 (6th volume)

 

10.56.10.01—.06 • 49:27 Md. R. 1117 (12-30-22)

10.58.06.01—.06 • 49:26 Md. R. 1090 (12-16-22)

10.58.16.02,.13—.19 • 49:26 Md. R. 1090 (12-16-22)

10.60.01.01 • 50:1 Md. R. 26 (1-13-23)

10.60.02.06 • 50:1 Md. R. 26 (1-13-23)

10.60.03.01 • 50:1 Md. R. 26 (1-13-23)

10.60.06.01 • 50:1 Md. R. 26 (1-13-23)

10.67.06.26-6 • 49:22 Md. R. 982 (10-21-22)

 

11 DEPARTMENT OF TRANSPORTATION

 

     Subtitles 01—10

 

11.01.18.01—.06 • 49:27 Md. R. 1118 (12-30-22)

11.02.06.01,.02 • 49:26 Md. R. 1092 (12-16-22)

11.03.01.01,.04 • 49:25 Md. R. 1057 (12-2-22)

 

12 DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

 

12.04.11.01—.08 • 50:1 Md. R. 28 (1-13-23)

 

13A STATE BOARD OF EDUCATION

 

13A.03.02.02,.04,.06,.07,.09,.09-1 • 49:9 Md. R. 533 (4-22-22)

13A.03.05.02—.04 • 49:26 Md. R. 1093 (12-16-22)

13A.06.10.01—.05 • 49:26 Md. R. 1093 (12-16-22)

13A.07.06.01—.15 • 49:1 Md. R. 39 (1-3-22) (ibr)

13A.08.01.01 • 49:26 Md. R. 1095 (12-16-22)

13A.12.01.01—.14 • 49:2 Md. R. 92 (1-14-22)

13A.12.02.01—.29 • 49:2 Md. R. 92 (1-14-22)

13A.12.03.01—.12 • 49:2 Md. R. 92 (1-14-22)

13A.12.04.01—.16 • 49:2 Md. R. 92 (1-14-22)

13A.12.05.01—.15 • 49:2 Md. R. 92 (1-14-22)

13A.12.06.01—.09 • 49:2 Md. R. 92 (1-14-22)

13A.12.07.01—.08 • 49:2 Md. R. 92 (1-14-22)

13A.15.01.02 • 49:24 Md. R. 1032 (11-18-22)

13A.15.04.03 • 49:24 Md. R. 1032 (11-18-22)

13A.15.13.01—.10 • 49:24 Md. R. 1032 (11-18-22)

13A.15.14.01—.09 • 49:24 Md. R. 1032 (11-18-22)

13A.15.15.01—.08 • 49:24 Md. R. 1032 (11-18-22)

13A.15.16.01—.04 • 49:24 Md. R. 1032 (11-18-22)

 

13B MARYLAND HIGHER EDUCATION COMMISSION

 

13B.08.01.02 • 49:16 Md. R. 772 (7-29-22)

13B.08.13.03 • 49:17 Md. R. 802 (8-12-22)

13B.08.14.02,.06,.07 • 49:17 Md. R. 803 (8-12-22)

 

14 INDEPENDENT AGENCIES

 

14.04.09.01—.04 • 49:9 Md. R. 536 (4-22-22)

14.09.04.02,.03 • 50:1 Md. R. 30 (1-13-23)

14.22.01.09—.11 • 50:1 Md. R. 32 (1-13-23)

14.22.02.02 • 50:1 Md. R. 32 (1-13-23)

14.39.02.06 • 49:23 Md. R. 1011 (11-4-22)

 

15 MARYLAND DEPARTMENT OF AGRICULTURE

 

15.03.01.02 • 49:18 Md. R. 832 (8-26-22) (ibr)

15.03.02.01 • 49:18 Md. R. 832 (8-26-22) (ibr)

15.14.10.02,.05 • 49:20 Md. R. 920 (9-23-22)

15.14.16.02—.04 • 49:20 Md. R. 921 (9-23-22)

 

20 PUBLIC SERVICE COMMISSION

 

20.50.02.02 • 49:25 Md. R. 1058 (12-2-22) (ibr)

20.50.09.01,.06,.14 • 49:26 Md. R. 1095 (12-16-22)

 

22 STATE RETIREMENT AND PENSION SYSTEM

 

22.03.04.01—.11 • 49:25 Md. R. 1059 (12-2-22)

 

26 DEPARTMENT OF THE ENVIRONMENT

 

     Subtitles 08—12 (Part 2)

 

26.11.19.20 • 49:27 Md. R. 1119 (12-30-22)

26.11.42.01—.11 • 49:27 Md. R. 1119 (12-30-22) (ibr)

 

27 CRITICAL AREA COMMISSION FOR THE CHESAPEAKE AND ATLANTIC COASTAL BAYS

 

27.01.01.01 • 49:25 Md. R. 1062 (12-2-22)

27.01.02.06-1,.06-3 • 49:25 Md. R. 1062 (12-2-22)

27.01.04.01,.01-1,.02,.03 • 49:25 Md. R. 1062 (12-2-22)

27.01.09.01,.01-2,.01-3 • 49:25 Md. R. 1062 (12-2-22)

27.01.14.06 • 49:25 Md. R. 1062 (12-2-22)

27.02.01.01 • 49:25 Md. R. 1062 (12-2-22)

27.02.05.05,.15-3 • 49:25 Md. R. 1062 (12-2-22)

 

30 MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

 

30.08.05.13 • 50:1 Md. R. 37 (1-13-23)

 

33 STATE BOARD OF ELECTIONS

 

33.01.07.01—.06 • 49:9 Md. R. 537 (4-22-22)

33.11.04.04 • 49:25 Md. R. 1065 (12-2-22)

 

The Division of State Documents

DEPOSITORIES FOR DOCUMENTS
INCORPORATED BY REFERENCE

Depositories for Documents Incorporated by Reference
into the Code of Maryland Regulations (COMAR)

 

 

Annapolis

MD Department of Legislative     Services

90 State Circle (21401)

Contact: Cynthia Stiverson

410-946-5430, 301-970-5400,

800-492-7111 x5400 (MD only)

FAX 410-946-5405

 

MD State Archives

350 Rowe Blvd. (21401)

Contact: Christine Alvey

410-260-6438

FAX 410-974-3895

 

MD State Law Library

Robert C. Murphy Courts of Appeal Bldg.

361 Rowe Blvd. (21401)

Contact: Deborah Judy

410-260-1430, 888-216-8156

FAX 410-974-2063

 

Baltimore

State Library Resource Center

Enoch Pratt Free Library

400 Cathedral St. (21201)

Contact: Lucy Jones

443-984-2448

FAX 410-396-4570

 

Thurgood Marshall Law Library

University of Md. Francis King     Carey School of Law

501 W. Fayette Street (21201)

Contact: Stephanie Bowe

410-706-0783

FAX 410-706-8354

 

Charlotte Hall

Southern MD Regional Library

37600 New Market Rd.

P.O. Box 459 (20622)

Contact: Susan Grant

301-934-9442

FAX 301-884-0438

 

College Park

Hornbake Library

University of MD

Marylandia Room (20742)

Contact: Liz Novara

301-314-2712

FAX 301-314-2709

 

Frostburg

Frostburg State University

Lewis J. Ort Library

1 Susan Eisel Drive (21532)

Contact: Lisa Hartman

301-687-4734

FAX 301-687-7069

 

Princess Anne

Frederick Douglass Library

University of MD Eastern Shore

(21853)

Contact: Marvella Rounds

410-651-7697

FAX 410-651-6269

 

Rockville

Montgomery County Public Library

Rockville Branch

21 Maryland Avenue (20850)

Contact: Ann Cohn

240-777-0140

FAX 240-777-0155

 

Salisbury

Salisbury University

Guerrieri Academic Commons

Room AC 180A

1134 S Salisbury Blvd. (21801)

Contact: Martha Zimmerman

410-677-0110

FAX 410-543-6203

 

Towson

Albert S. Cook Library

Towson University

8000 York Road (21252)

Contact: Carl Olson

410-704-3267

FAX 410-704-4755

Washington, D.C.

Library of Congress

Anglo-American Acquisitions Division

Government Documents Section

101 Independence Ave., S.E. (20540)

Contact: Richard Yarnall

202-707-9470

FAX 202-707-0380

 

 

Final Action on Regulations

 

Symbol Key

   Roman type indicates text already existing at the time of the proposed action.

   Italic type indicates new text added at the time of proposed action.

   Single underline, italic indicates new text added at the time of final action.

   Single underline, roman indicates existing text added at the time of final action.

   [[Double brackets]] indicate text deleted at the time of final action.

 

 

Title 11
DEPARTMENT OF TRANSPORTATION

Subtitle 07 MARYLAND TRANSPORTATION AUTHORITY

11.07.07 Electronic Toll Collection and Toll Violation Enforcement

Authority: Courts and Judicial Proceedings Article, §§7-301 and 7-302; Transportation Article, §§4-205, 4-312, 21-1414, 21-1415, 26-401, and
27-110; Annotated Code of Maryland

Notice of Final Action

[22-198-F]

On December 27, 2022, the Department of Transportation  adopted amendments to Regulations .02, .06, and .09 under COMAR 11.07.07 Electronic Toll Collection and Toll Violation Enforcement. This action, which was proposed for adoption in 49:23 Md. R. 1001—1002 (November 4, 2022), has been adopted as proposed.

Effective Date: January 23, 2023.

WILLIAM PINES
Executive Director

 

Subtitle 14 MOTOR VEHICLE ADMINISTRATION — VEHICLE INSPECTIONS

11.14.08 Vehicle Emissions Inspection Program

Authority: Environment Article, §§1-101, 1-404, 2-101—2-103, and 2-301—2-303; Transportation Article, §§12-104(b), 23-202(a), 23-206.2, 23-206.4, and 23-207; Annotated Code of Maryland

Notice of Final Action

[22-171-F]

On December 30, 2022, the Secretary of the Environment and the Administrator of the Motor Vehicle Administration jointly adopted amendments to Regulations .01—.06 and .20, new Regulation .07, amendments to and the recodification of existing Regulations .07—.14 and .16—.18 to be Regulations .08—.15 and .17—.19, respectively, the recodification of existing Regulation .15 to be Regulation .16, and the repeal of existing Regulation .19 under COMAR 11.14.08 Vehicle Emissions Inspection Program. This action, which was proposed for adoption in 49:19 Md. R. 878—885 (September 9, 2022), has been adopted as proposed.

Effective Date: January 23, 2023.

HORACIO A. TABLADA
Secretary of the Environment

CHRISTINE NIZER
Administrator
Motor Vehicle Administration

 

Subtitle 17 MOTOR VEHICLE ADMINISTRATION—DRIVER LICENSING AND IDENTIFICATION DOCUMENTS

11.17.09 Proof of Age, Full Name, Identity, Maryland Residence, and Lawful Status

Authority: Transportation Article, §§12-104(b), 12-301, 16-103.l, 16-104.2, 16-106, 16-115, and 16-121—16-122, Annotated Code of Maryland;
6 CFR 37

Notice of Final Action

[22-243-F]

On January 4, 2023, the Department of Transportation adopted new Regulation .08 under COMAR 11.17.09 Proof of Age, Full Name, Identity, Maryland Residence, Social Security Number, and Lawful Status. This action, which was proposed for adoption in 49:24 Md. R. 1031 (November 18, 2022), has been adopted as proposed.

Effective Date: January 23, 2023.

CHRISTINE NIZER
Administrator
Motor Vehicle Administration

 

Title 26
DEPARTMENT OF THE ENVIRONMENT

Subtitle 11 AIR QUALITY

26.11.18 Control of Agriculturally Related Installations

Authority: Environment Article, Title 2, Annotated Code of Maryland

Notice of Final Action

[22-176-F]

On December 20, 2022, the Secretary of the Environment adopted amendments to Regulation .05 under COMAR 26.11.18 Control of Agriculturally Related Installations. This action, which was proposed for adoption in 49:20 Md. R. 927 (September 23, 2022), has been adopted as proposed.

Effective Date: January 23, 2023.

HORACIO A. TABLADA
Secretary of the Environment


Proposed Action on Regulations

 

 


Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 18 BOATING—SPEED LIMITS AND OPERATION OF VESSELS

08.18.26 Susquehanna River

Authority: Natural Resources Article, §§8-703 and 8-704, Annotated Code of Maryland

Notice of Proposed Action

[22-285-P]

The Secretary of Natural Resources proposes to amend Regulation .06 under COMAR 08.18.26 Susquehanna River.

Statement of Purpose

The purpose of this action is to expand the existing speed zone area both north and south in the Susquehanna River at Havre de Grace located within Harford County. The current regulated area has a 6-knot speed limit zone effective on Saturdays, Sunday, and State holidays during the boating season. However, due to unsafe vessel activities in the area the Department is extending those restrictions. This will mitigate demonstrated safety concerns to both life and property. Additionally, the new regulated speed zone area will promote safe vessel operations. The expanded area will have a 6-knot speed limit zone effective on Saturdays, Sunday, and State holidays during the boating season, consistent with the rule in the current speed zone.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Susquehanna River Regulations, Regulatory Staff, Department of Natural Resources Fishing and Boating Services, 580 Taylor Avenue, E-4, Annapolis, MD 21401, or call 410-260-8300, or email to boatingregspubliccomment.dnr@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

.06 Havre de Grace.

[Havre de Grace encompasses all of the area enclosed by a line beginning at the Alliance Street sea wall, at or near Lat. 39° 32.502'N., Long. 76° 5.037' W., then running 90° (True) to a point, at or near Lat. 39° 32.502'N., Long. 76° 4.888' W., then running 355° (True) to a point, at or near Lat. 39° 32.742'N., Long. 76° 4.913' W., then running 338° (True) to a point, at or near Lat. 39° 32.870'N., Long. 76° 4.980' W., then running 272° (True) to a point, at or near Lat. 39° 32.873'N., Long. 76° 5.128' W. This area has a 6-knot speed limit on Saturdays, Sundays, and State holidays during the boating season.]

A. Area. All of the waters enclosed by a line beginning at a point at or near Lat. 39° 32.262' N., Long. 76° 5.541' W., then running 176° to a point, at or near Lat. 39° 32.113' N., Long. 76° 5.526' W., then running along the North shore of Tydings Island Eastward to a point, at or near Lat. 39° 32.193' N., Long. 76° 5.31' W., then running 93° to a point, at or near Lat. 39° 32.177' N., Long. 76° 4.902' W., then running 2° to a point, at or near Lat. 39° 32.502' N., Long. 76° 4.888' W., then running 355° to a point, at or near Lat. 39° 32.742' N., Long. 76° 4.913' W., then running 338° to a point, at or near Lat. 39° 32.87' N., Long. 76° 4.98' W., then running 328° to a point, at or near Lat. 39° 33.226' N., Long. 76° 5.273' W., then running 252° to a point, at or near Lat. 39° 33.185' N., Long. 76° 5.438' W., then running South along shore to the point of beginning.

B. The speed limit for the area described in §A of this regulation is 6 knots on Saturdays, Sundays, and State holidays during the boating season.

JEANNIE HADDAWAY-RICCIO
Secretary of Natural Resources

 

Title 09
MARYLAND DEPARTMENT OF LABOR

Subtitle 12 DIVISION OF LABOR AND INDUSTRY

09.12.81 Elevator, Escalator, and Chairlift Safety

Authority: Public Safety Article, §§12-805, 12-806, and 12-809, Annotated Code of Maryland

Notice of Proposed Action

[22-275-P-I]

The Commissioner of Labor and Industry proposes to amend Regulation .02 under COMAR 09.12.81 Elevator, Escalator, and Chairlift Safety.

Statement of Purpose

The purpose of this action is to amend the incorporation by reference of ASME 18.1, Safety Standard for Platform Lifts and Stairway Chairlifts to include ASME 18.1-2020, Safety Standard for Platform Lifts and Stairway Chairlifts. These national consensus standards regulate the platform lift and stairway lift industry. These updated consensus standards reflect changes to the industry such as technological innovations and safety applications.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Mischelle F Vanreusel, Acting Deputy Commissioner, Division of Labor and Industry, 10946 Golden West Drive, Suite 160, or call 4107672225, or email to mischelle.vanreusel@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

 

Editor’s Note on Incorporation by Reference

     Pursuant to State Government Article, §7-207, Annotated Code of Maryland, ASME A18.1-2020 (Revision of ASME A18.1-2017) Safety Standard for Platform Lifts and Stairway Chairlifts has been declared a document generally available to the public and appropriate for incorporation by reference. For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this document are filed in special public depositories located throughout the State. A list of these depositories can be found on page 7 of this issue of the Maryland Register, and is available online at www.dsd.state.md.us. The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.

.02 Safety Standard for Platform Lifts and Stairway Chairlifts.

A. Scope.

(1)—(11) (text unchanged)

(12) ASME A18.1-2020 (Revision of ASME A18.1-2017) Safety Standard for Platform Lifts and Stairway Chairlifts is incorporated by reference.

B.—F. (text unchanged)

MATTHEW S. HELMINIAK
Commissioner Labor and Industry

 

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.02 Physicians’ Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Proposed Action

[22-323-P-I]

The Secretary of Health proposes to amend Regulations .01, .03—.05, .07—.09, and .11 under COMAR 10.09.02 Physicians’ Services.

Statement of Purpose

The purpose of this action is to:

(1) Update the Maryland Medical Assistance Program Professional Service Provider Manual and Fee Schedule incorporated by reference;

(2) Allow services rendered via telehealth to be reimbursed in compliance with COMAR 10.09.49 and remove limitations on the reimbursement of services rendered by telephone in accordance with S.B. 3, Acts of 2021;

(3) Clarify the services for which a provider may be reimbursed up to acquisition costs;

(4) Allow physicians to be reimbursed for visits solely for the purpose of administering certain vaccines;

(5) Change the outdated term “recipient” to be “participant”; and

(6) Correct a reference in Regulation .09 to the provider participation criteria in Regulation .03.

Estimate of Economic Impact

I. Summary of Economic Impact. The proposed action increases reimbursement rates for covered Evaluation and Management codes to 100 percent of Medicare rates beginning July 1, 2022. The estimated economic impact is $11,944,936 in FY 2023.

 

II. Types of Economic Impact.

Revenue

(R+/R-)

Expenditure

(E+/E-)

Magnitude

A. On Issuing agency:

 

 

Maryland Department of Health

(E+)

$11,944,936

B. On other state agencies:

NONE

 

C. On local governments:

NONE

 

 

 

Benefit (+)

Cost (-)

Magnitude

D. On regulated industries or trade groups:

 

 

Maryland Medicaid providers

(+)

$11,944,936

E. On other industries or trade groups:

NONE

 

F. Direct and indirect effects on public:

NONE

 

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A and D. This amount assumes:

(1) For dates of service beginning July 1, 2022, Maryland Medical Assistance reimbursement rates for covered Evaluation and Management codes will increase to 100 percent of Medicare rates.

(2) This amount is subject to a 65.29 percent federal match ($7,798,849 federal and $4,146,087 general funds). It does not reflect the enhanced FMAP for non-ACA expansion participants due to the public health emergency.

Economic Impact on Small Businesses

The proposed action has a meaningful economic impact on small businesses. An analysis of this economic impact follows:

Maryland Medicaid providers who qualify as small businesses and render evaluation and management services will incur a portion of the collective benefit of increased reimbursement rates.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jourdan Green, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

 

Editor’s Note on Incorporation by Reference

     Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the 2022 Maryland Medical Assistance Program Professional Services Provider Manual Effective July 2022 has been declared a document generally available to the public and appropriate for incorporation by reference. For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of this document are filed in special public depositories located throughout the State. A list of these depositories can be found on page 7 of this issue of the Maryland Register, and is available online at www.dsd.state.md.us. The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(15) (text unchanged)

(16) “Participant” means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.

[(16)] (17)[(23)] (24) (text unchanged)

[(24) “Recipient” means a person who is certified as eligible for, and is receiving, Medical Assistance benefits.]

(25)—(27) (text unchanged)

.03 Conditions for Participation.

A. General requirements for participation in the Program are that a provider shall [meet all conditions for participation as set forth in COMAR 10.09.36.03.]:

(1) Meet all the conditions for participation as set forth in COMAR 10.09.36; and

(2) If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

B. Specific requirements for participation in the Program as a physicians’ services provider require that the provider:

(1) (text unchanged)

(2) May not place a restriction on a [recipient’s] participant’s right to select providers of his or her choice;

(3) May not knowingly employ or contract with a person, partnership, or corporation which has been disqualified from the Program to provide or supply services to Medical Assistance [recipients] participants unless prior written approval has been received from the Department;

(4)—(7) (text unchanged)

.04 Covered Services.

The Program covers the following medically necessary services rendered to [recipients] participants:

A. Physicians’ services rendered in the physician’s office, the [recipient’s] participant’s home, a hospital, a skilled or intermediate care nursing facility, a freestanding clinic, or elsewhere when these services are:

(1) (text unchanged)

(2) Clearly related to the [recipient’s] participant’s individual medical needs as diagnostic, curative, palliative, or rehabilitative services;

(3) Adequately described in the [recipient’s] participant’s medical record;

B.—F. (text unchanged)

G. Abortions performed in accordance with the Health-General Article, Title 20, Subtitles 1 and 2, Annotated Code of Maryland; [upon certification by the physician performing the procedure that the procedure is necessary, based upon the physician’s professional judgment, and that one of the following conditions exists:

(1) If continuation of pregnancy is likely to result in the death of the woman;

(2) If the woman is a victim of rape, sexual offense, or incest which has been reported to a law enforcement agency or a public health or social agency;

(3) If it can be ascertained by the physician within a reasonable degree of medical certainty that the fetus is affected by genetic defect or serious deformity or abnormality;

(4) If it can be ascertained by the physician within a reasonable degree of medical certainty that termination of the pregnancy is medically necessary because there is substantial risk that continuation of the pregnancy could have a serious and adverse effect on the woman’s present or future physical health;

(5) That there exists medical evidence that continuation of the pregnancy is creating a serious effect on the woman’s present mental health and if carried to term there is substantial risk of a serious or long lasting effect on the woman’s future mental health;]

H. (text unchanged)

I. Vaccine administrations when the vaccines [are]:

(1) Meet the following conditions for coverage under the Vaccines for Children Program:

[(1)] (a) (text unchanged)

[(2)] (b) Administered to [recipients] participants eligible for the Vaccines for Children program; and

[(3)] (c) Administered by providers eligible to be reimbursed for vaccine administration under the Vaccines for Children program[.]; or

(2) Are supplied to providers by the federal government at no charge, including but not limited to the administration of COVID-19 vaccinations.

.05 Limitations.

A. Services which are not covered are:

(1)—(8) (text unchanged)

(9) Immunizations required solely for travel outside the continental United States;

(10) [Injections] Injectable medications, and visits solely for the administration of [injections] injectable medications, unless medical necessity and the patient’s inability to take appropriate oral medications are documented in the patient’s medical records;

(11) Vaccine administration unless covered under Regulation .04 of this chapter;

[(11)] (12)[(17)] (18) (text unchanged)

[(18)] (19) Services which do not involve direct [(face-to-face)] patient contact;

[(19)] (20) (text unchanged)

[(20)] (21) Prescriptions for drugs written on prescription pads that do not prevent copying, modification, or counterfeiting; [and]

[(21)] (22) Physician-administered drugs from manufacturers that do not participate in the Federal Drug Rebate Program[.]; and

(21) Any covered service that requires a preauthorization, including physician-administered drugs and injectable medications, that is rendered without an approved preauthorization from the Program.

B.—H. (text unchanged)

I. Services not rendered in-person shall comply with the telehealth requirements established in COMAR 10.09.49 and any other subregulatory guidance issued by the Department.

.07 Payment Procedures.

A.—B. (text unchanged)

C. [The] Except as provided in §F of this regulation, the Provider shall charge the Program the provider’s customary charge to the general public for similar services[, except for injectable drugs, the provision of diagnostic or therapeutic radiopharmaceuticals, and dispensed medical supplies, in which case, the provider shall charge the Program the provider’s acquisition cost]. If the service is free to individuals not covered by Medicaid:

(1)—(2) (text unchanged)

D. The Maryland Medical Assistance Program’s procedures for payment are contained in the following documents, the provisions of which are incorporated by reference:

(1) The Professional Services Provider Manual and Fee Schedule (Effective [January 2020] July 2022); and

(2) (text unchanged)

E. Except as provided in §F of this regulation, [The] the Department will pay for covered services at the lesser of:

(1)—(2) (text unchanged)

F. The Program shall reimburse providers up to the acquisition cost for diagnostic and therapeutic radiopharmaceuticals, contraceptive products and devices, and injectable medications when the provider submits documentation indicating that the acquisition cost of the product, device, or drug is greater than the reimbursement allowed in §E of this regulation.

[F.] G.[H.] I. (text unchanged)

[I.] J. The provider may not bill the Department or the [recipient] participant for:

(1)—(2) (text unchanged)

(3) Professional services rendered by mail [or telephone]; or

(4) Providing a copy of a [recipient’s] participant’s medical record when requested by another licensed provider on behalf of the [recipient] participant.

[J.] K. The Program will make no direct payment to [recipients] participants.

[K.] L. (text unchanged)

[L. The program will reimburse the provider for injectable drugs at rates promulgated by the fee schedule under §D of this regulation.]

M.—P. (text unchanged)

[Q. The Program will reimburse the provider for the provision of diagnostic and therapeutic radiopharmaceuticals at actual cost.]

.08 Recovery and Reimbursement.

A. If the [recipient] participant has insurance or other coverage, or if any other person is obligated, either legally or contractually, to pay for, or to reimburse the [recipient] participant for, services covered by this chapter, the provider shall seek payment from that source first. If an insurance carrier rejects the claim or pays less than the amount allowed by the Medical Assistance Program, the provider may submit a claim to the Program. The provider shall submit a copy of the insurance carrier’s notice or remittance advice with the invoice. If payment is made by both the Program and the insurance or other source for the same service, the provider shall refund to the Department, within 60 days of receipt, the amount paid by the Program or the insurance or other source, whichever is less.

B. (text unchanged)

.09 Cause for Suspension or Removal and Imposition of Sanctions.

A.—D. (text unchanged)

E. A provider who voluntarily withdraws from the Program, or is removed or suspended from the Program according to this regulation, shall notify [recipients] participants, before rendering additional services, that the provider no longer honors Medical Assistance cards.

F. If the Department determines that a provider participating in the Program as a case manager has violated any provision of the agreement executed under the terms of Regulation [.03A(2)] .03B of this chapter, the Program may suspend or disqualify the provider from participating as a case manager without otherwise restricting the provider’s participation as a physician.

.11 Interpretive Regulation.

Except when the language of a specific regulation indicates an intent by the Department to provide reimbursement for covered services to Program [recipients] participants without regard to the availability of federal financial participation, State regulations shall be interpreted in conformity with applicable federal statutes and regulations.

DENNIS R. SCHRADER
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

Notice of Proposed Action

[22-292-P]

The Secretary of Health proposes to:

(1) Amend Regulations .01—.06 under COMAR 10.09.40 Early Intervention Service Coordination;

(2) Amend Regulations .01—.06 and adopt new Regulation .03-1 under COMAR 10.09.52 Service Coordination for Children with an IEP or Enrolled in the Autism Waiver; and

(3) Amend Regulations .01, .03, and .05 under COMAR 10.09.76 School-Based Health Centers (SBHC).

Statement of Purpose

The purpose of this action is to:

(1) Update terminology throughout the Early Intervention Services Case Management chapter to align regulations with current industry practices;

(2) Update language as it relates to children with disabilities, and provide further clarification on the differences between service coordination provided for Autism Waiver and IEP/IFSP participants; and

(3) Align regulations with the provisions of Ch. 606 (S.B. 830), Acts of 2021, “Secretary of Health — School Based Health Centers — Guidelines and Administration of Grants” which shifted approval authority of school-based health centers from Maryland State Department of Education (MSDE) to Maryland Department of Health (MDH), effective July 1, 2022.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has an impact on individuals with disabilities as follows:

The proposed action provides clarification on the differences between service coordination provided for Autism Waiver and IEP/IFSP participants.

Opportunity for Public Comment

Comments may be sent to Jourdan Green, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 01 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

 

10.09.40 Early Intervention [Services Case Management] Service Coordination

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

[(1) “Case management” means services which will assist participants in gaining access to the full range of Medical Assistance services, as well as to any additional needed medical, social, mental health, financial assistance, counseling, educational, and other support services.

(2) “Case manager” means an individual who:

(a) Is used by the provider chosen by the participant’s parent;

(b) Meets the requirements in Regulation .03C of this chapter; and

(c) Provides the covered services specified in Regulation .04 of this chapter.

(3) “Children’s Medical Services” means the State agency administering a program of services for children with special health care needs, as authorized by Title V of the Social Security Act and COMAR 10.22.08.]

[(4)] (1)[(5)] (2) (text unchanged)

[(6)] (3) “Developmental delay” [means that a child is functioning at least 25 percent below chronological age in at least one of the five developmental areas, as measured and verified by diagnostic instruments and procedures approved by the Maryland Infants and Toddlers Program] has the meaning stated in COMAR 13A.13.01.03B.

[(7)] (4) “Early intervention services” means services defined in COMAR 13A.13.01.03B(15) that:

(a)—(c) (text unchanged)

[(8)] (5) “Early intervention [services case management] service coordination means the [case management] coordination of services covered under this chapter.

[(9) “Early intervention services case management provider” means a provider of services covered under Regulation .04 of this chapter, which meets the requirements in Regulation .03 of this chapter and is chosen as the provider by a participant’s parent.]

[(10)] (6)[(12)] (8) (text unchanged)

[(13)] (9) “Maryland Infants and Toddlers Program” means the program designated by the Governor under Executive Order 01.01.1988.15 to plan, develop, and implement a Statewide, coordinated, comprehensive, multidisciplinary, interagency plan for early intervention services in Maryland[, with the Office for Children, Youth, and Families designated as the lead agency for this program under Article 49D, Annotated Code of Maryland].

[(14)] (10)[(16)] (12) (text unchanged)

[(17)] (13) “Multidisciplinary team” means [a group convened and conducted by a participant’s case manager to perform the multidisciplinary assessment or reassessment and develop or revise the participant’s IFSP, and which is comprised of the case manager, the participant’s family, and relevant service providers] the involvement of two or more disciplines or professions in the provision of integrated and coordinated services, including evaluation and assessment activities and the development of the IFSP.

[(18)] (14) “Parent” [means a biological or adoptive parent, a legal guardian, another person responsible for a child’s welfare, or a surrogate parent for those cases when:

(a) A public agency, after reasonable efforts, cannot discover the whereabouts of a biological or adoptive parent;

(b) A person cannot be identified with responsibility for a child’s welfare; or

(c) The child is a ward of the State] has the meaning stated in COMAR 13A.13.01.03B.

[(19)] (15) “Participant” means a federally qualified recipient [who is]:

[(a) A child between birth and 3 years old;

 (b) Admitted to early intervention services case management through an election statement, signed by the participant’s parent and filed with the provider chosen by the parent;]

(a) Who is aged birth to the beginning of the school year following the child’s fourth birthday;

(b) Whose parents have provided written consent for the use of public benefits consistent with COMAR 13A.13.01.12;

(c) [Not] Who is not receiving the same [case management] service coordination services under another Program authority; and

(d) [Determined by a multidisciplinary team to be eligible for early intervention services case management because the child:] Who is defined as a child with a developmental delay as defined in COMAR 13A.13.01.03.

[(i) Is experiencing developmental delays,

(ii) Has a diagnosed physical or mental condition that has a high probability of resulting in developmental delay, or

(iii) Demonstrates atypical development or behavior, which is demonstrated by abnormal quality of performance and function in at least one of the five developmental areas, interferes with current development, and is likely to result in future developmental delay.]

[(20)] (16) (text unchanged)

[(21)] (17) “Provider” means an early intervention [services case management] service coordination provider.

[(22) “Recipient” means a recipient as defined in COMAR 10.09.36.01.]

(18) “Service coordination” means the services provided, as part of the Maryland Infants and Toddlers Program, which assists participants in gaining access to the full range of Medical Assistance services, as well as to any additional needed medical, social, mental health, financial assistance, counseling, educational, and other support services.

(19) “Service coordinator” means an individual who:

(a) Is utilized by the provider and chosen by the participant’s parent;

(b) Is designated to carry out the IFSP service coordination activities;

(c) Meets the requirements in Regulation .03C of this chapter; and

(d) Provides the services specified in Regulation .04 of this chapter.

(20) “Telehealth” has the meaning as stated in COMAR 10.09.49.02.

.02 Licensing Requirements.

A. Social workers participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 18, Annotated Code of Maryland, or meet the social worker licensure and regulatory requirements of the state in which the services are provided.

B. Registered nurses participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 7, Annotated Code of Maryland, or meet the registered nurse licensure and regulatory requirements of the state in which the services are provided.

C. Audiologists participating as [case managers] service coordinators shall be licensed pursuant to [COMAR 13A.07.01.07K or] COMAR 10.41.03.03, or meet the audiologist licensure and regulatory requirements of the state in which the services are provided.

D. Nutritionists or dietitians participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 4, Annotated Code of Maryland, or meet the [nutritionist] corresponding licensure and regulatory requirements of the state in which the services are provided.

E. Occupational therapists participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 9, Annotated Code of Maryland, or meet the occupational therapist licensure and regulatory requirements of the state in which the services are provided.

F. Physical therapists participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 13, Annotated Code of Maryland, or meet the physical therapist licensure and regulatory requirements of the state in which the services are provided.

G. Clinical psychologists participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 16, Annotated Code of Maryland, or meet the clinical psychologist licensure and regulatory requirements of the state in which the services are provided.

H. School psychologists participating as [case managers] service coordinators shall be certified pursuant to COMAR [13A.07.07.07] 13A.12.03.08, or meet the school psychologist regulatory requirements of the state in which the services are provided.

I. Special educators participating as [case managers] service coordinators shall be certified pursuant to COMAR [13A.07.01.02] 13A.12.01.04, or meet the special educator regulatory requirements of the state in which services are provided.

J. Speech language pathologists participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 19, Annotated Code of Maryland[, be certified pursuant to COMAR 13A.07.01.07K], or meet the speech language pathologist licensure or certification and regulatory requirements of the state in which the services are provided.

K. Professional counselors participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 15, Annotated Code of Maryland, or meet the professional counselor licensure and regulatory requirements of the state in which services are provided.

L. Physicians participating as [case managers] service coordinators shall be licensed pursuant to Health Occupations Article, Title 14, Annotated Code of Maryland, or meet the physicians’ licensure and regulatory requirements of the state in which the services are provided.

.03 Conditions for Participation.

A. General requirements for participation in the Program are that providers shall do the following, either directly through staff or by agreement:

(1) (text unchanged)

(2) Maintain a file on each participant which meets the Program’s requirements and which includes for each contact made by the [case manager] service coordinator:

(a)—(c) (text unchanged)

(d) Nature, content, and unit or units of service provided[and];

(e) Place of service[.]; and

(f) Signature and printed name of the service coordinator.

B. Specific requirements for participation in the Program as an early intervention [services case management provider] service coordinator are that the provider shall do the following, either directly or indirectly by agreement:

[(1) Be the State agency, that is, Children’s Medical Services, administering a program of services for children with special health care needs, authorized under Title V of the Social Security Act, acting in conjunction with its local health department designees;]

[(2)] (1) Use qualified individuals as [case managers] service coordinators;

[(3)] (2) (text unchanged)

[(4) Be selected by the participant’s parent from among the local health department designees;

(5) Contact the participant’s family within 2 working days of the receipt of a referral for early intervention services case management, unless client-related extenuating circumstances are documented;]

[(6)] (3) Develop the IFSP within 45 working days of referral, unless client-related extenuating circumstances are documented in accordance with COMAR 13A.13.01.07B.

[(7)] (4) Have formal written policies and procedures, approved by the Department, which specifically address the provision of early intervention [services case management] service coordination to participants in accordance with the requirements of this chapter;

[(8) Be available to participants and their families for at least 8 hours a day, 5 days a week, except on State holidays;]

[(9)] (5) Designate specific qualified individuals as early intervention [services case managers] service coordinators;

[(10)] (6)[(13)] (9) (text unchanged)

C. A [case manager] service coordinator shall meet the following requirements:

(1) Be a professional who:

(a) Has a current license or certification, according to Regulation .02 of this chapter, in the profession most immediately relevant to a participant’s needs; and

(b) Has demonstrated training or experience in providing [case management] service coordination or other early intervention services to infants and toddlers with disabilities; or

[(c) Meets by October 1, 1995 the personnel standards for early intervention services case managers issued by the Maryland Infants and Toddlers Program; and

(d) Participates in ongoing training offerings, as specified in the interagency training plan for early intervention services; or]

(2) Be a nonprofessional who:

(a) Has a high school diploma or its equivalency who meets Personnel Standards described in COMAR 13A.07.01.02[,];

(b) Has demonstrated training or experience in providing [case management] service coordination or other early intervention services to infants and toddlers with disabilities; and

(c) (text unchanged)

.04 Covered Services.

A. (text unchanged)

B. Initial [Case Management Services] Service Coordination.

(1) A unit of service is defined as a completed initial Individualized Family Service Plan (IFSP) and at least one contact with the participant or the participant’s family, [in] on the participant’s behalf.

(2) The covered services include convening and conducting a multidisciplinary team to:

(a) (text unchanged)

(b) Develop an initial IFSP for a participant that identifies the:

(i) Participant’s needs for early intervention, medical, mental and behavioral health, social, educational, financial assistance, counseling, and other support services;

(ii)—(iv) (text unchanged)

(3) Administrative, supervisory, and monitoring services associated with the initial [case management] service coordination are included as a part of the service.

C. Ongoing [Case Management Services] Service Coordination.

(1) Ongoing [case management] service coordination is provided following the initial [case management services] service coordination.

(2) A unit of service includes [a monthly telephone call to, or visit with, the participant’s family, in the participant’s behalf, and] all [other] necessary covered services[.] and at least one monthly contact with the participant’s family on the participant’s behalf via:

(a) Telephone call;

(b) Telehealth or in-person visit; or

(c) Written communication.

(3)—(4) (text unchanged)

D. Annual IFSP Review.

(1) A unit of service is defined as a completed annual IFSP review and at least one contact with the participant or the participant’s family, [in] on the participant’s behalf.

(2) (text unchanged)

.05 Limitations.

A. Early intervention [services case management] service coordination is advisory in nature.

B. A restriction may not be placed on a qualified [recipient’s] participant’s option to receive early intervention [services case management] service coordination.

C. Early intervention [services case management] service coordination does not restrict or otherwise affect:

(1)—(4) (text unchanged)

D. Early intervention [services case management] service coordination may not be:

(1)—(4) (text unchanged)

E. Reimbursement may not be made for early intervention [services case management] service coordination if a participant is receiving a comparable case management service under another Program authority.

F. A participant’s [case manager] service coordinator may not be the participant’s parent.

.06 Payment Procedures.

A. Request for Payment.

(1) Requests for payment of early intervention [services case management] service coordination shall be submitted by an approved provider according to procedures established by the Department. The Department reserves the right to return to the provider, before payment, all [invoices] claims not properly signed and completed.

(2) A provider shall submit a request for payment on the [invoice] claim form designated by the Department. A separate [invoice] claim shall be submitted for each participant.

(3) The completed [invoice] claim form in §A(2)B[,] of this regulation[,] shall indicate the:

(a)—(d) (text unchanged)

(4) (text unchanged)

(5) The Program may not make direct payment to [recipients] participants.

B. (text unchanged)

C. Payment shall be made:

(1) (text unchanged)

(2) Only to one provider of early intervention [services case management] service coordination rendered to a participant during a billing period; and

(3) According to the following fee-for-service schedule for early intervention [services case management] service coordination:

[Description Fee Per Unit of Service]

(a) Initial [case management] service coordination (only one unit of service may be reimbursed per participant) ... $500;

(b) Ongoing [case management] service coordination (only one unit of service per month may be reimbursed for a participant after completion of initial [case management] service coordination or the annual IFSP review) ... $150;

(c) Annual IFSP review [(only one unit of service may be reimbursed for a participant annually, for a total of two units per participant)] ... $275 per review.

 

10.09.52 Service Coordination for Children with [Disabilities] an IEP or Enrolled in the Autism Waiver

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

(2) “Autism Waiver” or “Waiver means the Home and Community-Based Services Waiver for Children with Autism Spectrum Disorder.

[(3) “Children with disabilities” means those children who are waiver participants or:

(a) Who have been determined through appropriate assessment pursuant to COMAR 13A.05.01 as having temporary or long-term special education needs arising from cognitive, emotional, or physical factors, or any combination of these; and

(b) Whose ability to meet general education objectives is impaired to a degree that the services available in the general education program are inadequate in preparing them to achieve their education potential.]

(3) “Autism Waiver Service Coordination” means the coordination of waiver services covered under this chapter.

(4) “Autism Waiver Service Coordinator” means an individual who meets the requirements specified in Regulation .03-1 of this chapter and provides the autism waiver services specified in Regulations .04-1—04.2 of this chapter to a waiver participant.

[(4)] (5)—[(5)] (6) (text unchanged)

(7) “IEP service coordination” means the coordination of services which assists a participant in gaining access to the services recommended in the participant’s IEP.

(8) “IEP service coordinator” means an individual who meets the requirements in Regulation .03C of this chapter.

[(6)] (9) “Individualized Education Program (IEP)” means a written, individualized plan of care for a participant, that:

(a)—(b) (text unchanged)

(c) Conforms with the requirements in COMAR 13A.05.01 and 34 CFR §§300.320—300-324.

[(7)] (10) “Individualized education program (IEP) team” means the multidisciplinary team convened by a provider in accordance with COMAR 13A.05.01 to review a participant’s needs, [and] develop the participant’s IEP[.], and determine the placement of the participant in the least restrictive environment.

[(8)] (11) “Individualized family service plan (IFSP)” means a written, individualized plan for providing early intervention and other services for an infant, [or] toddler, or preschool-age child, in accordance with COMAR [10.09.40, 10.09.50, and] 13A.13.01.

[(9)] (12) (text unchanged)

[(10)] (13) “Local school system (LSS)” means [the public local education agency for each jurisdiction.] any public school system in Maryland responsible for providing public elementary or secondary education.

[(11)] (14) “Maryland Medicaid Managed Care Program” has the meaning stated in COMAR [10.09.62.01] 10.67.01.01.

[(12)] (15)—[(12-1)] (16) (text unchanged)

[(13) Parent.

(a) “Parent” means the parent of a participant.

(b) “Parent” includes:

(i) A natural parent;

(ii) A guardian;

(iii) An individual acting as a parent such as a relative or a stepparent with whom a child lives, including those relatives or stepparents who are foster parents;

(iv) Any other individual who is legally responsible for a child’s welfare; or

(v) A person appointed as the parent surrogate in accordance with COMAR 13A.05.01.]

(17) “Parent” has the meaning stated in COMAR 13A.13.01.03.

[(14)] (18)—[17)] (21) (text unchanged)

[(18)] (22) “Rare and expensive case management (REM)” has the meaning stated in [COMAR 10.09.62.01] COMAR 10.09.69.02.

[(19) “Recipient” has the meaning stated in COMAR 10.09.36.01.

(20) “Service coordination” means case management services which assist participants in gaining access to the services recommended in a participant’s IEP or waiver plan of care.

(21) “Service Coordination for Children with Disabilities” means the case management services covered under this chapter.

(22) “Service coordinator” means an individual who:

(a) Meets the requirements in Regulation .03C of this chapter; and

(b) Provides the covered services specified in Regulation .04 of this chapter, as well as Regulations .04-1 and .04-2 for a waiver participant.]

(23) “Telehealth” has the meaning as stated in COMAR 10.09.49.02.

[(23)] (24)[(24)] (25) (text unchanged)

[(25)] (26) “Waiver participant” means a [waiver eligible person who is enrolled in the Autism Waiver] child whose enrollment meets the requirements set forth in COMAR 10.09.56.

[(26)] (27) (text unchanged)

.02 Participant Eligibility.

A [recipient] participant is eligible [to participate in] for Service Coordination [for Children with Disabilities] if:

A. (text unchanged)

B. The following requirements are met:

(1) The [recipient] participant, for whom free and appropriate education is provided under the Individuals with Disabilities Education Act, is [2] aged 3 through 20 years old;

(2) An IEP team determines that the [recipient] participant is a child with disabilities who:

(a)—(b) (text unchanged)

(3) The [recipient] participant elects, or the [recipient’s] participant’s parent elects on the [recipient’s] participant’s behalf, to receive the services available under this chapter; and

[(4) The recipient is not receiving similar case management services under §1915(c) or (g) of Title XIX of the Social Security Act; and]

[(5)] (4) The [recipient] participant is not a resident of any of the facilities that receive Medicaid reimbursement for residential services.

.03 Conditions for Participation for IEP Service Coordination Providers.

A. General requirements for participation in the Program are that a provider shall [meet]:

(1) Meet all the conditions for participation as set forth in COMAR [10.09.36.03] 10.09.36; and

(2) If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

B. [Specific requirements for participation in the Program as a provider of Service Coordination for Children with Disabilities are that a provider] IEP service coordination providers shall:

(1) Be an agency within the State that:

(a)—(b) (text unchanged)

(2) Convene or participate on an IEP team or teams, in accordance with COMAR 13A.05.01[, which shall:

(a) Include individuals from at least two disciplines as specified in COMAR 13A.05.01 and determined by the participant’s disability, and provide the opportunity for participation to the participant’s parent or parents, and the participant, if appropriate, pursuant to COMAR 13A.05.01;

(b) Receive referrals of recipients who are 2 through 20 years old, or who are waiver participants, and are identified as potentially eligible for the services covered under this chapter;

(c) Conduct an assessment of a recipient within 90 days of receiving a written referral;

(d) Develop an IEP for a participant in accordance with COMAR 13A.05.01 within 30 calendar days of the determination of eligibility for the services covered under this chapter;

(e) Review the IEP and progress of each participant who is receiving the special education and related services recommended in the IEP, upon request of the parent or parents;

(f) Meet and conduct an annual review of each participant’s IEP and, if appropriate, revise the IEPs provisions; and

(g) Reconvene the IEP team to conduct an interim IEP review and modify the existing IEP at any time upon request of the professionals included on the team or the parent or parents, as considered necessary pursuant to the participant’s progress];

(3)—(4) (text unchanged)

(5) Maintain a file on each participant which meets the Program’s requirements [and] which shall include:

(a) (text unchanged)

(b) Written parental consent [for the] to initiate services covered under this chapter;

(c) [A record of service coordination encounters concerning the participant] Written parental consent prior to accessing the student’s public benefits or insurance the first time, and annually thereafter, in accordance with 34 CFR §300.154(d)(2);

(d) Approval from a participant’s parent of the [participant’s service coordinator and the] participant’s IEP before implementation of the service coordination; and

[(e) The following documentation for a waiver participant:

(i) Diagnosis of autism spectrum disorder every 3 years or more often as requested by MSDE, by a qualified diagnostician using an evaluation methodology considered sufficient by the multidisciplinary team;

(ii) Form for determination of eligibility for level of care in an intermediate care facility for the intellectually disabled and persons with related conditions (ICF/IID) — initial determination and redetermination, at least annually;

(iii) Consent form for autism waiver services, signed before Autism Waiver enrollment;

(iv) Form for determination of Medicaid eligibility for autism waiver services — initial determination and redetermination, at least annually;

(v) Waiver plan of care—initial plan, review at least annually, and any plan revisions;

(vi) Preauthorization by MSDE of any environmental accessibility adaptations reimbursed through the Autism Waiver; and

(vii) The waiver participant’s IEP developed in accordance with this chapter or individualized family service plan (IFSP) developed in accordance with COMAR 10.09.40;]

(e) A record of service coordination encounters including:

(i) A brief description of the service;

(ii) The location;

(iii) The name of the contact (parent/guardian or student);

(iv) The date of the service; and

(v) The service coordinator’s printed name and signature; and

(6) Employ or have under contract qualified personnel who convene or participate on IEP teams, convene or participate on [waiver] multidisciplinary teams as necessary, and develop participants’ IEPs [or waiver plans of care, and perform as service coordinators for participants; and

(7) Convene or participate on a waiver multidisciplinary team or teams for waiver participants, in accordance with the requirements of COMAR 10.09.56 and this chapter].

C. IEP Service Coordinator Requirements.

(1) [A] An IEP service coordinator shall:

(a) (text unchanged)

(b) Be [chosen] identified by the IEP team [or waiver multidisciplinary team, with the approval of the participant’s parent or parents, taking into consideration the:];

[(i) Primary disability manifested by the participant;

(ii) Participant’s needs; and

(iii) Services recommended in the IEP or waiver plan of care;]

(c) Participate with the IEP team [or waiver multidisciplinary team] in the development or revision of a participant’s IEP [or waiver plan of care] and in the IEP [or waiver plan of care] review;

(d) Assist the participant in gaining access to the services recommended in the IEP [or waiver plan of care]; and

(e) Collect and synthesize evaluation reports and other relevant information about a participant that might be needed by an IEP team [or waiver multidisciplinary team].

(2) [A] An IEP service coordinator shall have the following qualifications and be a:

(a) (text unchanged)

(b) Nonprofessional who meets the requirements in §C(4) [or (5)] of this regulation.

(3) A professional who is chosen as a participant’s service coordinator shall meet the following licensing or certification requirements, as appropriate, and be:

(a)—(b) (text unchanged)

(c) A professional counselor licensed to practice in accordance with Health Occupations Article, Title 17, Annotated Code of Maryland;

[(c)] (d)[(j)] (k) (text unchanged)

(4) A nonprofessional who is chosen as a participant’s service coordinator[, except the service coordinator for a waiver participant,] shall meet the following requirements:

[(a) Be a parent of a child with disabilities, but not of the participant;]

[(b)] (a) Have at least a high school diploma or the equivalent; [and]

(b) Have demonstrated training or experience in providing service coordination to students with disabilities; and

[(c) Have satisfactorily completed training in advocacy at a parent information center that is approved by MSDE.]

(c) Participate in ongoing service coordination training offerings as specified in the interagency plan for special education services.

[(5) A nonprofessional who is chosen as a service coordinator for a waiver participant shall have at least:

(a) 1 year of relevant training or experience; and

(b) A bachelor’s degree in social work or a related human services field.

(6) Service coordinators for waiver participants shall complete at least 5 hours of initial training on the Autism Waiver, offered by the Department and MSDE, before rendering Autism Waiver service coordination covered under Regulations .04-1 and .04-2 of this chapter.

(7) Service coordinators for waiver participants must attend one statewide training for Autism Waiver service coordinators per fiscal year.]

.03-1 Conditions for Participation for Autism Waiver Service Coordination Providers.

A. General requirements for participation in the Program are that a provider shall:

(1) Meet all the conditions for participation as set forth in COMAR 10.09.36; and

(2) If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

B. Specific requirements for participation in the Program as a provider of Autism Waiver Service Coordination are that a provider shall:

(1) Be an agency within the State that employs or has under contract qualified personnel who convene or participate on waiver multidisciplinary teams as necessary, develop participant’s waiver plans of care, and provide service coordination services for waiver participants;

(2) Designate specific, qualified individuals as service coordinators and verify their credentials for providing the services covered under this chapter;

(3) Convene or participate on a waiver multidisciplinary team or teams for waiver participants, in accordance with the requirements of COMAR 10.09.56 and this chapter;

(4) Be knowledgeable of the eligibility requirements and application procedures of federal, State, and local government assistance programs that are applicable to participants; and

(5) Maintain a file on each participant that meets the Program’s requirements and includes the waiver participant’s:

(a) Technical eligibility form approved by MSDE, reviewed and signed at least annually;

(b) Determination of eligibility for level of care in an intermediate care facility for the intellectually disabled and persons with related conditions (ICF/IID) — initial determination and redetermination, at least annually;

(c) Autism Waiver Risk Assessment pursuant to 10.09.56;

(d) Consent Form for Autism Waiver Services, signed before Autism Waiver enrollment and annually thereafter;

(e) Form for determination of Medicaid eligibility for Autism Waiver services — initial determination and redetermination, at least annually;

(f) Initial waiver plan of care, reviewed at least annually, and any plan revisions;

(g) Parental Rights and Responsibilities form reviewed and signed at least annually;

(h) Preauthorization by MSDE of any environmental accessibility adaptations reimbursed through the Autism Waiver, if applicable;

(i) Reportable Event forms concerning the waiver participant, if applicable;

(j) Record of ongoing service coordination encounters, including:

(i) A description of the service;

(ii) The location of the service;

(iii) Date of contact and name of the parent/guardian or participant;

(iv) Type of contact;

(v) Supportive documentation of the service; and

(vi) The service coordinator’s printed name and signature;

(k) Monthly tracking logs with Technical Eligibility Exemption Request Forms as applicable; and

(l) A copy of the treatment plans for each applicable service provided or Reportable Event form, as applicable, if a treatment plan was not submitted.

C. Autism Waiver Service Coordinator Requirements.

(1) An Autism Waiver service coordinator shall:

(a) Be employed by or under contract with a provider;

(b) Be approved by the participant’s parent or parents;

(c) Participate with the waiver multidisciplinary team in the development, or revision, of a participant’s waiver plan of care and in the waiver plan of care review;

(d) Assist the participant in gaining access to the services recommended in the waiver plan of care; and

(2) An Autism Waiver service coordinator who is chosen to provide services for a waiver participant shall have at least:

(a) 1 year of relevant training or experience; and

(b) A bachelor’s degree.

(3) An Autism Waiver service coordinator shall complete at least 5 hours of training on the Autism Waiver, offered by the Department and MSDE, prior to rendering Autism Waiver service coordination in accordance with Regulations .04-1 and .04-2 of this chapter.

(4) Autism Waiver service coordinators shall attend one Statewide training for Autism Waiver service coordinators per fiscal year.

.04 Covered Services — IEP Service Coordination.

A. (text unchanged)

B. Initial IEP.

(1) Definition. “Unit of service” means:

(a) (text unchanged)

(b) At least one contact by the participant’s service coordinator [or IEP team] in person, in writing, via telehealth, or by telephone with the participant or the participant’s parent, on the participant’s behalf relating to development of the IEP.

(2) (text unchanged)

C. Ongoing IEP Service Coordination.

(1) Ongoing IEP service coordination is provided by a participant’s service coordinator.

(2) Definition. For purposes of this section, “unit of service” means:

(a) At least one contact per month by the service coordinator in person, via telehealth, by telephone, or by written progress notes or log with the participant or the participant’s parent, on the participant’s behalf relating to the child’s ongoing IEP service coordination; and

(b) (text unchanged)

(3) As necessary, the Program shall include as covered services the following:

(a) (text unchanged)

(b) Maintaining contact with:

(i) (text unchanged)

(ii) A participant [and] or the participant’s parent through [home visits, office] in-person visits, written [notes, school visits] communication, telephone calls, telehealth, and follow-up service as necessary;

(c)—(d) (text unchanged)

(e) Providing a participant [and] or the participant’s parent with information and direction that will assist them in successfully accessing and using the services recommended in the IEP;

(f) Informing a participant’s parent of the participant’s and the family’s rights and responsibilities in regard to specific programs and resources recommended in the IEP; and

[(g) Conducting, with a participant’s parent at a meeting or by other means acceptable to the parent and the service coordinator, a periodic review of the participant’s IEP every 6 months, or more frequently if warranted or the parent requests a review; and]

[(h)] (g) (text unchanged)

(4) (text unchanged)

D. IEP Review.

(1) Definition. “Unit of service” means:

(a) A completed initial 60-day, interim, or annual IEP review as evidenced by a [signed] revised IEP or, if a revised IEP was not done, documented by the IEP team [records documenting a meeting in which there is participation by at least two different disciplines]; and

(b) At least one contact by the IEP service coordinator or IEP team in person, by telephone, via telehealth, or by written [progress notes or log] communication with the participant or the participant’s parent, on the participant’s behalf.

(2) (text unchanged)

.04-1 Covered Services — Autism Waiver Service Coordination — General Requirements.

A. (text unchanged)

B. Waiver Service Coordinator. A waiver service coordinator employed by a provider shall assist with meeting the provider’s responsibilities specified in this regulation and Regulation .04-2 of this chapter.

C. Waiver Multidisciplinary Team. A waiver multidisciplinary team:

(1) (text unchanged)

(2) Shall include:

(a)—(b) (text unchanged)

(c) A chairman who is the official representative of the local lead agency or local school system; and

[(d) Other appropriate professionals representing the local lead agency or local school system, as necessary and consistent with the Individuals with Disabilities Education Act (IDEA); and]

[(e)] (d) (text unchanged)

D. Waiver Plan of Care.

(1) (text unchanged)

(2) A waiver participant’s waiver plan of care shall be [approved by] submitted to MSDE before implementation.

(3) Any revisions or additions to a waiver participant’s waiver plan of care shall be [approved by] submitted to MSDE before implementation.

(4) A waiver participant’s service coordinator may make minor changes to the waiver participant’s waiver plan of care without reconvening the waiver multidisciplinary team, if the change is approved by [the chair of the multidisciplinary team and] the waiver participant’s parent or parents, and MSDE is notified.

(5) A waiver participant’s initial or revised waiver plan of care shall [be documented on the waiver plan of care form that includes] include the:

(a) [Description of each specific preauthorized service] Identification of Autism Waiver service or services to be delivered;

(b) (text unchanged)

[(c) Estimated duration;

(d) Approved frequency and units of services to be delivered; and]

(c) Service stop date;

(d) Approved amount of services to be delivered; and

(e) Provider or providers.

E. (text unchanged)

.04-2 Covered Services — Autism Waiver Service Coordination — Specific Requirements.

A. Waiver Initial Assessment.

(1) Definition. For the purposes of this section, “unit of service” means:

(a) A completed initial waiver plan of care, [approved by] submitted to MSDE and signed by the service coordinator, the waiver participant or the parent or parents of a minor child, and all other members of the waiver multidisciplinary team; or

(b) The provision of all [other] necessary services specified in §A(2) of this regulation.

(2) (text unchanged)

B. Waiver Ongoing Service Coordination.

(1) Definition. For the purposes of this section, a monthly “unit of service” means:

(a) At least one documented monthly contact by the waiver participant’s service coordinator in person, by telephone, via telehealth, or through written progress notes with the waiver participant or parent;

(b) A quarterly visit to the waiver participant’s residence, residential program, or day program conducted in person or via telehealth, including at least one in-person visit to the waiver participant’s residence every 12 months; and

(c) (text unchanged)

(2) The covered services shall include, as necessary:

(a)—(b) (text unchanged)

(c) Referring the waiver participant to [the] approved Autism Waiver providers specified in the waiver plan of care;

(d) Assisting the waiver participant with gaining access to the Autism Waiver services preauthorized in the waiver plan of care [according to the type, level, amount, frequency, and duration];

(e) (text unchanged)

(f) Providing the waiver participant and the parent or parents with information and direction to assist them with accessing and [using] successfully utilizing the Autism Waiver services preauthorized in the waiver plan of care;

(g) Maintaining contact with the waiver participant’s waiver and other service providers and with the waiver participant or parent through documented [home visits, office visits, school] in-person visits, telehealth contact, telephone calls, mailings, and follow-up services as necessary;

(h)—(i) (text unchanged)

(j) Making minor changes to the waiver participant’s waiver plan of care as necessary, without reconvening the waiver multidisciplinary team, if the change is approved by [MSDE and] the waiver participant’s parent or parents and submitted to MSDE;

(k) Assuring that the necessary documentation is maintained in the waiver participant’s [case] file, as specified in Regulation [.03B(5)(e)] .03-1B(5) of this chapter;

(l) Providing MSDE with required information in the established time frame on waiver participants enrolled in [or being terminated from] the Autism Waiver; and

(m) Monitoring on an ongoing basis:

(i) The appropriateness of the type, [level,] amount, [frequency,] duration, and quality of the Autism Waiver services received by a waiver participant;

(ii)—(iii) (text unchanged)

C. Waiver Reassessment.

[(1) Definition.] For the purposes of this section, “unit of service” means:

[(a)] (1) A completed waiver plan of care review at least every 12 months, with revisions as necessary, which is [approved by] submitted to MSDE and signed by the service coordinator, the waiver participant or the parent or parents of a minor child, and all other members of the waiver multidisciplinary team; [or

(b) The provision of all other services specified in §C(2) of this regulation.

(2) The covered services shall include:

(a) Convening, coordinating, and participating on the waiver multidisciplinary team at least every 12 months to review, and revise as necessary, the waiver participant’s waiver plan of care;

(b) Assisting waiver participants with the waiver’s eligibility redetermination process, as specified in COMAR 10.09.56;

(c) Coordinating with the Department for redetermination of the waiver participant’s Medicaid financial and technical eligibility in a timely fashion;

(d) Assisting the waiver participant or the parent or parents of a minor child with completion and submission of the application forms and accompanying documentation for the Medicaid financial and technical eligibility redetermination, before the deadline established by the Department;

(e) Completing a risk assessment within 45 days of receiving notification of eligibility by the Department using the Autism Waiver Risk Assessment form;

(f) Completing a risk assessment if the participant’s status changes, to ensure the applicant can be safely maintained in a home and community-based setting utilizing Autism Waiver services; and

(g) Providing written notice to a MSDE representative of the participant’s ineligibility for the Autism Waiver.]

(2) Assisting waiver participants with the waiver’s eligibility redetermination process, as specified in COMAR 10.09.56;

(3) Assisting families with making informed choices in selecting between a home and community-based waiver documented in the Autism Waiver Transitioning Youth Service Delivery Option Form or other documentation as required;

(4) Assisting the waiver participant or the parent or parents of a minor child with completion and submission of the application forms and accompanying documentation for the Medicaid financial and technical eligibility redetermination, in coordination with the Department, before the deadline established by the Department;

(5) Completing a risk assessment within 45 days of receiving notification of eligibility by the Department using the Autism Waiver Risk Assessment form;

(6) Completing a risk assessment if the participant’s status changes, to ensure the applicant can be safely maintained in a home and community-based setting utilizing Autism Waiver services; or

(7) Providing written notice to a MSDE representative of the participant’s ineligibility for the Autism Waiver.

.05 Limitations.

A. Service Coordination for Children with [Disabilities] an IEP or enrolled in the Autism Waiver is advisory in nature except for Autism Waiver Service Coordination, covered under Regulations .03-1, .04-1, and .04-2 of this chapter.

B. A restriction may not be placed on a qualified [recipient’s] participant’s option to receive the services covered under this chapter except that Autism Waiver Service Coordination, as defined by Regulations .03-1, .04-1, and .04-2 of this chapter, is required for waiver eligible persons who choose to enroll in the Autism Waiver.

C. (text unchanged)

D. Service Coordination for Children [with Disabilities] with an IEP or enrolled in the Autism Waiver may not be:

(1)—(3) (text unchanged)

E.—G. (text unchanged)

.06 Payment Procedures.

A. Request for Payment.

(1) (text unchanged)

(2) A provider shall:

(a)—(b) (text unchanged)

(c) Submit a request for payment in the manner specified by the Program, that includes the:

(i)—(ii) (text unchanged)

(iii) Provider’s name, location, and [identification] Medicaid provider number; and

(iv) (text unchanged)

(3)—(4) (text unchanged)

[(5) A waiver participant’s provider of residential habilitation services under COMAR 10.09.56 may:

(a) Provide the waiver participant with waiver ongoing service coordination under Regulation .04-2B of this chapter;

(b) Not provide the waiver participant with a waiver initial assessment under Regulation .04-2A of this chapter or a waiver reassessment under Regulation .04-2C of this chapter.]

B. (text unchanged)

C. The Program shall make payment only to one qualified provider for covered services rendered on a particular date of service to a participant and according to the following [fee-for-services] fee schedule covered under this chapter:

Description                                                 Fee Per Unit of Service

(1) (text unchanged)

(2) Ongoing IEP service coordination: no more than one unit of service per month may be reimbursed for a participant ... $150;

(3)—(6) (text unchanged)

D.—H. (text unchanged)

 

10.09.76 School-Based Health Centers (SBHC)

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(11) (text unchanged)

(12) “School-based health center (SBHC)” means a health center that:

(a)—(c) (text unchanged)

(d) Has been approved by the [Maryland State Department of Education (MSDE)] Maryland Department of Health.

(13) (text unchanged)

.03 Conditions for Participation.

A. General requirements for participation in the Program are that a provider shall [meet the conditions for participation as set forth in COMAR 10.09.36.03.]:

(1) Meet the conditions for participation as set forth in COMAR 10.09.36; and

(2) If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

B. To participate as a Maryland Medicaid SBHC, a provider shall:

(1) Be approved by the [Maryland State Department of Education (MSDE)] Maryland Department of Health as an SBHC;

(2)—(10) (text unchanged)

C. (text unchanged)

.05 Limitations.

The Program does not cover the following:

A.—D. (text unchanged)

[E. Services to individuals who are not enrolled in the school system;]

[F.] E.—[K.] J. (text unchanged)

[L.] K. Services provided outside of the physical location of the approved SBHC, unless services are rendered via telehealth in accordance with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

DENNIS R. SCHRADER
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.77 Urgent Care Centers

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

Notice of Proposed Action

[22-322-P]

The Secretary of Health proposes to amend Regulations .01, .03—.07, and .10 under COMAR 10.09.77 Urgent Care Centers.

Statement of Purpose

The purpose of this action is to:

(1) Ease the condition for participation that an urgent care center have a physician on-site during hours of operation by allowing certified nurse practitioners and physician assistants to satisfy this requirement;

(2) Permit services rendered via telehealth to be reimbursed in compliance with COMAR 10.09.49 Telehealth Services; and

(3) Replace outdated term ‘recipient’ with ‘participant’ throughout the chapter.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jourdan Green, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(7) (text unchanged)

(8) “Participant” means an individual who is certified as eligible for and is receiving Medical Assistance benefits.

[(8)] (9) “Patient” means a [recipient] participant awaiting or undergoing health care or treatment.

[(9)] (10)—[(11)] (12) (text unchanged)

[(12) “Recipient” means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.]

(13) (text unchanged)

.03 Conditions for Participation.

A. The general requirements for participation in the Program are that a provider shall [meet all conditions for participation as set forth in COMAR 10.09.36.03.]:

(1) Meet all the conditions for participation as set forth in COMAR 10.09.36; and

(2) If delivering services via telehealth, comply with COMAR 10.09.49 and any subregulatory guidance issued by the Department.

B. The specific requirements for participation in the Program as a free-standing urgent care center include the following:

(1)—(3) (text unchanged)

(4) During the hours of operation, have [at]:

(a) A supervising physician, available for consultation either in-person or via telehealth; and

(b) At least one qualified physician, certified nurse practitioner, or physician assistant present;

(5) Maintain adequate documentation of each [recipient] participant visit as part of the individual’s medical record, which, at a minimum, shall include:

(a) (text unchanged)

(b) [Recipient’s] Participant’s reason for visit;

(c)—(d) (text unchanged)

(6)—(7) (text unchanged)

.04 Covered Services.

The Program covers the following medically necessary services rendered to [recipients] participants in a free-standing urgent care center:

A.—B. (text unchanged)

C. Diagnostic, preventive, curative, palliative, rehabilitative, or ameliorative services, when clearly related to the [recipient’s] participant’s individual needs;

D.—E. (text unchanged)

.05 Limitations.

The Program does not cover the following:

A.—C. (text unchanged)

D. [Services which do not involve direct patient contact (face-to-face)] Services rendered via telehealth that do not comply with the telehealth requirements established in COMAR 10.09.49 and any other subregulatory guidance issued by the Department;

E.—I. (text unchanged)

.06 Payment Procedures.

A.—H. (text unchanged)

I. The Program may not make a direct payment to a [recipient] participant.

J. (text unchanged)

.07 Recovery and Reimbursement.

A. If the [recipient] participant has insurance, or other coverage, or if any other person is obligated, either legally or contractually, to pay for, or to reimburse the [recipient] participant for, services covered by this chapter, the provider shall seek payment from that source first. If an insurance carrier rejects the claim or pays less than the amount allowed by the Program, the provider may submit a claim to the Program. The provider shall submit a copy of the insurance carrier’s notice or remittance advice with the invoice. If payment is made by both the Program and the insurance or other source for the same service, the provider shall refund to the Department, within 60 days of receipt, the amount paid by the Program or the insurance or other source, whichever is less.

B. (text unchanged)

.10 Interpretive Regulation.

Except when the language of a specific regulation indicates intent by the Department to provide reimbursement for covered services to Program [recipients] participants without regard to the availability of federal financial participation, State regulations shall be interpreted in conformity with applicable federal statutes and regulations.

DENNIS R. SCHRADER
Secretary of Health

 

Subtitle 38 BOARD OF PHYSICAL THERAPY EXAMINERS

10.38.13 Telehealth

Authority: Health Occupations Article, §§1-1001—1-1006, Annotated Code of Maryland

Notice of Proposed Action

[22-295-P]

The Secretary of Health proposes to adopt new Regulations .01—.06 under a new chapter, COMAR 10.38.13 Telehealth. This action was considered by the Board of Physical Therapy Examiners at a public meeting held on October 20, 2020, notice of which was given by publication on the Board’s website at https://health.maryland.gov/bphte/Pages/index.aspx pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to provide new guidelines for physical therapists from which to practice telehealth pursuant to Chs. 15 and 16, Acts of 2020.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jourdan Green, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

.01 Scope.

A. This chapter governs the practice of physical therapy or limited physical therapy using telehealth as an adjunct to, or replacement for, in-person patient visits.

B. Nothing in these regulations restricts or limits reimbursement requirements pursuant to Health-General Article and Insurance Article, Annotated Code of Maryland.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Asynchronous” means not occurring in real time.

(2) “Board” means the Maryland Board of Physical Therapy Examiners.

(3) “In-person” means within the physical presence of the patient.

(4) “Synchronous” means occurring in real time.

(5) “Telehealth” has the meaning stated in Health Occupations Article, §1-1001, Annotated Code of Maryland.

(6) “Telehealth practitioner” means:

(a) A Maryland licensed physical therapist or physical therapist assistant performing telehealth services within their respective scope of practice; or

(b) A physical therapist or physical therapist assistant with a compact privilege in Maryland performing telehealth services within their respective scope of practice.

.03 Licensure.

A. Subject to the provisions of Health Occupations Article, §13-301, Annotated Code of Maryland, a telehealth practitioner shall be licensed in Maryland or hold a compact privilege in Maryland when providing telehealth services to a patient located in the State.

B. Telehealth practitioners licensed in this State are subject to the jurisdiction of the State and shall abide by the telehealth requirements of this chapter if either the practitioner or patient is physically located in this State.

.04 Standards of Practice for Telehealth.

A. Before providing telehealth services, a telehealth practitioner shall develop and follow a procedure to:

(1) Verify the identification of the patient receiving telehealth services within a reasonable degree of certainty through use of:

(a) A government-issued photograph identification;

(b) An insurance, Medicaid, or Medicare card; or

(c) Documentation of the patient’s:

(i) Date of birth; and

(ii) Home address;

(2) For an initial patient encounter, disclose the telehealth practitioner’s:

(a) Name;

(b) Maryland license number and type; and

(c) Contact information;

(3) Obtain oral or written consent from a patient or patient’s parent or guardian if State law requires the consent of a parent or guardian, including informing patients of the risks, benefits, and side effects of the recommended treatment plan;

(4) Securely collect and transmit a patient’s medical health information, clinical data, clinical images, laboratory results, and self–reported medical health and clinical history, as necessary, and prevent access to data by unauthorized persons through encryption or other means;

(5) Notify patients in the event of a data breach;

(6) Ensure that the telehealth practitioner provides a secure and private telehealth connection that complies with federal and state privacy laws; and

(7) Establish safety protocols to be used in the case of an emergency, including contact information for emergency services at the patient’s location.

B. Except when providing asynchronous telehealth services, a telehealth practitioner shall:

(1) Obtain or confirm an alternative method of contacting the patient in case of a technological failure;

(2) Confirm whether the patient is in Maryland and identify the specific practice setting in which the patient is located; and

(3) Identify all individuals present at each location and confirm they are allowed to hear the patient’s health information.

C. A telehealth practitioner shall be held to the same standards of practice and documentation as those applicable for in-person physical therapy practice appointments.

.05 Patient Evaluation.

A. A physical therapist who practices telehealth shall:

(1) Perform a synchronous or asynchronous clinical patient evaluation that is appropriate for the patient and the condition with which the patient presents before providing a treatment plan through telehealth; and

(2) If clinically appropriate for the patient, provide or refer a patient to:

(a) In-person treatment; or

(b) Another type of telehealth service.

B. A telehealth practitioner may not treat a patient based solely on an online questionnaire.

.06 Telehealth Practitioner Discipline.

A. The Board shall use the same standards of evaluating and investigating a complaint about and in disciplining a telehealth practitioner who practices telehealth as it would use for a licensee who does not use telehealth technology in the licensee’s practice.

B. The failure of a telehealth practitioner to comply with this chapter shall constitute unprofessional conduct and may be subject to disciplinary action by the Board.

DENNIS R. SCHRADER
Secretary of Health

 

Subtitle 47 ALCOHOL AND DRUG ABUSE ADMINISTRATION

10.47.07 Prescription Drug Monitoring Program

Authority: Health-General Article, §§21-2A-01 — 21-2A-09, Annotated Code of Maryland

Notice of Proposed Action

[22-314-P]

The Secretary of Health proposes to amend Regulations .02—.05 and .07—.09 and adopt new Regulation .05-1 under COMAR 10.47.07 Prescription Drug Monitoring Program.

Statement of Purpose

The purpose of this action is to enable the Maryland Prescription Drug Monitoring Program (PDMP) to implement recent expansion of the types of dispenses required to be reported to the PDMP by controlled dangerous substance (CDS) dispensers. These guidelines are being promulgated in accordance with Ch. 224, Acts of 2022, Public Health — Prescription Drug Monitoring Program — Naloxone Medication Data. In addition to aligning the regulations with recent statutory changes, the purpose of this action is to align Maryland reporting requirements with best practices by updating the required fields CDS dispensers must report for each dispense. The purpose of this action is to allow health licensing boards access to dispense data based on the prescription history of a patient, not only the dispensing or prescribing practices of a specific provider. This expanded access to data will support existing individual bono fide investigations facilitated by Boards. This expanded access of data for health licensing boards aligns with many other state PDMPs. Finally, the purpose of this action is to clean discrepancies between the Maryland PDMP statute and regulations specific to the PDMP Use Mandate.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jourdan Green, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499, or email to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)(9) (text unchanged) 

(10) Monitored Prescription Drug.

(a) “Monitored prescription drug” means a prescription drug that contains a Schedule II, Schedule III, Schedule IV, or Schedule V controlled dangerous substance designated under Criminal Law Article, Title 5, Subtitle 4, Annotated Code of Maryland.

(b) “Monitored prescription drug” does not include naloxone medication.

(11) “Naloxone medication” means an opioid antagonist approved by the federal Food and Drug Administration for the reversal of an opioid overdose.

(12) “Naloxone medication data” means the information required to be submitted to the Program when dispensing naloxone medication.

[(11)] (13)[(24)] (26) (text unchanged)

.03 Dispenser Reporting.

A. For each monitored prescription drug and naloxone medication dispensed, the dispenser shall report data elements required by American Society for Automation in Pharmacy (ASAP) standards in addition to the following [prescription monitoring data to the Department]:

(1) Identifying information for the prescription issued and drug dispensed, including:

(a)(g) (text unchanged)

(h) Metric quantity of drug dispensed and units; [and]

(i) Days’ supply of drug dispensed; and

(j) Date prescription was sold;

(2) Identifying information for the patient or animal owner or handler, as appropriate, including:

(a)(c) (text unchanged)

(d) [Sex] Gender;

(e) (text unchanged)

(f) Address, including residential house or building number, apartment number, street name, state, and zip code; [and]

(g) A patient identification number[, which may include:

(i) A state-issued driver’s license or identification card number;

(ii) An insurance or third-party payer identification number;

(iii) A passport identification number;

(iv) An employer-issued identification card number;

(v) A student identification card number;

(vi) A United States Permanent Resident Card identification number; or

(vii) A patient or customer identification number generated by the dispenser’s record management system];

(h) ID qualifier; and

(i) Species indication;

(3) [Identifying information] First and Last name for the prescriber, including:

(a) [A] For prescription monitoring data, a valid Drug Enforcement Administration registration number; [and] or

(b) [Last name; and] For naloxone medication data, a valid National Provider Identifier;

(4) Identifying information for the dispenser, including a valid Drug Enforcement Administration registration number[.]; and

(5) Additional data elements consistent with the standards established by the ASAP.

B. Reporting Deadline.

(1) A dispenser shall report prescription monitoring data and naloxone medication data to the Department to include zero reports at least once every 24 hours and in accordance with procedures developed by the Department and approved by the Advisory Board on Prescription Drug Monitoring.

(2) A dispenser that suffers a mechanical, electrical, or other technical failure that, as a direct consequence, precludes the dispenser’s ability to report prescription monitoring data or naloxone medication data electronically shall:

(a) (text unchanged)

(b) Submit a report for each monitored prescription drug and naloxone medication dispensed during the period of technical failure as soon as possible, but no later than 24 hours following reestablishment of the means of electronic reporting.

C.F. (text unchanged)

G. Waiver for Dispensing to Hospice Inpatients.

(1) On a form or in a manner approved by the Department, a pharmacy may apply to the Department to be granted a waiver from reporting prescription monitoring data or naloxone medication data for dispensing of monitored prescription drugs to hospice inpatients, provided that:

(a) (text unchanged)

(b) The pharmacy agrees that it will be subject to unannounced, on-site inspections by the Department to verify its reporting of prescription monitoring data and naloxone medication data on customers that are not hospice inpatients.

(2) (text unchanged)

.04 Review of Prescription Monitoring Data.

A. The Program shall review prescription monitoring data and naloxone medication data for indications of possible:

(1)(2) (text unchanged)

B. (text unchanged)

.05 Disclosure of Prescription Monitoring Data.

A.C. (text unchanged)

D. Disclosure of Prescription Monitoring Data to a Licensing Entity.

(1) (text unchanged)

(2) The licensing entity shall include in the administrative subpoena:

(a) Information sufficient to identify the unique prescriber, [or] dispenser, or patient about whom prescription monitoring data is requested;

(b)(d) (text unchanged)

E. (text unchanged)

F. Disclosure of Prescription Monitoring Data to a Patient or a Patient’s Authorized Representative.

(1) Upon request, the Program shall disclose to a patient 18 years old or older prescription monitoring data about [that] the patient provided that the request is submitted to the Program:

(a) [In person and is accompanied by:

(i) A] On a completed form approved by the Department[; and] that contains a notarized signature of the requester; or

[(ii) Valid photo identification issued by a government agency of any jurisdiction of the United States verifying that the patient is 18 years old or older; or]

(b) (text unchanged)

(2)(4) (text unchanged)

G.O. (text unchanged)

.05-1 Disclosure of Naloxone Medication Data.

Disclosure of Naloxone Medication Data for Public Health Surveillance, Research, Analysis, Education, and Public Reporting.

A. The Program shall disclose naloxone medication data for research, analysis, education, and public reporting:

(1) Upon approval by the Department of a written proposal or abstract explaining the purpose and scope of the research, analysis, education, and public reporting; and

(2) After redaction of all information that could identify a patient, prescriber, dispenser, or any other individual.

B. The Secretary may waive the requirement of §A(1) of this regulation for requests from units of the Department.

C. The Program may disclose de-identified naloxone medication data for public health surveillance purposes.

D. The Program may not disclose identifiable naloxone medication data to any entity, including but not limited to prescribers or dispensers.

.07 Confidentiality.

A. Prescription monitoring data and naloxone medication data are confidential, privileged, not subject to discovery, subpoena, or other means of legal compulsion in civil litigation, and are not public records.

B. (text unchanged)

C. The Program shall periodically conduct an audit review of prescription monitoring data and naloxone medication data and disclosure requests to ensure compliance with §B of this regulation.

.08 Penalties and Sanctions.

A. Civil Penalties. A dispenser who knowingly fails to submit prescription monitoring data or naloxone medication data to the Program as required by Regulation .03 of this chapter shall be subject to a civil penalty not exceeding $500 for each failure to submit required information.

B. Criminal Penalties. A person who knowingly discloses, uses, obtains, or attempts to obtain by fraud or deceit prescription monitoring data or naloxone medication data in violation of in Health-General Article, §21-2A, Annotated Code of Maryland, shall be guilty of a misdemeanor and on conviction is subject to imprisonment not exceeding 1 year or a fine not exceeding $10,000 or both.

C. Administrative Sanctions. A prescriber or pharmacist who knowingly discloses or uses prescription monitoring data or naloxone medication data in violation of Health-General Article, §21-2A, Annotated Code of Maryland shall be subject to disciplinary action by the appropriate licensing entity.

.09 General Provisions.

A. The Program shall make available the information technology necessary for dispensers to report prescription monitoring data and naloxone medication data to the Program.

B. (text unchanged)

C. A prescriber or pharmacist[:

(1) Is not required or obligated to access or use the prescription monitoring data available under the Program; and

(2) When], when acting in good faith, is not subject to liability or disciplinary action arising solely from:

[(a)] (1) Requesting or receiving[, or failing to request or receive,] prescription monitoring data from the Program; or

[(b)] (2) (text unchanged)

D. Redisclosure of Prescription Monitoring Data.

(1) Prescription monitoring data received under Health-General Article, §21-2A-06, Annotated Code of Maryland, and Regulation [.04] .05 of this chapter may be redisclosed only:  

(a) (text unchanged)

(b) For entities to which the Program has disclosed data [in accordance with Regulation .05C—E and H of this chapter], in furtherance of an existing, bona fide, individual investigation to another agency cooperating with or providing support [for] to the original data [recipient’s existing, bona fide, individual investigation].

(2) (text unchanged)

E. Redisclosure of Naloxone Medication Data. Naloxone medication data received under Health-General Article, §21-2A-6.1, Annotated Code of Maryland, and Regulation .05-1 of this chapter may be redisclosed only in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 U.S.C. §1320d et seq., as amended, and all other State and federal laws and regulations governing the security and confidentiality of protected health information and personal medical records.

[E.] F. The Program shall retain prescription monitoring data and naloxone medication data for 5 years from the date of receipt.

[F.] G. (text unchanged)

DENNIS R. SCHRADER
Secretary of Health

Subtitle 60 BOARD OF ENVIRONMENTAL HEALTH SPECIALISTS

Notice of Proposed Action

[22-320-P]

The Secretary of Health proposes to amend:

(1) Regulation .01 under COMAR 10.60.01 General Regulations;

(2) Regulation .06 under COMAR 10.60.02 Licensing Procedures;

(3) Regulation .01 under COMAR 10.60.03 Continuing Education; and

(4) Regulation .01 under COMAR 10.60.06 Fee Schedule.

This action was considered by the Board of Environmental Health Specialists at a public meeting held on April 6, 2022, notice of which was given by publication on the Board’s website at Pages - Board of Environmental Health Specialists Home (maryland.gov) pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to:

(1) Clarify the term “board-approved training”;

(2) Establish license expiration dates after June 30, 2023;

(3) Establish alternating biennial license renewal schedules for licensees in odd-numbered and even-numbered years;

(4) Clarify board-approved training requirements; and

(5) Provide a one-time, one-year prorated renewal fee for licenses expiring on June 30, 2023.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jourdan Green, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 , or email to mdh.regs@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

 

10.60.01 General Regulations

Authority: Health Occupations Article, §§21-101—21-502, Annotated Code of Maryland

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(2) (text unchanged)

(3) Approved Training.

(a) “Approved training” means Board-approved courses of study or programs of instruction in an area of environmental health sciences and related subjects designed to improve, advance, or extend professional skill and knowledge relating to the practice of an environmental health specialist [and that are approved by the Board in accordance with the requirements of this subtitle].

(b) “Approved training” includes, for licensees applying for renewal of a license for the first time, in-training or prior work experience as specified under COMAR 10.60.03.01C(7).

(4)—(22) (text unchanged)

 

10.60.02 Licensing Procedures

Authority: Health Occupations Article, §§21-101—21-502, Annotated Code of Maryland

.06 Expiration and Renewal of Licenses.

A. Expiration. After June 30, 2023, licenses shall expire pursuant to the following schedule:

(1) The license of a licensee with an even-numbered birth year shall expire on June 30 of an even-numbered year; and

(2) The license of a licensee with an odd-numbered birth year shall expire on June 30 of an odd-numbered year.

[A.] B. Conditions for License Renewal.

(1) [The] Except as provided in §B(2) and (3) of this regulation, the Board shall renew a license for a 2-year period if the licensee has:

(a)—(b) (text unchanged)

(c) Submitted satisfactory proof to the Board that the licensee has completed at least 20 clock hours of [Board-approved] approved training [obtained during the 2-year period before the license expiration date] during the license renewal period; and

(d) (text unchanged)

(2) For licenses expiring on June 30, 2023 only, the Board shall renew the license of a licensee with an even-numbered birth year for a 1-year period if the licensee meets the requirements set forth under §B(1) of this regulation.

(3) For licenses expiring on June 30, 2024 only, the Board shall renew a license for a 2-year period if the licensee has:

(a) Submitted an application for renewal to the Board before the expiration date of the license;

(b) Paid the renewal fee established by COMAR 10.60.06;

(c) Submitted satisfactory proof to the Board that the licensee has completed at least 10 clock hours of approved training during the 1-year period immediately preceding the license expiration date; and

(d) Not committed any act which, under Health Occupations Article, §21-312, Annotated Code of Maryland, would subject the licensee to disciplinary action by the Board.

[(2)] (4) The Board may deny the application to renew a license if the applicant has failed to satisfy the requirements of [§A(1)] §B of this regulation.

[B.] C. (text unchanged)

 

10.60.03 Continuing Education

Authority: Health Occupations Article, §§21-101—21-502, Annotated Code of Maryland

.01 Approval of Training.

A. The Board shall approve and credit training that meets the requirements of this regulation.

[A.] B. [Board-approved] Approved training shall be designed to improve, advance, or extend professional skill and knowledge relating to the practice of an environmental health specialist.

[B. For courses for which continuing education units (CEUs) have been assigned, one CEU is equivalent to 10 clock or classroom hours of approved training.]

C. [Board-approved] Approved training may consist of participation in any of the following:

(1)—(4) (text unchanged)

(5) Authoring a paper published in a professional journal requiring peer review; [or]

(6) Instruction of approved training courses[.]; or

(7) For licensees applying for renewal for the first time:

(a) On-the-job training in an environmental health specialist-in-training program under the supervision of an environmental health sponsor; or

(b) Practice as an environmental health specialist or its equivalent in another state or territory of the United States, as approved by the Board.

[D. The Board shall maintain a current list of all Board-approved training.

E. Assignment of Credit.

(1) The Board shall determine the hours of approved training as follows:

(a) For courses given in educational institutions, 1 hour of approved training is equivalent to 1 hour of classroom training;

(b) Credit hours for training such as online courses, correspondence courses, extension studies, and authored papers shall be determined by the Board on a case-by-case basis; and

(c) Credit hours for participation in instruction of an approved training course shall be:

(i) Credited to the instructor as 1 hour of credit for 1 hour of instruction;

(ii) Accepted for up to 10 hours of training per renewal period; and

(iii) Accepted only once per renewal period for each training course.

(2) Approved training shall be credited to the license renewal period only if:

(a) Taken during the renewal period;

(b) Evidence of completion is submitted to the Board within 90 calendar days of the date of completion of the training; and

(c) The training meets the requirements set forth in Regulation .01A of this chapter.

(3) Credit shall be received for other training approved by the Board on a case-by-case basis.

(4) Within the license renewal period, credit may not be received for training that is substantially similar to another training as determined by the Board.

(5) The requirement set forth under §E(2)(b) of this regulation does not apply to an individual who is on inactive status or non-renewed status who is seeking reactivation of a license.

(6) The Board may waive the requirement set forth under §E(2)(b) of this regulation if the Board determines that failure to submit evidence of completion to the Board within 90 calendar days of completion of the training is the result of unforeseen circumstances out of the licensee’s control.]

D. Determination of Hours of Approved Training. The Board shall determine the hours of approved training as follows:

(1) For courses for which continuing education units (CEUs) have been assigned, 1 CEU is equivalent to 10 clock or classroom hours of approved training;

(2) For courses given in educational institutions, 1 hour of classroom training is equivalent to 1 hour of approved training;

(3) For training such as online courses, correspondence courses, extension studies, authored papers, and any other approved training, the Board shall determine the hours of approved training on a case-by-case basis;

(4) For instruction of an approved training course, the Board shall grant:

(a) 1 hour of training for 1 hour of instruction;

(b) Up to 10 hours of training per license renewal period; and

(c) Hours as an instructor only once per license renewal period for each training course; and

(5) For licensees applying for renewal for the first time, the Board shall grant 5 hours of approved training for each full 6-month period that the licensee participated in training or work experience listed in §C(7) of this regulation within the license renewal period.

E. Assignment of Hours of Approved Training.

(1) The Board shall assign hours of approved training to a license renewal if the licensee:

(a) Completed the hours of training during the license renewal period, unless an extension has been granted pursuant to Regulation .04 of this chapter; and

(b) Submitted evidence of completion to the Board within 90 calendar days of the date of completion of the training.

(2) For licensees applying for renewal for the first time, the Board shall assign hours of approved training to the license renewal if the licensee completed training set forth under:

(a) §C(1)—(6) of this regulation after the date the initial license is issued and submitted evidence of completion to the Board within 90 calendar days of the date of completion of the training; or

(b) §C(7) of this regulation during the license renewal period.

(3) Within the license renewal period, credit may not be received for training that is substantially similar to another training as determined by the Board.

(4) The requirements set forth under §E(1) of this regulation do not apply to an individual who is on inactive status or non-renewed status who is seeking reactivation of a license.

(5) The Board may waive the requirement set forth under §E(1)(b) of this regulation if the Board determines that failure to submit evidence of completion to the Board within 90 calendar days of completion of the training is the result of unforeseen circumstances out of the licensee’s control.

F. Procedures.

(1) The sponsor of a training course or licensee may request of the Board approval of training on a form provided by the Board.

(2) The Board shall maintain a list of all approved training.

 

10.60.06 Fee Schedule

Authority: Health Occupations Article, §§21-205, 21-206, and 21-309, Annotated Code of Maryland

.01 Scope.

A.—C. (text unchanged)

D. The following fees apply:

(1)—(4) (text unchanged)

(5) One-time renewal fee for licenses expiring on June 30, 2023 for licensees with an even-numbered birth year whose license will be renewed for 1 year $100;

[(5)] (6)[(11)] (12) (text unchanged)

DENNIS R. SCHRADER
Secretary of Health

 

Title 12
DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

Subtitle 04 POLICE TRAINING AND STANDARDS COMMISSION

12.04.11 Police Complaint Mediation Program

Authority: Public Safety Article, §§3-207 and 3-208, Annotated Code of Maryland

Notice of Proposed Action

[22-277-P]

The Police Training and Standards Commission proposes to adopt new Regulations .01―.08 under a new chapter, COMAR 12.04.11 Police Complaint Mediation Program. This action was considered and approved by the Police Training and Standards Commission at a public meeting held on November 17, 2022.

Statement of Purpose

The purpose of this action is to adopt a new chapter, COMAR 12.04.11, that fulfills the requirement mandated by Public Safety Article, §3-207(d), Annotated Code of Maryland. During the 2016 Legislative Session, H.B. 1016 was introduced as a police reform bill and included a requirement for the Maryland Police Training and Standards Commission to establish a police complaint mediation program. The inclusion of mediation as a tool for effectively responding to and resolving police complaints is based upon a growing body of research that shows dispute resolution through mediation is effective in resolving procedural and interpersonal issues that are not necessarily subject to legal determination, and it gives the participants a greater degree of control over the outcome of the dispute, thus preserving community relationships. H.B. 1016 was enacted as Ch. 519, Acts of 2016, and the Commission later developed a model policy for mediation, but did not adopt regulations to implement a program. The proposed chapter establishes the regulations to create and maintain a police complaint mediation program as required by Public Safety Article, §3-207, Annotated Code of Maryland.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Wayne Silver, Director, Police Training and Standards Commission, Police and Correctional Training Commissions, 6852 4th Street, Sykesville, MD 21842, or call 410-875-3605, or email to wayne.silver@maryland.gov. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

.01 Purpose.

A. This chapter establishes a police complaint mediation program which provides an alternative method to address minor, nonviolent police misconduct complaints outside of the standard complaint process.

B. A law enforcement agency may refer a nonviolent complaint made against a police officer, subject to the agreement of the complainant and the involved police officer, to an independent mediation provider.

.02 General Provisions.

A. Mediation is a process for settling minor police misconduct disputes based on the voluntary participation of the disputing parties.

B. If eligible, voluntary mediation between community members and police officers may be used in place of the traditional administrative complaint process and administrative charging committees (ACC).

C. The mediation process can bridge the communication gap and create a greater understanding and appreciation between community members, police officers, and employing law enforcement agencies.

.03 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Confidential material” means any communication occurring during a mediation session that may not be disclosed outside the mediation except as allowed pursuant to Courts and Judicial Proceedings Article, §3-1804, Annotated Code of Maryland.

(2) “Impasse” means an outcome of a mediation session in which the parties are unable to resolve the dispute.

(3) “Independent mediation provider” means an organization, separate and apart from a law enforcement agency, that can provide mediators to conduct mediation sessions between complainants and law enforcement personnel.

(4) “Letter of conclusion” means a document signed by staff of the independent mediation provider that is delivered to a law enforcement agency indicating that a mediation session was held between a complainant and police officer.

(5) “Letter of consent to mediate” means a document signed by the parties in mediation indicating each party’s voluntarily participation in mediation, and witnessed by the mediator.

(6) “Mediation” has the meaning stated in COMAR 12.04.10.03B.

(7) “Mediator” means a trained, impartial third party, affiliated with an independent mediation provider, who will facilitate a mediation session between parties to assist them in reaching a voluntary resolution to their dispute.

(8) “Police misconduct” has the meaning stated in Public Safety Article, §3-101, Annotated Code of Maryland.

(9) “Resolution” means a mutual agreement resolving a conflict between two or more disputing parties.

.04 Establishing a Police Complaint Mediation Program.

A. The Maryland Police Training and Standards Commission (MPTSC) in collaboration with community-based mediation resources shall establish and maintain a listing of qualified mediation providers located within the State.

B. A law enforcement agency interested in establishing a mediation program shall contact MPTSC for referral to an appropriate mediation provider.

C. Prior to establishing a mediation process, a law enforcement agency shall enter into a memorandum of understanding (MOU) with a local independent mediation provider approved by MPTSC.

D. A local law enforcement agency shall establish guidelines for mediation consistent with this regulation and any policy guidelines provided by MPTSC.

E. A law enforcement agency that enters into an MOU with a qualified mediation provider shall report the establishment of a program to MPTSC and forward a copy to ensure the program meets the requirements of the regulation.

.05 Mediation Participation.

A. Participant Requirements.

(1) Participation in a mediation program is voluntary and shall be agreed upon by the complainant, law enforcement agency, and police officer identified in the complaint.

(2) A complainant or police officer who is the subject of a complaint of police misconduct has the right to decline mediation.

(3) If a police officer who is the subject of a complaint declines the offer to mediate the complaint, the decision to not participate may not be considered during any disciplinary proceeding.

(4) A party to mediation shall sign a letter of consent to mediate as an alternative to the formal police misconduct complaint process, outlined in COMAR 12.04.09 and the uniform citizen complaint process.

B. Confidentiality.

(1) All parties involved in a potential mediation process shall agree to the confidentiality requirements as set forth in Courts and Judicial Proceedings Article, §3-1803, Annotated Code of Maryland.

(2) Except as provided in Courts and Judicial Proceedings Article, §3-1804, Annotated Code of Maryland, statements shared during a mediation are considered confidential material and may not be disclosed in any judicial, administrative, or other proceeding.

C. Costs associated with participating in a mediation program are the responsibility of the law enforcement agency employing the involved police officer.

.06 Complaints Eligible for Mediation.

A. Complaint Eligibility.

(1) A nonviolent complaint of a minor nature is eligible for mediation if it falls into one of the following categories:

(a) Violation category A, as stated in COMAR 12.04.10.04D(2); or

(b) Violation category B, as stated in COMAR 12.04.10.04D(3).

(2) A law enforcement agency shall review the nature of the complaint and determine if mediation is appropriate, based on the following factors:

(a) Type and severity of the alleged violation;

(b) Circumstances of the alleged police misconduct; and

(c) Work history and past disciplinary record of the involved police officer.

(3) Even if a complaint is eligible for mediation, the agency head or designee has the authority to decide, for any reason, that a case may not be assigned for mediation.

B. Complaints Not Eligible.

(1) A complaint of police misconduct that involves any level of force is not eligible for mediation.

(2) A complaint is not eligible for mediation if it falls into one of the following categories:

(a) Violation category C, as stated in COMAR 12.04.10.04D(4);

(b) Violation category D, as stated in COMAR 12.04.10.04D(5);

(c) Violation category E, as stated in COMAR 12.04.10.04E(6); or

(d) Violation category F, as stated in COMAR 12.04.10.04D(7).

C. A complaint of police misconduct not eligible for mediation shall be handled through the process set forth in COMAR 12.04.09.

.07 Complaint Procedures.

A. When a minor complaint from a member of the public has been made to a law enforcement agency or police accountability board, a law enforcement agency shall review the nature of the complaint and determine if it is eligible for the mediation program.

B. Notification to Involved Parties.

(1) If the complaint is eligible and conforms to Regulation .06 of this chapter, the law enforcement agency shall notify the police officer who is the subject of the complaint of the mediation option.

(2) If the police officer agrees to mediation, the law enforcement agency shall notify the complainant of the mediation option.

C. If the police officer or a complainant decline to participate in mediation, the matter shall be referred back to the administrative complaint process set forth in COMAR 12.04.09.

D. If all parties to the complaint agree to the mediation process, the law enforcement agency shall contact the independent mediation provider in which there is a current memorandum of understanding (MOU) and proceed with the process pursuant to the MOU.

E. When a case has been referred to the mediation service, the independent mediation provider will manage the case through mediation and resolution.

.08 Resolution.

A. When the mediation process has concluded, the outcome shall be determined by the independent mediation provider to be:

(1) A successful resolution if all parties agree with the resolution; or

(2) An impasse if one or more parties to the complaint cannot agree to a satisfactory resolution.

B. An impasse shall be referred back to the law enforcement agency of the involved police officer for investigation and handled through the administrative complaint process set forth in COMAR 12.04.09.

C. A successful resolution shall be documented by the independent mediation provider in a written statement, signed by both parties and the mediator.

D. The mediator shall send a letter of conclusion to the referring law enforcement agency indicating the results of mediation.

E. Results of the mediation shall be tracked by the law enforcement agency and forwarded to the local police accountability board.

F. Complaint mediation statistics shall be included in the law enforcement agency’s annual reporting of complaints involving the public, and the statistics shall include the:

(1) Total number of complaints handled through mediation;

(2) Number of successful resolutions; and

(3) Number of mediation impasses.

G. If the police officer fails to comply with the actions and deadlines identified in the mediation agreement, a new complaint shall be initiated and the actions of the original complaint of misconduct shall be considered as a potential aggravating factor.

WOODROW W. JONES, III
Chair

 

Title 14
INDEPENDENT AGENCIES

Subtitle 09 WORKERS’ COMPENSATION COMMISSION

14.09.04 Legal Representation and Fees

Authority: Labor and Employment Article, §§9-309, 9-721, 9-731, and 9-734, Annotated Code of Maryland

Notice of Proposed Action

[22-282-P]

The Maryland Workers’ Compensation Commission proposes to amend Regulation .02, repeal existing Regulation .03, and adopt new Regulation .03 under COMAR 14.09.04 Legal Representation and Fees. This action was considered at a public meeting held on October 27, 2022, notice of which was given by publication in 49:22 Md. R. 987 (October 21, 2022) pursuant to General Provision Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to update the schedule of attorney’s fees.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Amy S. Lackington, Administrator, Workers’ Compensation Commission, 10 E. Baltimore Street, Baltimore, MD 21202, or call 410-864-5300, or email to alackington@wcc.state.md.us. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

Open Meeting

Final action on the proposal will be considered by the Workers’ Compensation Commission during a public meeting to be held on March 9, 2023, at 9:30 a.m., at 10 E. Baltimore Street, Baltimore, MD 21202.

.02 Attorney’s Fee, Medical Evaluation Fee, and Costs — Application or Petition for Approval.

A. Request for Attorney’s Fee Not in Excess of Schedule.

(1) — (8) (text unchanged)

(9) An attorney seeking approval of an attorney’s fee that does not exceed the maximum amount set forth in Regulation .03 of this chapter shall:

(a) Accurately calculate the fees sought; and

(b) Include an itemization of all attorney’s fees previously awarded by reference to the amount and date of the Commission’s orders.

(10) Failure to comply with this regulation may result in the reduction or denial of the attorney’s fee sought.

B. Petition for Attorney’s Fee in Excess of Schedule.

(1) — (3) (text unchanged)

(4) The Commission, at its discretion, may schedule a hearing on the petition for an attorney’s fee in excess of the schedule.

C. (text unchanged)

.03 Schedule of Attorney’s Fees.

A. The Commission shall approve attorney’s fees in accordance with the schedule of fees established by the Commission and set forth in §C of this regulation.

B. Definitions.

(1) In this regulation, the following terms have the meanings indicated.

(2) Terms Defined.

(a) “Award of compensation” means the amount of indemnity benefits actually paid or payable to the claimant after any credit or offset or reduction of the percentage of permanent partial disability following a stipulation, appeal, or other modification approved by the Commission.

(b) “Final award” means the award of compensation determined by the Commission after exhaustion of all applicable appeals, regardless of whether the award is increased or decreased because of any appeal.

(c) “Formal set-aside allocation” means a document reflecting a comprehensive analysis and projection of future injury-related medical needs and associated costs.

(d) “State average weekly wage” means the State average weekly wage in effect on the date of the accident or date of disablement.

C. Schedule of Fees.

(1) Amounts Excluded from Calculation. In calculating the attorney’s fee, an attorney may not include in the calculation any amounts paid or payable for medical services and prescription drugs, including but not limited to:

(a) Any monies allocated to future medical expenses through a formal set-aside allocation;

(b) Any monies apportioned to future medical benefits;

(c) Any monies already paid or owing for medical services and prescription drugs; or

(d) Any monies charged or to be charged for the administration of a formal set-aside allocation.

(2) Fee in Excess of Limits — Exceptional Circumstances. The Commission may approve an attorney’s fee in excess of the limits set forth in this regulation only if exceptional circumstances are shown under Regulation .02B of this chapter.

(3) Permanent Partial Disability.

(a) General. Except as otherwise provided in §C(3)(b) of this regulation, in a case in which a final award of compensation is made for permanent partial disability, the Commission may approve an attorney’s fee in a total amount not to exceed 60 times the State average weekly wage and computed as follows:

(i) Up to 20 percent of the first $50,000 of the total award of compensation;

(ii) Up to 15 percent of the next $50,000 of the total award of compensation; and

(iii) Up to 5 percent of the total award of compensation in excess of $100,000.

(b) Disability Due to Amputation or Loss of Vision — Generally. Except as provided in §C(3)(c) of this regulation, in a case in which the rate of compensation is set for permanent partial disability due to the amputation of an arm, leg, hand, or foot, or total loss of vision in one eye, and the sole issue before the Commission is the nature and extent of disability, the Commission may approve an attorney’s fee in an amount up to 5 percent of the compensation awarded, but not exceeding 7.5 times the State average weekly wage.

(c) Disability Due to Amputation or Loss of Vision — Worsening. In a case of worsening of a permanent partial disability due to the amputation of an arm, leg, hand, or foot, or total loss of vision in one eye, takes place or is discovered after the rate of compensation is set or compensation is terminated, the Commission may approve an attorney’s fee computed under §C(8) of this regulation on the increased award.

(4) Permanent Total Disability.

(a) General. Except as otherwise provided in this regulation, in a case in which an initial determination of permanent disability produces a final award of compensation for permanent total disability, the Commission may approve an attorney’s fee in an amount not exceeding 25 times the State average weekly wage.

(b) Special Cases. The Commission may approve an attorney’s fee in an amount not exceeding 15 times the State average weekly wage in a case in which compensability is not an issue and an award of compensation is made for permanent total disability established pursuant to either:

(i) Labor and Employment Article, §9-636(b), Annotated Code of Maryland, for the loss of two or more scheduled members; or

(ii) The stipulation on the extent of disability.

(5) Temporary Total and Temporary Partial Disability. The Commission may not approve an attorney’s fee in a case in which final award of compensation is made for temporary total or temporary partial disability or temporary total disability paid while a claimant is receiving vocational rehabilitation services unless the claimant’s right to the compensation is contested, and the issue is resolved by evidentiary hearing or by stipulation. In such a contested case, the fee may be in an amount not exceeding 10 percent of the compensation that has accrued as of the date of the award.

(6) Dependency Claims.

(a) In a case involving a claim of dependency where compensability is not contested, but the extent of dependency, partial or total, or the identity of a dependent, or both is contested, the Commission may approve a total attorney’s fee for attorneys representing all dependents:

(i) In an amount not exceeding 6.25 times the State average weekly wage in a case of partial dependency under Labor and Employment Article, §9-682, Annotated Code of Maryland; or

(ii) In an amount not exceeding 15 times the State average weekly wage in a case of total dependency under Labor and Employment Article, §9-681 or 9-683.3, Annotated Code of Maryland.

(b) In a case involving a claim of dependency where neither compensability nor dependency is contested and a record is being made solely to determine to whom payments of compensation shall be made, the Commission may approve an attorney’s fee in an amount not exceeding 2.5 times the State average weekly wage.

(c) In a case involving a claim of dependency where compensability and dependency are contested, the Commission may approve an attorney’s fee:

(i) In an amount calculated under §C(3)(a) of this regulation in a case involving a claim of partial dependency under Labor and Employment Article, §9-682 or 9-683.3, Annotated Code of Maryland; or

(ii) In an amount calculated under §C(4)(a) of this regulation in a case of total dependency under Labor and Employment Article, §9-681, Annotated Code of Maryland.

(7) Settlement Agreements. In a case in which an agreement of final compromise and settlement is approved, and upon the filing of an application or petition for an attorney’s fee in accordance with Regulation .02 of this chapter, the Commission may approve an attorney’s fee not exceeding 60 times the State average weekly wage and computed in accordance with §B(3)(a) of this regulation.

(8) Increase in Last Award of Compensation.

(a) Permanent Partial Disability. If the claimant is entitled to additional compensation as a result of an increase in a permanent partial disability award under §C(3) of this regulation the Commission may approve an additional attorney’s fee in an amount not exceeding the difference between the fee approved for all prior permanent partial disability awards and the fee computed under §C(3) or (4)(a) of this regulation on the increased award.

(b) Agreement of Final Compromise and Settlement. If the claimant is entitled to additional compensation as a result of an agreement of final compromise and settlement approved under §C(7) of this regulation following a prior award of permanent partial disability, the Commission may approve an additional attorney’s fee in an amount not exceeding the difference between the fee approved for all prior awards and the fee computed under §C(3) or (4) of this regulation on the increased award.

(c) In a case in which a determination of permanent disability made pursuant to Labor and Employment Article, §9-736(a), Annotated Code of Maryland, produces a final award of compensation for permanent total disability, the Commission may approve an additional attorney’s fee in an amount as follows:

(i) 20 percent of the first 200 weeks of permanent total disability benefits, excluding any cost-of-living increase as provided in Labor and Employment Article, §9-638 or §9-638.1, Annotated Code of Maryland, minus a fee or fees approved for all prior permanent disability awards; and

(ii) Not exceeding 15 times the State average weekly wage.

(9) Additional Fees for Appeals of Compensation Awards.

(a) When a compensation award of the Commission is appealed to a circuit court and the case is tried on appeal, the Commission may approve an additional attorney’s fee in an amount up to 5 percent of the first final indemnity award issued following the circuit court action, but not exceeding 7.5 times the State average weekly wage.

(b) When a decision of a circuit court on an appeal from a compensation award of the Commission is appealed to a higher appellate court and the appeal is briefed and decided on its merits, the Commission may approve an additional attorney’s fee for each appeal in an amount up to 5 percent of the first final indemnity award issued following the appellate action, but not exceeding 7.5 times the State average weekly wage.

(c) When an appeal from a compensation award of the Commission to a circuit court is not tried, or an appeal to a higher appellate court is not briefed and decided on its merits, the Commission may approve an additional attorney’s fee in an amount up to 2.5 percent of the first final indemnity award issued following the appellate action or circuit court action, but not exceeding 3.75 times the State average weekly wage.

(d) When a decision of the Commission on the issue of compensability of a claim is appealed to a circuit court, if the claim is determined on appeal to be compensable, the Commission, upon remand, may approve an additional attorney’s fee in an amount up to 5 percent of the first final indemnity award issued following the remand, but not exceeding 7.5 times the State average weekly wage.

(e) An attorney may be awarded an appeal fee under only one of paragraphs (a) — (d) of this subsection for a circuit court action or appellate court action.

(f) Once an appeal fee has been awarded for a circuit court action or appellate action, the Commission may not award an additional appeal fee based on the same circuit court action or appellate action.

D. Attorney’s Fee Allowed — Exceptional Circumstances.

(1) In exceptional circumstances as shown under Regulation .02B of this chapter, the Commission may approve an attorney’s fee in a case in which it is determined that the claimant is not entitled to any compensation or benefits. Nothing in this regulation prohibits the Commission from awarding an attorney’s fee under Regulation .02C of this chapter.

(2) In exceptional circumstances as shown under Regulation .02B of this chapter, the Commission may approve an attorney’s fee in a case involving issues such as medical care and treatment, or vocational rehabilitation, in which the claimant does not receive any monetary award. Nothing in this regulation prohibits the Commission from awarding an attorney’s fee under Regulation .02C of this chapter.

R. KARL AUMANN
Chairman

 

Subtitle 22 COMMISSION ON CRIMINAL SENTENCING POLICY

Notice of Proposed Action

[22-303-P]

The Maryland State Commission on Criminal Sentencing Policy proposes to amend:

(1) Regulations .09—.11 under COMAR 14.22.01 General Regulations; and

(2) Regulation .02 under COMAR 14.22.02 Criminal Offenses and Seriousness Categories.

Statement of Purpose

The purpose of this action is to modify Regulation .09 under COMAR 14.22.01 General Regulations to clarify the definition of “explosive” as it pertains to the assignment of weapon presence points in part C of the offense score. Additionally, the purpose of this action is to modify Regulations .10 and .11 under COMAR 14.22.01 General Regulations and Regulation .02 under COMAR 14.22.02 Criminal Offenses and Seriousness Categories to account for recent cannabis legislation enacted by Ch. 26 (H.B. 837), Acts of 2022. The legislation, as it impacts the noted regulations, substitutes the term marijuana with cannabis, legalizes the use or possession of a personal amount of cannabis, and reduces the maximum penalty from 5 years to 3 years for unlawfully possess with intent to distribute, manufacture, possess production equipment—cannabis.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to David Soule, Executive Director, Maryland State Commission on Criminal Sentencing Policy, University of Maryland, 4511 Knox Rd., Suite 309, College Park, MD 20742, or call 301-403-4165, or email to dsoule@umd.edu. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

 

14.22.01 General Regulations

Authority: Criminal Procedure Article, §6-211, Annotated Code of Maryland

.09 Offense Score.

A. (text unchanged)

B. Elements of the Offense Score.

(1)—(3) (text unchanged)

(4) Weapon Presence.

(a)—(b) (text unchanged)

(c) The individual completing the worksheet shall assign a score of 2 if a firearm or explosive material was present.

(d) (text unchanged)

(5) (text unchanged)

C. (text unchanged)

.10 Computation of the Offender Score.

A. (text unchanged)

B. Four Components of the Offender Score.

(1)—(2) (text unchanged)

(3) Prior Adult Criminal Record.

(a) In General.

(i) Except as noted in this paragraph, the prior adult criminal record includes all adjudications preceding the current sentencing event, whether the offense was committed before, during, or after the instant offense(s). The prior adult criminal record shall not include: adjudications that were expunged from the record or proven by the defense to have been eligible for expungement as a matter of right prior to the date of offense pursuant to Subtitle 1 (Expungement of Police and Court Records) of Title 10 (Criminal Records) of the Criminal Procedure Article, Annotated Code of Maryland; violations of public local laws; municipal infractions; contempt; criminal nonsupport; [marijuana possession or marijuana paraphernalia possession adjudications that qualify for a non-incarceration penalty due to evidence of medical necessity;] adjudications based on acts that are no longer crimes (e.g., cannabis possession); non-incarcerable traffic offenses; military adjudications imposed by an Article 15 proceeding or summary court-martial; findings of guilt by general or special courts-martial, if the elements of the offense require the defendant’s service in a military force, including but not limited to desertion, absence without leave (AWOL), and conduct unbecoming an officer and a gentleman, or do not constitute an offense under Maryland law; or more than one adjudication arising from a single criminal event.

(ii)—(iv) (text unchanged)

(b)—(c) (text unchanged)

(d) Convictions Out of Jurisdiction. If an offender has been convicted in another jurisdiction, excluding military adjudications (see §B(3)(e) of this regulation for instructions for scoring military adjudications), the individual completing the worksheet shall match the offense as closely as possible to the closest analogous Maryland offense. If no Maryland analogous offense exists, the individual completing the worksheet shall count the offense in the lowest seriousness category (VII), and shall inform the judge and parties. If the out of jurisdiction conviction is based on act that is not a criminal violation in Maryland (e.g., [marijuana] cannabis possession [less than 10 grams]), then the out of jurisdiction conviction shall be excluded from the prior adult criminal record. If there is a question as to the analogous guidelines offense for an out-of-State conviction, that question shall be brought to the attention of the judge at sentencing.

(e)—(h) (text unchanged)

(4) (text unchanged)

C. (text unchanged)

.11 Determining the Guidelines Sentence.

A.—C. (text unchanged)

D. Drug Offenses.

(1) (text unchanged)

(2) Sentencing Matrix for Drug Offenses.

 

SENTENCING MATRIX FOR DRUG OFFENSES
OFFENDER SCORE

OFFENSE
SERIOUSNESS
CATEGORY

0

1

2

3

4

5

6

7+

VII

P

P

P-1M

P-3M

P-4M

P-6M

P-9M

P-1Y

VI

Row VI is available for future use. There are currently no seriousness category VI drug offenses.

V

P-1M

P-3M

P-4M

P-6M

P-9M

P-1Y

1M-18M

2M-2Y

IV

P-3M

P-4M

P-6M

P-9M

P-1Y

1M-18M

2M-2Y

3M-3Y

III-A
[Marijuana] Cannabis import 45 kilograms or more, and MDMA 750 grams or more

P-6M

P-9M

P-18M

1M-2Y

3M-3Y

6M-5Y

1Y-6Y

2Y-8Y

III-B
[Non-marijuana] Non-cannabis and non-MDMA, Except Import

P-9M

P-18M

1M-2Y

3M-3Y

6M-5Y

1Y-6Y

2Y-8Y

4Y-12Y

III-C
[Non-marijuana] Non-cannabis and non-MDMA, Import

P-18M

1M-2Y

3M-3Y

6M-5Y

1Y-6Y

2Y-8Y

4Y-12Y

6Y-14Y

II

16Y-20Y

18Y-22Y

20Y-24Y

22Y-26Y

24Y-28Y

26Y-30Y

28Y-32Y

30Y-36Y

Note: (text unchanged)

E. (text unchanged)

 

14.22.02 Criminal Offenses and Seriousness Categories

Authority: Criminal Procedure Article, §6-211, Annotated Code of Maryland

.02 Seriousness Categories.

 

Offense Literal

CJIS
Code

Source

Felony or
Misd.

Max
Term

Min
Term

Offense Type

Ser.

Category

Fine

1—49  (text unchanged)

50

CDS and Paraphernalia
Controlled dangerous substance importation into State, [non-marijuana] non-cannabis

3-3550

CR, §5-614(a)

Felony

25Y

 

Drug

IIIC

$50,000

50-1

CDS and Paraphernalia
Controlled dangerous substance importation into State, [marijuana] cannabis (45 kilograms or more)

3-3550

CR, §5-614(a)

Felony

25Y

 

Drug

IIIA

$50,000

51  (text unchanged)

52

CDS and Paraphernalia
[Unlawful distribution, manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of certain equipment for illegal use; keeping common nuisance,]
Unlawfully distribute, PWID, manufacture, possess production equipment, distribute counterfeit, PWID counterfeit, possess counterfeiting equipment, keep common nuisance, possess false prescriptionnarcotics and hallucinogenics (e.g., PCP, heroin, cocaine, LSD, oxycodone, fentanyl, and methadone)

1-1118
1-1119
1-1120
1-1121
1-1122
1-1123
1-1124
1-1125
1-1126
1-1127
1-1128
1-1129
1-1131
1-1132
1-1133
1-1556
1-1557
1-1558

CR, §5-602(a)

CR, §5-603(a)

CR, §5-604

CR, §5-605

CR, §5-606

 

CR, §5-608(a)
CR, §5-609(a)

(penalty)

Felony

20Y

 

Drug

IIIB

$15,000

53

CDS and Paraphernalia
[Unlawful distribution, manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of certain equipment for illegal use; keeping common nuisance,]
Unlawfully distribute, PWID, manufacture, possess production equipment, distribute counterfeit, PWID counterfeit, possess counterfeiting equipment, keep common nuisance, possess false prescriptionnarcotics and hallucinogenics (e.g., PCP, heroin, cocaine, LSD, oxycodone, fentanyl, and methadone), subsequent

 

CR, §5-602(a)

CR, §5-603(a)

CR, §5-604

CR, §5-605

CR, §5-606

 

CR, §5-608(b)
CR, §5-609(b)
CR, §5-608(c)
CR, §5-609(c)
CR, §5-608(d)
CR, §5-609(d)

(penalty)

Felony

20Y
25Y
40Y

 

Drug

IIIB

$15,000
$25,000
$25,000

53-1—54  (text unchanged)

54-1

CDS and Paraphernalia
[Unlawful distribution, manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of certain equipment for illegal use; keeping common nuisance,]
Unlawfully distribute, PWID, manufacture, possess production equipment, distribute counterfeit, PWID counterfeit, possess counterfeiting equipment, keep common nuisance, possess false prescriptionMDMA (methylenedioxymethamphetamine), 750 grams or more

1-1127
1-1128
1-1129
1-1131
1-1132
1-1133
1-1556
1-1557
1-1558

CR, §5-602(a)

CR, §5-603(a)

CR, §5-604

CR, §5-605

CR, §5-606

 

CR, §5-609(a)

(penalty)

Felony

20Y

 

Drug

IIIA

$15,000

54-2

CDS and Paraphernalia
[Unlawful distribution, manufacture, etc.; counterfeiting, etc., manufacture, possession, etc., of certain equipment for illegal use; keeping common nuisance,]
Unlawfully distribute, PWID, manufacture, possess production equipment, distribute counterfeit, PWID counterfeit, possess counterfeiting equipment, keep common nuisance, possess false prescriptionMDMA (methylenedioxymethamphetamine), 750 grams or more, subsequent

 

CR, §5-602(a)

CR, §5-603(a)

CR, §5-604

CR, §5-605

CR, §5-606

 

CR, §5-609(b)
CR, §5-609(c)
CR, §5-609(d)

(penalty)

Felony

20Y
25Y
40Y

 

Drug

IIIA

$15,000
$25,000
$25,000

55—56  (text unchanged)

57

CDS and Paraphernalia
Controlled dangerous substance importation into State, [marijuana] cannabis (5 to less than 45 kilos)

1-0730

CR, §5-614(b)

Felony

10Y

 

Drug

IV

$10,000

58—58-1  (text unchanged)

58-2

CDS and Paraphernalia

Unlawfully PWID, manufacture, possess production equipment—cannabis

1-1692

1-1693

1-1694

CR, §5-602(b)(1)

CR, §5-603(b)

 

CR, §5-607(a)(2)

(penalty)

Misd.

3Y

 

Drug

V

$5,000

58-3

CDS and Paraphernalia

Unlawfully distribute, distribute counterfeit, PWID counterfeit, possess counterfeiting equipment, keep common nuisance, possess false prescriptioncannabis

1-0234
1-0235
1-0236
1-0238
1-0239
1-0728
2-3550

CR, §5-602(a)(1)

CR, §5-604

CR, §5-605

CR, §5-606

 

CR, §5-607(a)(1)

(penalty)

Felony

5Y

 

Drug

IV

$15,000

59

CDS and Paraphernalia
[Unlawful distribution, manufacture, etc.; counterfeiting, etc.; manufacture, possession, etc., of certain equipment for illegal use; keeping common nuisance,]
Unlawfully distribute, PWID, manufacture, possess production equipment, distribute counterfeit, PWID counterfeit, possess counterfeiting equipment, keep common nuisance, possess false prescriptionSchedules I through V non-narcotics (e.g., amphetamines, methamphetamine, [marijuana,] synthetic marijuana, diazepam, MDMA under 750 grams, and Valium) and buprenorphine

1-0233
1-0234
1-0235
1-0236
1-0237
1-0238
1-0239
1-0660
1-0728
2-3550

[CR, §5-607(a)]

CR, §5-602(a)

CR, §5-603(a)

CR, §5-604

CR, §5-605

CR, §5-606

 

CR, §5-607(a)(1)

(penalty)

Felony

5Y

 

Drug

IV

$15,000

60—63  (text unchanged)

64 Vacant

[CDS and Paraphernalia
Paraphernalia—possess or distribute controlled paraphernalia—marijuana]

[1-0566]
[1-1287]

[CR, §5-620(d)(2)]

[Misd.]

[1Y]

 

[Drug]

[VII]

[$1,000]

65

CDS and Paraphernalia
Paraphernalia—possess or distribute controlled paraphernalia—[non-marijuana] non-cannabis

1-0255
1-0256
1-0257

[CR, §5-620(d)(1)]

CR, §5-620(d)

Misd.

4Y

 

Drug

V

$25,000

66—66-1  (text unchanged)

67

CDS and Paraphernalia
Paraphernalia—use or possess with intent to use drug paraphernalia—[non-marijuana] non-cannabis, subsequent

5-3555

[CR, §5-619(c)(3)(ii)]

CR, §5-619(c)(2)(ii)

Misd.

2Y

 

Drug

VII

$2,000

68  (text unchanged)

69

CDS and Paraphernalia
Possession—unlawful possession or administering to another, obtaining, etc., substance by fraud, forgery, misrepresentation, etc.; affixing forged labels; altering etc., label—[marijuana] cannabis

1-1559
1-1560
1-1561
1-1562
1-1563
1-1564

CR, §5-601(c)(2)(i)

Misd.

6M

 

Drug

VII

$1,000

69-1

CDS and Paraphernalia
Possession—unlawful possession or administering to another; obtaining, etc., substance by fraud, forgery, misrepresentation, etc.; affixing forged labels; altering etc., label—[non-marijuana] non-cannabis, 1st offense

1-1110
1-1111
1-1112
1-1113
1-1114
1-1115
1-1117

CR, §5-601(c)(1)(i)

Misd.

1Y

 

Drug

VII

$5,000

69-2

CDS and Paraphernalia
Possession—unlawful possession or administering to another; obtaining, etc., substance by fraud, forgery, misrepresentation, etc.; affixing forged labels; altering etc., label—[non-marijuana] non-cannabis, 2nd or 3rd offense

 

CR, §5-601(c)(1)(ii)

Misd.

18M

 

Drug

VII

$5,000

69-3

CDS and Paraphernalia
Possession—unlawful possession or administering to another; obtaining, etc., substance by fraud, forgery, misrepresentation, etc.; affixing forged labels; altering etc., label—[non-marijuana] non-cannabis, 4th or subsequent offense

 

CR, §5-601(c)(1)(iii)

Misd.

2Y

 

Drug

VII

$5,000

70—421  (text unchanged)

Footnotes (text unchanged)

General Rules:

(a)—(b)  (text unchanged)

(c) For Prior Record calculations involving offenses in which the offender has been convicted in another jurisdiction, the individual completing the worksheet shall match the offense as closely as possible to the closest analogous Maryland offense. If no Maryland analogous offense exists, the individual completing the worksheet shall count the offense in the lowest seriousness category (VII), and shall inform the judge and parties. If the out of jurisdiction conviction is based on act that is not a criminal violation in Maryland (e.g., [marijuana] cannabis possession [less than 10 grams]), then the out of jurisdiction conviction shall be excluded from the prior adult criminal record. If there is a question as to the analogous guidelines offense for an out-of-State conviction, that question should be brought to the attention of the judge at sentencing.

DAVID SOULE
Executive Director


 

Title 30
MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

Subtitle 08 DESIGNATION OF TRAUMA AND SPECIALTY REFERRAL CENTERS

30.08.05 Trauma Center Designation and Verification Standards

Authority: Education Article, §13-509, Annotated Code of Maryland

Notice of Proposed Action

[22-307-P]

The Maryland Emergency Medical Services Board proposes to amend Regulation .13 under COMAR 30.08.05 Trauma Center Designation and Verification Standards.

Statement of Purpose

The purpose of this action is to remove the requirement for equipment that is no longer in current use.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Elizabeth Wooster, Director, Trauma & Injury Specialty Care Program, MIEMSS, 653 West Pratt Street, Baltimore, MD 21201, or call 410-706-3932, or email to ewooster@miemss.org. Comments will be accepted through February 13, 2023. A public hearing has not been scheduled.

.13 Facility or Unit Capabilities.

PARC

I

II

III

ED

A. Emergency Department. Emergency Department (ED) requirements are as follows:

    (1) — (11) (text unchanged)

    (12) Policies and protocols for trauma team response and roles in ED trauma resuscitation in accordance with Regulation .11 of this chapter; and

E

E

E

E

E

    (13) Drugs necessary for emergency care[; and].

E

E

E

E

E

    [(14) Auto transfusion equipment and capability immediately available.

E

E

E

E

E]

 

B. Operating Room. Operating Room (OR) requirements are as follows:

    (1) — (4) (text unchanged)

 

 

 

 

 

    (5) Rapid fluid infusers, [blood recapturing] thermal control equipment for patients and resuscitation fluids, intraoperative radiologic capabilities, equipment for fracture fixation, and equipment for bronchoscopy and gastrointestinal endoscopy;

E

E

E

E

NA

    (6) (7) (text unchanged)

 

 

 

 

 

C.J. (text unchanged)

 

 

 

 

 

THEODORE DELBRIDGE, M.D.
Executive Director

 

Special Documents

 

DEPARTMENT OF THE ENVIRONMENT

WATER AND SCIENCE ADMINISTRATION

Water Quality Certification 22-WQC-0029

 

Mike Snapp & Drum Point Property Owner’s Association

401 Lake Dr.

Lusby, MD 20657

 

Add’l. Info:  Pursuant to COMAR 26.08.02.10F(3)(c), The Maryland Department of the Environment is providing notice of its issuance of a Water Quality Certification 22-WQC-0029.

 

Location: End of Beech Dr. at community beach, Lusby, MD 20657

 

The purpose of the project is to nourish an existing community beach in the Drum Point community

1.     Construct a 20-foot wide by 107-foot long stone groin extending a maximum of 107 feet channelward of the mean high water line.

2.     Fill and grade with 240 cubic yards of clean sand fill along 150 feet of eroding shoreline and plant with 1,307 square feet of marsh vegetation.

 

The WQC and its attachments may be viewed at the following link:

https://mde.maryland.gov/programs/Water/WetlandsandWaterways/Pages/WQC.aspx

 

Appeal of Final Decision: This Water Quality Certification is a final agency decision. Any person aggrieved by the Department’s decision to issue this WQC may appeal such decision in accordance with COMAR 26.08.02.10F(4). A request for appeal shall be filed with the Department within 30 days of publication of the final decision and specify in writing the reason why the final decision should be reconsidered. A request for appeal shall be submitted to: Secretary of the Environment, Maryland Department of the Environment, 1800 Washington Boulevard, Baltimore, MD 21230. Any request for an appeal does not stay the effectiveness of this WQC.

 

Contact: Mel Throckmorton at mel.throckmorton@maryland.gov or 410-375-2803.

[23-01-06]

 

WATER AND SCIENCE ADMINISTRATION

Water Quality Certification 22-WQC-0037

 

The Wharf at Handys Point, Inc.

23150 Green Point Rd

Worton, MD 21678

 

Add’l. Info:      Pursuant to COMAR 26.08.02.10F(3)(c), The Maryland Department of the Environment is providing notice of its issuance of a Water Quality Certification 22-WQC-0037

 

Location: 23150 Green Point Rd., Worton, MD 21678

 

The purpose of the project is to control shoreline erosion and improve navigable access.

 

Description of Authorized Work: 

·       Remove two existing fixed piers and associated structures;

·       Construct a 98-foot long by 8-foot wide floating pier with two 25-foot long by 6-foot wide floating piers tapering from 8-foot wide at the point of connection to the main pier, six 25-foot long by 3-foot wide floating finger piers tapering from 8-foot wide at the point of connection to the main pier, one 12-foot long by 6-foot wide gangway, and six mooring piles all extending a maximum of 103.3 feet channelward of the mean high water line;

·       Construct a 101-foot long by 8-foot wide floating pier with two 40-foot long by 6-foot wide floating piers tapering from 8-foot wide at the point of connection to the main pier, four 40-foot long by 3-foot wide floating finger piers tapering from 8-foot wide at the point of connection, one 12-foot long by 6-foot wide gangway, and four mooring piles, all extending a maximum of 105.7 feet channelward of the mean high water line.

 

The WQC and its attachments may be viewed at the following link:

https://mde.maryland.gov/programs/Water/WetlandsandWaterways/Pages/WQC.aspx

 

Appeal of Final Decision. This Water Quality Certification is a final agency decision. Any person aggrieved by the Department’s decision to issue this WQC may appeal such decision in accordance with COMAR 26.08.02.10F(4). A request for appeal shall be filed with the Department within 30 days of publication of the final decision, and specify in writing the reason why the final decision should be reconsidered. A request for appeal shall be submitted to: Secretary of the Environment, Maryland Department of the Environment, 1800 Washington Boulevard, Baltimore, MD 21230. Any request for an appeal does not stay the effectiveness of this WQC.

 

Contact: Robert M. Simmons at robertm.simmons@maryland.gov or at 410-901-4044.

[23-01-07]

 

WATER AND SCIENCE ADMINISTRATION

Water Quality Certification 22-WQC-0038

 

Kees De Mooy & Town of Chestertown

118 Cross Street

Chestertown, MD 21620

 

Add’l. Info:  Pursuant to COMAR 26.08.02.10F(3)(c), The Maryland Department of the Environment is providing notice of its issuance of a Water Quality Certification 22-WQC-0038.

 

Location: 207 South Water St., Chestertown, MD 21620 (Chestertown Marina)

 

The purpose of the project is to improve navigable access by dredging at Chestertown Marina.

1.    Mechanically maintenance dredge an irregularly-shaped area within an existing footprint, measuring 83,766 square feet to a depth of 6 feet at mean low water.

2.     Remove 7,250 cubic yards of material which will be transported to a Dredge Disposal Site located at 25792 John Hanson Rd., Chestertown, MD 21620.

 

The WQC and its attachments may be viewed at the following link:

https://mde.maryland.gov/programs/Water/WetlandsandWaterways/Pages/WQC.aspx

 

Appeal of Final Decision: This Water Quality Certification is a final agency decision. Any person aggrieved by the Department’s decision to issue this WQC may appeal such decision in accordance with COMAR 26.08.02.10F(4). A request for appeal shall be filed with the Department within 30 days of publication of the final decision and specify in writing the reason why the final decision should be reconsidered. A request for appeal shall be submitted to: Secretary of the Environment, Maryland Department of the Environment, 1800 Washington Boulevard, Baltimore, MD 21230. Any request for an appeal does not stay the effectiveness of this WQC.

 

Contact:  Mel Throckmorton at mel.throckmorton@maryland.gov or 410-375-2803.

[23-01-08]

 

 

General Notices

 

Notice of ADA Compliance

   The State of Maryland is committed to ensuring that individuals with disabilities are able to fully participate in public meetings.  Anyone planning to attend a meeting announced below who wishes to receive auxiliary aids, services, or accommodations is invited to contact the agency representative at least 48 hours in advance, at the telephone number listed in the notice or through Maryland Relay.

 

COMMISSIONER OF FINANCIAL REGULATION

Subject: Bank Merger

Add'l. Info: On December 29, 2022, Summit Financial Group, Inc., a West Virginia corporation, filed an application, with the Office of the Commissioner of Financial Regulation (“Commissioner”), pursuant to Financial Institutions Article, §5-904, Annotated Code of Maryland, for approval of the merger of PSB Holding Corp., a Maryland corporation and registered bank holding company with and into Summit Financial Group, Inc., a West Virginia corporation, and registered bank holding company.

     In accordance with Financial Institutions Article, §3-703, Annotated Code of Maryland, Summit Financial Group, Inc., and its subsidiary bank, Summit Community Bank, Inc., a West Virginia state-chartered non-member bank located in Moorefield, West Virginia, also filed an application with the Commissioner to merge Provident State Bank, Inc., a Maryland chartered commercial bank located in Preston, Maryland, with and into Summit Community Bank, Inc., a West Virginia chartered non-member bank and a wholly-owned subsidiary of Summit Financial Group, Inc., with Summit Community Bank, Inc. being the surviving entity.

     This application is on file at the Office of the Commissioner of Financial Regulation, 1100 North Eutaw Street, Suite 611, Baltimore, Maryland 21201. Comments regarding this application must be submitted in writing and must be received by the Commissioner within 20 calendar days of the date of publication of this notice in the Maryland Register. For further information, contact Michelle Denoncourt, Assistant Commissioner at (410) 230-6104.

Contact: Michelle Denoncourt 410-230-6104

[23-01-01]

 

DEPARTMENT OF THE ENVIRONMENT

Subject: Public Meeting

Date and Time: January 19, 2023, 10 a.m. — 12 p.m.

Place: Virtual via Google Meet — please see details below.

Add'l. Info: The access link is available on monthly agenda at https://mde.maryland.gov/programs/permits/EnvironmentalBoards/Pages/BWW_Meetings.aspx.

     A portion of this meeting may be held in closed session

Contact: Dee Settar 410-537-4162

[23-01-02]

 

DEPARTMENT OF THE ENVIRONMENT

Subject: Public Hearing — Correction

Date and Time: January 31, 2023, 10 — 11 a.m. Please note this hearing date has been changed from what was published on December 30, 2022.

Place: Via the GoTo Meeting platform — please see details below.

Add'l. Info: The Maryland Department of the Environment (MDE) gives notice of a public hearing concerning the Baltimore Moderate Nonattainment Area 0.070 ppm 8-Hour Ozone State Implementation Plan Attainment Demonstration addressing the 2015 Ozone National Ambient Air Quality Standards (NAAQS).

     Use the following link to join by computer or laptop or call the toll free number:

     https://meet.goto.com/219418493

     U.S. (Toll Free): 1-877-309-2073

     Access Code: 219-418-493

     The Public Hearing will be held as required by federal law (Clean Air Act at 42 U.S.C. 7410(a) and 40 CFR 51.102). Interested persons are invited to attend and express their views. After the Department considers the comments received, and revises the proposal if necessary, all related items will be submitted to the U.S. Environmental Protection Agency. An electronic copy of the proposed Baltimore Moderate Nonattainment Area 0.070 ppm 8-Hour Ozone Attainment SIP revision will be available on the Maryland Department of the Environment’s website at https://mde.maryland.gov/programs/Air/AirQualityPlanning/Pages/index.aspx.

     Note: The public library systems in Maryland can be used for Internet access to view the document. Copies of the document can also be obtained via email by writing to Catherine Salarano at Catherine.Salarano@Maryland.gov.

     Written comments may be presented at the hearing, faxed to 410-537-3203, emailed to Catherine.Salarano@Maryland.gov, or mailed to Catherine Salarano, MDE ARA, 1800 Washington Boulevard, Suite 730, Baltimore, MD 21230. Comments must be received before 5 p.m. on January 31, 2023.

     Anyone needing special accommodations at a public hearing should contact the Department’s Fair Practices Office at (410) 537-3964. TTY users may contact the Department through the Maryland Relay Service at 1-800-735-2258.

Contact: Catherine Salarano 410-537- 4415

[23-01-03]

 

SPORTS WAGERING APPLICATION REVIEW COMMISSION

Subject: Public Meeting

Date and Time: January 18, 2023, 9 — 11 a.m.

Place: Via livestream at https://swarc.org/

Contact: James Butler 410-230-8781

[23-01-04]

 

BOARD OF WELL DRILLERS

Subject: Public Meeting

Date and Time: January 25, 2023, 9 a.m. — 12 p.m.

Place: Via Google Meet

Contact: Duane Johnson 410-537-4466

[23-01-05]