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Maryland Register
Issue Date: August 11, 2023 Volume 50 • Issue 16 • Pages 713 — 760
Governor Judiciary Regulations Special Documents General Notices
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| Pursuant to State Government Article, §7-206, Annotated Code of Maryland, this issue contains all previously unpublished documents required to be published, and filed on or before July 24, 2023 5 p.m.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 July 24, 2023. Gail S. Klakring Acting Administrator, Division of State Documents Office of the Secretary of State |
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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.
Wes Moore, Governor; Susan C. Lee, Secretary of State; Gail S. Klakring, Administrator; Mary D. MacDonald, Senior Editor,
Maryland Register and COMAR; Elizabeth
Ramsey, Editor, COMAR Online, and Subscription Manager;
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 ..................................................................... 717
COMAR Research Aids
Table of Pending Proposals ........................................................... 718
Index of COMAR Titles Affected in
This Issue
COMAR
Title Number and Name Page
03 Comptroller of the Treasury .............................................. 725
10 Maryland Department of Health ................................ 725, 730
11 Department of Transportation ............................ 724, 726, 750
13A State Board of Education ................................................... 727
13B Maryland Higher Education Commission ......................... 727
14 Independent Agencies ....................................................... 754
20 Public Service Commission ............................................... 728
26 Department of the Environment ........................................ 728
31 Maryland Insurance Administration .................................. 729
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.
Governor’s Council on the Chesapeake
and Coastal Bays
Watershed
Maryland’s Oyster Shell and Substrate
Taskforce
DISCIPLINARY PROCEEDINGS .................................. 723
Emergency Action on
Regulations
11 DEPARTMENT OF TRANSPORTATION
MOTOR VEHICLE ADMINISTRATION—VEHICLE
REGISTRATION
Electric Vehicle and Low Emission
Vehicle Excise Tax
Credit
03 COMPTROLLER OF THE TREASURY
Administrative and Procedural
Regulations—Sales and Use,
and Admissions and Amusement Taxes
10 MARYLAND DEPARTMENT OF HEALTH
Advanced Practice Nurse Services
Home Care for Disabled Children Under
a Model
Waiver
Therapeutic Behavioral Services
Targeted Case Management for People
with Developmental
Disabilities
11 DEPARTMENT OF TRANSPORTATION
MOTOR VEHICLE ADMINISTRATION—VEHICLE
REGISTRATION
Apportioned Registration of Fleet
Vehicles
MOTOR VEHICLE ADMINISTRATION—DRIVER
LICENSING AND IDENTIFICATION DOCUMENTS
Point System: Definition of Moving
Violation and
Assessment of Points
GENERAL INSTRUCTIONAL PROGRAMS
Test Administration and
Data-Reporting Policies and
Procedures
13B MARYLAND HIGHER EDUCATION COMMISSION
Minimum Requirements for Private Career
Schools
Additional Requirements for
For-Profit Institutions of Higher
Education
FIRE-RESCUE EDUCATION AND TRAINING
COMMISSION
Certification Standards and
Procedures for Emergency
Services Instructors
General Regulations and Policies for
Community
Colleges
Veterans of the Afghanistan and Iraq
Conflicts Scholarship
Program
SERVICE SUPPLIED BY ELECTRIC COMPANIES
Deanna Camille Green Rule — Contact
Voltage Survey
Requirement and Reporting
Service Quality and Reliability
Standards ...............................
Residential Electric Underground
Facilities
26 DEPARTMENT OF THE ENVIRONMENT
REGULATION OF WATER SUPPLY, SEWAGE DISPOSAL,
AND SOLID WASTE
On-Site Wastewater Property Transfer
Inspection
License
31 MARYLAND INSURANCE ADMINISTRATION
Standards for Medicare Supplement
Policies
Proposed Action on
Regulations
10 MARYLAND DEPARTMENT OF HEALTH
Employed Individuals with
Disabilities
Separate Children’s Health Insurance
Program (CHIP) and
CHIP Health Services Initiative
Eligibility
Maryland Medicaid Managed Care
Program: Eligibility and
Enrollment
Maryland Medicaid Managed Care
Program: Rare and
Expensive Case Management
Licensure and Continuing Education
Rules of Procedure for Board Hearings
Speech-Language Pathology Assistants
and Audiology
Assistants
11 DEPARTMENT OF TRANSPORTATION
MOTOR VEHICLE ADMINISTRATION —
ADMINISTRATIVE PROCEDURES
MOTOR VEHICLE ADMINISTRATION — DRIVER
LICENSING AND IDENTIFICATION DOCUMENTS
Proof of Age, Full Name, Identity,
Maryland Residence,
Social Security Number, and Lawful
Status
MOTOR VEHICLE ADMINISTRATION—
ADMINISTRATIVE PROCEDURES
MOTOR VEHICLE ADMINISTRATION—VEHICLE
EQUIPMENT
Safety Glass Replacement Standards
MOTOR VEHICLE ADMINISTRATION—VEHICLE
REGISTRATION
Electric Vehicle and Low Emission
Vehicle Excise Tax
Credit
MARYLAND HEALTH BENEFIT EXCHANGE
State-Based Young Adult Health
Insurance Subsidies Program
WATER AND SCIENCE ADMINISTRATION
Water Quality Certification 23-WQC-0008
Water Quality Certification
23-WQC-0010
Water Quality Certification 23-WQC-0016
Water Quality Certification
23-WQC-0021
Water Quality Certification 23-WQC-0028
Water Quality Certification 23-WQC-0029
Public Meeting .........................................................................
STATE COLLECTION AGENCY LICENSING BOARD
(SCALB)
MARYLAND INSURANCE ADMINISTRATION
MARYLAND HEALTH CARE COMMISSION
DEPARTMENT OF TRANSPORTATION/OFFICE OF
MINORITY BUSINESS ENTERPRISE
WORKERS’ COMPENSATION COMMISSION
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 |
Emergency and Proposed Regulations 5
p.m.* |
Notices,
etc. 10:30
a.m. |
Final Regulations 10:30
a.m. |
|
2023 |
|||
|
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.
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 and corrections pertaining to proposed regulations are listed, followed by “(err)” or “(corr),” respectively. 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.
05 DEPARTMENT OF HOUSING
AND COMMUNITY DEVELOPMENT
05.03.09.01—.11 •
50:7 Md. R. 304 (4-7-23)
05.20.05.01—.12 •
49:25 Md. R. 1054 (12-2-22)
08 DEPARTMENT OF NATURAL
RESOURCES
08.03.03.01 • 50:13 Md. R. 515 (6-30-23)
08.03.06.03 • 50:13 Md. R. 517 (6-30-23)
08.03.17.01,.02 • 50:13 Md. R. 517 (6-30-23) (ibr)
08.18.07.02 •
50:14 Md. R. 596 (7-14-23)
09 MARYLAND DEPARTMENT OF LABOR
09.03.14.01—.18 • 50:4 Md. R. 125 (2-24-23)
50:7 Md. R. 307 (4-7-23) (corr)
09.10.01.07 • 50:15 Md. R. 684 (7-28-23)
09.10.01.17 • 50:15 Md. R. 685 (7-28-23)
09.12.32.01—06 • 49:21 Md. R. 953 (10-7-22)
09.22.01.13 • 50:3 Md. R. 92 (2-10-23)
10 MARYLAND DEPARTMENT OF HEALTH
Subtitle 09 (2nd volume)
10.09.04.01,.03,.04,.07
• 50:7 Md. R. 307 (4-7-23)
10.09.06.02,.04,.06,.07,.09
• 50:11 Md. R. 448 (6-2-23)
10.09.07.08 •
50:7 Md. R. 309 (4-7-23)
10.09.08.01—.06,.09,.10
• 50:13 Md. R. 520 (6-30-23)
10.09.12.06,.07 •
50:6 Md. R. 222 (3-24-23)
10.09.16.01—.13 •
50:4 Md. R. 136 (2-24-23)
10.09.28.01,.02,.04,.06
• 50:13 Md. R. 522 (6-30-23)
10.09.30.01—.11 •
50:15 Md. R. 685 (7-28-23)
10.09.31.01,.03—.06
• 49:22 Md. R. 982 (10-21-22)
10.09.33.01,.02,.06,.07,.09
• 50:6 Md. R. 227 (3-24-23)
10.09.36.01—.03,.07,.09—.11
• 50:13 Md. R. 524 (6-30-23)
10.09.40.01—.06 •
50:1 Md. R. 13 (1-13-23)
10.09.41.03,.04,.07 • 50:16 Md. R. 730 (8-11-23)
10.09.52.01—.06 •
50:1 Md. R. 13 (1-13-23)
10.09.54.01,.04,.14,.16,.17,.22
• 50:3 Md. R. 94 (2-10-23)
10.09.56.22 •
50:4 Md. R. 140 (2-24-23)
10.09.62.01—.15 •
50:16 Md. R. 732 (8-11-23)
10.09.63.01—.06 •
50:13 Md. R. 526 (6-30-23)
10.09.69.04,.14,.17
• 50:16 Md. R. 737 (8-11-23)
10.09.76.01,.03,.05
• 50:1 Md. R. 13 (1-13-23)
10.09.89.09—.12,.14
• 50:6 Md. R. 230 (3-24-23)
Subtitles 10—22 (3rd volume)
10.11.04.02,.04 • 50:15 Md. R.
689 (7-28-23)
10.14.08.01—.08 • 50:13 Md. R.
528 (6-30-23)
10.15.03.02,.27 • 50:15 Md. R.
690 (7-28-23)
10.19.07.02 • 50:13 Md. R. 530
(6-30-23)
10.19.08.01—.06 • 50:13 Md. R.
530 (6-30-23)
10.21.01.04,.08 • 49:23 Md. R.
1000 (11-4-22)
Subtitles 23—36 (4th volume)
10.24.01.01—.22 •
50:14 Md. R. 597 (7-14-23)
10.26.02.02—.05 •
50:15 Md. R. 691 (7-28-23)
10.26.06.01—.03 •
50:15 Md. R. 691 (7-28-23)
10.27.01.05 •
50:13 Md. R. 532 (6-30-23)
10.28.01.01—.06 •
49:26 Md. R. 1084 (12-16-22)
10.34.34.02—.12 •
50:13 Md. R. 533 (6-30-23)
Subtitles 37—52 (5th volume)
10.37.10.26 • 49:18 Md. R. 822 (8-26-22)
10.38.08.01—.08 •
50:15 Md. R. 693 (7-28-23)
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)
10.41.01.01—.04 •
50:16 Md. R. 738 (8-11-23)
10.41.02.01,.02,.04
• 50:16 Md. R. 738 (8-11-23)
10.41.03.02,.03,.05,.06
• 50:16 Md. R. 738 (8-11-23)
10.41.04.01,.02,.06,.08
• 50:16 Md. R. 738 (8-11-23)
10.41.05.01—.07 •
50:16 Md. R. 738 (8-11-23)
10.41.06.01—.06 • 49:26 Md. R. 1087 (12-16-22)
10.41.08.01-1,.02,.06,.08,.11,.12,.14
• 50:16 Md. R. 738 (8-11-23)
10.41.09.02 •
50:16 Md. R. 738 (8-11-23)
10.41.11.01—.10 •
50:16 Md. R. 738 (8-11-23)
10.41.13.02,.04 •
50:16 Md. R. 738 (8-11-23)
10.42.06.02,.03,.05—.11
• 50:15 Md. R. 695 (7-28-23)
10.42.10.01—.06 • 49:26 Md. R. 1088 (12-16-22)
10.43.17.01—.06 •
50:2 Md. R. 68 (1-27-23)
10.46.08.01—.06 •
49:27 Md. R. 1116 (12-30-22)
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)
10.63.01.02,.05 •
50:4 Md. R. 143 (2-24-23)
10.63.02.02 •
50:4 Md. R. 143 (2-24-23)
10.63.03.20,.21 •
50:4 Md. R. 143 (2-24-23)
10.64.01.15 •
50:15 Md. R. 698 (7-28-23)
10.65.10.01—.06 •
50:2 Md. R. 69 (1-27-23)
10.67.01.01 •
50:16 Md. R. 732 (8-11-23)
10.67.02.01 •
50:16 Md. R. 732 (8-11-23)
10.67.06.26-6 • 49:22 Md. R. 982 (10-21-22)
10.67.06.26-7 • 50:13 Md. R. 526 (6-30-23)
10.67.08.02 •
50:14 Md. R. 618 (7-14-23)
11 DEPARTMENT OF
TRANSPORTATION
Subtitles 11—23 (MVA)
11.11.05.03 •
50:16 Md. R. 750 (8-11-23)
11.11.05.04 •
50:16 Md. R. 751 (8-11-23)
11.12.01.14 •
50:15 Md. R. 698 (7-28-23)
11.13.12.01,.04,.05,.09
• 50:16 Md. R. 752 (8-11-23)
11.15.40.01—.04 •
50:16 Md. R. 753 (8-11-23)
11.17.09.05 • 50:16 Md. R. 750 (8-11-23)
11.17.21.05 •
50:16 Md. R. 750 (8-11-23)
13A STATE BOARD OF EDUCATION
13A.02.06.01,.02,.05—.07
• 50:14 Md. R. 620 (7-14-23)
13A.07.06.01—.15
• 50:14 Md. R. 621 (7-14-23) (ibr)
13A.12.01.01—.14
• 50:14 Md. R. 633 (7-14-23)
13A.12.02.01—.29
• 50:14 Md. R. 633 (7-14-23)
13A.12.03.01—.12
• 50:14 Md. R. 633 (7-14-23)
13A.12.04.01—.16
• 50:14 Md. R. 633 (7-14-23)
13A.12.05.01—.15
• 50:14 Md. R. 633 (7-14-23)
13A.12.06.01—.09
• 50:14 Md. R. 633 (7-14-23)
13A.12.07.01—.08
• 50:14 Md. R. 633 (7-14-23)
50:15 Md. R. 707 (7-28-23) (err)
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.08.20.02—.13
• 50:4 Md. R. 158 (2-24-23)
14 INDEPENDENT AGENCIES
14.01.02.02,.03 •
50:15 Md. R. 699 (7-28-23)
14.01.03.01—.17 •
50:14 Md. R. 659 (7-14-23)
14.04.01.01 •
50:14 Md. R. 661 (7-14-23)
14.04.02.04—06 •
50:14 Md. R. 661 (7-14-23)
14.04.06.03,.07 •
50:14 Md. R. 661 (7-14-23)
14.04.09.01—.07 •
50:14 Md. R. 661 (7-14-23)
14.22.01.12,.14 • 50:13 Md. R. 534 (6-30-23)
14.35.07.22 • 50:13 Md. R. 535 (6-30-23)
14.35.19.03 •
50:16 Md. R. 754 (8-11-23)
14.35.20.01—.12 •
50:13 Md. R. 536 (6-30-23)
14.37.01.01 •
50:14 Md. R. 663 (7-14-23)
14.37.02.01—.11 •
50:14 Md. R. 663 (7-14-23)
14.37.03.01,.02 •
50:14 Md. R. 663 (7-14-23)
14.37.04.02 •
50:14 Md. R. 663 (7-14-23)
14.37.05.02 • 50:14 Md. R. 663 (7-14-23)
14.40.04.01—.03 •
50:15 Md. R. 700 (7-28-23)
14.40.05.03,.04 •
50:15 Md. R. 702 (7-28-23)
21 STATE PROCUREMENT
REGULATIONS
21.01.02.01 • 50:12 Md. R. 480
(6-16-23)
21.01.03.01,.01-1,.03 • 50:12 Md.
R. 480 (6-16-23)
21.02.01.04 • 50:12 Md. R. 480
(6-16-23)
21.03.05.01 • 50:12 Md. R. 480
(6-16-23)
21.05.01.01 • 50:12 Md. R. 480
(6-16-23)
21.05.02.01 • 50:12 Md. R. 480
(6-16-23)
21.05.02.14 • 50:13 Md. R. 539
(6-30-23)
21.05.03.02 • 50:12 Md. R. 480
(6-16-23)
21.05.03.03 • 50:13 Md. R. 539
(6-30-23)
21.05.06.01 • 50:12 Md. R. 480
(6-16-23)
21.05.07.06 • 50:12 Md. R. 480
(6-16-23)
21.05.08.05 • 50:12 Md. R. 480
(6-16-23)
21.05.09.08 • 50:12 Md. R. 480
(6-16-23)
21.05.13.01,.03,.05 • 50:12 Md.
R. 480 (6-16-23)
21.05.14.01—.06 • 50:12 Md. R.
480 (6-16-23)
21.05.15.01—.05 • 50:12 Md. R.
480 (6-16-23)
21.06.09.01 • 50:12 Md. R. 480
(6-16-23)
21.07.01.31 • 50:12 Md. R. 480
(6-16-23)
21.07.02.05-2 • 50:12 Md. R. 480
(6-16-23)
21.07.03.27 • 50:12 Md. R. 480
(6-16-23)
21.08.03.03 • 50:12 Md. R. 480
(6-16-23)
21.10.08.01,.02,.06 • 50:12 Md.
R. 480 (6-16-23)
21.11.01.02,.06 • 50:12 Md. R.
480 (6-16-23)
21.11.03.03,.09,.17 • 50:12 Md.
R. 480 (6-16-23)
21.11.03.10 • 50:13 Md. R. 539
(6-30-23)
21.11.05.01—.07 • 50:12 Md. R.
480 (6-16-23)
21.11.14.04 • 50:12 Md. R. 480
(6-16-23)
21.13.01.08,.14,.18 • 50:12 Md.
R. 480 (6-16-23)
26 DEPARTMENT OF THE
ENVIRONMENT
Subtitles 01—07 (Part 1)
26.04.01.01,.01-1,.20,.37 • 50:3
Md. R. 106 (2-10-23) (ibr)
Subtitles 08—12 (Part 2)
26.11.17.01,.04 •
50:11 Md. R. 455 (6-2-23)
26.11.34.02 •
50:10 Md. R. 417 (5-19-23)
30 MARYLAND INSTITUTE FOR
EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)
30.09.12.04 •
50:13 Md. R. 541 (6-30-23)
30.09.14.04 •
50:13 Md. R. 541 (6-30-23)
33 STATE BOARD OF
ELECTIONS
33.01.01.01 • 50:15 Md. R. 703
(7-28-23)
33.02.03.01—.05 • 50:13 Md. R.
542 (6-30-23)
33.07.11.01,.02 • 50:15 Md. R.
703 (7-28-23)
33.12.02.01 • 50:13 Md. R. 542
(6-30-23)
33.13.10.05 • 50:12 Md. R. 492
(6-16-23)
33.13.13.06 • 50:12 Md. R. 492 (6-16-23)
33.13.21.01—.05 •
50:15 Md. R. 705 (7-28-23)
33.15.02.01 •
50:15 Md. R. 703 (7-28-23)
33.15.03.01,.02 •
50:15 Md. R. 703 (7-28-23)
33.17.04.06 •
50:13 Md. R. 542 (6-30-23)
33.17.05.03 •
50:13 Md. R. 542 (6-30-23)
33.17.07.01 • 50:13 Md. R. 542 (6-30-23)
33.18.01.02 •
50:15 Md. R. 705 (7-28-23)
33.19.01.01 •
50:13 Md. R. 542 (6-30-23)
33.19.02.01 •
50:13 Md. R. 542 (6-30-23)
(Amends Executive Order
01.01.1985.02)
Governor’s Council on the Chesapeake and
Coastal Bays Watershed
WHEREAS, The State of
Maryland is committed to protecting the Chesapeake Bay and Coastal Bays
Watershed;
WHEREAS, Climate
change, pollution, and sea-level rise threaten the State’s residents and
economy;
WHEREAS, Cross-agency
collaboration across all relevant agencies is critical to achieve improvements
in the health of the Chesapeake Bay and surrounding Coastal Bays Watershed; and
WHEREAS, Innovative
and emerging technology and industries, environmental and STEAM (science,
technology, engineering, arts and mathematics) education requirements, economic
value in restoration, and connecting with underserved, overburdened and under-
and unemployed communities is critical for maximizing outcomes for the Bay and
surrounding watershed.
NOW, THEREFORE, I,
WES MOORE, GOVERNOR OF THE STATE OF MARYLAND, BY THE VIRTUE OF THE AUTHORITY
VESTED IN ME BY THE CONSTITUTION AND LAWS OF MARYLAND, HEREBY AMEND EXECUTIVE
ORDER 01.01.1985.02 AND PROCLAIM THE FOLLOWING EXECUTIVE ORDER, EFFECTIVE
IMMEDIATELY:
A. Establishment. There is a Governor’s Council on the Chesapeake and Coastal Bays Watershed (“Council”).
B. Membership. The Council shall consist of the following members:
(1) The Secretary of Natural Resources;
(2) The Secretary of the Environment;
(3) The Secretary of Health;
(4) The Secretary of Agriculture;
(5) The Secretary of Planning;
(6) The Director of the Maryland Energy Administration;
(7) The Executive Director of the Maryland Environmental Service;
(8) The State’s Chief Resilience Officer; and
(9) Other officials of the Executive Branch that the Governor may designate.
(10) The President of the University of Maryland Center for Environmental Sciences is invited to be, and shall be upon acceptance, a member of the Commission.
C. Chair. The Governor shall appoint a Chair from among the members of the Council.
D. Meetings of the Council.
(1) The Council shall meet at least quarterly to receive information and discuss issues of Chesapeake and Coastal Bays Watershed management.
(2) The Council Chair may convene meetings of the Council and shall preside over the meetings.
E. Functions. The principal functions of the Council are to:
(1) Advise and provide periodic recommendations to the Governor about matters related to the management of the Chesapeake and Coastal Bays Watershed and surrounding areas, including but not limited to:
a. Progress in meeting the annual Statewide implementation plan;
b. Need for programmatic and budgetary adjustments;
c. The results and conduct of Chesapeake and Coastal Bays Watershed monitoring programs;
d. Establishment of annual Chesapeake and Coastal Bays Watershed research priorities; and
e. Maryland's participation on regional issues of Chesapeake and Coastal Bays Watershed management;
(2) Promote interagency coordination and integration of Chesapeake and Coastal Bays Watershed related programs to:
a. Guide the State’s restoration and water quality improvement programs consistent with the most up-to-date scientific knowledge and technologies;
b. Accelerate the restoration of the Chesapeake and Atlantic Coastal Bays and local watersheds to ensure that all Marylanders have clean drinking water and accessible clean waterways;
c. Promote equity by focusing on the long-term, collective benefits of healthy watersheds and their connection to the health of Maryland’s environment, economy and people;
d. Ensure that investments in watershed restoration provide important climate resiliency benefits; and
e. Develop strategies to address the challenges and opportunities that the State’s population growth presents to Bay restoration and the environment overall;
(3) Develop and oversee the State’s coordinated environmental, cultural and natural resources infrastructure while pursuing innovative partnerships and funding opportunities;
(4) Seek regular input of Maryland citizens and stakeholders, particularly those representing underserved and overburdened communities.
F. Administration.
(1) The Council may establish working groups as necessary.
(2) The Council shall be staffed by Executive Department staff.
(3) The Council shall establish appropriate procedures to seek advice on issues related to research, management, and public participation.
G. This Executive Order shall be implemented in a manner that is consistent with all applicable statutes and regulations. Nothing in this Executive Order shall operate to contravene any State or federal law or to affect the State’s receipt of federal funding.
H. If any provision of this Executive Order or its application to any person, entity, or circumstance is held invalid by any court of competent jurisdiction, all other provisions or applications of the Executive Order shall remain in effect to the extent possible without the invalid provision or application. To achieve this purpose, the provisions of this Executive Order are severable.
GIVEN Under My Hand and the Great Seal of the
State of Maryland, in the Town of Queenstown, Queen Anne’s County, Maryland,
this 20th Day of July, 2023.
ATTEST:
SUSAN C. LEE
Secretary of State
[23-16-18]
Maryland’s Oyster Shell and
Substrate Taskforce
WHEREAS, Increasing
the abundance of the Eastern Oyster, a critical species for Maryland’s economy
and water quality, is a priority of the Moore-Miller Administration;
WHEREAS, Oysters play
a valuable role in creating reefs that clean water and provide habitat for
critical species, including crabs and striped bass;
WHEREAS, Oysters are
a defining species and their reefs a defining feature of the character and
culture of the Chesapeake Bay; and
WHEREAS, The State of
Maryland is currently limited in its ability to process oyster shells for use
in promoting oyster reproduction and must ship oyster shells out of state for
processing, thus losing a valuable resource for the State and the Chesapeake
Bay watershed.
NOW, THEREFORE, I,
WES MOORE, GOVERNOR OF THE STATE OF MARYLAND, BY THE VIRTUE OF THE AUTHORITY
VESTED IN ME BY THE CONSTITUTION AND LAWS OF MARYLAND, HEREBY PROCLAIM THE
FOLLOWING EXECUTIVE ORDER, EFFECTIVE IMMEDIATELY:
A. Establishment. There is a Maryland’s Oyster Shell and Substrate Taskforce (“Taskforce”), housed in the Department of Natural Resources.
B. Membership. The Taskforce shall be comprised of members, appointed by the Governor, representing the following sectors:
(1) The Secretary of Natural Resources or their designee;
(2) The Secretary of Commerce or their designee;
(3) A local government official;
(4) The University of Maryland Center for Environmental Science;
(5) A commercial waterman;
(6) A recreational fisherman;
(7) An economist from one of the State’s Historically Black Colleges and Universities;
(8) The Oyster Recovery Partnership;
(9) A seafood company owner;
(10) A private oyster hatchery owner;
(11) The State’s aquaculture industry; and
(12) The State’s conservation community.
C. Chair. The Governor shall appoint a Chair from among the members of the Taskforce. The Chair shall serve at the pleasure of the Governor.
D. Functions. The principal functions of the Taskforce are to:
(1) Identify strategies and solutions to retain shell, increase abundance and create an overall additive situation for oyster substrate across the Chesapeake Bay;
(2) Evaluate strategies based on the ability to meet the demand from the public fishery, aquaculture industry and restoration component in the near term and focusing on meeting needs for the growth of all three components; and
(3) Evaluate the economic impacts substrate has on the State and develop recommendations that take into consideration costs and benefits for the fishery.
E. Procedures.
(1) The Taskforce shall meet monthly.
(2) The Taskforce Chair may convene meetings of the Taskforce and shall preside over the meetings.
(3) A majority of the Taskforce members shall constitute a quorum for the transaction of any business.
(4) The Taskforce may adopt other procedures as necessary to ensure the orderly transaction of business.
(5) The Taskforce shall be staffed by the Department of Natural Resources.
F. Reports.
(1) The Taskforce shall submit a report to the Governor containing recommendations for achieving a positive oyster shell and substrate environment by December 1, 2024.
(2) The Taskforce shall hire a consultant to facilitate the reporting to the Governor, in a manner consistent with applicable law and subject to the availability of appropriations.
G. This Executive Order shall be implemented in a manner that is consistent with all applicable statutes and regulations. Nothing in this Executive Order shall operate to contravene any State or federal law or to affect the State's receipt of federal funding.
H. If any provision of this Executive Order or its application to any person, entity, or circumstance is held invalid by any court of competent jurisdiction, all other provisions or applications of the Executive Order shall remain in effect to the extent possible without the invalid provision or application. To achieve this purpose, the provisions of this Executive Order are severable.
GIVEN Under My Hand and the Great Seal of the State of Maryland, in the
City of Cambridge, Dorchester County, this 20th Day of July, 2023.
WES MOORE
Governor
ATTEST:
SUSAN C. LEE
Secretary of State
[23-16-19]
This is to certify that by an Order of this Court dated July 17, 2023, ELLEN F. BIGHAM (CPF# 9106200014), as of July 17, 2023, Ellen F. Bigham’s name has been stricken from the register of attorneys in this Court Maryland Rule 19-761(b).
* * * * * * * * * *
This is to certify that by an Order of this Court dated July 28, 2023, BRIEN M. PENN (CPF# 0312170142), as of July 28, 2023, Brien M. Penn’s name has been replaced on the register of attorneys permitted to practice law in the Supreme Court of Maryland. Notice of this action is given in accordance with Maryland Rule 19-761(b).
[23-16-16]
Emergency Action on Regulations
Symbol Key
• Roman
type indicates text existing before emergency status was granted.
• Italic
type indicates new text.
• [Single brackets] indicate deleted text.
Emergency Regulations
Under State
Government Article, §10-111(b), Annotated Code of Maryland, an agency may
petition the Joint Committee on Administrative, Executive, and Legislative
Review (AELR), asking that the usual procedures for adopting regulations be set
aside because emergency conditions exist. If the Committee approves the
request, the regulations are given emergency status. Emergency status means
that the regulations become effective immediately, or at a later time specified
by the Committee. After the Committee has granted emergency status, the
regulations are published in the next available issue of the Maryland Register.
The approval of emergency status may be subject to one or more conditions,
including a time limit. During the time the emergency status is in effect, the
agency may adopt the regulations through the usual promulgation process. If the
agency chooses not to adopt the regulations, the emergency status expires when
the time limit on the emergency regulations ends. When emergency status
expires, the text of the regulations reverts to its original language.
Title 11
DEPARTMENT OF TRANSPORTATION
Subtitle 15 MOTOR VEHICLE ADMINISTRATION—VEHICLE REGISTRATION
11.15.40 Electric Vehicle and Low Emission
Vehicle Excise Tax Credit
Authority: Transportation
Article, §§12-104(b), 11-103.4, and 13-815, Annotated Code of Maryland
Notice of Emergency Action
[23-157-E]
The Joint Committee on Administrative, Executive, and Legislative Review has granted emergency status to new Regulations .01—.04 under a new chapter, COMAR 11.15.40 Electric Vehicle and Low Emission Vehicle Excise Tax Credit.
Emergency status began:
July 19, 2023.
Emergency status
expires: December 31, 2023.
Editor’s Note: The text of this document will not be printed
here because it appears as a Notice of Proposed Action on page 753 of this
issue, referenced as [23-157-P].
CHRISTINE NIZER
Administrator
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 03
COMPTROLLER OF THE TREASURY
Notice of Final Action
[23-093-F]
On August 1, 2023, the Comptroller of the Treasury adopted:
(1) New Regulation .47 under COMAR 03.06.01 Sales and Use Tax; and
(2) Amendments to Regulations .02 and .03 under COMAR 03.06.03 Administrative and Procedural Regulations—Sales and Use, and Admissions and Amusement Taxes.
This action, which was proposed for adoption in 50:12 Md. R. 478—479 (June 16, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
BROOKE LIERMAN
Comptroller of the Treasury
Title 10
MARYLAND DEPARTMENT OF HEALTH
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.01 Advanced Practice Nurse Services
Authority: Health-General Article, §§2-104(b), 15-103, 15-105, and 15-141.2, Annotated Code of Maryland
Notice of Final Action
[22-286-F]
On July 21, 2023, the Secretary of Health adopted amendments to Regulations .03 and .06 under COMAR 10.09.01 Advanced Practice Nurse Services. This action, which was proposed for adoption in 50:4 Md. R. 135—136 (February 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
LAURA HERRERA SCOTT
Secretary of Health
Subtitle 09 MEDICAL CARE PROGRAMS
Authority: Health-General Article, §§2-104(b), 15-103, 15-105, and 15-141.2, Annotated Code of Maryland
Notice of Final Action
[22-291-F]
On July 21, 2023, the Secretary of Health adopted amendments to Regulations .03 and .07 under COMAR 10.09.15 Podiatry Services. This action, which was proposed for adoption in 50:4 Md. R. 136 (February 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
LAURA HERRERA SCOTT
Secretary of Health
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.27 Home Care for Disabled Children Under a Model Waiver
Authority: Health-General Article, §§2-104(b), 15-103, 15-105, and 15-141.2, Annotated Code of Maryland
Notice of Final Action
[22-344-F]
On July 21, 2023, the Secretary of Health adopted amendments to Regulations .01 and .03—.06 under COMAR 10.09.27 Home Care for Disabled Children Under a Model Waiver. This action, which was proposed for adoption in 50:6 Md. R. 225—227 (March 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
LAURA HERRERA SCOTT
Secretary of Health
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.34 Therapeutic Behavioral Services
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
Notice of Final Action
[23-008-F]
On July 21, 2023, the Secretary of Health adopted amendments to Regulation .06 under COMAR 10.09.34 Therapeutic Behavioral Services. This action, which was proposed for adoption in 50:6 Md. R. 228—229 (March 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
LAURA HERRERA SCOTT
Secretary of Health
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.48 Targeted Case Management for People with Developmental Disabilities
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
Notice of Final Action
[22-339-F]
On July 21, 2023, the Secretary of Health adopted amendments to Regulation .08 under COMAR 10.09.48 Targeted Case Management for People with Developmental Disabilities. This action, which was proposed for adoption in 50:6 Md. R. 229—230 (March 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
LAURA HERRERA SCOTT
Secretary of Health
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.53 Early and Periodic Screening, Diagnosis, and Treatment: Nursing Services for Individuals Younger than 21 Years Old
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
Notice of Final Action
[23-011-F]
On July 21, 2023, the Secretary of Health adopted amendments to Regulations .01 and .07 under COMAR 10.09.53 Early and Periodic Screening, Diagnosis, and Treatment: Nursing Services for Individuals Younger than 21 Years Old. This action, which was proposed for adoption in 50:7 Md. R. 311—312 (April 7, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
LAURA HERRERA SCOTT
Secretary of Health
Title 11
DEPARTMENT OF TRANSPORTATION
Subtitle 15 MOTOR VEHICLE ADMINISTRATION—VEHICLE REGISTRATION
11.15.22 Apportioned Registration of Fleet Vehicles
Authority: Transportation Article, §12-406, Annotated Code of Maryland
Notice of Final Action
[23-080-F]
On August 1, 2023, the Motor Vehicle Administration adopted the repeal of Regulation .17 under COMAR 11.15.22 Apportioned Registration of Fleet Vehicles. This action, which was proposed for adoption in 50:12 Md. R. 479 (June 16, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
CHRISTINE NIZER
Administrator
Subtitle 17 MOTOR VEHICLE ADMINISTRATION—DRIVER LICENSING AND IDENTIFICATION DOCUMENTS
11.17.13 Point System: Definition of Moving Violation and Assessment of Points
Authority: Transportation Article, §§12-104(b) and 16-402, Annotated Code of Maryland
Notice of Final Action
[22-305-F]
On July 21, 2023, the Motor Vehicle Administration adopted amendments to Regulation .02 under COMAR 11.17.13 Point System: Definition of Moving Violation and Assessment of Points. This action, which was proposed for adoption in 50:10 Md. R. 408 (May 19, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
CHRISTINE NIZER
Administrator
Title 13A
STATE BOARD OF EDUCATION
Subtitle 03 GENERAL INSTRUCTIONAL PROGRAMS
Notice of Final Action
[23-078-F]
On July 25, 2023, the State Board of Education adopted amendments to:
(1) Regulations .02, .04, .06, .07, .09, and .09-1 under COMAR 13A.03.02 Graduation Requirements for Public High Schools in Maryland; and
(2) Regulations .01 and .02 under COMAR 13A.03.04 Test Administration and Data-Reporting Policies and Procedures.
This action, which was proposed for adoption in 50:11 Md. R. 449—452 (June 2, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
MOHAMMED CHOUDHURY
State Superintendent of Schools
Title 13B
MARYLAND HIGHER EDUCATION COMMISSION
Notice of Final Action
[22-329-F]
On April 26, 2023, the Maryland Higher Education Commission adopted:
(1) Amendments to Regulation .17 under COMAR 13B.01.01 Minimum Requirements for Private Career Schools; and
(2) Amendments to Regulations .01, .06, and .11 and new Regulation .14 under COMAR 13B.02.06 Additional Requirements for For-Profit Institutions of Higher Education.
This action, which was proposed for adoption in 50:4 Md. R. 153—155 (February 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
SANJAY RAI, PH.D.
Acting Secretary of Higher Education
Subtitle 03 FIRE-RESCUE EDUCATION AND TRAINING COMMISSION
13B.03.01 Certification Standards and Procedures for Emergency Services Instructors
Authority: Education Article, §11-105 and Title 11, Subtitle 5, Annotated Code of Maryland
Notice of Final Action
[22-326-F]
On April 26, 2023, the Maryland Higher Education Commission adopted amendments to Regulations .03 and .13 under COMAR 13B.03.01 Certification Standards and Procedures for Emergency Services Instructors. This action, which was proposed for adoption in 50:4 Md. R. 155—156 (February 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
SANJAY RAI, PH.D.
Acting Secretary of Higher Education
Subtitle 07 COMMUNITY COLLEGES
13B.07.02 General Regulations and Policies for Community Colleges
Authority: Education Article, §§15-106.11 and §16-305, Annotated Code of Maryland
Notice of Final Action
[22-325-F]
On April 26, 2023, the Maryland Higher Education Commission adopted amendments to Regulation .03 under COMAR 13B.07.02 General Regulations and Policies for Community Colleges. This action, which was proposed for adoption in 50:4 Md. R. 156 (February 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
SANJAY RAI, PH.D.
Acting Secretary of Higher Education
13B.08.12 Veterans of the Afghanistan and
Iraq Conflicts Scholarship Program
Authority: Education Article,
§§11-105(u), 18-204(c), and 18-604, Annotated Code of Maryland
Notice of Final Action
[22-327-F]
On April 26, 2023, the Maryland Higher Education Commission adopted new Regulations .01—.08 under a new chapter, COMAR 13B.08.12 Veterans of the Afghanistan and Iraq Conflicts Scholarship Program. This action, which was proposed for adoption in 50:4 Md. R. 156—158 (February 24, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
SANJAY RAI, PH.D.
Acting Secretary of Higher Education
Title 20
PUBLIC SERVICE COMMISSION
Subtitle 50 SERVICE SUPPLIED BY ELECTRIC COMPANIES
Notice of Final Action
[23-022-F]
On July 18, 2023, the Maryland Public Service Commission adopted:
(1) Amendments to Regulation .03 under COMAR 20.50.01 General;
(2) Amendments to Regulation .02 under COMAR 20.50.02 Engineering;
(3) Amendments to Regulation .04 under COMAR 20.50.03 Records and Reports;
(4) Amendments to Regulation .01 under COMAR 20.50.11 Deanna Camille Green Rule — Contact Voltage Survey Requirement and Reporting; and
(5) Amendments to Regulations .01, .02, .04, .05, and .08—.14 and new Regulations .15—.18 under COMAR 20.50.12 Service Quality and Reliability Standards.
This action, which was proposed for adoption in 50:10 Md. R. 410—417 (May 19, 2023), has been adopted with the nonsubstantive changes shown below.
Effective Date: August 21, 2023.
Attorney General’s Certification
In accordance with State Government Article, §10-113, Annotated Code of Maryland, the Attorney General certifies that the following changes do not differ substantively from the proposed text. The nature of the changes and the basis for this conclusion are as follows:
Regulation .08: This nonsubstantive change was made in order to clarify that the subsections First Call Resolution, Average Handling Time, and Vulnerable Individuals Notified Before Storms shall be included in each utility's annual performance report.
20.50.12 Service Quality and Reliability Standards
Authority: Public Utilities Article, §§7-213, 13-201, and 13-202, Annotated Code of Maryland
.08 Customer Communications Standards.
A.—C. (proposed text unchanged)
D. Other Customer Communications Information.
[[(1)]] Each utility shall state in its supplemental annual performance report:
[[(a)]] (1)—[[(b)]] (2) (proposed text unchanged)
[[(2)]] (3)—[[(4)]] (5) (proposed text unchanged)
E.—H. (proposed text unchanged)
ANDREW S. JOHNSTON
Executive Secretary
Subtitle 85 CONSTRUCTION OF UNDERGROUND ELECTRIC AND COMMUNICATION FACILITIES FOR RESIDENTIAL AND NON-RESIDENTIAL CUSTOMERS
20.85.03 Residential Electric Underground Facilities
Authority: Public Utilities Article, §§2-121 and 5-101, and Title 12, Subtitle 1, Annotated Code of Maryland
Notice of Final Action
[23-023-F]
On July 18, 2023, the Maryland Public Service Commission adopted the repeal of Regulation .09 under COMAR 20.85.03 Residential Electric Underground Facilities. This action, which was proposed for adoption in 50:10 Md. R. 417 (May 19, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
ANDREW S. JOHNSTON
Executive Secretary
Title 26
DEPARTMENT OF THE ENVIRONMENT
Subtitle 04 REGULATION OF WATER SUPPLY, SEWAGE DISPOSAL, AND SOLID WASTE
26.04.12 On-Site Wastewater Property
Transfer Inspection License
Authority: Environment Article, §9-217.2, Annotated Code
of Maryland
Notice of Final Action
[22-182-F]
On August 2, 2023, the Maryland Department of the Environment adopted new Regulations .01—.07 under a new chapter, COMAR 26.04.12 On-Site Wastewater Property Transfer Inspection License. This action, which was proposed for adoption in 50:2 Md. R. 73—74 (January 27, 2023), has been adopted with the nonsubstantive changes shown below.
Effective Date: August 21, 2023.
Attorney General’s Certification
In accordance with State Government Article, §10-113, Annotated Code of Maryland, the Attorney General certifies that the following changes do not differ substantively from the proposed text. The nature of the changes and the basis for this conclusion are as follows:
The changes resolve an internal inconsistency in the minimum number of exam questions by subcategory between Regulations .04 and .05. and a typographical error.
.04 Training Course
Requirements.
A. A training course for an
on-site wastewater property transfer inspection license shall include:
(1)—(4) (proposed text unchanged)
(5) A closed book examination
with a minimum of 100 multiple choice questions with:
(a) (proposed text
unchanged)
(b) [[20]] 15 questions
specific to the Department standard inspection form; and
(c) [[20]] 10 questions
specific to final inspection determinations regarding replacement or repair to
an on-site wastewater system.
B.—C. (proposed text unchanged)
.05 Training Course Provider
Requirements.
A.—J. (proposed text unchanged)
K. Unless the Department [[withdrawals]]
withdraws the approval of the training provider or a training course
such approval shall remain valid for 1 year.
L.—N. (proposed text unchanged)
SERENA MCILWAIN
Secretary of the Environment
Title 31
MARYLAND INSURANCE ADMINISTRATION
Authority: Insurance Article, §§2-108, 2-109, 10-121, and 10-128.1, Annotated Code of Maryland
Notice of Final Action
[23-092-F]
On August 1, 2023, the Maryland Insurance Administration adopted amendments to Regulations .02—.07 under COMAR 31.04.22 Title Insurers. This action, which was proposed for adoption in 50:12 Md. R. 491—492 (June 16, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
KATHLEEN A. BIRRANE
Insurance Commissioner
Subtitle 10 HEALTH INSURANCE—GENERAL
31.10.06 Standards for Medicare Supplement Policies
Authority: Health-General Article, §§19-705 and 19-706; Insurance Article, §§2-109 and 8-403(b), Title 15, Subtitle 9, and Title 27; Annotated Code of Maryland
Notice of Final Action
[23-059-F]
On July 14, 2023, the Maryland Insurance Administration adopted amendments to Regulation .06 under COMAR 31.10.06 Standards for Medicare Supplement Policies. This action, which was proposed for adoption in 50:9 Md. R. 385 (May 5, 2023), has been adopted as proposed.
Effective Date: August 21, 2023.
KATHLEEN A. BIRRANE
Insurance Commissioner
Proposed Action on Regulations
Title 10
MARYLAND DEPARTMENT OF HEALTH
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.41 Employed Individuals with Disabilities
Authority: Health-General Article, §15-138, Annotated Code of Maryland
Notice of Proposed Action
[23-160-P]
The Secretary of Health proposes to amend Regulations .03, .04, and .07 under COMAR 10.09.41 Employed Individuals with
Disabilities. At this time, the Secretary of Health also withdraws the
amendments to Regulations .04 and .07 under COMAR 10.09.41 Employed Individuals with Disabilities that were
proposed in 49:16 Md. R. 762—763 (July 29, 2022).
Statement of Purpose
The purpose of this action is to expand the eligible population for the Employed Individuals with Disabilities (EID) Program by establishing less restrictive financial eligibility requirements and setting new premium levels for higher-income participants
Estimate of Economic Impact
I. Summary of Economic Impact. The proposed action establishes less restrictive financial eligibility requirements and sets new premium levels for higher income participants. The Department anticipates this action to both increase enrollment in the EID program, as well as additional revenue from premiums to offset the costs. The Department expects the total Fiscal Year 2024 expenditures to be $3,258,144. The Department anticipates increased revenues to total $937,314.
II. Types of Economic Impact.
|
Impacted Entity |
Revenue (R+/R-) Expenditure (E+/E-) |
Magnitude |
|
A. On issuing agency: |
|
|
|
(1) Maryland Department of Health |
(R+) |
$937,314 |
|
(2) Maryland Department of Health |
(E+) |
$3,258,144 |
|
B. On other State agencies: |
NONE |
|
|
C. On local governments: |
NONE |
|
|
|
|
|
|
|
Benefit (+) Cost (-) |
Magnitude |
|
D. On regulated industries or trade groups: |
NONE |
|
|
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(1). The Department estimates that the 1,211 new participants will be subject to a $129 PMPM premium.
(a) The increase in revenue is therefore estimated to be $156,219 per month.
(b) The Department anticipates a January 1, 2024, effective date, bringing the total Fiscal Year 2024 revenue increase to $937,314.
A(2). The Department estimates that 1,211 new participants will enroll in the Program following the eligibility expansion.
(a) The Department estimates that these new participants will be covered at a cost of $448.41 per member per month (PMPM).
(b) The increase in expenditure is therefore estimated to be $543,024 per month.
(c) The Department anticipates a January 1, 2024, effective date, bringing the total Fiscal Year 2024 expenditures to $3,258,144.
Economic Impact on Small Businesses
The proposed action has a meaningful economic impact on small
businesses. An analysis of this economic impact follows:
Providers, qualifying as small businesses, that serve EID enrollees stand to benefit from increased revenue as 1,211 new participants are projected to enroll as a result of the proposed action.
Impact on Individuals with Disabilities
The proposed action has an impact on individuals with disabilities as follows:
The purpose of the proposed action is to enable more employed Marylanders with disabilities to qualify for low-cost health care through the EID Medicaid buy-in program.
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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
.03 Nonfinancial Eligibility.
A. (text unchanged)
B. An applicant or [recipient] participant meets the nonfinancial eligibility requirements for Medical Assistance benefits under this regulation if the applicant or [recipient] participant:
(1) Is [18] 16
years old or older, but younger than 65 years old;
(2)—(5) (text unchanged)
C. (text unchanged)
.04 Financial Eligibility.
A. (text unchanged)
B. Consideration of Income.
(1) Except as provided in §B(2) or C of this regulation, the Department shall determine, in accordance with the policies and procedures for aged, blind, or disabled coverage groups specified at COMAR 10.09.24, [whether an applicant or recipient meets the income standards for eligibility for the EID coverage group] the countable net income of an EID applicant or participant for purposes of determining the applicable premium amount under Regulation .07 of this chapter.
(2)—(3) (text unchanged)
(4) Income Standards. [For
an applicant or recipient to be eligible for Medical Assistance benefits under
this chapter, the total countable net income attributed to the applicant’s or
recipient’s assistance unit pursuant to §B of this regulation may not exceed
300 percent of the federal poverty level for a family unit size equivalent to
the number of individuals in the assistance unit, determined in accordance with
§A of this regulation.] Effective January 1, 2024, no income standard applies to applicants or participant
under this chapter.
C. Consideration of Resources.
(1) Except as provided in this section [or §D of this regulation], whether an applicant [or recipient] meets the resource standards for eligibility for the EID coverage group shall be determined according to the policies and procedures for aged, blind, or disabled coverage groups specified in COMAR 10.09.24.
(2) To determine the total countable resources of an [assistance unit] applicant, the Department shall apply the general resource exclusions and specific resource exclusions for aged, blind, or disabled coverage groups specified in COMAR 10.09.24 to the total gross resources of the [assistance unit] applicant.
(3) From the total countable resources of the [assistance unit] applicant determined pursuant to §C(1) and (2) of this regulation, the Department shall subtract the aggregate current cash value of the [assistance unit’s] applicant’s or participant’s ownership interest in any of the following types of accounts:
(a)—(b) (text unchanged)
(c) Pension plan; [or]
(d) Keogh plan[.];
(e) Individual retirement account (IRA);
(f) Independence Account; or
(g) Other retirement accounts as defined by the IRS.
(4) For an applicant or participant to be eligible for Medical
Assistance benefits under this chapter, the countable resources attributed to
the applicant’s or participant’s assistance unit pursuant to §§C and D of this
regulation may not exceed $10,000 for an individual.
[D. Resource Standards.
For an applicant or recipient to be eligible for Medical Assistance benefits
under this chapter, the countable resources attributed to the applicant’s or
recipient’s assistance unit pursuant to §D of this regulation may not exceed:
(1) $10,000 for
an individual; and
(2) $15,000 for an individual with a spouse.]
D. Independence Accounts.
(1) Account Provisions.
(a) Contributions to any of the participant’s registered
Independence Accounts are subject to the rules described in this section and to
any policies of the respective financial institution governing the account.
(b) All contributions to the participant’s Independence Account
or accounts, including interest, dividends, or other gains from the principal,
shall be treated as an exempt asset for the purpose of calculating eligibility
for Medical Assistance and the EID program.
(c) The purpose of an Independence Account is to allow the participant
to purchase any items or services that may aid in the participant’s pursuit of
personal or financial independence.
(d) The EID participant shall be the sole owner of any account
registered as an Independence Account.
(e) The Department shall assess the participant’s Independence
Account as a part of the verification process at redetermination for Medical
Assistance. The review process shall include verifying all contributions to the
participant’s Independence Account with the financial institution holding the participant’s
account.
(f) The total amount a participant deposits in all independence
accounts during an annual certification period may not exceed the participant’s
gross earned income for that annual certification period.
(2) Independence Account Registration.
(a) A person shall complete an account registration form to
register an applicable account as an Independence Account with the Department.
(b) A person shall re-register the Independence Account with the
Department if the financial institution or other information for the
Independence Account changes.
(c) The applicant or participant shall report any changes in
personal or financial status that may affect the applicant’s or participant’s eligibility
for Medical Assistance as described in COMAR 10.09.24.
(d) For all registered Independence Accounts, the date of account
creation may be no earlier than the date an EID participant is determined
eligible for Medical Assistance under this section.
(e) For all registered Independence Accounts, the funds in the
Independence Account shall be held separate from the participant’s non-exempt
assets.
.07 Premium.
A. Submission of Premium.
(1)—(2) (text unchanged)
(3) An applicant or [recipient] participant whose assistance unit has income:
(a) (text unchanged)
(b) Above 200 percent, but at or below 250 percent of the federal poverty level, shall pay a monthly premium of $40; [or]
(c) Above 250 percent, but at or below 300 percent of the federal poverty level, shall pay a monthly premium of $55[.];
(d) Above 300 percent, but at or below 450 percent of the
federal poverty level, shall pay a monthly premium of 4 percent of the monthly
net countable income determined under Regulation .04B of this chapter;
(e) Above 450 percent, but at or below 600 percent of the
federal poverty level, shall pay a monthly premium of 5 percent of the monthly
net countable income determined under Regulation .04B of this chapter; or
(f) Above 600 percent of the federal poverty level, shall pay a
monthly premium of 7.5 percent of the monthly net countable income determined
under Regulation .04B of this chapter.
(4)—(6) (text unchanged)
B.—C. (text unchanged)
LAURA HERRERA SCOTT
Secretary of Health
Notice of Proposed Action
[23-124-P]
The Secretary of Health proposes to :
(1) Adopt new Regulations .01—.15 under a new chapter, COMAR 10.09.62 Separate Children’s Health Insurance Program (CHIP) and CHIP Health Services Initiative Eligibility;
(2) Amend Regulation .01 under COMAR 10.67.01 Maryland Medicaid Managed Care Program: Definitions; and
(3) Amend Regulation .01
under COMAR 10.67.02 Maryland Medicaid Managed Care Program: Eligibility and
Enrollment.
Statement of Purpose
The purpose of this action is to:
(1) Expand covered services to include coverage for noncitizen pregnant individuals and their children younger than 1 year old in accordance with Ch. 28 (H.B. 1080), Acts of 2022, Maryland Medical Assistance Program—Healthy Babies Equity Act; and
(2) Update COMAR 10.67.01 Maryland Medicaid Managed Care Program: Definitions and COMAR 10.67.02 Maryland Medicaid Managed Care Program: Eligibility and Enrollment to reflect the expanded coverage.
Estimate of Economic Impact
I. Summary of Economic Impact. The fiscal impact of this proposal is estimated to be $163,500,000 in Fiscal Year 2024. As MDH already covers labor and delivery costs and coverage for newborns up to 1 year old for this population, the additional costs will be for prenatal and postpartum care, including both full medical and dental coverage.
II. Types of Economic Impact.
|
Impacted Entity |
Revenue (R+/R-) Expenditure (E+/E-) |
Magnitude |
|
A. On issuing agency: |
|
|
|
Maryland Department of Health |
(E+) |
$163,500,000 |
|
B. On other State agencies: |
NONE |
|
|
C. On local governments: |
NONE |
|
|
|
|
|
|
|
Benefit (+) Cost (-) |
Magnitude |
|
D. On regulated industries or trade groups: |
|
|
|
Maryland Medicaid providers |
(+) |
$163,500,000 |
|
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. The amount assumes:
(1) For dates of service beginning July 1, 2023, Medicaid will begin reimbursing for medical and dental services for noncitizen pregnant, birthing, and postpartum individuals. Presently, Medicaid does not cover these services for this group.
(2) The estimated number of participants who will be eligible for the new coverage group is 6,000.
(3) Medicaid estimates it will reimburse prenatal services at a rate of approximately $2,755 per member per month (PMPM) and provide participants with coverage with 9 months of coverage; postpartum coverage is estimated to cost $615 PMPM and will be covered for 4 months.
(3) The total impact of this new benefit in FY 2024 is estimated to be $163,500,000.
(4) This amount is subject to a 65 percent blended federal match ($106,300,00 federal funds; $57,200,000 general funds).
D. See A. above.
Economic Impact on Small Businesses
The proposed action has a meaningful economic impact on small
businesses. An analysis of this economic impact follows:
The proposed action expands coverage to non-citizen pregnant people and their children younger than 1 year old effective July 1, 2023. To the extent that providers who qualify as small businesses render services to newly eligible Maryland Medicaid adult participants, they will benefit from the reimbursement of services rendered to the new coverage population.
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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.62 Separate Children’s Health Insurance Program (CHIP) and
CHIP Health Services Initiative Eligibility
Authority: Estates and Trusts Article, §14.5-1002;
Health-General Article, §§2-104(b), 2-105(b), 15-103, 15-105, 15-121, and
15-401—15-407; Annotated Code of Maryland
A. This chapter governs the determination of eligibility for the
separate Children’s Health Insurance Program (separate CHIP) and the CHIP
Health Services Initiative with an income standard based on the modified
adjusted gross income methodology specified in the Affordable Care Act of 2010,
effective January 1, 2014.
B. Eligibility for the separate CHIP Program may be established
for a targeted low-income child from conception to birth when the birthing
parent would qualify for Medicaid but for their immigration status, when the
family income is equal to or less than 250 percent of the federal poverty
level.
C. Eligibility for the CHIP Health Services Initiative for the
birthing parent of a targeted low-income child may be established beginning on
the first day of the month following the end of the pregnancy and ending on the
last day of the fourth month after the pregnancy ends if the targeted
low-income child applied for the separate CHIP Program on or before the day
prior to their birth and was subsequently found eligible for the separate CHIP
Program.
A. In this chapter, the following terms have the meanings
indicated.
B. Terms Defined.
(1) “Affordable Care Act” means the Patient Protection and
Affordable Care Act of 2010 (Pub.L.111-148), as amended by the Health Care and
Education Reconciliation Act of 2010 (Pub.L.111-152), as amended by the Three
Percent Withholding Repeal and Job Creation Act (Pub.L.112-56).
(2) Applicant.
(a) “Applicant” means an individual whose written application
for the separate CHIP Program has been submitted to the local health department
or the local department of social services but has not received final action.
(b) “Applicant” includes an individual whose application is
submitted through a representative.
(3) “Application” means the filing of a written, telephonic, or
electronic signed application for health coverage in an insurance affordability
program to the Department or its designee.
(4) “Application date” means the date on which a written,
telephonic, or electronic signed application is received by the Department or
its designee.
(5) “Authorized representative” has the meaning stated in COMAR
10.01.04.12.
(6) “Birthing parent” means the individual who gives birth to
the targeted low-income child who is enrolled in the separate CHIP Program on
the day prior to their birth.
(7) “CHIP Health Services Initiative” means services offered to
improve the health of low-income children pursuant to §2105(a)(1)(D)(ii) of the
Social Security Act.
(8) “Department” means the Maryland Department of Health.
(9) “Determination” means a decision regarding an applicant’s
eligibility for the separate CHIP Program.
(10) “Eligibility worker” means an employee of the local health
department, or the local department of social services, responsible for
determining the eligibility of applicants and participants.
(11) “Family members” means those individuals living with the
applicant whose income is counted as household income under Regulation .07B of
this chapter.
(12) “Federal poverty level” means the nonfarm income official
poverty level as defined by the Office of Management and Budget and revised
annually in accordance with §673(2) of the Omnibus Budget Reconciliation Act of
1981.
(13) “Inpatient services” means services received by a participant while in a
medical institution, birthing center, or clinic for which Medical Assistance is
provided.
(14) “Institution for mental diseases” means an institution
which falls within the jurisdiction of Health-General Article, §19-307(a)(1),
Annotated Code of Maryland, and is licensed under COMAR 10.07.04.
(15) “Insurance affordability program” means a program that is
one of the following:
(a) Maryland Medicaid;
(b) The Maryland Children’s Health Insurance Program (CHIP),
including the program known as Maryland Children’s Health Program (MCHP)
Premium;
(c) The separate CHIP Program;
(d) An optional state basic health program established under
§1331 of the Affordable Care Act;
(e) A program that makes available to qualified individuals
coverage in a qualified health plan through the Maryland Health Benefit
Exchange with advance payments of the premium tax credit established under 26
U.S.C. §36B of the Internal Revenue Code; or
(f) A program that makes available coverage in a qualified
health plan through the Maryland Health Benefit Exchange with cost-sharing
reductions established under 42 U.S.C. §1402 of the Affordable Care Act.
(16) “Living together” means sharing a common household.
(17) “MAGI” means modified adjusted gross income, as calculated
for purposes of determining eligibility for insurance affordability programs
under the Affordable Care Act.
(18) “Maryland Health Benefit Exchange” means the unit of State
government that determines initial and continuing eligibility for the MAGI-based
insurance affordability programs, including, by delegation, certain eligibility
in the program.
(19) “Maryland Medicaid Managed Care Program” has the meaning
stated in COMAR 10.09.24.02.
(20) “Period under consideration” has the meaning stated in COMAR
10.09.24.02.
(21) “Postpartum period” means the period of time beginning on the first day of the
month following the end of the pregnancy and ending on the last day of the
fourth month after the pregnancy ends.
(22) “Public institution” has the meaning stated in COMAR 10.09.24.02.
(23) “Qualified alien” has the meaning defined in 8 U.S.C.
§1641.
(24) “Participant” means an individual who is certified as
eligible for the Maryland Children’s Health Program.
(25) “Redetermination” has the meaning stated in COMAR 10.09.24.02.
(26) “Separate CHIP Program” means the program for targeted
low-income children established under Title XXI of the Social Security Act.
(27) “Spouse” has the meaning stated in COMAR 10.09.24.02.
(28) “Targeted low-income child” means an individual who
qualifies for the Maryland Children’s Health Program from conception to birth
when the birthing parent is not eligible for Medicaid as a citizen or qualified
alien, when the family income is equal to or less than 250 percent of the
federal poverty level.
(29) “Title XIX” means the title of the Social Security Act, 42
U.S.C. §1396 et seq., which governs establishment of a medical assistance
program for low-income individuals.
(30) “Title XXI” means the title of the Social Security Act
through which funding is provided, in part, for the separate CHIP Program.
A. Eligibility for the separate CHIP Program may be established
for a targeted low-income
child from conception to birth when the:
(1) Birthing
parent is not a citizen or qualified alien; and
(2) Family
income is equal to or less than 250 percent of the federal poverty level.
B.
Eligibility for the CHIP Health Services Initiative may be established for a
birthing parent for postpartum coverage if a targeted low-income child applied
for the separate CHIP Program on or before the day prior to their birth and was
subsequently found eligible for the separate CHIP Program.
A. The Department or its designee shall determine eligibility
for a targeted low-income child and a birthing parent.
B. The Department or its designee shall give oral, written, or
electronic information about the separate CHIP Program and CHIP Health Services
Initiative such as:
(1) Requirements for eligibility;
(2) Available services;
(3) An individual’s rights and responsibilities;
(4) Information in plain English, supported by translation
services; and
(5) Information accessible to disabled individuals requesting an
application.
C. An individual requesting health coverage from an insurance affordability
program shall be given an opportunity to apply.
D. The Department or its designee shall make the application
available to the individual without delay by telephone, by mail, in person, or
by internet or other available electronic means, and in a manner accessible to
disabled individuals requesting an application.
E. A resident temporarily absent from the State but intending to
return may apply for health coverage from an insurance affordability program by
telephone, by mail, in person, or by internet or other available electronic
means to the Department or its designee in any jurisdiction. The individual
shall:
(1) Demonstrate continued residency in the State; and
(2) Meet all nonfinancial and financial requirements to be
determined eligible.
F. Application Filing and Signature Requirements.
(1) An individual who wishes to apply for health coverage under
an insurance affordability program shall submit a written, telephonic, or
electronic application signed under penalty of perjury to the Department or its
designee in any jurisdiction. An applicant is responsible for completing the
application but may be assisted in the completion by an individual of the
applicant’s choice.
(2) For the purpose of establishing eligibility of a child
applicant who is neither pregnant nor postpartum, a parent or stepparent living
with the child shall complete and sign the written, telephonic, or electronic
application. If the child does not live with a parent, an authorized
representative who is 21 years old or older shall complete and sign the
application.
G. The date of application shall be the date on which a written,
telephonic, or electronic signed application is received by the Department or
its designee. The application may be mailed or submitted electronically to the
Department or its designee.
H. An individual who has filed a written, telephonic, or
electronic application may voluntarily withdraw that application, but the
application remains the property of the Department or its designee and the
withdrawal does not affect the periods under consideration specified under §I
of this regulation.
I. Period Under Consideration.
(1) The Department or its
designee shall establish a current period under consideration based on the date
of application established under §G of this regulation.
(2) For a targeted low-income child, the period under
consideration is from conception to birth, and for retroactive eligibility, the
1, 2, or 3 months immediately preceding the month of application for the
separate CHIP Program if those months are prior to the birth.
(3) For the birthing parent, the period under consideration is
the postpartum period and contingent on the application of the targeted
low-income child on or before the last day of the fourth month after the pregnancy ends.
J. Processing applications time limitations shall operate in accordance with the
requirements of COMAR 10.09.24.04.
K. Required Information. All information needed to determine
eligibility for the separate CHIP Program and CHIP Health Services Initiative
shall be reported. When there is evidence of inconsistency between information
attested by the applicant and data reported by the State and federal databases,
the applicant shall be required to offer an explanation and appropriate
verification to reconcile the inconsistency.
.05 Application —
Additional Requirements.
A. Third-Party Liability.
(1) A participant shall notify the Department or its designee
within 10 working days when medical treatment has been provided as a result of
a motor vehicle accident or other occurrence in which a third party might be
liable for the participant’s
medical expenses.
(2) A participant shall cooperate with the Department or its
designee in completing a form designated by the Department to report all
pertinent information and in collecting available health insurance benefits and
other third-party payments.
(3) In accident situations, a participant shall notify the Department or its
designee of the:
(a) Time, date, and location of the accident;
(b) Name and address of the participant’s attorney;
(c) Names and addresses of all parties and witnesses to the
accident; and
(d) Police report number if an investigation is made.
B. The Department or its designee shall:
(1) Maintain a written or electronic record including
documentation of any required elements of eligibility; and
(2) Restrict disclosure of information concerning a participant to purposes
directly connected with the administration of the Medical Assistance Program,
including:
(a) Establishing eligibility;
(b) Determining the extent of coverage under Medical Assistance;
(c) Providing services for participants; and
(d) Conducting or assisting an investigation, prosecution, or
civil or criminal proceeding related to the administration of the Medical
Assistance Program.
C. An applicant or participant shall give consent to verify information needed to
establish eligibility to the Department or its designee, by submitting a
written, telephonic, or electronic application.
.06 Nonfinancial
Eligibility Requirements.
A. Individuals
qualifying for coverage under this section are not required to provide a Social
Security number or meet satisfactory immigration status.
B. Residency.
To be eligible for benefits under this chapter, an individual shall be a
resident of Maryland, in accordance with the requirements of COMAR
10.09.24.05-3.
C. Age. To be
eligible for benefits under this chapter, a birthing parent shall apply for
coverage before the last day of the fourth month after the pregnancy
ends, regardless of the
birthing parent’s age.
D. Inmate of
a Public Institution. To receive benefits under this chapter, a targeted
low-income child or birthing parent may not be an inmate of a public
institution, as specified in COMAR 10.09.24.05-5B.
E.
Institution for Mental Diseases. To be eligible for benefits under this
chapter, a targeted low-income child or birthing parent may not be a patient in
an institution for mental diseases, unless such individuals are eligible in
accordance with COMAR 10.09.24.05-5C.
F. No Private
Health Insurance. In order to be eligible for benefits under Title XXI of the
Social Security Act, a targeted low-income child or birthing parent whose
income is equal to 133 percent but less than 250 percent of the Federal Poverty
Level may not be covered by an employer-sponsored health benefit plan.
G. Required Information.
(1) An applicant shall report to the Department all information
needed to determine eligibility for the separate CHIP Program and CHIP Health
Services Initiative.
(2) When there is evidence of inconsistency between information
attested by the applicant and data reported by the State and federal databases,
the applicant shall be required to offer an explanation and appropriate
verification to reconcile the inconsistency.
.07 Consideration of
Household Income.
A. The applicant shall report the income of any family
member, except for the income of a member that does not file a federal tax
return and is not claimed as a federal tax dependent.
B. Determining Countable Household Income.
(1) In determining an applicant’s financial eligibility
for the separate CHIP Program, the applicant’s current household income is
considered.
(2) For the targeted low-income child applicant, household
income shall consist of the income of the child applicant and the following
family members when living with the child applicant:
(a) The child applicant’s parents; and
(b) At the option of the child applicant’s parents, any of
the child applicant’s siblings.
C. When an individual has regular income the amount to be
considered is that which is available or can reasonably be expected to be
available for a projected period of 12 months, including the month of
application.
D. Treatment
of Income.
(1) Countable
gross income for the separate CHIP Program shall be the household income
calculated according to MAGI.
(2) MAGI
income limits shall be:
(a) Converted
from traditional income limits to account for elimination of income disregards;
and
(b) Increased
by 5 percentage points of the federal poverty level for the following
circumstances:
(i) When an
individual’s income exceeds the Medicaid income standard; and
(ii) The
income standard is the highest income standard under which the individual can
be determined eligible.
(3) Household
Composition. For purposes of determining the income standard applicable to an
applicant or participant, the following rules apply:
(a) An
individual plus anyone for whom the individual claims personal exemption shall
be included in the federal tax filing unit in the taxable year in which an
initial determination or renewal of eligibility is being made;
(b) For an
individual who does not file a federal tax return and is not claimed as a
federal tax dependent in the taxable year in which an initial determination or
renewal of eligibility is being made, the household size shall consist of the
individual and the following individuals:
(i) Spouse;
and
(ii) Natural,
adopted, or step children;
(c) In the
taxable year in which an initial determination or renewal of eligibility is
being made, the household size of a child applicant shall consist of the child
and the following individuals:
(i) Natural,
adopted, or step parents; and
(ii) Natural,
adopted, or step siblings;
(d) In the case of a married couple living together,
each spouse shall be included in the household of the other spouse, regardless
of whether they expect to file a joint federal tax return in the taxable year
in which an initial determination or renewal of eligibility is being made; and
(e) For a child applicant, the household size shall consist of
the child and the following individuals:
(i) Natural, adopted, or step parents; and
(ii) Natural, adopted, or step siblings.
(4) No resources or assets test may be applied to an
applicant or participant who is subject to a MAGI-based income test.
.08 Determining
Financial Eligibility.
An applicant is
financially eligible for the separate CHIP Program or the CHIP Health Services
Initiative if, for the period under consideration, the applicant’s countable
household income as determined under Regulation .07 of this chapter does not
exceed 250 percent of the federal poverty level for a family size equal to the
size of the family of the applicant.
A. For a targeted low-income child, certification for the
separate CHIP Program begins:
(1) On the first day of the month of application, no earlier
than conception, and continues until the last day of the month in which the
pregnancy ends; or
(2) For retroactive coverage, if medical expenses were incurred
during the earlier months:
(a) 3 months before the month of application but no earlier than
conception; and
(b) Continues until the last day of the month in which the
pregnancy ends.
B. For the
birthing parent of a targeted low-income child, certification for the CHIP
Health Services Initiative begins:
(1) On the
first day of the month following the end of the pregnancy, and continues
until the last day of the
fourth month after the pregnancy ends;
(2) For retroactive coverage, if medical
expenses were incurred during the earlier months:
(a) 3 months before the month of application, if those months
are not prior to the last day of the month in which the pregnancy ends; and
(b) Continues until the last day of the month in which the
pregnancy ends.
A. A targeted
low-income child certified for the separate CHIP Program is entitled to all
health benefits through the Maryland Medicaid Managed Care Program.
B. A birthing
parent certified for the CHIP Health Services Initiative is entitled to all
health benefits through the Maryland Medicaid Managed Care Program.
.11 Post-Eligibility Requirements.
A. Notice of
Eligibility Determination. The Department or its designee shall inform an
applicant of the applicant’s legal rights and obligations and give the
applicant written or electronic notification of the following:
(1) For
eligible individuals:
(a) The basis
and effective date for eligibility;
(b)
Instructions for reporting changes that may affect the participants’
eligibility; and
(c) The right
to request a hearing; or
(2) For ineligible individuals:
(a) A finding
of ineligibility, the reason for the finding, and the regulation supporting the
finding;
(b)
Information regarding application for MAGI Exempt coverage groups; and
(c) The right
to request a hearing.
B.
Participant Responsibility.
(1) After an
individual has been determined to be eligible for the separate CHIP Program and
is enrolled in the separate CHIP Program, the participant or the participant’s
representative shall:
(a) Within 10
days of the occurrence, notify the Department if there is a change in the
participant’s, the participant’s parent’s, or the participant’s guardian’s:
(i) Income;
(ii)
Employment;
(iii)
Address; or
(iv) Health
insurance coverage status;
(b) Limit use of the Medical Assistance card to the
individual whose name appears on the card; and
(c) When written or electronic notice of
cancellation is received, discontinue
use of the Medical Assistance card on the first day of ineligibility and return
the card to the Department.
(2) Failure to comply with §B(1) of this regulation may
result in:
(a) The termination of assistance; or
(b) Referral to the Department for fraud investigation, or
for criminal or civil prosecution.
(3) A participant shall cooperate with the Department’s
quality control and audit review process, including verification of all
information pertinent to the determination of eligibility.
(4) If the participant refuses to cooperate, the
participant’s coverage shall be terminated subject to timely and adequate
notice under COMAR 10.01.04.03.
C.
Unscheduled Redetermination.
(1) The
Department or its designee shall:
(a) Promptly
make an unscheduled redetermination of a child participant’s eligibility when
changes in circumstances or relevant facts are:
(i) Reported
by someone on the participant’s behalf; or
(ii) Brought
to the attention of the Department or its designee from other responsible
sources;
(b) Notify
the participant that redetermination is required to establish continuing
eligibility; and
(c) Notify
the participant of the required information and verifications needed to
determine eligibility and the time standards in acting in the redetermination
process.
(2)
Eligibility Decisions. Participants who are determined:
(a) Eligible
for the remainder of the certification period shall be sent notice in
accordance with §A(1) of this regulation; or
(b)
Ineligible because of a change in circumstances or failure to establish
eligibility following a change in circumstance shall be sent notice in
accordance with §A(2) of this regulation.
(3) A
participant whose eligibility has been canceled may reapply at any time after
the cancellation of eligibility and a new period under consideration shall be
established.
D. Scheduled
Redetermination. Except for children eligible as newborns of eligible individuals
the Department or its designee shall make a scheduled redetermination of a
child participant’s eligibility at least every 12 months.
The
requirements relating to hearings under COMAR 10.01.04 apply to this chapter.
The
requirements relating to fraud and abuse under COMAR 10.09.24.14 apply to this
chapter.
.14 Adjustments and
Recoveries.
The
requirements relating to adjustments and recoveries under COMAR 10.09.24.15,
except for COMAR 10.09.24.15A(1) and (2), apply to this chapter.
State
regulations shall be interpreted in conformity with applicable federal statutes
and regulations, except if the language of a specific regulation indicates an
intent by the Department to provide reimbursement for covered services to
Program participants without regard to the availability of federal financial
participation.
Subtitle 67 MARYLAND HEALTHCHOICE PROGRAM
10.67.01 Maryland Medicaid Managed Care Program: Definitions
Authority: Health-General Article, §§15-101 and 15-103(b), Annotated Code of Maryland
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
(1)—(29) (text unchanged)
(29-1) “CHIP Health Services Initiative” means services offered
to improve the health of low-income children pursuant to 5 U.S.C.
§2105(a)(1)(D)(ii) of the Social Security Act.
(30)—(160) (text unchanged)
(160-1) “Separate CHIP Program” means the program for targeted
low-income children established under Title XXI of the Social Security Act.
(161)—(182) (text unchanged)
10.67.02 Maryland Medicaid Managed Care Program: Eligibility and Enrollment
Authority: Health-General Article, §15-103(b)(3), (4), (6), (16), and (23) Annotated Code of Maryland
A. Criteria. Except as provided in §B of this regulation, a Program [recipient] participant shall be enrolled in the Maryland Medicaid Managed Care Program, described in this chapter, if the [recipient] participant is eligible for receipt of Medical Assistance benefits by qualifying:
(1) As categorically needy or medically needy under COMAR 10.09.24, unless the [recipient] participant is:
(a)—(d) (text unchanged)
(e) Otherwise certified for a period of less than [6] 9 months;
(2) For the Pregnant Women and Children’s Program on or after January 1, 1997, unless the [recipient] participant enters the Program during the postpartum period; [or]
(3) For the Maryland Children’s Health Program on or after July 1, 1998[.]; or
(4) For the Separate CHIP Program and CHIP Health Services
Initiative on or after July 1, 2023.
B. A [recipient] participant is not eligible for the Maryland Medicaid Managed Care Program if the [recipient] participant:
(1)—(7) (text unchanged)
LAURA HERRERA SCOTT
Secretary of Health
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.69 Maryland Medicaid Managed Care Program: Rare and Expensive Case Management
Authority: Health-General Article, §§15-102.1(b)(1) and 15-103(b)(4)(i), Annotated Code of Maryland
Notice of Proposed Action
[23-114-P]
The Secretary of Health proposes to amend Regulations .04, .14, and .17 under COMAR 10.09.69 Maryland Medicaid Managed
Care Program: Rare and Expensive Case Management.
Statement of Purpose
The purpose of this action is to:
(1) Clarify conditions for participant disenrollment from the Rare and Expensive Case Management (REM) program and when disenrollment takes effect;
(2) Effectuate a 4 percent rate increase for REM services provided in the FY 2023 budget; and
(3) Update the REM qualifying diagnoses in accordance with ICD-10, effective on October 1, 2022.
Estimate of Economic Impact
I. Summary of Economic Impact. The Fiscal Year (FY) 2023 budget includes a 4 percent rate increase for REM case management providers. The total impact for FY 2023 is $335,516.
II. Types of Economic Impact.
|
Impacted Entity |
Revenue (R+/R-) Expenditure (E+/E-) |
Magnitude |
|
A. On issuing agency: |
|
|
|
Maryland Department of Health |
(E+) |
$335,516 |
|
B. On other State agencies: |
NONE |
|
|
C. On local governments: |
NONE |
|
|
|
|
|
|
|
Benefit (+) Cost (-) |
Magnitude |
|
D. On regulated industries or trade groups: |
|
|
|
Maryland Medicaid providers |
(+) |
$335,516 |
|
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. This amount assumes:
(1) Estimated FY 2023 REM program costs are based on FY 2022 program expenditures. Utilization will remain consistent throughout FY 2023.
(2) Effective July 1, 2022, reimbursement rates for REM services will increase by 4 percent. This rate change represents an estimated $335,516 increase in total funds (47 percent general funds $157,693; 53 percent federal funds $177,823).
D. See A. above.
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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
.04 Participant Enrollment and Disenrollment.
A.—J. (text unchanged)
K. Department-Initiated Disenrollment. The Department shall
disenroll from REM an enrollee:
(1) Who has been continuously institutionalized for a period of
more than 90 successive days in a long-term care facility, subject to the
long-term care facility obtaining the Department’s determination that the
enrollee’s institutionalization has been medically necessary;
(2) Who has been, or is expected to be, continuously
institutionalized for more than 30 successive days in an institution for mental
disease (IMD);
(3) Upon admission to an intermediate care facility for
individuals with intellectual disabilities or persons with related conditions
(ICF/IID);
(4) Who loses Medicaid eligibility or who changes to an assistance
category not eligible for MCO enrollment, subject to COMAR 10.67.02;
(5) Who has died; or
(6) Who is an inmate of a public institution, including a State-operated
institution or facility.
L. Effective Date of Disenrollment. An enrollee’s disenrollment
shall take effect:
(1) Immediately when the enrollee dies;
(2) From the first day of the month following the month in which
the enrollee lost Medicaid eligibility;
(3) On the first day of the month following the month in which
the Department receives the required notification, when the enrollee
permanently relocates outside of the State; or
(4) From the first day of the month following the month in which
the Department verifies an enrollee is an inmate.
.14 Payment Procedures—Request for Payment.
A.—C. (text unchanged)
[D. Effective July 1, 2020, through December 31, 2020, the Department shall pay $428.71 for a case management assessment, as described in Regulation .05C of this chapter.
E. Effective July 1, 2020, through December 31, 2020, the Department shall make payments monthly for case management services at one of the rates specified below:
(1) Level of Care 1: $316.56;
(2) Level of Care 2: $188.66; or
(3) Level of Care 3: $99.58.]
[F.] D. [Effective] For dates of service from January 1, 2021, through June 30, 2022, the Department shall pay $445.86 for a case management assessment, as described in Regulation .05C of this chapter.
[G.] E. [Effective] For dates of service from January 1, 2021, through June 30, 2022, the Department shall make payments monthly for case management services at one of the rates specified below:
(1)—(3) (text unchanged)
F. Effective July 1, 2022, the Department shall pay $463.69 for
a case management assessment, as described in Regulation .05C of this chapter.
G. Effective July 1, 2022, the Department shall make payments
monthly for case management services at one of the rates specified below:
(1) Level of Care 1: $342.39;
(2) Level of Care 2: $204.07; or
(3) Level of Care 3: $107.70.
H. (text unchanged)
.17 Table of Rare and Expensive Disease Diagnosis.
|
ICD10 |
ICD 10 Description |
Age Limit |
|
B20—D67 |
(text unchanged) |
(text unchanged) |
|
[D68.0] |
[Von Willebrand’s disease] |
[0—64] |
|
D68.00 |
Von Willebrand disease, unspecified |
0—64 |
|
D68.01 |
Von Willebrand disease, type 1 |
0—64 |
|
D68.020 |
Von Willebrand disease, type 2A |
0—64 |
|
D68.021 |
Von Willebrand disease, type 2B |
0—64 |
|
D68.022 |
Von Willebrand disease, type 2M |
0—64 |
|
D68.023 |
Von Willebrand disease, type 2N |
0—64 |
|
D68.029 |
Von Willebrand disease, type 2, unspecified |
0—64 |
|
D68.03 |
Von Willebrand disease, type 3 |
0—64 |
|
D68.04 |
Acquired von Willebrand disease |
0—64 |
|
D68.09 |
Other von Willebrand disease |
0—64 |
|
D68.1—G71.02 |
(text unchanged) |
(text unchanged) |
|
G71.031 |
Autosomal dominant limb girdle muscular
dystrophy |
0—64 |
|
G71.032 |
Autosomal recessive limb girdle muscular
dystrophy due to calpain-3 dysfunction |
0—64 |
|
G71.033 |
Limb girdle muscular dystrophy due to
dysferlin dysfunction |
0—64 |
|
G71.0340 |
Limb girdle muscular dystrophy due to
sarcoglycan dysfunction, unspecified |
0—64 |
|
G71.0341 |
Limb girdle muscular dystrophy due to alpha
sarcoglycan dysfunction |
0—64 |
|
G71.0342 |
Limb girdle muscular dystrophy due to beta
sarcoglycan dysfunction |
0—64 |
|
G71.0349 |
Limb girdle muscular dystrophy due to other
sarcoglycan dysfunction |
0—64 |
|
G71.035 |
Limb girdle muscular dystrophy due to
anoctamin-5 dysfunction |
0—64 |
|
G71.038 |
Other limb girdle muscular dystrophy |
0—64 |
|
G71.039 |
Limb girdle muscular dystrophy, unspecified |
0—64 |
|
G71.09—Z99.2 |
(text unchanged) |
(text unchanged) |
LAURA
HERRERA SCOTT
Secretary of Health
Subtitle 41 BOARD OF EXAMINERS
FOR AUDIOLOGISTS, HEARING AID DISPENSERS, [AND] SPEECH-LANGUAGE PATHOLOGISTS, AND MUSIC THERAPISTS
Notice of Proposed Action
[23-138-P]
The Secretary of Health proposes to:
(1) Amend Regulations .01—.04 under COMAR 10.41.01 Collection of Fees;
(2) Amend Regulations .01, .02, and .04 under COMAR 10.41.02 Code of Ethics;
(3) Amend Regulations .02, .03, .05, and .06 under COMAR 10.41.03 Licensure and Continuing Education;
(4) Amend Regulations .01, .02, .06, and .08 under COMAR 10.41.04 Rules of Procedure for Board Hearings;
(5) Adopt new Regulations .01—.07 under a new chapter, COMAR 10.41.05 Music Therapy;
(6) Amend Regulations .01-1, .02, .06, .08, .11, and .12, and adopt new Regulation .14 under COMAR 10.41.08 Hearing Aid Dispensing;
(7) Amend Regulation .02 under COMAR 10.41.09 Civil Penalties;
(8) Amend Regulations .01, .02, and .05—.07, repeal existing Regulation .03, adopt new Regulation .04, amend and recodify existing Regulations .04, .08, and .09 to be .03, .09, and .10, respectively, and recodify existing Regulation .10 to be .08 under COMAR 10.41.11 Speech-Language Pathology Assistants and Audiology Assistants; and
(9) Amend Regulations .02 and .04 under COMAR 10.41.13 Sanctioning Guidelines.
This action was considered by the Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists at public meetings held on October 15, 2020, October 21, 2021, and March 17, 2022, notice of which was given by publication on the Board’s website at Pages - Board of Audiologists, Hearing Aid Dispensers & Speech-Language Pathologists (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) Add audiology assistants to this subtitle pursuant to Chs. 713 and 714, Acts of 2021;
(2) Add music therapists to this subtitle pursuant to Ch. 800, Acts of 2021;
(3) Provide a new fee for The Audiology and Speech-Language Pathology Interstate Compact pursuant to Ch. 158, Acts of 2021;
(4) Add a music therapists roster fee;
(5) Remove the incorrect term “temporary” speech-language pathology assistant license and replace it with the proper term of “limited” as set forth under Health Occupations Article, §2-310, Annotated Code of Maryland;
(6) Add cultural competence and non-discrimination language for licensees pursuant to Ch. 428, Acts of 2020;
(7) Update and clarify licensure requirements;
(8) Add a provision for new criminal history background checks every 6 years;
(9) Update and clarify continuing education requirements;
(10) Add license reactivation requirements to the regulations;
(11) Clarify and define testing procedures and standards for hearing aid dispensers;
(12) Update sanctions and penalties to remove obsolete categories; and
(13) Remove obsolete language throughout the subtitle.
Estimate of Economic Impact
I. Summary of Economic Impact. The new application and certification for the Certification Board of Music Therapists is expected to increase the Board’s revenue by $23,850.
II. Types of Economic Impact.
|
Impacted Entity |
Revenue (R+/R-) Expenditure (E+/E-) |
Magnitude |
|
A. On issuing agency: |
|
|
|
(1) Music therapist license |
(R+) |
$23,850 |
|
(2) Music therapists roster fee |
(R-) |
Indeterminable |
|
(3) Compact privilege |
(R+) |
Indeterminable |
|
(4) Audiology assistant license |
(R+) |
Indeterminable |
|
B. On other State agencies: |
NONE |
|
|
C. On local governments: |
NONE |
|
|
|
|
|
|
|
Benefit (+) Cost (-) |
Magnitude |
|
D. On regulated industries or trade groups: |
|
|
|
(1) Compact privilege |
(-) |
Indeterminable |
|
(2) Audiology assistant license |
(-) |
Indeterminable |
|
(3) Music therapists roster fee |
(-) |
Indeterminable |
|
(4) Music therapist license |
(-) |
$23,850 |
|
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(1). Due to the fact that licensure for music therapists has not existed previously, the applicant must first be certified with the Certification Board of Music Therapists. There are currently 159 certified music therapists in Maryland, and the Board projects that all 159 Therapists will apply for licensure. The licensing fee is $150, so $150 x 159 = $23,850.
(2). Music therapists are new to this Board, and there is no available data to reliably estimate the number of roster requests.
(3). The compact privilege is new to this Board, and there is no available data to reliably estimate the number of applications.
(4). Audiology assistants have never been licensed, so there is no available data to estimate how many individuals will apply for this credential.
D(1)—(3). See A(1)—(3).
(4). The currently certified music therapists have never paid licensing fees, so this will be a new cost for those licensees. The licensing fee is $150, so $150 x 159 = $23,850.
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 (TTY 800-735-2258), or email to mdh.regs@maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
10.41.01 Collection of Fees
Authority: Health Occupations Article, §§2-205 and 2-206, Annotated Code of Maryland
.01 Scope.
This chapter governs all persons licensed as audiologists, audiology assistants, hearing aid dispensers, speech-language pathologists, [or] speech-language pathology assistants, or music therapists in the State.
.02 Fees.
A. Application fee for full audiology, [or] speech-language pathology, or music therapy license ... $150
B.—G. (text unchanged)
H. Application fee for Audiology and Speech-Language Pathology
Interstate Compact (ASLP-IC) privileges … $100
[H.] I.—[K.] L. (text unchanged)
[L.] M. [Replacement] Physical copy of registration certificate ... $5
[M.] N. [Replacement] Physical copy of wall certificate ... $25
[N.] O. Application fee for full speech-language pathology assistant or audiology assistant license ... $100
[O.] P. Application fee for [temporary] limited speech-language pathology assistant license ... $100
[P.] Q. Biennial renewal of full speech-language pathology assistant or audiology assistant license fee ... $100
[Q.] R. Renewal of [temporary] limited speech-language pathology assistant license fee ... $25
[R.] S.—[V.] W. (text unchanged)
X. Music therapists roster fee … $55
[W.] Y. — [X.] Z. (text unchanged)
.03 Changes in Fees.
A. Fees are subject to change by action of the [Boards of Examiners] Board. All licensees and applicants will be notified of changes.
B. Application forms should be requested from[:] the Board of Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists [Maryland Department of Health, 4201 Patterson Avenue, Baltimore, MD 21215-2299].
.04 Fee Exceptions.
An audiologist, hearing aid dispenser, [or] speech-language pathologist, or music therapist who holds a current license is exempt from paying the license verification fee.
10.41.02 Code of Ethics
Authority: Health Occupations Article, §§1-212, 2-205, and 2-314, Annotated Code of Maryland
.01 Scope.
This chapter governs individuals licensed as audiologists, audiology assistants, hearing aid dispensers, speech-language pathologists, [or] speech-language pathology assistants, or music therapists in the State.
.02 Ethical Responsibilities.
A.—B. (text unchanged)
C. Professional Conduct.
(1)—(6) (text unchanged)
(7) Licensees may not refuse to treat based upon:
(a) Race;
(b) Religion;
(c) Color;
(d) Age;
(e) National origin;
(f) Marital status;
(g) Sexual orientation;
(h) Gender identity; or
(i) Disability.
D.—E. (text unchanged)
F. Sexual Misconduct.
(1) An audiologist, audiology assistant, hearing aid dispenser, speech-language pathologist, [or] speech-language pathology assistant, or music therapist may not engage in sexual misconduct in the practice of audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy.
(2) (text unchanged)
G. Penalties. Violation of Regulation .02 may result in Board action to reprimand the licensee, place the licensee on probation, or suspend or revoke the licensee’s license. The Board may also impose a penalty not exceeding [$1,000] $5,000.
.04 Special Responsibilities.
A.—D. (text unchanged)
E. [The licensee may not
discriminate on the basis of race,
religion, gender, age, national origin, sexual orientation, or handicapping
condition in] In the licensee’s professional relationships with colleagues or
individuals served professionally[.],
the licensee may not discriminate on the basis of:
(1) Race;
(2) Religion;
(3) Color;
(4) Age;
(5) National origin;
(6) Marital status;
(7) Sexual orientation;
(8) Gender identity; or
(9) Disability.
F.—G. (text unchanged)
H. The licensee shall [maintain]:
(1) Maintain adequate
records of professional services rendered and products dispensed, [and shall allow access to these
records when appropriately authorized.]
including:
(a) A full written report outlining all diagnostic results and
any recommendations;
(b) Daily therapy notes such as subjective, objective,
assessment, and plan (SOAP) log notes;
(c) License number on written client reports and evaluations;
(d) Progress reports; and
(e) All documents related to referrals; and
(2) Allow access to these records when appropriately authorized.
I.—L. (text unchanged)
10.41.03 Licensure and Continuing Education
Authority: Health Occupations Article, §§2-205, 2-302, 2-302.2,
2-304,
2-305, 2-308, 2-310, 2-310.2, 2-311(c), 2-312(b), 2-314(11), and 2-314.9,
Annotated Code of Maryland
.02 Definitions.
A. (text unchanged)
B. Terms Defined.
(1) (text unchanged)
(2) “Board” means the Board of Examiners for Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists.
(3)—(7) (text unchanged)
.03 [Requirements for] Licensure Requirements.
A. Limited Licensure.
(1) (text unchanged)
(2) An individual seeking limited licensure shall fulfill the following requirements:
(a)—(b) (text unchanged)
(c) Demonstrate oral English competency as follows:
(i) (text unchanged)
(ii) Achievement of a minimum score [as defined by the Board] of 105, with at least a 26 on Speaking and Listening, on the Test of English as a Foreign Language (TOEFL) within the 2 years preceding license application.
(3)—(4) (text unchanged)
B. Supervision of Professional Experience for Audiologists.
(1)—(3) (text unchanged)
(4) At least 80 percent of the applicant’s employment during the clinical training shall be in direct client contact, which includes:
(a) (text unchanged)
(b) Screening, response to intervention (RTI), or observations of clients;
(c) [Habilitation/rehabilitation;
and] Treatment, such as:
(i) Hearing device fitting;
(ii) Diagnostic assessment; and
(iii) Rehabilitation; and
(d) Activities related to client management[.], including:
(i) Writing reports and notes;
(ii) Billing;
(iii) Making rounds; and
(iv) Attendance at an individualized education program (IEP),
individualized family service plan (IFSP) meeting, or other meetings related to
the management of a client’s diagnosis and treatment plan.
(5)—(8) (text unchanged)
[(9) Individuals granted an audiology limited license before July 31, 2007:
(a) Are exempt from the on-site direct supervision and may follow the initial supervision plan submitted with the application for the limited license; and
(b) Shall follow the current hours per week, hours per period, or both, to complete the limited license, although the Board may review and determine if an exemption should be made on an individual basis.
(10) If a limited license is eligible to be renewed after September 30, 2007, the licensee is no longer exempt from any of the current standards.]
C. Supervision of [Professional Experience] Clinical Fellowship for Speech Pathologists.
(1)—(3) (text unchanged)
(4) At least 80 percent of the applicant’s employment during the clinical fellowship shall be in direct client contact, which includes:
(a) (text unchanged)
(b) Screening, response to intervention (RTI), or observations of clients;
(c) [Habilitation/rehabilitation;
and] Treatment, such as:
(i) Diagnostic assessment; and
(ii) Rehabilitation; and
(d) Activities related to client management[.], including:
(i) Writing reports and notes;
(ii) Billing;
(iii) Making rounds; and
(iv) Attendance at an individualized education program (IEP),
individualized family service plan (IFSP) meeting, or other meetings related to
the management of a client’s diagnosis and treatment plan.
(5) An individual serving as a supervisor:
(a)—(d) (text unchanged)
(e) Shall provide a minimum of [36 hours] 4 hours per month for at least 9 months of supervisory activities during the clinical fellowship to include a minimum of 2 hours of other monitoring activities each month.
(6)—(8) (text unchanged)
D. Full Licensure.
(1) Licensure Requirements for Audiologists.
(a)—(c) (text unchanged)
(d) The applicant shall demonstrate oral English competency as follows:
(i) (text unchanged)
(ii) Achievement of a minimum score [as defined by the Board] of 105, with at least a 26 on Speaking and Listening, on the Test of English as a Foreign Language (TOEFL) within the 2 years preceding license application.
(2)—(3) (text unchanged)
(4) Licensure Requirements for Speech-Language Pathologists.
(a)—(c) (text unchanged)
(d) The applicant shall demonstrate oral English competency as follows:
(i) (text unchanged)
(ii) Achievement of a minimum score [as defined by the Board] of 105, with at least a 26 on Speaking and Listening, the Test of English as a Foreign Language (TOEFL) within the 2 years preceding license application.
(5) (text unchanged)
.05 Renewal of Licensure.
A. (text unchanged)
B. Full Licensure.
(1) (text unchanged)
(2) The applicant for license renewal is required to [maintain]:
(a) Maintain evidence of
satisfactory completion of continuing education requirements[.]; and
(b) For an audiologist or hearing aid dispenser, submit proof of
calibration for each audiometer in use within the previous 12-month period.
(3) (text unchanged)
(4) A licensee shall undergo a new criminal records history
check as set forth in Health Occupations Article, §2-303.1, Annotated Code of
Maryland, every three renewal cycles or every 6 years.
C. (text unchanged)
D. If the Board determines that a licensee has practiced in this State after the license has expired, the Board may:
(1) (text unchanged)
(2) Take action as follows against a licensee for unprofessional conduct if it determines that the licensee practiced in this State after the license has expired:
[(a) Issue a nonpublic consent agreement in which the licensee agrees to make an anonymous donation of $250 to a charitable institution and to perform 40 hours of Board-approved pro bono services;]
[(b)] (a)—[(c)] (b) (text unchanged)
.06 Continuing Education.
A. Required Continuing Education Units.
(1) Within the 2-year renewal period immediately preceding the licensee’s application for renewal, the licensee shall earn 30 continuing education units (CEUs) as follows:
(a) A minimum of 20 CEUs in the area of licensure[; and] that includes a minimum of 1 CEU in each of the following
areas:
(i) Cultural competency; and
(ii) Ethics;
(b) No more than 10 CEUs in areas related to speech-language
pathology or audiology or both, including practice management[.],
that includes:
(i) Supervision;
(ii) Billing; and
(iii) Interdisciplinary collaboration; and
(c) Related training that does not include annual training
requirements for:
(i) Job orientation;
(ii) Job maintenance; or
(iii) Other general training or information related to human
health.
(2) It is recommended that a licensee applying for the renewal
of a license successfully complete, within the 2-year licensing period as a
part of the required 30 hours of Board-approved continuing education programs,
a minimum of 2 CEUs in the area of supervision.
[(2)] (3) Within the 2-year renewal period immediately preceding the licensee’s application for renewal, an individual licensed as both an audiologist and a speech-language pathologist shall earn 40 CEUs as follows:
(a) A minimum of 15 CEUs in each area of licensure[;
and] that includes a minimum
of 1 CEU in each of the following areas:
(i) Cultural competency; and
(ii) Ethics;
(b) No more than 10 CEUs in areas related to speech-language
pathology and audiology, including practice management[.], that includes:
(i) Supervision;
(ii) Billing; and
(iii) Interdisciplinary collaboration; and
(c) Related training that does not include annual training
requirements for:
(i) Job orientation;
(ii) Job maintenance; or
(iii) Other general training or information related to human
health.
(4) It is recommended that a licensee applying for the renewal
of a license successfully complete, within the 2-year licensing period as a
part of the required 30 hours of Board-approved continuing education programs,
a minimum of 2 CEUs in the area of supervision.
[(3)] (5) (text unchanged)
B. Time Period for CEUs.
(1) (text unchanged)
(2) A speech-language pathologist licensee shall complete the required CEUs within the 2-year period [ending December 31 of the year] immediately preceding the [renewal year] license expiration.
(3) An individual licensed as both an audiologist and a speech-language pathologist shall complete the required CEUs within the 2-year period [ending December 31st of the year] immediately preceding [renewal] the license expiration.
(4)—(9) (text unchanged)
C. Approval of Continuing Education Programs.
(1) (text unchanged)
(2) Providers of continuing education shall give a participant a certificate of completion which includes the following information:
(a) (text unchanged)
(b) [Description of program] Course title;
(c)—(e) (text unchanged)
(3) Not later than 30 days before a program, a provider of continuing education shall submit to the Board a [request]:
(a) Request for [prior] approval of the program[.], using the form available on the Board’s website; and
(b) Biography for each course presenter.
(4) Individual Approval of Program.
(a) If a provider has not requested prior approval of a program, a licensee may apply to the Board for approval of continuing education units for the program, using the approved form available on the Board’s website.
(b) Not later than 30 days [before] after a program, the licensee shall submit to the Board a request for approval of continuing education units for individual participation, using the approved form available on the Board’s website.
(c) (text unchanged)
(5) The following are examples of areas in which CEUs may be earned in activities concerning speech-language pathology and audiology:
(a) Academic course work in areas of speech-language pathology or
audiology, or both, or related disciplines, taken at accredited colleges or
universities where, along with the
submission of an unofficial transcript and course description:
(i) 15 CEU credit hours will be awarded for each 3 credit course
earned;
(ii) 10 CEU credit hours will be awarded for each 2 credit
course earned; or
(iii) 5 CEU credit hours will be awarded for each 1 credit
course earned;
(b) (text unchanged)
(c) [Presentation or
attendance] Attendance at lectures, workshops, or [inservice] in-service programs;
(d) Other professional activities such as presentations, books, papers, or publications, [or audiovisual materials; or] where:
(i) 1 hour of CEU credit may be earned by the presenter for each
hour of presentation of a program, with a maximum of 3 CEUs;
(ii) 10 hours of CEU credit may be earned for a professional or
scientific paper prepared by the licensee or certificate holder, with a maximum
per paper of 10 CEUs for the first author, 8 CEUs for the second author, 6 CEUs
for the third author, and 4 CEUs for all other authors;
(iii) Authoring of a book chapter may earn a maximum of 10 CEUs,
only in the year of publication; and
(iv) Editing or reviewing of a scientific or professional
journal recognized by the Board, with a maximum of 8 CEUs for each year of
service; or
(e) (text unchanged)
(6) (text unchanged)
(7) Pro Bono Work.
(a) CEUs may be earned for pro bono work performed outside of a place of employment at the rate of 1 Maryland CEU [for every 8 hours] per hour of Board-approved CEU activity, up to a maximum of [3] 10 CEU credits in any single 2-year period.
(b)—(e) (text unchanged)
D. Documentation of CEUs.
(1) A licensee shall submit a signed form to the Board via mail or by electronic means attesting to the licensee’s completion of the required CEUs at the time of license renewal.
(2)—(4) (text unchanged)
E. Continuing Education Audit Procedures.
(1)—(3) (text unchanged)
(4) The licensee being audited shall submit to the Board [a report] official certificates or transcripts via mail or by electronic means showing evidence of the continuing education hours required for renewal [on a form approved by the Board along with the appropriate documentation] by the date indicated on the audit notification.
(5) [If a licensee
submits a false statement of continuing education the] The Board may take
formal disciplinary action against the licensee[.], if the licensee:
(a) Submits a false statement of continuing education; or
(b) Fails to submit the required documents by the date indicated
on an audit notification.
F. Reactivation.
(1) If a license has been in an inactive status for no more than
three 2-year renewal cycles of inactivity, the licensee may apply for
reactivation of the inactive license.
(2) The Board shall reactivate the license if the
speech-pathologist or audiologist:
(a) Submits to the Board satisfactory proof of completion of at
least 30 hours of CEU activity for every 2-year cycle of inactivity; and
(b) Pays to the Board the renewal fee and the reactivation fee
set by the Board.
[F.] G. Reinstatement Requirement.
(1) (text unchanged)
(2) The Board shall reinstate the license if the speech-language pathologist or audiologist:
(a) Submits to the Board satisfactory proof of completion of [continuing education hours required of a practitioner on active status during the period] at least 30 hours of CEU activity for every 2-year cycle of inactivity; and
(b) (text unchanged)
[G.] H. Reapplication Requirement.
(1) (text unchanged)
(2) The speech-language pathologist or audiologist whose license has been expired for more than 5 years may become licensed if the speech-language pathologist or audiologist:
(a) (text unchanged)
(b) Submits to the Board satisfactory proof of completion of [continuing education hours required of a practitioner on active status during the period] at least 30 hours of CEU activity for every 2-year cycle of inactivity, not to exceed 100 hours; and
(c) (text unchanged)
10.41.04 Rules of Procedure for Board Hearings
Authority: Health Occupations Article, §§2-205, 2-313, and 2-315; State Government Article §10-206; Annotated Code of Maryland
.01 Scope.
This chapter governs procedures for disciplinary matters and hearings before the State Board of Examiners for Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists.
.02 Definitions.
A. (text unchanged)
B. Terms Defined.
(1)—(3) (text unchanged)
(4) “Board” means the State Board of Examiners for Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists.
(5)—(6) (text unchanged)
(7) “Cease and desist letter” means an informal action consisting of a nonpublic letter issued by the Board ordering:
(a) (text unchanged)
(b) An unlicensed individual to cease the unauthorized practice of audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy.
(8) “Charging document” means a nonpublic document issued by the Board which:
(a) Alleges conduct by a licensee which the Board believes constitutes a violation under the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act;
(b) Sets forth provisions of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act that the Board believes were violated; and
(c) (text unchanged)
(9) “Complaint” means a written allegation or other information received by the Board that a licensee may have violated the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act and which may be grounds for an investigation or disciplinary action by the Board.
(10)—(15) (text unchanged)
(16) “Investigation” means the gathering of information to assist the Board in determining if there is reasonable cause to charge a licensee with a violation of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act.
(17) Letter of Admonishment.
(a) “Letter of admonishment” means informal action consisting of a nonpublic letter issued by the Board closing a case, if the Board believes a licensee has engaged in conduct that violates the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act, admonishing the licensee not to repeat the conduct.
(b) (text unchanged)
(18) “Letter of education” means informal action consisting of a nonpublic letter to a licensee:
(a) Issued by the Board if the Board does not believe that conduct rose to the level of a violation of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act; and
(b) In which the Board educates the licensee concerning the laws and standards of the practice of audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy.
(19) Letter of Surrender.
(a) “Letter of surrender” means a public letter accepted by the Board in which the licensee agrees to surrender the license to practice audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy.
(b) (text unchanged)
(20) “Licensure” means permission to engage in the practice of audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy which is evidenced by a license issued by the Board.
(21) “Maryland Audiologists, Hearing Aid Dispensers, [and] Speech Language Pathologists, and Music Therapists Act” means Health Occupations Article, Title 2, Annotated Code of Maryland.
(22)—(24) (text unchanged)
(25) “Preliminary investigation” means the gathering of information to be used by the Board to determine if the Board should dismiss a complaint or conduct further investigation to determine if there is reasonable cause to charge a licensee with a violation of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act.
(26) (text unchanged)
(27) “Prohibited act” means conduct specified in the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act which may result in sanctions or penalties.
(28)—(30) (text unchanged)
(31) “Respondent” means a licensee, subject to the jurisdiction of the Board, that has been:
(a) Given notice to answer allegations concerning violations of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act;
(b)—(c) (text unchanged)
(32) “Revocation” means the removal of an audiologist’s, hearing aid dispenser’s, [or] speech-language pathologist’s, or music therapist’s license to practice audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy.
(33)—(36) (text unchanged)
(37) “Surrender” means the voluntary relinquishing of a license to practice audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy that may be subject to certain conditions set by the Board.
(38)—(39) (text unchanged)
.06 Sanctions, Hearings, and Final Order.
A. Surrender of License.
(1) The Board may require conditions for surrender of a license, including:
(a) An admission of a violation of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act;
(b)—(f) (text unchanged)
(2) (text unchanged)
B. (text unchanged)
C. Burden of Proof.
(1) (text unchanged)
(2) The administrative prosecutor has the burden to demonstrate by a preponderance of the evidence that the licensee has committed a violation or violations of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act.
D. (text unchanged)
E. Board Final Decision and Order.
(1) (text unchanged)
(2) Upon a finding that there has been a violation of the Maryland Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists Act, the Board may order that the licensee be fined, reprimanded, placed on probation, or the license suspended or revoked.
.08 Probation and Violation of Probation Proceedings.
A. If the Board imposes a period of probation as a sanction, the Board may impose conditions of probation which the Board considers appropriate, including but not limited to:
(1)—(2) (text unchanged)
(3) Providing free audiology, hearing aid dispensing, [or] speech-language pathology, or music therapy services in a Board-approved program;
(4)—(11) (text unchanged)
B.—G. (text unchanged)
10.41.05 Music Therapy
Authority: Health Occupations Article, §§2-101, 2-201, 2-202(a),
2-206(a) and (d)(2), 2-501, and 2-4A-01—2-4A-25, Annotated Code of Maryland
.01 Scope.
This chapter governs all persons licensed as music therapists in
the State.
.02 Definitions.
A. In this chapter, the following terms have the meanings
indicated.
B. Terms Defined.
(1) “Board” means the State Board of Examiners for Audiologists,
Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists.
(2) “CBMT-certified” means a music therapist who:
(a) Is currently certified by the Certification Board for Music
Therapists; and
(b) Has completed the educational and clinical training
requirements established by the American Music Therapy Association.
(3) “Individualized music therapy treatment plan” means a music
therapy treatment plan for a client that identifies the goals, objectives, and
potential strategies for the music therapy services appropriate for the client
using music therapy interventions, including:
(a) Music improvisation;
(b) Receptive music listening;
(c) Songwriting;
(d) Lyric discussion;
(e) Music and imagery;
(f) Music performance;
(g) Learning through music; and
(h) Movement to music.
(4) “Licensed professional music therapist” means an individual
who is licensed by the Board to engage in the practice of music therapy.
(5) “Practice of music therapy” has the meaning stated in Health
Occupations Article, §2-4A-01, Annotated Code of Maryland.
.03 Licensure
Requirements.
A. To qualify for a license, an applicant shall be an individual
who meets the requirements of this chapter.
B. The applicant shall:
(1) Be of good moral character;
(2) Be at least 18 years old;
(3) Be a CBMT-certified music therapist;
(4) Provide proof of:
(a) Passing the examination for certification offered by the
Certification Board for Music Therapists (CBMT) or any successor organization
approved by the Board; or
(b) Being transitioned into Board licensure and that the
applicant is currently a CBMT-certified music therapist;
(5) Hold a bachelor’s degree or higher in music therapy, or its
equivalent, including clinical training, from an educational program that is:
(a) Approved by the American Music Therapy Association or any
successor organization; and
(b) Within an accredited college or university;
(6) Be in good standing based on a review of the applicant’s
music therapy licensure, certification, or registration history in other
jurisdictions, including a review of any disciplinary actions in the practice
of music therapy; and
(7) Meet any other requirements established by the Board.
C. To apply for a license, an applicant shall:
(1) Submit an application to the Board on the form that the
Board requires;
(2) Pay to the Board the application fee set by the Board; and
(3) Submit to a criminal history records check in accordance
with Health Occupations Article, §2–303.1, Annotated Code of Maryland.
D. The Board shall issue a license to any applicant who meets
the requirements of:
(1) Health Occupations Article, Title 2, Subtitle 4A, Annotated
Code of Maryland; or
(2) §C of this regulation and provides evidence satisfactory to
the Board that the applicant is licensed and in good standing as a music
therapist in another jurisdiction where the qualifications required are equal
to or greater than those required in this subtitle.
E. The Board shall include on each license that the Board
issues:
(1) The full name of the licensed music therapist;
(2) The dates of issuance and expiration; and
(3) A license number.
F. A music therapist license authorizes the licensee to engage
in the practice of music therapy while the license is effective.
.04 Renewal of
Licensure.
A. A license expires on a date set by the Board unless the
license is renewed for an additional term as set forth under §D of this
regulation.
B. A license may not be renewed for a term longer than 2 years.
C. At least 1 month before a license expires, the Board shall
send to the licensee, by first-class mail or email to the last known address of
the licensee, a renewal notice that states the:
(1) Expiration date;
(2) Due date by which the renewal application shall be received
by the Board for the renewal to be issued and mailed before the license
expires; and
(3) Amount of the renewal fee.
D. Before a license expires, the licensee periodically may renew
the license for an additional term if the licensee:
(1) Otherwise is entitled to be licensed;
(2) Pays to the Board a renewal fee set by the Board; and
(3) Submits to the Board:
(a) A renewal application on the form that the Board requires;
and
(b) Satisfactory evidence of compliance with any continuing
education requirements established by the Board under Regulation .05 of this
chapter.
E. A licensee shall undergo a new criminal records history check
as set forth in Health Occupations Article, §2-303.1, Annotated Code of
Maryland, every three renewal cycles or every 6 years.
.05 Continuing Education
Requirements.
A. The continuing education
requirements shall include proof of completion of at least 40 hours of
continuing education in a program approved by CBMT or any successor
organization approved by the Board that includes:
(1) A minimum of 1 CEU in the area of cultural competency;
(2) A minimum of 1 CEU in the area of ethics;
(3) Supervision;
(4) Billing;
(5) Interdisciplinary collaboration; and
(6) Related training that does not include annual training
requirements for:
(a) Job orientation;
(b) Job maintenance; or
(c) Other general training or information related to human
health.
B. It is recommended that a licensee applying for the renewal of
a license successfully complete, within the 2-year licensing period as a part
of the required 40 hours of Board-approved continuing education programs, a
minimum of 2 CEUs in the area of supervision.
C. The Board shall renew the license of each licensee who meets
the requirements of Regulations .04 and .05 of this chapter.
.06 Inactive Status,
Reactivation, Reinstatement, and Reapplication.
A. Inactive Status.
(1) The Board shall place a licensee on inactive status if the
licensee submits to the Board:
(a) An application for inactive status on the form that the
Board requires; and
(b) The inactive status fee set by the Board.
(2) The Board shall license an individual on inactive status who
applies for a license if the individual meets:
(a) The renewal requirements of Health Occupations Article,
§2–4A–10, Annotated Code of Maryland; and
(b) Any continuing education requirements established by the
Board.
(3) The Board may not require
payment of a late fee by an individual as a condition to licensing set forth
under §B of this regulation.
B. Reactivation.
(1) If a license has been in
an inactive status for no more than two 2-year renewal cycles of inactivity,
the licensee may apply for reactivation of the inactive license.
(2) The Board shall
reactivate the license if the music therapist:
(a) Submits to the Board satisfactory proof of completion of at
least 40 hours of CEU activity, in a program approved by CBMT or any successor
organization, for every 2-year cycle of inactivity; and
(b) Pays to the Board the renewal fee and the reactivation fee
set by the Board.
C. Reinstatement.
(1) If a license has been expired for 5 years or less, a music
therapist may apply for reinstatement of the expired license.
(2) The Board shall reinstate the license if the music
therapist:
(a) Submits to the Board satisfactory proof of completion of
continuing education hours required of a music therapist on active status
during the period of inactivity; and
(b) Pays to the Board the renewal fee and the reinstatement fee
set by the Board.
D. Reapplication.
(1) The Board may not reinstate the license of a music therapist
who fails to apply for reinstatement of the license within 5 years after the
license expires.
(2) The music therapist whose license has been expired for more
than 5 years may become licensed if the music therapist:
(a) Meets the current requirements for obtaining a license;
(b) Submits to the Board satisfactory proof of completion of
continuing education hours required of a music therapist on active status
during the period of inactivity; and
(c) Pays to the Board the application fee set by the Board.
.07 Licensee
Responsibilities.
A. A licensee shall notify the Board in writing of a change of:
(1) Mailing address within 30 days after the change;
(2) Name within 30 days after the change; or
(3) Email address within 30 days after the change if the
licensee has previously submitted an email address to the Board.
B. A licensee who fails to comply with the requirements of this
regulation may be subject to disciplinary action.
10.41.08 Hearing Aid [Dispensers] Dispensing
Authority: Health Occupations Article, §§2-101(d), 2-205, 2-302.1,
2-304,
2-308, 2-310.1, 2-311(c), 2-311—2-314.8, 2-314(10) and (11), and 2-314.9,
Annotated Code of Maryland
.01-1 Definitions.
A. (text unchanged)
B. Terms Defined.
(1) (text unchanged)
(2) “Locked,
nonproprietary programming software” means software that any provider can
render inaccessible to other hearing aid programmers.
[(2)] (3) (text unchanged)
(4) “Proprietary
programming software” means software that is:
(a) Used to
program hearing aids that is supplied by a hearing aid distributor or
manufacturer for the exclusive use by affiliated providers; and
(b) Locked and
inaccessible to nonaffiliated providers.
.02 Application for License.
A.—E. (text unchanged)
F. The Board shall include in the application for a limited license the following statement: “I do hereby affirm, under penalty of perjury, that I am the holder of a valid unrevoked, unsuspended license issued by the Maryland Board of Examiners for Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists and that I have read the above excerpts, and that I fully understand my responsibilities as supervisor for the applicant who will work and train under my supervision and for whose technical training and ethical conduct I am to be responsible. I further affirm that I have read the application of the above-named person and that to the best of my knowledge all answers are true and correct.”
G.—H. (text unchanged)
I. The applicant shall demonstrate oral English competency as follows:
(1) (text unchanged)
(2) Achievement of a minimum score [as defined by the Board] of 105, with at least a 26 on Speaking and Listening, on the Test of English as a Foreign Language (TOEFL) within the 2 years preceding license application.
J.—K. (text unchanged)
.06 Practice of Limited Licensee.
A. (text unchanged)
B. On obtaining a limited license, the holder of a limited license shall engage in the practice of fitting and dispensing hearing aids for 20 consecutive days under the direct and continuous supervision of a licensee. The licensee shall provide direct supervision subsequently for a minimum of [20] 40 hours per month for at least 6 months.
C. The supervising hearing aid dispenser shall be immediately
available and physically on-site.
[C.] D.—[I.] J. (text unchanged)
[J.] K. The supervisor of a limited licensee:
(1) (text unchanged)
(2) Shall conduct all required direct and continuous supervision
as defined in §B of this regulation, at a Maryland hearing aid dispensing
practice only;
[(2)] (3)—[(5)] (6) (text unchanged)
.08 Testing Procedures.
A. (text unchanged)
B. The licensee or holder of a limited license shall perform the following minimum testing procedures on each client [seen] evaluated prior to the fitting of a hearing aid or hearing aids:
(1) [Air conduction tests
at frequencies of 500-1,000-2,000-4,000 hertz,] Pure tone air conduction thresholds at 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz, including [appropriate] masking as needed, if
the threshold [of the second ear
tested appears to differ by 30
decibels at any one frequency from those of the first ear; and] between the ears differs, at any frequency, by:
(a) 40 decibels when using supra aural headphones;
(b) 60 decibels when using insert earphones, properly inserted;
or
(c) Inter-octave frequencies that shall be tested if there is a
difference of 15dB or greater between octave frequencies as specified under
§B(1)(a) and (b) of this regulation;
(2) [Bone conduction tests at frequencies of
500-1,000-2,000-4,000 hertz, including appropriate masking, if there is a
greater than 10 decibel difference in the bone readings of one ear over the
other.] Pure tone bone conduction thresholds, including masking as needed, at
500 Hz, 1000 Hz, 2000 Hz, and 4000Hz; and
(3) Word recognition scores obtained using recorded word lists
or monitored live voice. Presentation level shall be at least 40dB above speech
recognition threshold or at least 5dB above the threshold at 2000Hz, or both,
if within level of tolerance.
C. The use of speech stimuli, such as speech in noise testing, is recommended before and [during] after the fitting of the hearing aid.
D. The use of probe microphone measurements are recommended to
verify the audibility of speech at 50dB, 65dB, and 80dB input levels as well as
MPO measurements to avoid damage to the peripheral auditory system and check
comfort of the hearing aid users.
[D.] E. The hearing aid dispenser shall [maintain]:
(1) Maintain and retain all test results as part of a client’s record. Part or all of the tests may be performed by an otologist or clinical audiologist, but [copies of the tests given] the test may not be more than 6 months old[. The hearing aid dispenser shall retain the test results in the client’s record.] for the use of a hearing device fitting; and
(2) Provide to the client a copy of all:
(a) Test results;
(b) Recommendations; and
(c) Referrals.
[E.] F. (text unchanged)
[F.] G. Before fitting or selling a hearing aid to a potential client, the licensee shall refer the client to a physician, preferably one specializing in the diseases of the ear, if the licensee determines that the client has any of the following conditions:
(1)—(4) (text unchanged)
(5) Pain, discomfort, foreign body/material, or active drainage
in the ear;
[(5)] (6) Air-bone gap in
excess of 15 decibels on more than one frequency; [or]
(7) Evidence of congenital or traumatic deformity of the ear,
not previously evaluated;
(8) Unilateral or asymmetrical hearing loss with a difference of
greater than 15dB pure tone average between ears, or asymmetry greater than
15dB at 2 or more frequencies; or
[(6)] (9) (text unchanged)
.11 Continuing Education Requirements.
A. A licensee applying for renewal of a license shall have successfully completed, within the 2-year licensing period, a total of 30 hours of Board-approved continuing education programs. Of the 30 hours, the licensee shall complete:
(1) 26 or more hours of instruction directly relating to the practice of fitting hearing aids, including the:
(a)—(b) (text unchanged)
(c) Psychology of the hearing impaired; [and]
(2) Not more than:
(a) (text unchanged)
(b) 5 hours of continuing education credit in a single continuing education cycle by attending regularly scheduled Board meetings where 1 hour of an open session at a Board meeting equals 1 hour of continuing education credit[.];
(3) A minimum of 1 CEU in the area of cultural competency; and
(4) A minimum of 1 CEU in the area of ethics.
B. It is recommended that a licensee applying for the renewal of
a license successfully complete, within the 2-year licensing period as a part
of required 30 hours of Board-approved continuing education programs a minimum
of 2 CEUs in the area of supervision.
[B.] C.—[C.] D. (text unchanged)
[D.] E. First-Time Renewal of License.
(1) Continuing education units shall be prorated for:
(a) (text unchanged)
(b) Newly licensed individuals; and
(c) Individuals seeking reinstatement[; and
(d) Individuals who have been licensed in another state and are seeking licensure in Maryland].
(2) The Board shall waive all continuing education requirements for a licensee obtaining full licensure within the last 6 months [of the beginning] of the renewal cycle.
[E.] F. (text unchanged)
.12 Renewal of Licensure.
A. A licensee shall undergo a new criminal records history check
as set forth in Health Occupations Article, §2-303.1, Annotated Code of
Maryland, every three renewal cycles or every 6 years.
[A.] B.—[B.] C. (text unchanged)
.14 Sale of Hearing Aid Software Guidelines.
A. To the extent not inconsistent with federal law, a licensee shall,
before the consummation of a sale of a hearing aid that uses proprietary
programming software or locked, nonproprietary programming software, provide
the purchaser with a written notice that:
(1) States, “The
hearing aid being purchased uses proprietary or locked programming software and
can only be serviced or programmed at specific facilities or locations.”;
(2) Shall be
signed by the purchaser before the sale; and
(3) Includes a
copy that is kept and maintained by the licensee.
B. To the
extent not inconsistent with federal law, a licensee shall, upon the
consummation of a sale of a hearing aid, deliver to the purchaser a written
receipt, signed by or on behalf of the licensee, containing all of the
following:
(1) The date of consummation of the sale;
(2) Specifications as to the make, serial number, and model
number of the hearing aid or aids sold;
(3) The address of the principal place of business of the
licensee, and the address and office hours at which the licensee shall be
available for fitting or post-fitting adjustments and servicing of the hearing
aid or aids sold;
(4) A statement to the effect
that the aid or aids delivered to the purchaser are used or reconditioned, as
the case may be, if that is the fact;
(5) The number of the licensee’s license and the name and
license number of any other hearing aid dispenser, temporary licensee, or
trainee licensee, who provided any recommendation or consultation regarding the
purchase of the hearing aid; and
(6) The terms of any guarantee or written warranty, as required
by federal law or regulations, made to the purchaser with respect to the
hearing aid or hearing aids.
10.41.09 Civil Penalties
Authority: Health Occupations Article, §§2-205, 2-314.9, and 2-315, Annotated Code of Maryland
.02 Definitions.
A. (text unchanged)
B. Terms Defined.
(1) “Board” means Board of Examiners for Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists.
(2) “Licensee” means an individual licensed by the Board to practice audiology, hearing aid dispensing, [or] speech-language pathology, music therapy, or assists in the practice of speech-language pathology or audiology.
(3) (text unchanged)
10.41.11 Speech-Language Pathology Assistants and Audiology Assistants
Authority: Health Occupations Article, §§2-101, 2-102, 2-205, 2-308,
2-311(c), 2-312(b), [2-314(10) and (11)] 2-314, [and] 2-319, 2-3A 01—
2-3A-07, 2-401, 2-402.4, and 2-406, Annotated Code of Maryland
.01 Definitions.
A. (text unchanged)
B. Terms Defined.
(1) “Audiology assistant” means an individual who:
(a) Meets the minimum qualifications established under:
(i) Health Occupations Article, Title 2, Subtitle 3A, Annotated
Code of Maryland; and
(ii) This chapter;
(b) Does not work independently; and
(c) Works under the general supervision of an audiologist
licensed under Health Occupations Article, Title 2, Annotated Code of Maryland.
[(1)] (2) “Board” means the State Board of Examiners for Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists.
[(2)] (3)—[(3)] (4) (text unchanged)
[(4)] (5) “Delegation agreement” means an agreement between a speech-language pathology assistant or an audiology assistant and a supervising speech-language pathologist or audiologist which identifies the supervising speech-language pathologist or audiologist and the facility at which the speech-language pathology assistant or the audiology assistant will be practicing.
[(5)] (6) “Direct supervision” means on-site, in-view, observation and guidance by a supervising speech-language pathologist or audiologist while on an assigned activity.
(7) “General supervision” means the supervision of a licensed
audiology assistant by a licensed audiologist who may or may not be present
when the licensed audiology assistant assists in the practice of audiology.
[(6)] (8) “Indirect supervision” means those activities other than direct observation and guidance conducted by a supervising speech-language pathologist or audiologist including, but not limited to:
(a)—(c) (text unchanged)
[(7)] (9)—[(9)] (11) (text unchanged)
.02 Speech-Language Pathology Assistant License Requirements.
A. The Board shall issue a speech-language pathology assistant license to an applicant who:
(1) Meets the following qualifications:
(a) Has completed the educational requirements in [Regulation .03A of this chapter] §C of this regulation;
(b) Has completed the clinical hours requirements in [Regulation .03B of this chapter] §D of this regulation;
(c) (text unchanged)
(d) Has completed a period of not less than 9 months of supervised practice as specified in Regulation [.03C] .03B of this chapter; and
(e) (text unchanged)
(2) (text unchanged)
B. (text unchanged)
C. Academic Curriculum Requirements.
(1) A speech-language pathology assistant shall demonstrate
completion of one of the following requirements, unless a request for an
exception based on extenuating circumstances, with documented continuing education during the previous 5 years
is approved by the Board:
(a) An associate’s
degree from an approved program for speech-language pathology assistants at an
accredited institution;
(b) An associate’s degree or higher in an allied health field
from an accredited institution with minimum course work that includes at least
3 credit hours in each of the following areas:
(i) Language acquisition and usage throughout the lifespan;
(ii) Speech disorders;
(iii) Anatomy and physiology of speech systems;
(iv) Language disorders, including pragmatics; and
(v) Phonology;
or
(c) A
baccalaureate degree in speech-language pathology or communication science
disorders from an accredited institution.
(2) The Board shall accept only an official transcript that
demonstrates course work completed with a grade of at least a “C” taken for
credit.
(3) Academic course titles which are not self-explanatory shall
be substantiated through course descriptions in official school catalogs or
bulletins, or by other official means.
(4) Degrees or course work, or both, received at foreign
universities are acceptable only if the course work and clinical practicum
hours can be demonstrated, at the applicant’s expense, to meet the requirements
of this section.
D. Clinical Hours Requirements.
(1) A speech-language pathology assistant shall demonstrate at
the time of application for licensure:
(a) Completion of at least 25 hours of clinical observation and
75 hours of clinical assisting experience in an associate’s program; or
(b) 25 observation and 75 clinical practice hours as a
speech-language pathology student in a bachelor’s or master’s program obtained
within an educational institution or in one of the educational institution’s
cooperating programs.
(2) Alternative Method for Completion of Clinical Hours.
(a) If an applicant has not obtained the hours required in §D(1)
of this regulation, the applicant may file with the Board a written plan for an
alternative method to obtain the hours which shall include:
(i) A plan for the clinical observation, or clinical assisting
experience, or both, designed and signed by the supervising speech-language
pathologist;
(ii) Further information or revisions as requested by the Board;
(iii) An application for limited licensure; and
(iv) The fee for limited licensure.
(b) The plan for obtaining the 75 hours of clinical assistance
shall include 100 percent direct supervision by the supervising speech-language
pathologist of the speech-language pathologist assistant during any client
contact hours.
(c) The Board shall approve the plan and issue the limited
license before any clinical observation or clinical assisting experience may be
obtained.
(d) The limited licensee shall then complete the hours in
accordance with the Board-approved plan within 60 days.
(e) If the Board does not receive proof of successful completion
of the hours by the end of 90 days, the limited assistant license is void and
the speech-language pathology assistant may reapply.
[.04] .03 [Issuance of] Speech-Language Pathology Assistant Limited License.
A. (text unchanged)
B. [A speech-language pathology assistant shall complete a delegation agreement for each supervising speech-language pathologist.] Supervised Practice Requirements.
(1) A speech-language pathology assistant shall have a limited
license from the Board before beginning supervised practice.
(2) The Board shall issue a limited license to practice as a
speech-language pathology assistant to an applicant who:
(a) Is of good moral character;
(b) Meets the qualifications indicated in Regulation .02A of
this chapter and:
(i) Has completed the requirements of Regulation .02D(1) of this
chapter; or
(ii) Has submitted a plan approved by the Board as provided in
Regulation .02D(2) of this chapter;
(c) Submits the completed application and fee to the Board; and
(d) Submits a delegation agreement to the Board for each
supervising speech-language pathologist.
(3) During the period of limited licensure, the speech-language
pathology assistant shall:
(a) Practice only under the supervision of:
(i) A fully licensed speech-language pathologist; or
(ii) In an exempt setting, an individual who holds a Certificate
of Clinical Competence in speech-language pathology from the American
Speech-Language-Hearing Association;
(b) Demonstrate completion, within the first 60 days, under
direct supervision as documented by the supervising speech-language pathologist
of:
(i) At least 25 hours of clinical observation earned during the
educational training or on the job, or both; and
(ii) A cumulative total of 75 hours of clinical assistance
earned during the educational training or on the job, or both; and
(c) Practice a minimum of 9 months under a limited license.
(4) The limited license shall expire 12 months after its
effective date.
(5) The supervising speech-language pathologist shall ensure
that the speech-language pathology assistant demonstrates successful completion
of the Board’s competency skills checklist.
(6) The speech-language pathology assistant shall submit the
completed competency skills checklist to the Board at least 60 days before the
limited license expiration date.
.04 Audiology Assistant
License Requirements.
A. The Board shall issue an audiology assistant license to an
applicant who:
(1) Meets the following qualifications:
(a) Holds a high school diploma or equivalent degree such as a
GED from an accredited institution;
(b) Is of good moral character;
(c) Demonstrates oral competency;
(d) Submits a criminal history records check in accordance with
Health Occupations Article, §2-303.1, Annotated Code of Maryland;
(e) Submits an application to the Board on the form that the
Board requires; and
(f) Pays the application fee set by the Board; or
(2) Meets the qualifications for waiver of requirements in
Regulation .05 of this chapter.
B. Incomplete Applications.
(1) If an incomplete application is submitted to the Board, the
Board shall notify the applicant within 30 days after receipt of an incomplete
application of the materials that are required.
(2) An application is not complete until all required material,
including the application fee and supporting documentation, is received by the
Board.
(3) If the applicant fails to provide the required documentation
within 1 year of receipt of the initial receipt, the Board may administratively
close the application.
(4) An applicant whose application is administratively closed
may reapply and submit with the new application proof of compliance with:
(a) This subtitle; and
(b) Health Occupations Article, Title 2, Annotated Code of
Maryland.
C. Academic Curriculum Requirement. An audiology assistant shall
provide proof of completion of a high school diploma or higher.
D. An audiology assistant:
(1) May not work independently; and
(2) Works under the general supervision of a licensed
audiologist.
.05 Waiver of Requirements [— Speech-Language Pathology Assistants].
A. The Board may waive the qualifications required for a license to practice as a speech-language pathology assistant or an audiology assistant under this chapter for an individual who:
(1)—(2) (text unchanged)
(3) Has been working as [a]:
(a) A speech-language
pathology assistant [for at least 2
years;] prior to October 1, 2007; or
(b) An audiology assistant prior to October 1, 2022;
(4) Has completed the educational requirements in [Regulation .03A] Regulations .02C and .04C of this chapter;
(5)—(6) (text unchanged)
B. The Board may waive any of the qualifications required for a license to practice as a speech-language pathology assistant or an audiology assistant under this chapter for an individual who:
(1) Holds a valid registration as a speech-language pathology assistant or an audiology assistant from the American Speech-Language-Hearing Association;
(2) Holds a valid license, certification, or registration as a speech language pathology assistant or an audiology assistant in another state whose qualifications for a speech-language pathology assistant or an audiology assistant are equivalent to the qualifications for a speech-language pathology assistant or an audiology assistant in this State; or
(3) (text unchanged)
.06 [Speech-Language Pathology Assistant] Scope of Practice.
A. A speech-language pathology assistant or an audiology assistant may provide only services which assist the direct services provided by a supervising speech-language pathologist or audiologist, and not services which are alternatives to direct services.
B. Activities within the scope of practice of a speech-language pathology assistant or an audiology assistant shall include the following:
(1) Engaging only in those duties planned, designed, and supervised by a supervising speech-language pathologist or audiologist;
(2) Following treatment plans or protocols developed by the supervising speech-language pathologist or audiologist who maintains professional responsibility for the plans of care;
(3) (text unchanged)
(4) Identifying the licensee as a speech-language pathology assistant or an audiology assistant to consumers and co-professionals;
(5) Following specified screening protocols developed by the supervising speech-language pathologist or audiologist when conducting speech-language or audiology screenings; and
(6) Reporting documented evidence of treatment and non-interpretive data regarding the client’s performance to the supervising speech-language pathologist or audiologist.
C. Activities within the scope of practice of a speech-language pathology assistant or an audiology assistant may include the following:
(1)—(3) (text unchanged)
(4) Performing checks and maintenance of equipment; [and]
(5) Participating with the supervising speech-language pathologist or audiologist in research projects, in-service training, and public relations programs[.];
(6) Assisting the speech-language pathologists or audiologists
during patient assessments; and
(7) Assisting the audiologists with basic diagnostic tests, such
as audiometry and tympanometry.
D. Activities not within the scope of practice of a speech-language pathology assistant or an audiology assistant include:
(1) (text unchanged)
(2) Participating in parent conferences, case conferences, or interdisciplinary team meetings without the presence of the supervising speech-language pathologist or audiologist, or other licensed speech-language pathologist or audiologist designated by the supervising speech-language pathologist or audiologist;
(3)—(6) (text unchanged)
(7) Disclosing clinical or confidential information either orally or in writing to anyone other than the supervising speech-language pathologist or audiologist; or
(8) Providing specialized [dysphagia] treatment that requires advanced knowledge and training.
E. Audiology assistants may not perform any task:
(1) Without the express knowledge and approval of the
supervising audiologist; and
(2) That may be prohibited by state or federal law.
.07 [Requirements of the Supervising Speech-Language Pathologist] Supervisor Responsibilities.
A. A supervising speech-language pathologist or audiologist is responsible for the direction of all client services provided by a speech-language pathology assistant or an audiology assistant.
B. A licensed full-time (35 hours or more a week) speech-language pathologist or audiologist may not supervise more than the equivalent of two full-time (35 hours or more a week) speech-language pathology assistants or audiology assistants.
C. A licensed part-time (less than 35 hours a week) speech-language pathologist or audiologist may not supervise more than the equivalent of one full-time (35 hours a week) speech-language pathology assistant or audiology assistant.
D. A supervising speech-language pathologist or audiologist shall:
(1) Have a minimum of 3 years work experience (2 years since receipt of full license or ASHA-CCC) as a speech-language pathologist or audiologist;
(2) Maintain on-going contact with all clients seen by a speech-language pathology assistant or an audiology assistant by participating in:
(a)—(b) (text unchanged)
(3) Provide supervision of the speech-language pathology assistant or the audiology assistant that is a combination of direct on-site activities and indirect activities;
(4) Be on-site to supervise the speech-language pathology assistant [a minimum of 2 times per month] during the first 2 hours of treatment for each client and then at least 1 direct hour of supervision during each subsequent month;
(5) Provide general supervision to the audiology assistant and
continuous availability by phone or telehealth technologies;
[(5)] (6) Conduct and maintain performance evaluations of the speech language pathology assistant or the audiology assistant within the first 3 months, and at least annually thereafter, that are cosigned by both the supervising speech-language pathologist or audiologist and the speech-language pathology assistant or the audiology assistant;
[(6)] (7) Provide a copy of the signed performance evaluation to the speech-language pathology assistant or the audiology assistant;
[(7)] (8) Maintain documentation of client contact and supervisory activities of the speech-language pathology assistant or the audiology assistant; and
[(8)] (9) Have the authority to combine in-person client contact and on-site supervision of the speech-language pathology assistant or the audiology assistant when appropriate.
[.08] .09 [Term and] License Renewal [of Speech-Language Pathology Assistant License].
A. A speech-language pathology assistant or an audiology assistant license expires on the date set by the Board, unless it is renewed for an additional term as provided in this regulation.
B. (text unchanged)
C. At least 1 month before the license expires, the Board shall notify the speech-language pathology assistant or the audiology assistant of the date the license expires and the procedures for renewing the license.
D. The speech-language pathology assistant or the audiology assistant is responsible for renewing licensure.
E. The speech-language pathology assistant or the audiology assistant may apply to renew the license for another term if the speech-language pathology assistant or the audiology assistant:
(1)—(2) (text unchanged)
(3) Submits to the Board:
(a) text unchanged)
(b) Satisfactory evidence of compliance with any continuing education requirements under [Regulation .09] Regulation .10 of this chapter; and
(c) A delegation agreement for each supervising speech-language pathologist or audiologist.
F. A speech-language pathology assistant or an audiology
assistant shall undergo a new criminal records history check as set forth in
Health Occupations Article, §2-303.1, Annotated Code of Maryland, every three
renewal cycles or every 6 years.
[F.] G.—[G.] H. (text unchanged)
[.09] .10 Continuing Education Requirements [(CEU) for Speech-Language Pathology Assistants].
A. A speech-language pathology assistant or an audiology assistant shall obtain CEUs as a means of staying current in the field.
B. The speech-language pathology assistant or the audiology assistant shall earn a minimum of ten CEUs as a condition of renewal as follows:
(1) (text unchanged)
(2) Five CEUs in work-related areas[.] that may include the recommended completion of:
(a) A minimum of 1 CEU in the area of cultural competency;
(b) A minimum of 1 CEU in the area of ethics; and
(c) Related training that does not include annual training
requirements for:
(i) Job orientation;
(ii) Job maintenance; or
(iii) Other general information related to health care.
C. The speech-language pathology assistant or the audiology assistant shall retain records documenting completion of CEUs.
D. At the time of license renewal, the Board shall audit 25 percent of the speech-language pathology assistants or the audiology assistants for compliance with the continuing education requirement.
E. If the speech-language pathology assistant or the audiology assistant is audited by the Board, the speech-language pathology assistant or the audiology assistant shall submit to the Board the following:
(1)—(2) (text unchanged)
(3) Documentation of earned CEUs completed within the 2 years immediately preceding the license expiration date.
10.41.13 Sanctioning Guidelines
Authority: Health Occupations Article, §§1-606, 2-314, and 2-314.9, Annotated Code of Maryland
.02 Definitions.
A. (text unchanged)
B. Terms Defined.
(1) “Board” means the State Board of Examiners for Audiologists, Hearing Aid Dispensers, [and] Speech-Language Pathologists, and Music Therapists.
(2) (text unchanged)
(3) “License” means a license issued by the Board to:
(a)—(b) (text unchanged)
(c) Practice speech-language pathology; [or]
(d) Practice music therapy; or
[(d)] (e) Assist in the practice of speech-language pathology or audiology.
(4) “Licensee” means an individual licensed by the Board to:
(a)—(b) (text unchanged)
(c) Practice speech-language pathology; [or]
(d) Practice music therapy; or
[(d)] (e) Assist in the practice of speech-language pathology or audiology.
(5)—(6) (text unchanged)
.04 Guidelines for Disciplinary Sanctions and Imposition of Penalties.
A. Subject to the provisions of this section, the Board may impose sanctions and penalties for violations of the Maryland Audiology, Hearing Aid Dispensing, [and] Speech-Language Pathology, and Music Therapy Act and its regulations according to the guidelines set forth in the following chart:
|
Violation |
Minimum Sanction/Penalty |
Maximum Sanction/Penalty |
|
(1)—(20) (text unchanged) |
|
|
|
[(21) Immoral behavior |
Reprimand |
Revocation; $5,000 fine |
|
(22) Discrimination against HIV or HIV positive patient |
Reprimand |
Suspension for 90 days; $1,000 fine] |
|
[(23)] (21)— [(26)] (24) (text unchanged) |
|
|
B.—D. (text unchanged)
LAURA HERRERA SCOTT
Secretary of Health
Title 11
DEPARTMENT OF TRANSPORTATION
Notice of Proposed Action
[23-132-P]
The Administrator of the Motor Vehicle Administration proposes to amend:
(1) Regulation .03 under COMAR
11.11.05 Motor Vehicle Fees;
(2) Regulation .05 under COMAR 11.17.09 Proof of Age, Full Name, Identity, Maryland Residence, Social Security Number, and Lawful Status; and
(3) Regulation .05
under COMAR 11.17.21 Proof of Age, Name, Identity,
and Residency for Federally Noncompliant Driver Licenses and Identification
Cards.
Statement of Purpose
The purpose of this action is to update the term “inmate” to be “incarcerated individual” pursuant to Ch. 721 (S.B. 293), Acts of 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 Tracey C. Sheffield, Regulations Coordinator, MVA, 6601 Ritchie Highway, N.E., Room 200, Glen Burnie, MD 21062, or call 410-768-7545, or email to tsheffield@mdot.maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
Subtitle 11 MOTOR VEHICLE ADMINISTRATION — ADMINISTRATIVE PROCEDURES
11.11.05 Motor Vehicle Fees
Authority: Transportation Article, §12-104(b), Annotated Code of Maryland, and as cited in Regulations .02—.06 of this chapter
.03 Driver’s License and Identification Card Fees.
|
Service |
Section |
Fee |
|
A.—G. (text
unchanged) |
|
|
|
H. Identification
Card: |
|
|
|
(1)—(2) (text unchanged) |
|
|
|
(3) Issued to an [inmate] incarcerated
individual within 60 days of release from the Department of Public Safety
and Correctional Services or Federal Bureau of Prisons. |
12-301 |
1 |
|
(4)—(6) (text unchanged) |
|
|
|
I. (text unchanged)
|
Subtitle 17 MOTOR VEHICLE ADMINISTRATION — DRIVER LICENSING AND IDENTIFICATION DOCUMENTS
11.17.09 Proof of Age, Full Name, Identity, Maryland Residence, Social Security Number, and Lawful Status
Authority: Transportation Article, §§12-104(b), 12-301, 16-103.1,
16-104.2, 16-106, 16-115, and 16-121—16-122, Annotated Code of Maryland;
6 CFR 37
.05 Source Document Exception Process.
A.—B. (text unchanged)
C. The Administration may accept the following documents as proof
of Maryland residency if submitted by an applicant under the following
circumstances[.]:
(1)—(3) (text unchanged)
(4) If the applicant is an [inmate] incarcerated individual or former [inmate] incarcerated individual within 60 days of release:
(a)—(c) (text unchanged)
(5)—(6) (text unchanged)
D.—F. (text unchanged)
11.17.21 Proof of Age, Name, Identity, and Residency for Federally Noncompliant Driver Licenses and Identification Cards
Authority: Transportation Article, §§12-104(b), 12-301, 16-103.1, 16-104.2, 16-106, 16-115, 16-121, and 16-122, Annotated Code of Maryland
.05 Exception Process.
A. If an applicant is unable to comply with the Maryland residency source document requirements set forth in Regulation .04C of this chapter due to circumstances beyond the applicant’s control, the applicant may submit the following alternate source documents under the following circumstances[.]:
(1)—(3) (text unchanged)
(4) If the applicant is an [inmate]
incarcerated individual or former [inmate] incarcerated
individual within 60 days of release:
(a)—(c) (text unchanged)
(5)—(6) (text unchanged)
B. (text unchanged)
CHRISTINE NIZER
Administrator
Subtitle 11 MOTOR VEHICLE ADMINISTRATION—ADMINISTRATIVE PROCEDURES
Authority: Transportation Article, §12-104(b), Annotated Code of Maryland, and as cited in Regulations .02—.06 of this chapter
Notice of Proposed Action
[23-129-P]
The Administrator of the Motor Vehicle Administration proposes to amend Regulation .04 under COMAR 11.11.05 Motor Vehicle Fees.
Statement of Purpose
The purpose of this action is to set the fee charged for the issuance of a high occupancy vehicle (HOV) sticker pursuant to Ch. 121 (H.B. 123), Acts of 2023.
Estimate of Economic Impact
I. Summary of Economic Impact. This proposal is for the purpose of authorizing certain plug–in electric drive vehicles for which a permit has been obtained from the Motor Vehicle Administration to use high occupancy vehicle (HOV) lanes regardless of the number of passengers in the vehicles; and generally relating to the use of HOV lanes by plug–in electric drive vehicles.
Currently, MDOT MVA has a permit in place. This proposal would not have an impact on either the expenditures or the revenues for MDOT MVA. The production cost and the mailing of the sticker are offset by the $5 fee for each sticker. MDOT MVA plans on charging a $5 fee for each sticker, and that would cover the cost of the production of the sticker and the mailing. Currently, there are approximately 60,000 registered vehicles eligible under the bill to receive (HOV) lanes stickers. The anticipation is that approximately 35,000 customers will request HOV stickers. Also, programming hours would be required but could be handled with existing resources.
II. Types of Economic Impact.
|
Impacted Entity |
Revenue (R+/R-) Expenditure (E+/E-) |
Magnitude |
|
A. On issuing agency: |
|
|
|
Maryland Department of Transportation |
(R+) |
175,000 |
|
B. On other State agencies: |
NONE |
|
|
C. On local governments: |
NONE |
|
|
|
|
|
|
|
Benefit (+) Cost (-) |
Magnitude |
|
D. On regulated industries or trade groups: |
NONE |
|
|
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. Ch. 121 (H.B. 123), Acts of 2023, requires the MDOT MVA to charge a fee of up to $20 for (HOV) lanes stickers. If the MDOT MVA charges a $5 fee to the customer per HOV sticker, the estimated income would be $175,000. This would be 35,000 stickers at a $5 cost for a total of $175,000.
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 Tracey C. Sheffield, Regulations Coordinator, MVA, 6601 Ritchie Highway, N.E., Room 200, Glen Burnie, MD 21062, or call 410-768-7545, or email to tsheffield@mdot.maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
.04 Vehicle Registration Fees.
|
Service |
Section |
Fee |
|
A.—L. (text
unchanged) |
||
|
M. High occupancy
vehicle (HOV) sticker. |
25-108 |
5 |
CHRISTINE NIZER
Administrator
Subtitle 13 MOTOR VEHICLE ADMINISTRATION—VEHICLE EQUIPMENT
11.13.12 Safety Glass Replacement Standards
Authority: Commercial Law
Article, §13-301; Transportation Article,
§§12-104(b) and 22-406[,];
Annotated Code of Maryland.
Notice of Proposed Action
[23-130-P]
The Administrator of the Motor Vehicle Administration proposes to amend
Regulations .01, .04, .05, and .09 under COMAR 11.13.12 Safety Glass Replacement Standards.
Statement of Purpose
The purpose of this regulation is to conform the regulations to the newly adopted ANSI standard for glass installation, and to conform the regulation to the disclosures pursuant to Ch. 561 (H.B. 920), Acts of 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 Tracey C. Sheffield, Regulations Coordinator, MVA, 6601 Ritchie Highway, N.E., Room 200, Glen Burnie, MD 21062, or call 410-768-7545, or email to tsheffield@mdot.maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
.01 Scope.
This chapter implements the American National Standards Institute/Auto Glass Safety Council/Automotive Glass Replacement Safety Standard (ANSI/AGSC/AGRSS) addressing procedures, education, and product performance for motor vehicles falling within the guidelines of the Federal Motor Vehicle Safety Standard (FMVSS) [208 and 212].
.04 Vehicle Assessment Before Replacement.
A.—B. (text unchanged)
C. If, after the assessment made under §A of this regulation, it has been determined that the vehicle has an ADAS which could require recalibration after any automotive glass replacement, and the technician chooses not to follow Regulation .08I of this chapter, the technician may not undertake or complete the installation. The owner/operator then shall be so notified verbally and in writing. Documentation of customer notification shall be kept as a record in accordance with the provisions of Regulation .08G of this chapter. The technician shall provide the customer with a written statement that the work to be performed on the motor vehicle will meet or exceed the original equipment manufacturer specifications.
D. (text unchanged)
.05 Selection of Glass and Retention Systems.
Those engaged in automotive glass replacement shall:
A.—C. (text unchanged)
D. Use only retention systems that have lot numbers and expiration
dates printed on appropriate products; [and]
E. Use glass products compatible with the ADAS which may be
affected/impacted by the glass replacement[.]; and
F. Use only equipment specifically designed and purposed for recalibration
when recalibration of the ADAS is required by the vehicle manufacturer. Further:
(1) Recalibration shall be
completed using either an OEM-approved recalibration system/procedure, or
equivalent recalibration procedure as assured in writing by the equivalent
recalibration equipment manufacturer;
(2) Equivalent recalibration
equipment, and the procedures used in conjunction with that equipment, shall be
represented in writing by the manufacturer as being suitable for and compatible
with the accurate recalibration of ADAS on the vehicle specifically contained
within that equipment’s database;
(3) Recalibration equipment
shall only be used on vehicles specifically covered within the device’s
database/software and may not be used to recalibrate models beyond the scope of
the software; and
(4) Recalibration equipment may
not be altered or modified without the express permission of the manufacturer,
and all regular maintenance shall be sufficient to comply with the manufacturer’s
requirements.
.09 Education.
A. (text unchanged)
B. Technicians performing recalibration/calibration procedures shall be fully qualified for the tasks they are required to perform. Such qualifications shall include, at a minimum, completion of a comprehensive training program with a final exam and ongoing education component. Curriculum used for ADAS training shall be kept on file (in an auditable format) and shall contain the following elements:
(1) What ADAS are, what they
do, and how they function;
(2) Types of ADAS;
(3) Purpose of recalibration/calibration and the need for precise
execution; and
(4) Types of recalibration/calibration:
(a) Static;
(b) Dynamic; or
(c) Dual (static and dynamic).
(5) Comprehensive and manufacturer specific recalibration/calibration
training for the system/equipment used by the automotive glass company are as follows:
(a) Set up and operation of the equipment; and
(b) Maintenance of the equipment.
(6) Successful completion/mastery of the training shall be verified
by a final exam which includes:
(a) Knowledge assessment of ADAS and the recalibration/calibration
process; and
(b) Skill assessment to verify proper technique and use of equipment.
[B.] C. (text unchanged)
CHRISTINE NIZER
Administrator
Subtitle 15 MOTOR VEHICLE ADMINISTRATION—VEHICLE REGISTRATION
11.15.40 Electric Vehicle and Low Emission
Vehicle Excise Tax Credit
Authority: Transportation
Article, §§12-104(b), 11-103.4, and 13-815, Annotated Code of Maryland
Notice of Proposed Action
[23-157-P]
The Administrator of the Motor Vehicle Administration proposes to adopt
new Regulations .01—.04 under a new chapter,
COMAR 11.15.40 Electric Vehicle and Low
Emission Vehicle Excise Tax Credit.
Statement of Purpose
The purpose of this action is to adopt new regulations to set procedures for excise tax credits issued for eligible zero-emission vehicles pursuant to Ch. 234 (H.B. 1391), Acts of 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 no impact on individuals with disabilities.
Opportunity for Public Comment
Comments may be sent to Tracey C. Sheffield, Regulations Coordinator, MVA, 6601 Ritchie Highway, N.E., Room 200, Glen Burnie, MD 21062, or call 410-768-7545, or email to tsheffield@mdot.maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
.01 Purpose.
This chapter applies to
applications for excise tax credits issued for eligible zero-emission vehicles.
.02 Incorporation by
Reference.
In this chapter, 15 U.S.C.
§1232, as amended, is incorporated by reference.
.03 Definitions.
A. In this chapter, the
following terms have the meanings indicated.
B. Terms Defined.
(1) “Administration”
means the Motor Vehicle Administration.
(2) “Autocycle” has the
meaning stated in Transportation Article, §11-103.4, Annotated Code of
Maryland.
(3) Base Purchase Price.
(a) “Base purchase price”
means the standard vehicle price as printed on the Monroney sticker.
(b) “Base purchase price”
does not include:
(i) Shipping or freight
charges;
(ii) After manufacture items
included with the vehicle at the time of purchase;
(iii) Extended warranties;
(iv) State or federal taxes;
(v) Registration fees;
(vi) Calculation of a dealer
trade-in allowance;
(vii) Dealer discounts or
rebates;
(viii) State, federal, or
local government purchase incentives; or
(ix) Vehicle options.
(3) “Excise tax” has the
meaning stated in Transportation Article, §13-809, Annotated Code of Maryland.
(4) “Fuel cell electric
vehicle” has the meaning stated in Transportation Article, §11-125.1, Annotated
Code of Maryland.
(5) “Monroney sticker”
means the label required under 15 U.S.C. §1232, as amended.
(6) “Zero-emission
plug-in electric drive vehicle” has the meaning stated in Transportation
Article, §13-815, Annotated Code of Maryland.
.04 Electric Vehicle
Excise Tax Credit Eligibility.
A. For determining
eligibility of a zero-emission plug-in electric vehicle, fuel cell electric
vehicle, zero-emission electric motorcycle, or zero
(1) The vehicle was
purchased new and titled for the first time on or after July 1, 2023, but
before July 1, 2027;
(2) The vehicle has not
been modified from original manufacturer specifications;
(3) The vehicle is
acquired for use
(4) The vehicle has a
total base purchase price not exceeding $50,000;
(5) If applicable, the
vehicle has a battery capacity of at least 5.0 kilowatt hours; and
(6) The applicant is
either:
(a) An individual who has
not received a previous excise tax credit for the purchase of a vehicle in
accordance with Transportation Article, §13-815; Annotated Code of Maryland; or
(b) A business entity
that has not received excise tax credits for the purchase of more than 10
vehicles in accordance with Transportation Article, §13-815, Annotated Code of
Maryland.
B. Subject to available
funding, the credit shall be issued in an amount in accordance with
Transportation Article, §13-815, Annotated Code of Maryland.
CHRISTINE NIZER
Administrator
Subtitle 35 MARYLAND HEALTH BENEFIT EXCHANGE
14.35.19 State-Based Young Adult Health Insurance Subsidies Program
Authority: Insurance Article, §31-106(c)(1)(iv), Annotated Code of Maryland
Notice of Proposed Action
[23-154-P]
The Maryland Health Benefit Exchange proposes to amend Regulation .03 under COMAR 14.35.19 State-Based Young Adult Health Insurance Subsidies
Program. This action was considered at the regular session of the MHBE
Board of Trustees on June 20, 2023.
Statement of Purpose
The purpose of this action is to comply with Chs. 256 (S.B. 601) and 257 (H.B. 814), Acts of 2023, which extended the Young Adult Health Insurance Subsidies Pilot Program through 2025.
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 Becca Lane, Senior Health Policy Analyst, Maryland Health Benefit Exchange, 750 E Pratt St., 6th Floor, Baltimore, MD 21202, or call 410-547-7371, or email to becca.lane@maryland.gov. Comments will be accepted through September 11, 2023. A public hearing has not been scheduled.
.03 Eligibility Requirements for Subsidies Through the Program.
A.—C. (text unchanged)
D. In any calendar [years 2022 and 2023] year of the program:
(1)—(4) (text unchanged)
E. (text unchanged)
MICHELE EBERLE
Executive Director
WATER AND SCIENCE ADMINISTRATION
Water Quality Certification 23-WQC-0008
Sun TRS Castaways
LLC
27777 Franklin Rd,
Ste 200
Southfield,
MI 48034
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 23-WQC-0008
Location: 12550 Eagles Nest Rd, Berlin, MD
21811
The purpose of
the project is to provide for deeper water for navigation.
Description of Authorized Work: Maintenance dredge by mechanical method an
8,953 square foot area, and new mechanical
dredge a 16,573 square foot area in both Private and State tidal
wetlands to a maximum depth of 3.0 feet at mean low water; to provide for
periodic maintenance dredging for six years; and transport 1,575 cubic yards of
dredged material to an approved disposal site located at 7968 Libertytown Road,
Berlin, MD in Worcester County.
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: Miles Simmons at robertm.simmons@maryland.gov or at 410-901-4044.
[23-16-12]
WATER AND SCIENCE ADMINISTRATION
Water Quality Certification 23-WQC-0010
Flying
Point Marina
Attn:
Phil Cianelli
C/o
Doldon W. Moore & Associates
P.O.
Box 1
Owings,
MD 20736
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 23-WQC-0010
Location: 324 Flying Point Road, Edgewood,
Maryland 21040
The
project includes the following:
1.
Remove
any unauthorized structures, as determined by MDE Compliance Program, which
include a covered structure over the bridge.
2.
Clarify
and reauthorize the following structures that appeared in a previous
authorization: a. 201-foot and 9-inch replacement bulkhead 18-inches
channelward of the mean high water line around an existing jetty; b. 242-foot
long by 8-foot wide pier with a 10-foot section tapering out to 16-feet and
9-inches where it meets the bulkhead; extending 242 channelward of the
bulkhead.
3.
Mechanically
or hydraulically maintenance dredge a previously dredged marina basin and
entrance channel totaling 215,167 square feet (4.93 acres) that include the
following sections:
-
Section
A (entrance channel): 8,476 square feet;
-
Section
B (around the T-head pier): 73,180 square feet;
-
Sections
C, D, E (original marina basin): 133,511 square feet;
-
All
section will be dredged to a depth of 4.5 feet at mean low water;
-
Approximately
11,650 cubic yards of dredged material will be transported by hydraulic
pipeline, by barge, or by truck to the Bush River Dredged Material Placement
Site at Fords Lane, Perryman, Harford County, Maryland 21001;
-
Provide
periodic maintenance dredging for a period of 6 years.
4.
In
the entrance channel area, construct or install the following:
-
182-foot
long segmented breakwater containing an 87-foot long by 11-foot wide segment
and a 95-foot long by 11-foot wide segment extending a maximum of 161 feet
channelward of the mean high water line;
-
Six
4-pile dolphin channel markers extending a maximum of 325 feet channelward of
the mean high water line.
5.
On
the “T head” pier, construct or install the following:
-
Twelve,
60-foot long by 6-foot wide floating finger piers, that each include 14-foot
long by 3- foot wide gangways;
-
Three
60-foot long by 6-foot wide floating piers that each include 12-foot long by
3-foot wide gangways;
-
Boatlift
with associated piles;
-
26
new mooring piles; e. 62-foot long by 13-foot wide floating jet ski dock to
accommodate 12 jet skis;
-
18-foot
long by 8-foot wide by 12-foot high covering over the gas pump area;
-
8-foot
long by 8-foot wide by 12-foot high covering over the pump out area;
-
All
extending a maximum of 250 channelward of the mean high water line.
6.
Around
the island, construct or install the following:
-
50-foot
long by 5-foot wide floating parallel pier;
-
100-foot
long by 5-foot wide floating parallel pier;
-
Two
30-foot long by 6-foot wide floating finger piers that include 10-foot long by
3-foot wide gangways;
-
Two
mooring piles;
-
Boatlift
with associated piles.
7.
Near
the main building, construct or install the following:
-
Two
40-foot long by 6-foot wide floating work platforms.
8.
In the original marina basin area, construct
the following:
-
640
linear feet of replacement bulkhead 18 inches channelward of an existing
bulkhead
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: Matt Wallach at matthew.wallach@maryland.gov or 410-207-0893
[23-16-11]
WATER AND SCIENCE ADMINISTRATION
Water Quality Certification 23-WQC-0016
Bay Bridge Marina
337 Pier One Rd.
Stevensville,
MD 21666
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 23-WQC-0016
Location: 337 Pier One Rd, Stevensville, MD 21666
The purpose of
the project is to provide for deeper water for navigation.
Description of Authorized Work: Maintenance dredge by mechanical method a
1,200-foot long by 55-foot wide area and a new dredge area of 1,610 square feet
in State wetlands to a maximum depth of 6.5 feet at mean low water; to provide
for periodic maintenance dredging for six years; and transport approximately 5,000
cubic yards of dredge material to an approved disposal site located at 337 Pier
One Road, Stevensville in Queen Anne’s County, Maryland.
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: Miles Simmons at robertm.simmons@maryland.gov or at 410-901-4044.
[23-16-13]
WATER AND SCIENCE ADMINISTRATION
Water Quality Certification 23-WQC-0021
McLean
Contracting Company.
Attn:
Cory Heisey
C/o
Joe Wallenfelsz
6700
McLean Way
Glen
Burnie, MD 21060
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 23-WQC-0021
Location: 2001 Benhill Avenue, Baltimore,
MD 21226
The work
includes the following:
- Construct 1,164 linear feet of bulkhead,
which includes 606 linear feet of replacement bulkhead 18 inches channelward of
an existing bulkhead and 558 linear feet of bulkhead constructed 18 inches
channelward of an existing relieving platform;
- Fill 38,000 square feet (.87 acres) with up
to 24,000 cubic yards of clean fill.
- Construct a 245 foot long by 31-foot wide
temporary trestle with four 24-inch mooring piles 245 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: Matt Wallach at matthew.wallach@maryland.gov or 410-207-0893
[23-16-14]
WATER AND SCIENCE ADMINISTRATION
Water Quality Certification
23-WQC-0028
Wroten Island Land
Conservation, Inc
C/o Mike Novak
1401 Hollingsworth
Rd
Joppa, MD 21085
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 23-WQC-0028.
Location: The project
is located at Wroten Island in the Honga River near Crapo in Dorchester County,
Maryland.
The purpose of the
project is to stabilize an eroding shoreline.
Project Description: Stabilize
an eroding island as depicted on plans dated January 7, 2022 and described
below:1.Construct a 224-foot long by 22-foot wide stone groin all within a
maximum of 161 feet channelward of the mean high water line;
2. a 1,253 linear
foot low profile stone marsh edging revetment all within a maximum of 8 feet
channelward of the marsh/open water interface, and 3. a 141-foot long by
14-foot wide groin within a maximum of 67 feet channelward of the mean high
water line at the southwest peninsula; and 4.construct 112-foot long by 14-foot
wide groin within a maximum of 92 feet channelward of the mean high water line,
5.a 1,302 linear foot linear foot low profile stone marsh edging revetment all
within a maximum of 8 feet channelward of the marsh/open water interface, and 6. a 52-foot long by 14-foot wide stone groin
all within a maximum of 43 feet channelward of the mean high water line at the
northeast peninsula.
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: Mary Phipps-Dickerson at (443) 509-0797 or mary.phippsdickerson@maryland.gov
[23-16-10]
WATER AND SCIENCE ADMINISTRATION
Water Quality Certification
23-WQC-0029
Kentmorr Marina Properties LLC
910 Kentmorr Road
Stevensville, Maryland 21666
Add’l. Info: Pursuant to COMAR 26.08.02.10F(1)(d), The Maryland Department of the Environment is providing notice of a scheduled Public Hearing for Water Quality Certification 23-WQC-0029.
Location: 910 Kentmorr Road in Stevensville, Queen Anne’s County, Maryland 21666
Kentmorr Marina LLC
has requested a Water Quality Certification for the proposed tidal wetland
impacts to the existing marina, which includes to hydraulically or mechanically dredge an approximately 2,000 linear
feet by 76 feet wide (151,249 square foot) entrance channel area to a maximum
depth of -6.0 ft at mean low water, approximately 55,349 square feet of channel
area is proposed as maintenance dredging and approximately 95,900 square feet
as new dredging area; to provide for periodic dredging for six years; place up
to approximately 5,682 cubic yards of resulting dredge spoil to nourish an
existing beach within the historic footprint, a maximum of 73 feet channelward
of the mean high water line; and transport surplus dredge material to an
approved disposal site at 5360 Browns Way Road, Churchton in Anne Arundel
County, Maryland. The purpose of the project is to improve navigable access and
restore an existing beach to within its historic footprint.
The purpose of this
notice is to solicit comments from the public about the proposed work and to
announce the date of a Maryland Department of the Environment public
informational hearing on the subject application. At this time, no decision has
been made as to whether a certification will be issued. An in person public
informational hearing has been scheduled for the referenced project on Thursday,
September 28, 2023 at the Centreville Branch of the Queen Anne’s County Public
Library, 121 Commerce Street, Centreville, Maryland, 21617. The hearing will begin at 6:30 P.M. and end
no later than 8:00 P.M. Written comments will be accepted until October 13,
2023.
Contact: R. Miles Simmons at robertm.simmons@maryland.gov or 410-627-4826.
[23-16-15]
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.
Date and Time: September 22, 2023, 10 a.m. — 12 p.m.
Place: Wades Point, 10090 Wades Point Rd., McDaniel, MD
Contact: Jana Davis 410-974-2941
[23-16-07]
STATE COLLECTION AGENCY LICENSING BOARD (SCALB)
Date and Time: September 12, 2023, 2 — 3 p.m.; thereafter, the public meetings will take place the second Tuesday of every month, accessed via the Google Meet information given below.
Place: Via Google Meet
Add’l. Info: Google Meet joining info:
Video call link:
https://meet.google.com/ahz-mgnk-jsu
Or dial: (US) +1 530-738-1353
PIN: 815 799 863 #
More phone numbers:
https://tel.meet/ahz-mgnk-jsu?pin=1097700804795
If necessary, the Board will convene in a
closed session to seek the advice of counsel or review confidential materials,
pursuant to General Provisions Article, §3-305, Annotated Code of Maryland.
Contact: Ayanna Daugherty 410-230-6019
[23-16-17]
Date and Time: August 23, 2023, 9 a.m. — 12 p.m.
Place: Via Google Meet
Contact: Duane Johnson 410-537-4466
[23-16-01]
DEPARTMENT OF THE ENVIRONMENT
Date and Time: August 23, 2023, 9 a.m. — 12 p.m.
Place: Dept. of the Environment, 1800 Washington Blvd., Baltimore, MD
Contact: Taj Goodlow 410-537-4466
[23-16-02]
Date and Time: August 21, 2023, 1 — 3 p.m.
Place: Via Google Meet — please see details below.
Add’l. Info: The Maryland CHW State Advisory Committee meets
quarterly. Members of the public are welcome to attend, but are requested to
pre-register with this link:
The Google Meet link and call in line are available on the Maryland CHW State Advisory Committee webpage at https://pophealth.health.maryland.gov/Community-Health-Workers/Pages/Advisory-Committee.aspx.
Contact: Tina Backe 443-401-7531
[23-16-06]
MARYLAND INSURANCE ADMINISTRATION
Date and Time: Monday August 28, 2023, 2:00 p.m. to 5:00
p.m.
Add’l. Info: The Maryland Insurance Administration will conduct a public hearing on
specific rate increase requests being made by certain Long-Term Care Insurance
carriers operating in Maryland.
In the individual long-term care market,
the hearing will focus on requests from Continental General Insurance Company,
Allianz Life Insurance Company of North America, Transamerica Life Insurance
Company and Unum Life Insurance Company of America.
In the group long-term care market, the
hearing will focus on requests from Unum Life Insurance Company of America.
The purpose of the hearing is for insurance
company officials to explain the reasons for the rate increases, to explain the
new benefit options and for the MIA to consider whether the proposed rate
increase is in compliance with Maryland’s laws and regulations relating to long
term care insurance.
Interested stakeholders will also have the
opportunity to provide comments at the hearing. Prior to the hearing, copies of
each company’s actuarial memorandum will be posted to the Maryland Insurance
Administration’s website.
Given
the current COVID-19 situation, to protect the public health, safety, and
welfare, the hearing will be held via Zoom.
Dial-in Information:
Zoom Gov link:
https://www.zoomgov.com/j/1600635999
Dial-in: (646) 828-7666
Webinar ID: 160 063 5999
Information about the Maryland Relay
Service can be found at doit.maryland.gov/mdrelay.
If you will be dialing into the public
hearing, and wish to provide oral testimony, please RSVP to Nancy Muehlberger.
Testimony will only be heard from those who have RSVP’d in advance of the public
hearing. Written comments and RSVPs should be sent to Nancy Muehlberger by
August 21, 2023, either by email to longtermcare.mia@maryland.gov or by mail to 200 St. Paul Place, Suite 2700, Baltimore, MD 21202, or by
fax to 410-468-2038.
Any questions regarding this matter should
be directed to Nancy Muehlberger, Actuarial Analyst, by August 21, 2023, by
email to Nancy.Muehlberger@maryland.gov.
For more information on the hearing please
see the following link:
https://insurance.maryland.gov/Consumer/Pages/Long-Term-Care-Hearing-August-28-2023.aspx
Contact: Nancy Muehlberger, 410-468-2050
[23-16-20]
MARYLAND HEALTH CARE COMMISSION
Subject: Formal Start of Review
Add’l. Info: The Maryland Health Care Commission (MHCC) hereby gives notice of docketing of the following application for Certificate of Need:
Hygea Detox at Camp Meade — Docket No. 23-02-2468 — Establish a 16-bed adult detoxification Track One Alcoholism and Drug Abuse Intermediate Care Facility (“ICF”) at the site of the former Maryland House Detox facility, a 1.9029 acre site in Anne Arundel County, located at 817 S. Camp Meade Rd, Linthicum Heights, Maryland; Proposed Cost: $136,781.
MHCC shall review the applications under Health-General Article, §19-101 et seq., Annotated Code of Maryland, COMAR 10.24.01, and the applicable State Health Plan standards.
Any affected person may make a written request to the Commission to receive copies of relevant notices concerning the application. All further notices of proceedings on the application will be sent only to affected persons who have registered as interested parties.
Persons desiring to become interested parties in the Commission’s review of the above-referenced application must meet the requirements of COMAR 10.24.01.01B(2) and (20) and must also submit written comments to the Commission no later than close of business September 11, 2023. These comments must state with particularity the State Health Plan standards or review criteria that you believe have not been met by the applicant as stated in COMAR 10.24.01.08F.
Please refer to the Docket Number listed above in any correspondence on the application. Copies of the application are available for review in the office of MHCC during regular business hours by appointment. All correspondence should be addressed to Wynee Hawk, Director, Center for Health Care Facilities and Planning, Maryland Health Care Commission, 4160 Patterson Avenue, Baltimore, Maryland 21215.
Contact: Ruby Potter 410-764-3276
[23-16-05]
MARYLAND HEALTH CARE COMMISSION
Subject: Formal Start of Review
Add’l. Info: The Maryland Health Care Commission (MHCC) hereby gives
notice of docketing of the following application for Certificate of Need:
University of Maryland Shore Medical Center at Easton — (Talbot County) — Docket No. 23-20-2463 — Propose to replace and relocate the regional medical center three miles to the north of the existing facility. The new hospital will have 110 acute care beds and 12 special hospital rehabilitation beds, for a total of 122 inpatient beds. It will also have 25 observation beds. The facility will have seven operating rooms and 27 emergency department treatment spaces. The replacement facility is needed to address the aging, inefficient, and obsolete existing hospital building, and will complement the health care infrastructure developed in the five-county eastern shore region over the past decade; Proposed Cost: $539,558,871.
MHCC shall review the applications under Health-General Article, §19-101 et seq., Annotated Code of Maryland, COMAR 10.24.01, and the applicable State Health Plan standards.
Any affected person may make a written request to the Commission to receive copies of relevant notices concerning the application. All further notices of proceedings on the application will be sent only to affected persons who have registered as interested parties. Persons desiring to become interested parties in the Commission’s review of the above-referenced application must meet the requirements of COMAR 10.24.01.01B(2) and (20) and must also submit written comments to the Commission no later than close of business September 11, 2023. These comments must state with particularity the State Health Plan standards or review criteria that you believe have not been met by the applicant as stated in COMAR 10.24.01.08F.
Please refer to the Docket Number listed above in any correspondence on the application. Copies of the application are available for review in the office of MHCC during regular business hours by appointment. All correspondence should be addressed to Wynee Hawk, Director, Center for Health Care Facilities and Planning, Maryland Health Care Commission, 4160 Patterson Avenue, Baltimore, Maryland 21215.
Contact: Ruby Potter 410-764-3276
[23-16-09]
DEPARTMENT OF TRANSPORTATION/OFFICE OF MINORITY BUSINESS ENTERPRISE
Date and Time: August 23, 2023, 8 a.m. — 5 p.m.; Additional Dates: September 6, September 20, and October 4, 2023
Place: Virtual Meeting — please see the website for details.
Add’l. Info: Meetings are being held virtually until further notice. Please check the website for additional information https://mdot.maryland.gov.
Contact: Sabrina Bass 4108651240
[23-16-04]
WORKERS’ COMPENSATION COMMISSION
Date and Time: August 24, 2023, 9:30 — 11:30 a.m.
Place: 10 E. Baltimore St., Baltimore, MD
Add’l. Info: Portions of this meeting may be held in closed session.
Contact: Amy S. Lackington 410-864-5300
[23-16-03]