Md. Code Regs. 10.09.26.03

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.26.03 - Conditions for Participation

A. General requirements for participation in the Medical Assistance Program are that the providers:

(1) Meet all conditions for participation specified in COMAR 10.09.36, except as otherwise specified in this regulation;

(2) Meet the licensure requirements as provided in Regulation .02 of this chapter;

(3) Have a provider agreement in effect with the Developmental Disabilities Administration and the Medical Assistance Program;

(4) Verify the licenses of all service agencies with whom they contract and have a copy of the same available for inspection;

(5) Verify the licenses and credentials of all professionals whom they employ or with whom they contract and have a copy of same available for inspection;

(6) Maintain a written clinical record for each waiver participant which includes:

(a) A copy of the waiver participant's signed statement indicating the alternatives of care locations offered to him or her, and his or her choice;

(b) Date of:

(i) Discharge from a State residential center or a nursing or chronic care facility into the services covered under this chapter; or

(ii) Diversion from a State residential center or chronic care facility into the services covered under this chapter; and

(7) Have waiver participants reevaluated annually by the interdisciplinary team.

B. Services coordination providers shall submit individualized service plans to the DDA or its designee.

C. Environmental Modifications.

(1) Residential habilitation or residential option services providers shall provide environmental modifications as necessary to meet the needs of waiver participants after receiving prior authorization from DDA.

(2) Environmental modifications shall be:

(a) Provided by the residential habilitation or residential option services provider in getting a residence ready to be occupied; and

(b) Performed in accordance with applicable codes of the locality.

D. Respite Care.

(1) Residential habilitation or residential option services providers shall provide respite care as necessary to meet the needs of waiver participants.

(2) Respite care services shall be received in a:

(a) State residential center; or

(b) Community residence:

(i) Operated by a provider of residential habilitation services; and

(ii) Licensed by the State, in accordance with COMAR 10.22.03.02A(9)(b) and (c), to provide respite care.

E. Medical day care providers:

(1) Shall meet the requirements of COMAR 10.09.07; and

(2) Are exempt from meeting the requirements of Regulation .18D of this chapter.

Md. Code Regs. 10.09.26.03

Regulations .03 adopted as an emergency provision effective February 13, 1984 (11:5 Md. R. 455); emergency status extended at 11:7 Md. R. 621; adopted permanently effective August 12, 1984 (11:15 Md. R. 1330)
Regulations .03A, amended as an emergency provision effective November 19, 1990 (17:24 Md. R. 2835); emergency status extended at 18:4 Md. R. 444 (February 22, 1991); amended permanently effective February 18, 1991 (18:3 Md. R. 305)
Regulations .03 amended as an emergency provision effective June 8, 1992 (19:12 Md. R. 1130); emergency status extended at 19:19 Md. R. 1702; adopted permanently effective September 28, 1992 (19:19 Md. R. 1707)
Regulation .03E adopted as an emergency provision effective July 1, 2008 (35:17 Md. R. 1480); emergency status extended at 36:2 Md. R. 96; emergency status extended at 36:17 Md. R. 1310; amended permanently effective October 19, 2009 (36:21 Md. R. 1591)