Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 01 - PROCEDURES › Chapter 10.01.18 - Sexual Abuse Awareness and Prevention Training › Section 10.01.18.02 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Admission" means the process by which an
				  individual is accepted as a resident or patient in a State facility and
				  includes the physical act of the individual entering the State
				  facility.
(2) "Central coordinator"
				  means an individual or individuals designated by the Deputy Secretary for the
				  unit of the Department responsible for the operations of each State facility
				  to:
(a) Oversee development of policies and
				  materials;
(b) Monitor compliance;
				  and
(c) Identify and make
				  recommendations for improving a State facility's prevention and detection of,
				  and response to, inappropriate sexual behavior in State facilities.
(3) "Covered program" means any of
				  the following facilities and programs:
(a) A
				  State facility as defined in §B(22) of this regulation;
(b) Non-State operated residential treatment
				  centers for emotionally disturbed children and adolescents, licensed under
				  COMAR 10.07.04;
(c) Vocational and
				  day services programs, licensed by the Developmental Disabilities
				  Administration under COMAR 10.22.02 and 10.22.07; and
(d) The following programs licensed by the
				  Behavioral Health Administration:
(i)
				  Psychiatric rehabilitation programs for adults licensed under COMAR
				  10.63.03.09;
(ii) Residential rehabilitation programs
				  licensed under COMAR
				  10.63.04.05;
(iii) Supported employment programs licensed
				  under COMAR
				  10.63.03.16; and
(iv) Psychiatric rehabilitation programs for
				  minors licensed under COMAR 10.63.03.10.
(4) "Department" means the Maryland
				  Department of Health.
(5) External
				  Law Enforcement Agency.
(a) "External law
				  enforcement agency" means the Department of State Police or a police agency of
				  a county or municipal corporation.
(b) "External law enforcement agency" does
				  not include the police force of the Maryland Department of Health.
(6) "Inappropriate sexual
				  behavior" means:
(a) Sexual abuse as defined
				  in §B(17) of this regulation; and
(b) Any sexual act, as defined in §B(18)
				  of this regulation, between a staff member of a covered program and an
				  individual receiving services at the covered program.
(7) "Individual" means a person receiving
				  services or treatment at a State facility.
(8) "Initial plan of care" means the first
				  plan of care created for an individual by the treatment team and is created at
				  the first treatment team meeting.
(9) "Internal complaint process" means a
				  written policy and procedure for a covered program 's handling and
				  investigation of reports of inappropriate sexual behavior, as defined in
				  §B(3) of this regulation, and appropriate actions in response to verified
				  incidents of inappropriate sexual behavior, occurring within the covered
				  program.
(10) "Licensed" means
				  being licensed by the Department or approved by the Department to receive
				  funding to provide services in Maryland.
(11) "Peer training" means awareness and
				  prevention training regarding inappropriate sexual behavior that is provided by
				  a peer of the individual receiving services.
(12) "Plan of care" means a written document
				  addressing the needs of the individual receiving services from a covered
				  program, and the covered program's plan for provision of services and treatment
				  to meet those needs, developed in accordance with applicable State and federal
				  laws and regulations.
(13) "Program
				  director" means the individual who is responsible for the daily operations of a
				  covered program as outlined in the chapter under the appropriate subtitle that
				  delineates the requirements for a specific program.
(14) "Protection plan" means a document
				  created to address the individual's needs, with respect to the individual's:
(a) Risk of being subjected to the
				  perpetrator of inappropriate sexual behavior at the facility; and
(b) Treatment team's plan for mitigating the
				  individual's risk.
(15)
				  Reasonable Safety Precautions.
(a) "Reasonable
				  safety precautions" means an established set of measures, procedures, and
				  protocols taken in order to maintain the safety of individuals upon admission
				  to the State facility.
(b)
				  Reasonable safety precautions may include but are not limited to:
(i) Unit restriction, including dining on the
				  unit;
(ii) Increased nursing
				  contacts or more frequent observation by nurses;
(iii) Restrictions on activities;
(iv) Increased staffing assigned to the
				  individual; and
(v) Similar or
				  additional measures implemented.
(c) The type of reasonable safety precautions
				  implemented and the reason for the reasonable safety precautions shall be
				  documented in the individual's records.
(16) "Risk assessment screen" means a uniform
				  tool, developed by the Department, used by a facility to:
(a) Screen an individual for a history of
				  being subjected to, or perpetrating, inappropriate sexual behavior, and related
				  trauma; and
(b) Assess an
				  individual's risk of being subjected to, or perpetrating, inappropriate sexual
				  behavior while at the facility.
(17) Sexual Abuse.
(a) "Sexual abuse" means any sexual act, as
				  defined in §B(18) of this regulation, that is made or threatened to be
				  made without the consent of an individual who is the recipient of the action,
				  or without the consent of an individual solicited to take the action, which
				  occurs on the premises of a covered program or at any off-premises activity
				  sponsored by the covered program.
(b) "Sexual abuse" includes sexual harassment
				  and sexual assault.
(c) "Sexual
				  abuse" does not include an action taken reasonably related to the provision of
				  care, treatment, or services to an individual including:
(i) The performance of an accepted medical or
				  behavioral procedure pursuant to and in accordance with orders of an
				  appropriately qualified licensed health care professional; and
(ii) An action taken by a staff member that
				  complies with applicable laws and policies on the use of physical
				  intervention.
(18) "Sexual act" means any of the following,
				  if it can reasonably be construed to be for sexual arousal or gratification, or
				  for the abuse of either party, and not for an accepted medical or behavioral
				  purpose:
(a) An act in which an object or part
				  of an individual's body penetrates, however slightly, into another individual's
				  genital opening or anus;
(b)
				  Intentional physical contact, or an attempt to make physical contact, either
				  directly or through clothing, between the genitals, finger or fingers, hand or
				  hands, or mouth of one individual and the genitals, groin, inner thigh,
				  buttocks, anus, breast, or mouth of another individual;
(c) Intentional physical contact, or an
				  attempt to make physical contact, between the tongue or mouth of one individual
				  and any part of the body of another individual;
(d) The following nonphysical contacts:
(i) The intentional exposure by an individual
				  to another of the individual's naked genitals, groin, inner thigh, buttocks,
				  anus, or breast;
(ii) The
				  intentional exposure by an individual to another of photographs of an
				  individual's naked genitals, groin, inner thigh, buttocks, anus, or
				  breast;
(iii) The intentional
				  observation by an individual of another individual's naked genitals, groin,
				  inner thigh, buttocks, anus, or breast;
(iv) Verbal or written description of,
				  questions or suggestions regarding, or requests for any of the physical
				  contacts described in §B(18)(a)-(c) of this regulation;
(v) Photographing, drawing, transmitting an
				  image of, saving an image of, or recording the naked body or body parts of
				  another individual;
(vi)
				  Intentionally exposing an individual to photographs, pictures, drawings,
				  diagrams, or other graphic depictions of naked body or body parts of an
				  individual; and
(vii) Intentionally
				  causing another individual to make or attempt any of the physical contacts
				  described in §B(18)(a)-(c) of this regulation; and
(e) Other intentional acts directed to
				  another individual and performed for the purpose of arousing sexual thoughts or
				  feelings and not for purposes related to the provision of care.
(19) "Sexual assault" means any of
				  the following:
(a) A sexual offense as defined
				  in Criminal Law Article, Title 3, Annotated Code of Maryland; and
(b) Any other sexual act that is a crime
				  under State or federal law.
(20) "Sexual harassment" means intimidation,
				  bullying, or coercion of a sexual nature or unwelcome sexual advances, requests
				  for sexual favors, and other verbal or physical conduct of a sexual nature that
				  tends to create a hostile or offensive environment.
(21) "Staff member" means any individual
				  employed by a covered program, whether contractually or permanently and any
				  individual who volunteers with, is a contractor for or consultant to, works as
				  an intern or resident for, or otherwise is engaged by, the covered program at
				  any facility or location in which services are provided to
				  individuals.
(22) "State facility"
				  means the following institutions operated by the Department:
(a) A psychiatric hospital, licensed pursuant
				  to COMAR 10.07.01;
(b) An
				  intermediate care facility for individuals with developmental disabilities
				  licensed pursuant to COMAR 10.07.20;
(c) A forensic residential center, licensed
				  pursuant to COMAR 10.07.13; and
(d)
				  Regional institutes for children and adolescents licensed and operated pursuant
				  to COMAR 10.07.04 and COMAR 10.21.06.
(23) "Treatment team" means the group of
				  individuals at the covered program who, in accordance with applicable State and
				  federal law and regulations, are responsible for the development and
				  implementation of a plan of care for an individual receiving services from the
				  covered program.