reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.13 - License Revocation

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the
				  Department's designated approval unit determines that a program licensed under
				  this chapter has violated a requirement of this chapter, the Department may
				  revoke the license.
B. If the
				  Department's designated approval unit determines that the program has violated
				  a requirement of a sanction imposed under Regulation .14 of this chapter, the
				  Department may revoke the license.
C. If the Department revokes a program's
				  license under this regulation, the program shall notify individuals receiving
				  services from the program, or the guardians of these individuals, of the
				  revocation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.14 - Intermediate Sanctions

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the
				  Department determines that a program licensed under this chapter has violated a
				  requirement of this subtitle, the Department's designated approval unit may
				  take one or more of the following actions:
(1) Prohibit the program from serving any
				  additional individuals;
(2) Require
				  the program to reduce the number of individuals currently receiving
				  services;
(3) Prohibit the program
				  from providing specific services or restricting the program to providing only
				  specified services;
(4) Require the
				  program, and any of its staff, to receive mandatory training in identified
				  areas;
(5) Require the program to
				  use the services of a consultant approved in advance by the
				  Department;
(6) Require the
				  establishment of an escrow account;
(7) Impose a civil money penalty, in
				  accordance with this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.15 - Directed Plan of Correction

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  If the Department determines that a program licensed under this chapter has
				  violated any requirement of this chapter, the Department's designated approval
				  unit may impose a directed plan of correction, in addition to any intermediate
				  sanctions imposed in accordance with this chapter.
B. The directed plan of correction may
				  include any one or more of the following:
(1)
				  Mandating staffing patterns, specifying the number of personnel, personnel
				  qualifications, or both;
(2)
				  Imposing a temporary site monitor, whereby the Department maintains an on-going
				  physical presence for the purpose of providing assistance and evaluating the
				  extent of the program's progress in correcting violations;
(3) Requiring the program to submit periodic
				  reports of the program's progress in correcting violations.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.16 - Settlement Agreement

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Department may enter into a settlement agreement with a program licensed under
				  this chapter that has violated a requirement of this chapter, establishing
				  specific conditions for continued operation, including time limits for
				  compliance.
B. A settlement
				  agreement is a public document and may be disseminated under the State
				  Government Article, §§
										10-611 -10-630,
				  Annotated Code of Maryland.
C. A
				  copy of the settlement agreement shall be distributed to individuals served by
				  the program or posted in a public location at the program's physical
				  site.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.17 - Initiation of Receivership

Current through Register Vol. 51, No. 14, July 12, 2024
The Secretary or designee may take action to initiate
					 receivership of a program licensed under this chapter, pursuant to
					 Health-General Article, §§19-333 -19-339, Annotated Code of
					 Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.18 - Civil Money Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Notwithstanding any penalty that may be imposed under the Civil False Claims
				  Act, pursuant to Health-General Article, §2-611, Annotated Code of
				  Maryland or other statute, the Department may impose a civil monetary penalty
				  on a person for:
(1) Operating a
				  community-based behavioral health services program without a license, if one is
				  required by law or regulation;
(2)
				  Any material and egregious violation of any provision of this subtitle;
				  or
(3) Both.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.19 - Program's Right to a Hearing on Proposed Sanctions

Current through Register Vol. 51, No. 14, July 12, 2024
A. A program licensed under this chapter that
				  is aggrieved by the proposal of the Department's designated approval unit to
				  take any of the following actions may appeal the Department's decision by
				  filing a request for an administrative hearing in accordance with Regulation
				  .20 of this chapter:
(1) The denial of an
				  application for a license or for renewal of a license;
(2) The summary suspension of a license,
				  under Regulation .11 of this chapter;
(3) The denial of a request for modification
				  of a license, under Regulation .07 of this chapter;
(4) The denial of a request to discontinue a
				  program, under Regulation .10 of this chapter;
(5) A revocation of a license, under
				  Regulation .13 of this chapter;
(6)
				  The imposition of a sanction under Regulation .14, .16, or .18 of this
				  chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.20 - Hearing Procedures

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the
				  Department's designated approval unit proposes to take an action listed in
				  Regulation .19 of this chapter, the Department shall deliver a written notice
				  of the proposed action to the program director, in accordance with the
				  provisions of COMAR 10.01.03.05.
B. Within 10 working days after receipt of
				  the notice of the proposed action, the program may submit to the Department, at
				  the address identified in the notice, a written request for a hearing, with
				  copies to the:
(1) Administration;
(2) CSA, LAA, or LBHA, as appropriate;
				  and
(3) Director of the
				  Department's designated approval unit.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.06 - Application and Licensure Process › Section 10.63.06.21 - Deadlines and Effective Dates of this Chapter

Current through Register Vol. 51, No. 14, July 12, 2024
A. Accreditation-based Licenses. The
				  following shall apply for programs that are required by law and this chapter to
				  be accredited to be licensed:
(1) A program
				  may not operate on or after April 1, 2018 without a license;
(2) To be licensed on or before April 1,
				  2018, a program shall submit a completed and accurate application to the
				  Department's designated approval unit before January 1, 2018;
(3) An accreditation-based license may be
				  issued on or after, and not before, January 1, 2017;
(4) The Department's designated approval unit
				  shall begin accepting applications for accreditation-based licenses on October
				  1, 2016;
(5) As of October 1, 2016,
				  applications for an accreditation-based license shall include evidence that the
				  program is accredited by an approved accreditation organization;
(6) The Department's designated approval unit
				  may not accept an application for initial certification or approval under COMAR
				  Title 10, Subtitles 21 or 47 after September 30, 2016;
(7) A program with a certification or
				  approval under COMAR Title 10, Subtitles 21 or 47:
(a) May apply for renewal of the
				  certification or approval before January 1, 2018;
(b) If eligible for renewal, shall receive a
				  certification or approval, valid until April 1, 2018; and
(c) May not operate under the certification
				  or approval after March 31, 2018.
(8) A program that is certified or approved
				  based on deemed status in accordance with COMAR
				  10.21.16.10 or COMAR
				  10.47.04.05 shall receive a
				  license, which shall be effective during the current accreditation period;
				  and
(9) If the Department's
				  designated approval unit cannot issue a license by April 1, 2018 for a program
				  that submits a completed, accurate application for a license before January 1,
				  2018, the Department's designated approval unit shall extend the expiration
				  date of the existing approval or certification to complete the license
				  application process.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.01 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
A. This chapter
				  establishes a pilot program for outpatient civil commitment (OCC) to allow for
				  the release of individuals who are involuntarily committed for inpatient
				  treatment under Health-General Article, §10-632, Annotated Code of
				  Maryland, on the condition of admission to the OCC pilot program.
B. This chapter is not intended to impose any
				  exhaustion requirement on an individual as a prerequisite to the individual's
				  pursuing concurrently or in any order any legal remedy to obtain release from
				  an inpatient facility.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.03 - Pilot Program

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Department authorizes the Administration to create a program to provide
				  community-based treatment to individuals with mental disorders who were:
(1) Admitted to an inpatient facility under
				  Health-General Article, Title 10, Annotated Code of Maryland; and
(2) Released on condition of admission to the
				  program pursuant to the requirements of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.04 - Length of Time of the Pilot Program

Current through Register Vol. 51, No. 14, July 12, 2024
The program and the regulations under this chapter shall
					 end on the expiration of the federal grant program funding.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.05 - Admission Criteria

Current through Register Vol. 51, No. 14, July 12, 2024
A. To be
				  involuntarily admitted to the program, an individual shall meet the following
				  criteria:
(1) Have a mental
				  disorder:
(2) Be 18 years old or
				  older:
(3) Be a resident of
				  Baltimore City:
(4) Have had two or
				  more involuntary inpatient facility admissions in the preceding 12 months,
				  including the most recent admission, before the application for admission into
				  the program:
(5) Has a demonstrated
				  history of refusing community treatment that has been a significant factor in
				  contributing to the current involuntary inpatient admission;
(6) Has a treatment history and behavior that
				  indicates the need for outpatient treatment to prevent deterioration after
				  discharge and that is substantially likely to result in the individual becoming
				  a danger to self or others in the community in the foreseeable
				  future;
(7) Has been offered, and
				  refused, the opportunity to accept voluntary outpatient admission into the
				  program on discharge from the inpatient facility;
(8) Is substantially likely to benefit from
				  the outpatient treatment;
(9) Would
				  not be a danger to self or others in the community if released to the program;
				  and
(10) For whom treatment in the
				  program is the least restrictive alternative appropriate for the
				  individual.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.06 - Application for Admission

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  administrative head of an inpatient facility may submit an application to the
				  Administration for admission to the program of an individual who is committed
				  to the inpatient facility under Health-General Article, §10-632, Annotated
				  Code of Maryland.
B. The
				  Administration shall provide an application form that includes the following:
(1) The statutory authority for the
				  application;
(2) The applicant's:
(a) Name;
(b) Address; and
(c) Telephone number;
(3) The name and address of the individual
				  for whom the program is being requested;
(4) The criteria for admission into the
				  program;
(5) The facts that support
				  the applicant's determination that the individual who is the subject of the
				  application meets each criterion for admission to the program; and
(6) The signature and verification by a
				  physician, psychiatrist, psychologist, psychiatric nurse practitioner, licensed
				  certified social worker-clinical, licensed master social worker, or licensed
				  clinical professional counselor on behalf of the inpatient facility.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.07 - Application Approval and Development of Treatment Plan

Current through Register Vol. 51, No. 14, July 12, 2024
A. Within 3 business days from receiving an
				  application for admission, the Administration shall:
(1) Determine whether the individual meets
				  the criteria for admission to the program;
(2) Determine whether the program is
				  appropriate to meet the individual's needs; and
(3) Provide written notice to the individual
				  and to the administrative head of the inpatient facility of the
				  Administration's decision to approve or deny the application.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.08 - Schedule of Hearing, Notice of Hearing, and Rights

Current through Register Vol. 51, No. 14, July 12, 2024
A. If the application for admission to the
				  program has been approved, the inpatient facility staff shall:
(1) Schedule a hearing with the Office of
				  Administrative Hearings;
(2) Notify
				  the legal service provider that the hearing has been scheduled;
(3) Provide the individual with a copy of the
				  application and proposed treatment plan; and
(4) Provide the individual with a copy of the
				  Notice of Hearing and Rights.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.09 - Hearing

Current through Register Vol. 51, No. 14, July 12, 2024
A. Within 10
				  business days from the Administration's approval of the program application, a
				  hearing shall be held by the Office of Administrative Hearings to decide if the
				  patient meets the program admission requirements of this chapter.
B. The hearing may be postponed for good
				  cause for not more than 10 business days from date of the postponed
				  hearing.
C. Burden of Proof. The
				  Administration shall demonstrate by clear and convincing evidence that the
				  individual meets each of the requirements set forth under Regulation .05 of
				  this chapter.
D. Rights of Parties.
(1) At a hearing, the parties have the right
				  to:
(a) Be represented by counsel;
(b) Present witnesses;
(c) Cross-examine witnesses presented by the
				  other party;
(d) Present
				  documentary or other relevant evidence;
(e) Submit rebuttal evidence; and
(f) Present summation and argument.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.10 - Orders

Current through Register Vol. 51, No. 14, July 12, 2024
A. An order shall:
(1) Specify that each of the admission
				  criteria has been met;
(2) Order
				  the individual to adhere to program recommendations including a treatment plan
				  or support services, or both, as needed by the individual; and
(3) Specify the date on which the order shall
				  expire.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.11 - Settlement Conference

Current through Register Vol. 51, No. 14, July 12, 2024
A. Before
				  the hearing, if the individual elects to participate in the program
				  voluntarily, the ALJ shall convene a settlement conference at the time, date,
				  and place designated for the hearing.
B. The settlement conference shall include
				  the individual, the legal service provider, and a representative of the
				  inpatient facility.
C. In order for
				  the individual to be voluntarily admitted to the program, the individual shall
				  sign the settlement agreement and agree to adhere to program recommendations
				  including a treatment plan or support services, or both, as needed by the
				  individual.
D. The settlement
				  agreement shall be witnessed by the ALJ.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.12 - Discharge from the Program

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Before Discharge. Before the expiration of the program order, the
				  Administration shall ensure that a transition plan is in place which provides
				  the outpatient services necessary to support the individual in the
				  community.
B. Early Discharge. The
				  Administration may discharge an individual from the program prior to the
				  expiration of the program order upon finding that the individual is:
(1) Not likely a danger to self or others
				  without the order; and
(2)
				  Compliant with the treatment plan and is likely to remain compliant in the
				  future without the order.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.13 - Relation to Other Admission Provisions

Current through Register Vol. 51, No. 14, July 12, 2024
A. Nothing in this chapter prevents the
				  admission to a hospital pursuant Health-General Article, §10-601 et seq.,
				  Annotated Code of Maryland, of an individual participating in the
				  Program.
B. An individual's
				  participation in the program does not prohibit the individual's evaluation and
				  involuntary admission under Health-General Article, §10-601 et seq.,
				  Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 63 - COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES › Chapter 10.63.07 - Outpatient Civil Commitment (OCC) Pilot Program › Section 10.63.07.14 - Effective Date

Current through Register Vol. 51, No. 14, July 12, 2024
This chapter is effective July 1, 2017.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.01 - 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) "Accompany the patient to the hospital"
				  means, in the case of a transfer of care to a hospital, the direct-entry
				  midwife:
(a) If possible, will ride in the
				  ambulance with the patient; or
(b)
				  Travel by other means to the hospital.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.02 - Scope of Practice

Current through Register Vol. 51, No. 14, July 12, 2024
The practice of direct-entry midwifery includes:
A. Providing the necessary supervision, care,
				  and advice to a patient during a low-risk pregnancy, labor, delivery, and
				  postpartum period;
B. Newborn care
				  authorized under Health Occupations Article, § 8-6 C-02, Annotated Code of
				  Maryland, provided in a manner that is:
(1)
				  Consistent with national direct-entry midwifery standards; and
(2) Based on the acquisition of clinical
				  skills necessary for the care of pregnant women and newborns, including
				  antepartum, intrapartum, and postpartum care;
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.03 - Scope of Practice - Prohibitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The practice of direct-entry midwifery
				  does not include:
(1) Pharmacological
				  induction or augmentation of labor or artificial rupture of membranes before
				  the onset of labor;
(2) Surgical
				  delivery or any surgery except an emergency episiotomy;
(3) Use of forceps or vacuum
				  extractor;
(4) Except for the
				  administration of a local anesthetic, administration of an
				  anesthetic;
(5) Administration of
				  any kind of narcotic analgesic; or
(6) Administration of any prescription
				  medication not authorized in accordance with Regulation .07 of this
				  chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.04 - Required Consultation

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  licensed direct-entry midwife shall consult with a health care practitioner and
				  document:
(1) The consultation;
(2) The recommendations of the consultation;
				  and
(3) The discussion of the
				  consultation with the client if any of the following conditions are present
				  during prenatal care:
(a) Significant mental
				  disease, including depression, bipolar disorder, schizophrenia, and other
				  conditions that impair the ability of the patient to participate effectively in
				  the patient's care or that require the use of psychotropic drugs to control the
				  condition;
(b) Second or third
				  trimester bleeding;
(c)
				  Intermittent use of alcohol into the second trimester;
(d) Asthma;
(e) Diet-controlled gestational
				  diabetes;
(f) History of genetic
				  problems, intrauterine death after 20 weeks' gestation, or
				  stillbirth;
(g) Abnormal Pap
				  smear;
(h) Possible ectopic
				  pregnancy;
(i)
				  Tuberculosis;
(j) Controlled
				  hypothyroidism, being treated with thyroid replacement and euthyroid, and with
				  thyroid test numbers in the normal range;
(k) Rh sensitization with positive antibody
				  titer;
(I) Breech presentation
				  between 35 and 38 weeks;
(m)
				  Transverse lie or other abnormal presentation between 35 and 38
				  weeks;
(n) Premature rupture of
				  membranes at 37 weeks or less;
(o)
				  Small for gestational age or large for gestational age fetus;
(p) Polyhydramnios or
				  oligohydramnios;
(q) Previous LEEP
				  procedure or cone biopsy;
(r)
				  Previous obstetrical problems, including uterine abnormalities, placental
				  abruption, placenta accreta, obstetric hemorrhage, incompetent cervix, or
				  preterm delivery for any reason;
(s) Post-term maturity (41 0/7 to 6/7 weeks
				  gestational age);
(t) Inflammatory
				  bowel disease, in remission; or
(u)
				  Primary herpes simplex virus, infection or any active infection at time of
				  delivery.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.05 - Required Transfer of Care

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Except for §B of this regulation, a licensed direct-entry midwife shall
				  arrange immediate emergency transfer to a hospital if:
(1) The patient requests transfer;
				  or
(2) The patient or newborn is
				  determined to have any of the following conditions during labor, delivery, or
				  the immediate postpartum period:
(a)
				  Unforeseen noncephalic presentation;
(b) Unforeseen multiple gestation;
(c) Nonreassuring fetal heart rate or
				  pattern, including:
(i) Tachycardia
(ii) Bradycardia;
(iii) Significant change in baseline;
				  or
(iv) Persistent late or severe
				  variable decelerations;
(d) Prolapsed cord;
(e) Unresolved maternal hemorrhage;
(f) Retained placenta;
(g) Signs of fetal or maternal
				  infection;
(h) Patient with a third
				  or fourth degree laceration or a laceration beyond the licensed direct-entry
				  midwife's ability to repair;
(i)
				  Apgar of less than seven at 5 minutes;
(j) Obvious congenital anomalies;
(k) Need for chest compressions during
				  neonatal resuscitation;
(I)
				  Newborn with persistent central cyanosis;
(m) Newborn with persistent grunting and
				  retractions;
(n) Newborn with
				  abnormal vital signs;
(o) Gross or
				  thick meconium staining, when discovered; or
(p) Newborn with excessive dehydration due to
				  inability to feed.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.06 - Assistant for Home Birth

Current through Register Vol. 51, No. 14, July 12, 2024
At the time of delivery, a licensed direct-entry midwife
					 shall be assisted by a second individual who has:
A. Completed the American Academy of
				  Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP)
				  within the previous 2 years; and
B.
				  The skills and equipment necessary to perform a full resuscitation of the
				  newborn in accordance with the principles of NRP.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.07 - Licensed Direct-Entry Midwifery Formulary, Equipment, and Medical Devices

Current through Register Vol. 51, No. 14, July 12, 2024
A. As
				  approved by the Board, in accordance with Health Occupations Article § 8-6
				  C-02 (b)(8), Annotated Code of Maryland, a licensed direct-entry midwife may:
(1) Obtain and administer medications;
				  and
(2) Obtain and use equipment
				  and devices for the practice of midwifery.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.08 - License Required and Exceptions

Current through Register Vol. 51, No. 14, July 12, 2024
A. An individual shall be licensed by the
				  Board before the individual may practice direct-entry midwifery in the
				  State.
B. This regulation does not
				  apply to:
(1) An individual who assists at a
				  birth in an emergency;
(2) An
				  individual who is licensed as a health care practitioner whose scope of
				  practice allows the individual to practice direct-entry midwifery; or
(3) A student who is practicing direct-entry
				  midwifery while engaged in a Board-approved clinical midwife educational
				  experience under the supervision of a licensed direct-entry midwife.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.09 - Patient's Refusal to Transfer Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. If a patient chooses to give birth at home
				  in a situation prohibited by this chapter or in which a licensed direct-entry
				  midwife recommends transfer, the licensed direct-entry midwife shall:
(1) Transfer care of the patient to a health
				  care practitioner; and
(2) Complete
				  the standard form developed under Regulation . 10 of this chapter and:
(a) Submit the completed form to the
				  accepting health care practitioner; and
(b) Cease to take responsibility for the
				  patient's pregnancy care within 1 week after the transfer.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.10 - Plan of Care

Current through Register Vol. 51, No. 14, July 12, 2024
A. A licensed
				  direct-entry midwife shall develop a general written plan for:
(1) Emergency transfer of a patient, a
				  newborn, or both;
(2) Transport of
				  a newborn to a newborn nursery or neonatal intensive care nursery;
				  and
(3) Transport of a patient to
				  an appropriate hospital with a labor and delivery unit.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.11 - Informed Consent Agreements

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Before initiating care, a licensed direct-entry midwife shall obtain a signed
				  copy of the Board-approved standardized informed consent agreement.
B. The agreement developed under §A of
				  this regulation shall include acknowledgment by the patient of receipt, at a
				  minimum, of the following:
(1) The licensed
				  direct-entry midwife's training and experience;
(2) Instructions for obtaining a copy of the
				  regulations under this chapter;
(3)
				  Instructions for obtaining a copy of the NARM certification
				  requirements;
(4) Instructions for
				  filing a complaint with the Board;
(5) Notice of whether the licensed
				  direct-entry midwife has professional liability insurance coverage;
(6) A description of the procedures,
				  benefits, and risks of home births, including those conditions that may arise
				  during delivery; and
(7) Any other
				  information that the Board requires.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.12 - Required Reports

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Annually, beginning October 1, 2016, a licensed direct-entry midwife shall
				  submit a report to the Committee, in a form specified by the Board, of the
				  following information regarding cases in which the licensed direct-entry
				  midwife assisted during the previous fiscal year ending June 30, when the
				  intended place of birth was an out-of-hospital setting:
(1) The total number of patients served as
				  primary caregiver at the onset of care;
(2) The number, by county, of live births
				  attended as primary caregiver;
(3)
				  The number, by county, of cases of fetal demise, infant deaths, and maternal
				  deaths attended as primary caregiver at the discovery of the demise or
				  death;
(4) The number of women
				  whose primary care was transferred to another health care practitioner during
				  the antepartum period and the reason for the transfer;
(5) The number, reason for, and outcome of
				  each nonemergency hospital transfer during the intrapartum or postpartum
				  period;
(6) The number, reason for,
				  and outcome of each urgent or emergency transport of an expectant mother in the
				  antepartum period;
(7) The number,
				  reason for, and outcome of each urgent or emergency transport of an infant or
				  mother during the intrapartum or immediate postpartum period;
(8) The number of planned out-of-hospital
				  births at the onset of labor and the number of births completed in an
				  out-of-hospital setting;
(9) A
				  brief description of any complications resulting in the morbidity or mortality
				  of a mother or a neonate; and
(10)
				  Any other information required by the Board in this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.13 - Direct-Entry Midwifery Advisory Committee

Current through Register Vol. 51, No. 14, July 12, 2024
A. There is a Direct-Entry Midwifery Advisory
				  Committee within the Board.
B.
				  Committee Appointments.
(1) The Committee
				  shall consist of seven members appointed by the Board, in accordance with the
				  following.
(a) Three shall be licensed
				  direct-entry midwives;
(b) Two
				  shall be licensed registered nurses certified as nurse-midwives;
(c) One shall be a representative of the
				  Maryland Hospital Association; and
(d) One shall be a consumer member who meets
				  the requirements stated in Health Occupations Article, § 8-6 C-ll,
				  Annotated Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.14 - Committee Duties

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Committee shall:
(1) Review applications for
				  licensure as a licensed direct-entry midwife and make recommendations to the
				  Board regarding applicants;
(2)
				  Maintain a list of all licensed direct-entry midwives;
(3) Make recommendations to the Board
				  regarding continuing education requirements for licensed direct-entry
				  midwives;
(4) Review advertising by
				  licensed direct-entry midwives and by institutions that offer a direct-entry
				  midwife program and make recommendations to the Board, as necessary;
(5) Advise the Board on matters relating to
				  the practice of direct-entry midwifery;
(6) Collect the reports required to be
				  submitted by each licensed direct-entry midwife under Regulation .12 of this
				  chapter;
(7) Make recommendations
				  to the Board regarding regulations relating to the practice of direct-entry
				  midwifery that are necessary to carry out the provisions of this
				  chapter;
(8) At the request of the
				  Board, investigate complaints against licensed direct-entry midwives;
				  and
(9) Keep a record of the
				  Committee's proceedings.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.15 - Qualifications of Applicants for Initial Licensure

Current through Register Vol. 51, No. 14, July 12, 2024
A. An applicant
				  shall:
(1) Be of good moral
				  character;
(2) Be a high school
				  graduate or have completed equivalent education;
(3) Be 21 years old or older;
(4) Hold a current cardiopulmonary
				  resuscitation (CPR) certification issued by the American Red Cross or the
				  American Heart Association;
(5)
				  Have completed in the past 2 years the American Academy of Pediatrics or
				  American Heart Association Neonatal Resuscitation Program (NRP);
(6) Hold a current valid Certified
				  Professional Midwife credential granted by NARM; and
(7) Have completed a midwifery education
				  program as describe in §B of this regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.16 - Applications for Licenses and Issuance of Licenses

Current through Register Vol. 51, No. 14, July 12, 2024
A. To apply for a license to practice
				  direct-entry midwifery an applicant shall submit:
(1) To a criminal history records check
				  (CHRC) in accordance with Health Occupations Article, §
											8-303, Annotated
				  Code of Maryland;
(2) A completed
				  application to the Board on the form that the Board requires; and
(3) Written, verified evidence that the
				  requirement submissions to a CHRC in accordance with Health Occupations
				  Article, §
											8-303, Annotated
				  Code of Maryland, is being met;
(4)
				  Any documentation requested from the applicant by the Board including, but not
				  limited to:
(a) An official certified or true
				  test court documents; and
(b) A
				  signed and dated explanation, written by the applicant, regarding the facts and
				  circumstances, outcome, and current status of any criminal history record
				  information received by the Board:
(i) Under
				  §A(1) of this regulation;
(ii)
				  In an answer to a question on the Board's application form;
(iii) Any other source; and
(iv) Any additional documentation requested
				  by the Board if the documentation received from the applicant under §A(4)
				  of this regulation is incomplete or insufficient; and
(5) The initial application fee
				  specified in Regulation .18 of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.17 - Term and Renewal of License and Reinstatement of License

Current through Register Vol. 51, No. 14, July 12, 2024
A. A license issued
				  under this regulation authorizes the licensee to practice direct-entry
				  midwifery while the license is active.
B. A license:
(1) Expires on October 28 of every
				  odd-numbered year;
(2) Is valid for
				  2 years, except for an initial license issued before the next renewal
				  date;
(3) Issued for less than the
				  full 2-year period shall be renewed at the next annual renewal date;
				  and
(4) May be renewed for an
				  additional term if the applicant:
(a) Meets
				  the renewal requirements under §B(4)(c) of this regulation:
(b) Pays to the Board a renewal fee specified
				  in Regulation 18 of this chapter; and
(c) Submits to the Board:
(i) A renewal application on the form that
				  the Board requires; and
(ii)
				  Satisfactory evidence of compliance with any continuing education or other
				  competency requirements for license renewal.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.18 - Fees

Current through Register Vol. 51, No. 14, July 12, 2024
A. The fees listed
				  in this regulation are not refundable.
B. An initial license shall only be valid
				  until the next renewal period.
C.
				  The fees are as follows:
(1) Initial
				  application fee - $900;
(2)
				  Biennial renewal - $800;
(3)
				  Reactivation fee - $800;
(4)
				  Reinstatement Fee - $900; and
(5)
				  Inactive Status Fee - $100.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.01 - Practice of Licensed Direct-Entry Midwives › Section 10.64.01.19 - Prohibited Acts

Current through Register Vol. 51, No. 14, July 12, 2024
A. Unless
				  authorized to practice direct-entry midwifery, an individual may not represent
				  to the public by title, description of service, method, procedure, or
				  otherwise, that the individual is authorized to practice direct-entry midwifery
				  in the State.
B. A licensee may not
				  advertise in a manner that is unreasonable, misleading, or
				  fraudulent.
C. Unless authorized to
				  practice direct-entry midwifery, an individual may not use the abbreviation
				  "LDEM" or use the designation "licensed direct-entry midwife".
D. Unless authorized to practice direct-entry
				  midwifery or certified as a registered nurse midwife under Health Occupations
				  Article, Title 8, Annotated Code of Maryland, an individual may not use the
				  designation "midwife".
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.02 - Code of Ethics for Licensed Direct-Entry Midwives › Section 10.64.02.01 - 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) "Abandonment" means:
(a) The unilateral termination of the
				  licensed direct-entry midwife-client relationship by the direct-entry midwife
				  without reasonable notice;
(b)
				  Failure of the licensed direct-entry midwife to:
(i) Provide the client with a referral to an
				  appropriate health care professional; or
(ii) Make reasonable arrangements with an
				  appropriate and qualified healthcare professional to assume care for the
				  client; and
(c) Leaving a
				  client in the intrapartum period without properly terminating care and ensuring
				  adequate care for the mother and unborn child.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.02 - Code of Ethics for Licensed Direct-Entry Midwives › Section 10.64.02.02 - Ethical Responsibilities

Current through Register Vol. 51, No. 14, July 12, 2024
A. A
				  licensed direct-entry midwife shall:
(1)
				  Provide services with respect for human dignity and the uniqueness of a client
				  unrestricted by consideration of social or economic status, religious
				  affiliation, personal attributes, or the nature of health problems;
(2) Safeguard a client's right to privacy by
				  maintaining confidentiality of information;
(3) Act to safeguard a client and the public
				  if health care and safety are affected by the incompetent, unethical, or
				  illegal practice of any individual;
(4) Promptly report a breach of
				  confidentiality or privacy;
(5)
				  Assume responsibility and accountability for one's judgments and actions while
				  providing direct-entry midwifery services;
(6) Maintain competence in direct-entry
				  midwifery;
(7) Exercise informed
				  judgment and use individual competence and qualifications as criteria in
				  seeking consultation, accepting responsibilities, and delegating direct-entry
				  midwifery activities to others;
(8)
				  Inform the Board regarding unethical conduct by another licensed direct-entry
				  midwife;
(9) Provide information
				  about fees upon request by a client;
(10) Notify the Board in writing within 30
				  days if any license, certificate, permit, or registration granted by another
				  state or territory for the practice of direct-entry midwifery or certified
				  professional midwifery is restricted, suspended, revoked, or subjected to other
				  disciplinary action by a licensing or certifying authority; and
(11) Make a client's record available to the
				  client upon request, complying with all applicable State and federal laws and
				  regulations governing disclosure of medical records.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 64 - BOARD OF NURSING - LICENSED DIRECT-ENTRY MIDWIVES › Chapter 10.64.02 - Code of Ethics for Licensed Direct-Entry Midwives › Section 10.64.02.03 - Quality Assessment and Improvement

Current through Register Vol. 51, No. 14, July 12, 2024
Violation of this chapter may result in the Board taking
					 disciplinary action against a licensee pursuant to Health Occupations Article,
					 §
										8-6C-20, Annotated
					 Code of Maryland.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 65 - BOARD OF MASSAGE THERAPY EXAMINERS › Chapter 10.65.01 - General Regulations › Section 10.65.01.01 - Licensure or Registration Required; Exceptions

Current through Register Vol. 51, No. 14, July 12, 2024
All proceedings of the Board in regular session shall be
					 governed by Robert's Rules of Order.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 65 - BOARD OF MASSAGE THERAPY EXAMINERS › Chapter 10.65.01 - General Regulations › Section 10.65.01.02 - Board Officers, Members, and Staff

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Board shall, as the appointing
				  authority, direct the operation of the staff through the executive
				  director.
B. Board members may not
				  have monetary, pecuniary, or other interest in the affairs of any:
(1) Staff member; or
(2) Organization engaged in business with the
				  Board, including:
(a) Businesses;
(b) Enterprises; or
(c) Other for-profit organizations.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 65 - BOARD OF MASSAGE THERAPY EXAMINERS › Chapter 10.65.01 - General Regulations › Section 10.65.01.03 - Scope

Current through Register Vol. 51, No. 14, July 12, 2024
Except as specifically provided in this chapter, this
					 chapter does not limit the right of an individual to:
A. Practice a health occupation that the
				  individual is otherwise authorized to practice under the Health Occupations
				  Article, Annotated Code of Maryland; or
B. Advertise an occupation that the
				  individual is otherwise authorized to practice under the Health Occupations
				  Article, Annotated Code of Maryland.