Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 3 › Subtitle 22 - DEVELOPMENTAL DISABILITIES › Chapter 10.22.12 - Eligibility for and Access to Community Services for Individuals with Developmental Disability › Section 10.22.12.03 - 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) "Administration" means the Developmental
				  Disabilities Administration (DDA).
(2) "Alternative living unit (ALU)" means a
				  residence that:
(a) Provides residential
				  services for individuals who, because of developmental disability, require
				  specialized living arrangements;
(b) Admits not more than three individuals;
				  and
(c) Provides 10 or more hours
				  of supervision per unit, per week.
(3) "Applicant" means the individual who
				  files an application for services with the DDA.
(4) "Application for services" means the
				  instrument:
(a) Used to make preliminary
				  determination of eligibility for DDA services, the nature of the disability,
				  the services required, and how these services are to be provided;
(b) Providing the basis for preliminary
				  determination of service priority.
(5) "Appropriate evaluation" means the
				  assessment of an individual using accepted professional standards to document
				  the presence of a:
(a) Developmental
				  disability as defined in Health-General Article, §7-101, Annotated Code of
				  Maryland; or
(b) Disability that
				  qualifies the individual for individual support services only as defined in
				  Health-General Article, §7-403(c), Annotated Code of Maryland.
(6) "Caregiver" means the person
				  who is primarily responsible for the ongoing care of the individual who is
				  applying for services from the DDA. If the applicant is the caregiver, this
				  term is applicable to the applicant.
(6-1) "Community Supported Living Arrangements Services
					 (CSLA)" means one or more of the following services to assist an individual
					 with developmental disability or an individual eligible for support services
					 only in those nonvocational activities necessary to enable that individual to
					 live in the individual's own home, apartment, family home, or rental unit, with
					 not more than two other recipients of these services:
(a) Personal assistance;
(b) Supports that enhance the individual's
				  opportunities for community participation and to exercise choice and control
				  over the individual's own life;
(c)
				  Community integration training services necessary to assist the individual in
				  achieving and maintaining increased integration, interdependence, and
				  productivity;
(d) 24-hour emergency
				  assistance;
(e) Assistive
				  technology;
(f) Adaptive
				  equipment;
(g) Case management
				  services;
(h) Environmental
				  modification;
(i) Respite care;
				  and
(j) Other services as approved
				  by the Secretary or the Secretary's designee.
(7) "Department" means the Department of
				  Health and Mental Hygiene.
(8)
				  "Developmental Disabilities Administration access unit" ("DDA access unit" or
				  "unit") means the component which is under contract with the DDA to conduct the
				  preliminary assessment of eligibility and priority for services based on the
				  information provided on the application.
(9) "Developmental disability" means a
				  severe, chronic disability of an individual that:
(a) Is attributable to a physical or mental
				  impairment other than the sole diagnosis of mental illness, or to a combination
				  of mental and physical impairments;
(b) Is manifested before the individual
				  becomes 22 years old;
(c) Is likely
				  to continue indefinitely;
(d)
				  Results in an inability to live independently without external support or
				  continuing and regular assistance; and
(e) Reflects the need for a combination and
				  sequence of special, interdisciplinary, or generic care, treatment, or other
				  services that are individually planned and coordinated for the
				  individual.
(10)
				  "Director" means the Director of the Developmental Disabilities
				  Administration.
(11) "Eligibility
				  for support services only" means an individual shall have a severe chronic
				  disability that is:
(a) Attributable to a
				  physical or mental impairment other than the sole diagnosis of mental illness,
				  or to a combination of mental and physical impairments; and
(b) Likely to continue
				  indefinitely.
(12)
				  "Family support services" means a program designed to enable a family to
				  provide for the needs of a child with developmental disability living in the
				  home. Family support services include:
(a)
				  Individual and family counseling;
(b) Personal care;
(c) Day care;
(d) Specialized equipment;
(e) Health services;
(f) Respite care;
(g) Housing adaptations;
(h) Transportation; and
(i) Other necessary services.
(13) "Grabau class" means those
				  individuals:
(a) Who are confined in a
				  SRC;
(b) Whose level of
				  intellectual and personal skills is sufficient to allow them to function
				  outside the SRC;
(c) Who have been
				  characterized by the SRC as having maladaptive behavior or emotional
				  disturbance of sufficient severity as to require their continued placement with
				  the SRC; and
(d) Who have been
				  confirmed as members of the class through an appropriate evaluation and
				  staffing process designated by the DDA.
(14) "Home and Community Based Waiver
				  (waiver)" means the document and any amendments to it submitted by the single
				  State agency for Title XIX and approved by the Secretary of Health and Human
				  Services, which authorizes the waiver of statutory requirements limiting
				  coverage for home and community based services under the Medicaid State
				  Plan.
(15) "Individual" means the
				  person for whom an application for services has been filed with the
				  DDA.
(16) "Individual family care
				  home (IFC)" means a private single family residence licensed by the Department
				  under COMAR 10.22.08 which:
(a) Under
				  supervision, provides a home for individuals with developmental disability in a
				  family atmosphere; and
(b) Provides
				  habilitation services for one to three individuals who are not related to the
				  caregiver.
(17)
				  Individual Support Services.
(a) "Individual
				  support services" means an array of services that are designed to increase or
				  maintain an individual's ability to live alone or in a family
				  setting.
(b) "Individual support
				  services" includes:
(i) In-home assistance
				  with meals and personal care;
(ii)
				  Counseling;
(iii) Physical,
				  occupational, or other therapies;
(iv) Architectural modification;
				  and
(v) Any other services that the
				  Administration considers appropriate to meet the individual's needs.
(18) "Knott class"
				  means individuals with intellectual disabilities who were or are deemed
				  inappropriately placed within Mental Hygiene Administration
				  facilities.
(19) "Local review
				  committee (LRC)" means the committee established by the regional director to
				  review the service needs of eligible persons and make recommendations to the
				  regional director.
(20) "Low
				  intensity support services" means support services in accordance with COMAR
				  10.22.06. Services qualifying for this category are:
(a) Designed to be one-time only;
(b) Low cost with a cap of $3,000 per
				  individual per year; or
(c)
				  Approved by the regional office only if the cost of the services exceeds $3,000
				  or the services are needed beyond 1 calendar year.
(21) "Personal contact" means a discussion of
				  circumstances with the applicant, caregiver, or other proponent, when one
				  exists, with a representative of the DDA, who has knowledge in the disability
				  or has access to the assistance of someone with knowledge in the disability,
				  for the purpose of gathering information relevant to the determination of
				  eligibility, service needs, and priorities.
(22) "Preliminary determination" means the
				  outcome of the review of information supplied by or for the individual applying
				  for DDA-funded services to produce an initial assessment of eligibility,
				  service needs, and priorities.
(23)
				  "Program" means a prescribed set of services and activities designed to achieve
				  specific objectives related to the needs of the individuals served.
(24) "Proponent" means any person or agency
				  who has a legitimate interest in the welfare of the individual applying for DDA
				  services or being served in a DDA-licensed, operated, or funded
				  program.
(25) "Provider" means a
				  licensed agency which provides services through an appropriate agreement with
				  the Department.
(26) "Regional
				  director" means the director's designee who is charged with the management of
				  the service delivery system in a specific geographic area of the
				  State.
(27) "Resident" means an
				  individual who:
(a) Demonstrates that that
				  individual is living in the State voluntarily with an intent to remain on a
				  permanent basis, including children with parents or guardians who reside out of
				  the State;
(b) Resides out-of-State
				  but whose parents or guardians are residents of Maryland; or
(c) Is a migrant worker and, while in the
				  State, needs medical care and is not receiving assistance from any other state
				  or political jurisdiction.
(28) "Secretary" means the head of the
				  Department of Health and Mental Hygiene.
(29) "Secretary's designee" means the
				  Director of the Developmental Disabilities Administration.
(30) "Service coordinator" means a
				  professional who is assigned the responsibility for assisting the consumer in
				  accessing the service delivery system more efficiently and effectively. This
				  assistance is effected through planning, monitoring, and coordinating the
				  medical, social, habilitative, and vocational services necessary to meet the
				  identified needs of the consumer, as agreed upon and specified in the
				  consumer's individualized service plan.
(31) "State residential center (SRC)" means a
				  place that:
(a) Is owned and operated by the
				  State;
(b) Provides residential
				  services for individuals with intellectual disabilities and who, because of
				  intellectual disabilities, require specialized living arrangements;
				  and
(c) Admits nine or more
				  individuals with intellectual disabilities.
(32) "Waiting list" means, for the purpose of
				  this chapter, those individuals considered eligible for services and who have
				  not received those services under the auspices of these regulations.