Capitol Building

Maryland Register


Issue Date: October 27, 2017

Volume 44 • Issue 22 • Pages 1027-1064

IN THIS ISSUE

Governor

Regulations

Special Documents

General Notices

 

Pursuant to State Government Article, §7-206, Annotated Code of Maryland, this issue contains all previously unpublished documents required to be published, and filed on or before October 6, 2017 5 p.m.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 October 6, 2017.
 
Gail S. Klakring
Acting Administrator, Division of State Documents
Office of the Secretary of State

Seal

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; Fax 410-280-5647. 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.

Lawrence J. Hogan, Jr., Governor; John C. Wobensmith, Secretary of State; Gail S. Klakring, Administrator; Mary D. MacDonald, Senior Editor, Maryland Register and COMAR; Elizabeth Ramsey, Editor, COMAR Online, and Subscription Manager; Tami Cathell, Help Desk, COMAR and Maryland Register Online.

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 ....................................................................  1030

 

COMAR Research Aids

Table of Pending Proposals .........................................................  1031

 

Index of COMAR Titles Affected in This Issue

COMAR Title Number and Name                                                  Page

08        Department of Natural Resources ....................................  1039

09        Department of Labor, Licensing, and Regulation .............  1037

10        Maryland Department of Health .............................  1037, 1043

14        Independent Agencies ......................................................  1038

20        Public Service Commission .............................................  1054

30        Maryland Institute for Emergency Medical Services
Systems (MIEMSS) ....................................................  1059

31        Maryland Insurance Administration .................................  1038

 

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.

 

The Governor

EXECUTIVE ORDER 01.01.2017.22 .........................................  1033

EXECUTIVE ORDER 01.01.2017.23 .  1033

EXECUTIVE ORDER 01.01.2017.24 .........................................  1034

 

Regulatory Review and Evaluation

MARYLAND DEPARTMENT OF HEALTH

Notice of Availability of Evaluation Reports ............................  1036

 

Final Action on Regulations

09  DEPARTMENT OF LABOR, LICENSING, AND
   REGULATION

COMMISSIONER OF FINANCIAL REGULATION

Foreclosure Procedures for Residential Property .  1037

BOARD OF BARBERS

General Regulations .  1037

10  MARYLAND DEPARTMENT OF HEALTH

COMMUNITY-BASED BEHAVIORAL HEALTH
   PROGRAMS AND SERVICES

Outpatient Civil Commitment (OCC) Pilot Program ..  1037

14  INDEPENDENT AGENCIES

COMMISSION ON CRIMINAL SENTENCING POLICY

Criminal Offenses and Seriousness Categories .  1038

CANAL PLACE PRESERVATION AND DEVELOPMENT
   AUTHORITY

Public Information Requests .  1038

State Economic Growth, Resource Protection, and Planning
   Policy Project Review
..  1038

31  MARYLAND INSURANCE ADMINISTRATION

INSURANCE PRODUCERS AND OTHER INSURANCE
   PROFESSIONALS

Insurance Producers — Continuing Education
   Requirements .  1038

PROPERTY AND CASUALTY INSURANCE

Coverage for Loss Caused by Water That Backs Up Through
   Sewers or Drains .  1038

Homeowner’s Insurance Notice .  1038

UNFAIR TRADE PRACTICES

Homeowner's Insurance and Private Passenger Motor
   Vehicle Insurance — Standards for Cancellation and
   Nonrenewal  1038

PROPERTY AND CASUALTY INSURANCE

Underwriting Period .  1038

 

Proposed Action on Regulations

08  DEPARTMENT OF NATURAL RESOURCES

FISHERIES SERVICE

Crabs .  1039

Fish .  1039

Striped Bass .  1039

Gear  1039

10  MARYLAND DEPARTMENT OF HEALTH

MEDICAL CARE PROGRAMS

Home Health Services .  1043

Medical Laboratories .  1043

Early and Periodic Screening, Diagnosis, and Treatment:
   Nursing Services for Individuals Younger than 21 Years
   Old .  1043

Free-Standing Independent Diagnostic Testing
   Facilities .  1043

Portable X-ray Providers .  1043

1915(i) Intensive Behavioral Health Services for Children,
   Youth, and Families .  1044

MARYLAND HEALTH CARE COMMISSION

State Health Plan for Facilities and Services: General Surgical
   Services .  1046

BOARD OF PHYSICIANS

Physician Licensure by Conceded Eminence .  1047

BOARD OF PHARMACY

Pharmacy Technicians .  1049

HEALTH SERVICES COST REVIEW COMMISSION

Rate Application and Approval Procedures .  1050

20  PUBLIC SERVICE COMMISSION

TAXICABS

Taxicab Drivers of Baltimore City Taxicabs .  1054

TRANSPORTATION

General  1056

30  MARYLAND INSTITUTE FOR EMERGENCY
   MEDICAL SERVICES SYSTEMS (MIEMSS)

GENERAL

Documents Incorporated by Reference .  1059

 

Special Documents

DEPARTMENT OF THE ENVIRONMENT

SUSQUEHANNA RIVER BASIN COMMISSION

18 CFR Part 801 — General Policies .  1061

 

General Notices

HALL OF RECORDS COMMISSION

Public Hearing .  1063

MARYLAND DEPARTMENT OF HEALTH/OFFICE OF
   HEALTH SERVICES

Community Pathways Waiver — Proposal — Request for
   Public Comment  1063

MARYLAND INSURANCE ADMINISTRATION

Public Hearing .  1063

MARYLAND STATE LOTTERY AND GAMING CONTROL
   COMMISSION

Public Meeting .  1063

MARYLAND HEALTH CARE COMMISSION

Public Meeting .  1063

Receipt of Application .  1063

DEPARTMENT OF NATURAL RESOURCES/FISHING AND
   BOATING SERVICES

Public Notice — Commercial Striped Bass Common Pool
   Hook and Line Season Modification .  1064

BOARD OF OCCUPATIONAL THERAPY PRACTICE

Public Meeting .  1064

STATE HOUSE TRUST

Public Meeting .  1064

MARYLAND DEPARTMENT OF
   TRANSPORTATION/MARYLAND BOARD OF
   AIRPORT ZONING APPEALS (BAZA)

Public Hearing .  1064

BOARD OF WELL DRILLERS

Public Meeting .  1064

WORKERS' COMPENSATION COMMISSION

Public Meeting .  1064

DIVISION OF WORKFORCE DEVELOPMENT AND
   ADULT LEARNING/MARYLAND APPRENTICESHIP
   AND TRAINING COUNCIL

Public Meeting .  1064

 

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.state.md.us, 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 JULY 20, 2018

Issue
Date

Emergency

and Proposed

Regulations

5 p.m.*

Final

Regulations

10:30 a.m.

Notices, etc.

10:30 a.m.

2017

November 13***

October 23

November 1

October 30

November 27***

November 6

November 15

November 13

December 8

November 20

November 29

November 27

December 22

December 4

December 13

December 11

2018

January 5**

December 18

December 27

December 22

January 19**

December 29

January 10

January 8

February 2**

January 12

January 24

January 22

February 16

January 29

February 7

February 5

March 2**

February 12

February 21

February 16

March 16

February 26

March 7

March 5

March 30

March 12

March 21

March 19

April 13

March 26

April 4

April 2

April 27

April 9

April 18

April 16

May 11

April 23

May 2

April 30

May 25

May 7

May 16

May 14

June 8**

May 21

May 30

May 25

June 22

June 4

June 13

June 11

July 6

June 18

June 27

June 25

July 20

July 2

July 11

July 9

 

*   Due date for documents containing 8 to 18 pages — 48 hours before date shown; due date for documents exceeding 18 pages — 1 week before date shown

NOTE:  ALL DOCUMENTS MUST BE SUBMITTED IN TIMES NEW ROMAN, 9-POINT, SINGLE-SPACED FORMAT. THE REVISED PAGE COUNT REFLECTS THIS FORMATTING.

** Note closing date changes

***   Note issue date and 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 pertaining to proposed regulations are listed, followed by “(err)”. 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.

 


08 DEPARTMENT OF NATURAL RESOURCES

 

08.02.03.07 • 44:22 Md. R. 1039 (10-27-17)

08.02.05.01,.02,.07 • 44:22 Md. R. 1039 (10-27-17)

08.02.15.04,.07 • 44:22 Md. R. 1039 (10-27-17)

08.02.25.04—.07 • 44:22 Md. R. 1039 (10-27-17)

 

09 DEPARTMENT OF LABOR, LICENSING, AND REGULATION

 

09.01.04.01—.17 • 44:20 Md. R. 949 (9-29-17)

09.03.06.02—.27 • 44:2 Md. R. 92 (1-20-17)

09.03.13.02 • 44:21 Md. R. 987 (10-13-17)

09.12.31 • 44:21 Md. R. 987 (10-13-17)

                 44:21 Md. R. 988 (10-13-17)

09.13.05.03 • 44:2 Md. R. 114 (1-20-17)

09.19.07.01 • 44:3 Md. R. 192 (2-3-17)

09.23.06.02—.17 • 44:19 Md. R. 900 (9-15-17)

09.32.01.05,.12,.15-1,.16,.24 • 44:3 Md. R. 193 (2-3-17)

09.32.01.18 • 44:3 Md. R. 194 (2-3-17)

09.35.02.02,.03 • 43:21 Md. R. 1170 (10-14-16)

 

10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE

 

     Subtitles 01—08 (1st volume)

 

10.01.01.01—.11 • 44:2 Md. R. 131 (1-20-17)

10.01.04.03,.04,.08 • 44:21 Md. R. 988 (10-13-17)

 

     Subtitle 09 (2nd volume)

 

10.09.04.04,.05,.07 • 44:22 Md. R. 1043 (10-27-17)

10.09.09.04,.05,.07 • 44:22 Md. R. 1043 (10-27-17)

10.09.53.04,.05,.07 • 44:22 Md. R. 1043 (10-27-17)

10.09.87.04,.05,.07 • 44:22 Md. R. 1043 (10-27-17)

10.09.88.04,.05,.07 • 44:22 Md. R. 1043 (10-27-17)

10.09.10.07-1,.07-2 • 44:21 Md. R. 1001 (10-13-17)

10.09.12.03—.05,.07 • 44:20 Md. R. 952 (9-29-17)

10.09.33.09 • 44:21 Md. R. 1002 (10-13-17)

10.09.36.03 • 44:20 Md. R. 953 (9-29-17)

10.09.36.03-1 • 44:21 Md. R. 1002 (10-13-17)

10.09.44.03 • 44:10 Md. R. 491 (5-12-17)

10.09.62.01 • 44:21 Md. R. 988 (10-13-17)

10.09.63.02,.03,.06 • 44:21 Md. R. 988 (10-13-17)

10.09.64.03,.11 • 44:21 Md. R. 988 (10-13-17)

10.09.65.02,.04,.15,.17,.19,.20,.28 • 44:21 Md. R. 988 (10-13-17)

10.09.66.01,.02 • 44:21 Md. R. 988 (10-13-17)

10.09.67.01,.04,.19 • 44:21 Md. R. 988 (10-13-17)

10.09.68.01—.03 • 44:21 Md. R. 988 (10-13-17)

10.09.71.02,.04,.05 • 44:21 Md. R. 988 (10-13-17)

10.09.72.01,.06 • 44:21 Md. R. 988 (10-13-17)

10.09.79.01—.08 • 44:11 Md. R. 529 (5-26-17)

10.08.80.08 • 44:21 Md. R. 1003 (10-13-17)

10.09.84.02,.05—.07,.10,.15,.18,.19,.23,
     .24
• 44:21 Md. R. 1004 (10-13-17)

10.09.89.10—.14 • 44:22 Md. R. 1044 (10-27-17)

10.09.96.01—.13 • 44:21 Md. R. 1006 (10-13-17)

 

     Subtitles 10 — 22 (3rd Volume)

 

10.22.17.06—.08 • 44:20 Md. R. 954 (9-29-17)

10.22.18.04 • 44:20 Md. R. 954 (9-29-17)

 

     Subtitles 23 — 36 (4th Volume)

 

10.24.11.01 • 44:22 Md. R. 1046 (10-27-17) (ibr)

10.27.01.02 • 44:2 Md. R. 131 (1-20-17)

10.29.15.02—.05,.07,.08 • 43:26 Md. R. 1494 (12-23-16)

                                            44:12 Md. R. 595 (6-9-17)

10.32.13.02—.04,.06,.08 • 44:22 Md. R. 1047 (10-27-17)

10.32.22.02,.03,.05 • 44:21 Md. R. 1008 (10-13-17)

10.34.34.05 • 44:22 Md. R. 1049 (10-27-17)

 

     Subtitles 37—66 (5th Volume)

 

10.37.10.03,.03-1,.04-1,.04-2,.04-3,
     .11
• 44:22 Md. R. 1050 (10-27-17)

10.62.01.01 • 43:22 Md. R. 1245 (10-28-16)

10.62.08.03,.05—.07 • 43:22 Md. R. 1245 (10-28-16)

10.62.09.03 • 43:22 Md. R. 1245 (10-28-16)

10.62.12.02 • 43:22 Md. R. 1245 (10-28-16)

10.62.15.04—.07 • 43:22 Md. R. 1245 (10-28-16)

10.62.19.02,.04—.06 • 43:22 Md. R. 1245 (10-28-16)

10.62.20.03 • 43:22 Md. R. 1245 (10-28-16)

10.62.22.02 • 43:22 Md. R. 1245 (10-28-16)

10.62.25.03,.05—.07 • 43:22 Md. R. 1245 (10-28-16)

10.62.26.03 • 43:22 Md. R. 1245 (10-28-16)

10.62.28.02 • 43:22 Md. R. 1245 (10-28-16)

 

11 DEPARTMENT OF TRANSPORTATION

 

     Subtitles 01—10

 

11.01.18.01,.02 • 43:22 Md. R. 1251 (10-28-16)

 

     Subtitles 11—22 (MVA)

 

11.14.08.01,.03—.05,.09 • 44:18 Md. R. 868 (9-1-17)

 

12 DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

 

12.02.27.01—.40 • 44:19 Md. R. 902 (9-15-17)

12.03.01.01—.35 • 44:19 Md. R. 902 (9-15-17)

12.12.30.01—.40 • 44:19 Md. R. 902 (9-15-17)

12.16.02.01—.40 • 44:19 Md. R. 902 (9-15-17)

 

13A STATE BOARD OF EDUCATION

 

13A.04.16.01—.03 • 44:18 Md. R. 871 (9-1-17)

13A.06.07.01,.06—.08,.10 • 44:21 Md. R. 1010 (10-13-17)

 

13B MARYLAND HIGHER EDUCATION COMMISSION

 

13B.02.06.01—.13 • 44:13 Md. R. 634 (6-23-17)

 

14 INDEPENDENT AGENCIES

 

14.06.03.07 • 44:20 Md. R. 964 (9-29-17)

14.36.01.03,.13 • 44:17 Md. R. 844 (8-18-17)

14.36.04.01,.04—.08 • 44:17 Md. R. 844 (8-18-17)

 

15 DEPARTMENT OF AGRICULTURE

 

15.01.12.01—.07 • 44:20 Md. R. 965 (9-29-17)

 

19A STATE ETHICS COMMISSION

 

19A.01.01.02 • 44:16 Md. R. 812 (8-4-17)

19A.01.01.02 • 44:16 Md. R. 816 (8-4-17)

19A.03.04.01—.04 • 44:16 Md. R. 812 (8-4-17)

19A.04.01.02 • 44:16 Md. R. 816 (8-4-17)

19A.04.Appendix A • 44:16 Md. R. 812 (8-4-17)

19A.04.Appendix A • 44:16 Md. R. 816 (8-4-17)

19A.04.Appendix B • 44:16 Md. R. 812 (8-4-17)

19A.04.Appendix B • 44:16 Md. R. 816 (8-4-17)

19A.05.Appendix A • 44:16 Md. R. 812 (8-4-17)

19A.05.Appendix A • 44:16 Md. R. 816 (8-4-17)

19A.05.Appendix B • 44:16 Md. R. 812 (8-4-17)

19A.05.Appendix B • 44:16 Md. R. 816 (8-4-17)

19A.07.01.06 • 44:16 Md. R. 812 (8-4-17)

 

20 PUBLIC SERVICE COMMISSION

 

20.90.01.19 • 44:22 Md. R. 1054 (10-27-17)

20.95.01.03,.11,.22—.24,.26 • 44:22 Md. R. 1056 (10-27-17)

 

26 DEPARTMENT OF THE ENVIRONMENT

 

     Subtitles 08—12 (Part 2)

 

26.08.02.03-1,.03-3,.04-1,.08 • 44:11 Md. R. 533 (5-26-17)

26.08.07.04 • 43:24 Md. R. 1361 (11-28-16)

26.08.09.01,.04,.06,.07,.08 • 44:11 Md. R. 533 (5-26-17)

26.11.02.01,.10 • 44:14 Md. R. 685 (7-7-17)

26.11.09.01,.04,.06,.11 • 44:12 Md. R. 600 (6-9-17)

26.11.33.01—.14 • 44:12 Md. R. 602 (6-9-17)

26.11.36.01—.04 • 44:14 Md. R. 685 (7-7-17)

 

     Subtitles 19—27 (Part 4)

 

26.19.01.01—.61 • 43:23 Md. R. 1293 (11-14-16) (ibr)

 

30 MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

 

30.01.02.01 • 44:22 Md. R. 1059 (10-27-17) (ibr)

 

31 MARYLAND INSURANCE ADMINISTRATION

 

31.03.05.09,.15 • 44:20 Md. R. 967 (9-29-17)

31.10.44.01—.09 • 44:15 Md. R. 776 (7-21-17)

31.10.45.01—.06 • 44:21 Md. R. 1012 (10-13-17)

 

33 STATE BOARD OF ELECTIONS

 

33.16.02.01 • 44:19 Md. R. 930 (9-15-17)

33.16.04.02 • 44:19 Md. R. 930 (9-15-17)

33.16.05.03,.04 • 44:19 Md. R. 930 (9-15-17)

33.16.06.04 • 44:19 Md. R. 930 (9-15-17)

33.16.07.03 • 44:19 Md. R. 930 (9-15-17)

 

35 DEPARTMENT OF VETERANS AFFAIRS

 

35.06.01.01—.07 • 44:21 Md. R. 1014 (10-13-17)

 


The Governor

EXECUTIVE ORDER 01.01.2017.22

Maryland Cybersecurity

 

WHEREAS, The State of Maryland is susceptible to a wide range of threats and hazards, including the threat of a cyber-hazards and/or other cyberattacks (“Cyber-hazards”) on the Executive Branch of State government (“State Government”);

 

WHEREAS, It is necessary for State Government to maintain and constantly improve plans to combat that threat and to implement such plans effectively;

 

WHEREAS, The Governor’s Office of Homeland Security was created by Executive Order 01.01.2003.18 to “… direct homeland security efforts across State Government and coordinate with federal and local government, private sector, academia and the public to find solutions that ensure public safety while protecting individual freedoms…”;

 

WHEREAS, The Governor’s Office of Homeland Security is best suited to coordinate, improve and implement cybersecurity plans, by working with State Government units and agencies, including the Department of Information Technology (“DoIt”), the Maryland Military Department (the “Military”) and the Maryland Emergency Management Agency (“MEMA”), and to seek input and information from other sources, including other branches of State government, the federal government, the private sector and academia; and

 

WHEREAS, Such plans should consider and incorporate as appropriate the recommendations of the Maryland Cybersecurity Council, as set forth in its Activities Reports, and in the Cyber Disruption Contingency Plan prepared by DoIt and MEMA in April 2017;

 

NOW, THEREFORE, I, LAWRENCE J. HOGAN, JR., GOVERNOR OF THE STATE OF MARYLAND, BY VIRTUE OF THE POWER INVESTED IN ME BY THE CONSTITUTION AND THE LAWS OF MARYLAND, INCLUDING BUT NOT LIMITED TO TITLE 14 OF THE PUBLIC SAFETY ARTICLE, DECLARE THE FOLLOWING, EFFECTIVE IMMEDIATELY:

A. The responsibility to maintain and improve a cybersecurity plan for State Government (the “Cybersecurity Plan”), pursuant to Section 14-106 of the Public Safety Article, is hereby delegated to the Director of Homeland Security or the Director’s designee (the “Director”). 

B. The Cybersecurity Plan shall improve the processes and procedures designed to shield State Government from Cyber-hazards, and to manage and minimize the consequences of such Cyber-hazards. 

C. In order to maintain and improve the Cybersecurity Plan, the Director shall:

1. Coordinate with State Government units and agencies, including but not limited to DoIt, the Military and MEMA.  All such State Government units and agencies are directed to provide support, analysis and collaboration, as requested, by the Director, including by making personnel and resources available.

2. Consult with other branches, units and instrumentalities of State government, including but not limited to, the General Assembly, the Judiciary Department, the Attorney General’s Office, the Treasury Department, and the Comptroller, to share information and analyze existing plans and best practices for cybersecurity for their mutual benefit.

3. Consult with the private sector and academia, as necessary, to maintain, improve and implement the Cybersecurity Plan.

4. Consider and incorporate, where appropriate, the recommendations made in the Maryland Cybersecurity Council’s Activities Reports and in DoIt’s and MEMA’s Cyber Disruption Contingency Plan.

D. The responsibility to oversee the implementation of the Cybersecurity Plan, pursuant to Section 14-106 of the Public Safety Article, is hereby delegated to the Director.  All State Government units and agencies, including but not limited to DoIt, the Military and MEMA, are directed to assist the Director in such implementation, including by providing the Director with access to all personnel and resources as may be necessary, as determined by the Director. 

E. The draft Cybersecurity Plan is subject to review or revision by the Governor and shall be presented to the Governor by the end of May 2018.

 

GIVEN Under My Hand and the Great Seal of the State of Maryland, in the City of Annapolis, this 5th Day of October, 2017.

LAWRENCE J. HOGAN, JR.
Governor

 

ATTEST:

JOHN C. WOBENSMITH
Secretary of State

[17-22-14]

 

EXECUTIVE ORDER 01.01.2017.23

Maryland Disability Employment Awareness Month

(Rescinds Executive Order 01.01.2009.10)

 

WHEREAS, Workplaces that welcome the talents of all people, including people with disabilities, are a critical part of efforts to build an inclusive community and strong economy;

 

WHEREAS, The Americans with Disabilities Act of 1990 was enacted to promote inclusion, full participation, economic self-sufficiency, and equality of opportunity for all people with disabilities;

 

WHEREAS, Despite the progress made since passage of the Americans with Disabilities Act of 1990, people with disabilities still experience unemployment rates far above the national average;

 

WHEREAS, People with disabilities continue to disproportionately experience poverty and economic instability in comparison to people without disabilities;

 

WHEREAS, Employment is often the most direct and cost-effective means to empower people with disabilities to achieve independence, economic self-sufficiency, and full community participation;

 

WHEREAS, People with disabilities bring valuable skills to the workforce, and represent an untapped segment of the labor pool for the public, private, and nonprofit sectors; 

 

WHEREAS, Increased public awareness is necessary to reduce the barriers faced by Marylanders with disabilities in entering the workforce and securing employment;

 

WHEREAS, Self-employment is understood to be a growing and viable option for many with disabilities, and increased opportunities to expand self-employment awareness and skills will benefit both the State’s economy and the disability community; and

 

WHEREAS, Designating a Disability Employment Awareness Month in Maryland will increase public awareness and respect for Marylanders with disabilities who are seeking employment;

 

NOW, THEREFORE, I, LAWRENCE J. HOGAN, JR., GOVERNOR OF THE STATE OF MARYLAND, BY VIRTUE OF THE POWER INVESTED IN ME BY THE CONSTITUTION AND THE LAWS OF MARYLAND, DECLARE THE FOLLOWING:

(1) Each State department, board, agency, authority, board, or instrumentality controlled by the Governor (an “Executive unit”) shall annually observe October as Disability Employment Awareness Month to celebrate the many and varied contributions of people with disabilities.

(2) The Department of Disabilities, throughout the year, but with special emphasis during Disability Employment Awareness Month, shall:

a. reinforce the value and talents people with disabilities add to Maryland’s workplaces and communities;

b. affirm Maryland’s commitment to an inclusive community; and

c. enhance Maryland’s stature as a national leader in disability employment policy and practice.

(3) The Department of Disabilities’ efforts shall include:

a. Increasing public awareness of:

1.how the many skills and talents of Marylanders with disabilities benefit Maryland businesses;

2. the barriers Marylanders with disabilities face in obtaining employment;

3. the untapped potential of job seekers with disabilities; and

4. the potential for those with disabilities to obtain economic independence by becoming self-employed and to contribute to the State’s economy as business owners and employers;

b. research and development of best practices, and ongoing collaboration with other State units, to achieve inclusive, competitive, integrated employment for Marylanders with disabilities by connecting them with employers and expanding knowledge and opportunities for self-employment;

c. coordinating the development and maintenance of a digital resource guide for State units and local jurisdictions that details best practices to increase employment, retention, self-employment, and business ownership of those with disabilities;

d. support for events, including those sponsored by other State units, local governments, or private or nongovernmental organizations, that highlight how businesses benefit from the skills and talents of individuals with disabilities; and

e. provision of related information and assistance to other Executive units, the Maryland State Department of Education, the University System of Maryland, Morgan State University, Saint Mary’s College of Maryland, public community colleges, and local governments.

(4) To promote individuals with disabilities’ access to technology, the Department of Disabilities shall:

a. hold special events, including those advancing assistive technology that expands employment in community integrated settings; and

b. recommend the designation of a State agency, entity, or staff person to:

1. provide accessibility technical assistance during State procurement processes; and

2. address any accessibility concerns of State employees.

(5) Executive units shall otherwise encourage the citizens they serve to, throughout the year, participate in and promote events celebrating the rights, skills, and talents of those with disabilities.

 

Given Under My Hand and the Great Seal of the State of Maryland in the City of Annapolis, this 10th Day of October, 2017.

LAWRENCE J. HOGAN, JR.
Governor

 

ATTEST:

JOHN C. WOBENSMITH
Secretary of State

[17-22-15]

 

EXECUTIVE ORDER 01.01.2017.24

Maryland Outdoor Recreation Economic Commission

 

WHEREAS, Maryland’s treasured and diverse natural, cultural, historical and recreational resources, from the Atlantic Ocean to the Chesapeake Bay to the Appalachian Mountains, are a significant part of the State’s brand identity, economy and quality of life;

 

WHEREAS, The outdoor recreation economy in Maryland generates 109,000 direct jobs, $951 million in state and local tax revenue, $4.4 billion in wages and salaries and $14 billion in consumer spending;

 

WHEREAS, Providing improved access to world-class outdoor activities, such as hiking, biking, horseback riding, paddling, boating, fishing, hunting, camping, swimming, wildlife-viewing, and visitation to historic sites, will support economic investment in the State’s outdoor recreation industry and nature and heritage tourism economies;

 

WHEREAS, Careful and thoughtful stewardship of the State’s natural heritage and rich history is a critical responsibility necessary to protect the quality of life of its citizenry and future generations; and

 

WHEREAS, Greater engagement of the outdoor recreation industry as well as other private and public stakeholders will strengthen the State’s efforts to attract and retain businesses that rely on and value Maryland’s tremendous outdoor and heritage resources;

 

NOW, THEREFORE, I, LAWRENCE J. HOGAN, JR., GOVERNOR OF THE STATE OF MARYLAND, BY VIRTUE OF THE POWER INVESTED IN ME BY THE CONSTITUTION AND THE LAWS OF MARYLAND, DECLARE THE FOLLOWING:

A. Established. There is hereby established the Maryland Outdoor Recreation Economic Commission to advise and make recommendations to the Governor on actions that will strengthen the outdoor economy and Maryland.

B. Membership. The Commission shall be comprised of seventeen (17) members to be appointed by the Governor and who will serve at the pleasure at the Governor, including:

1) The Secretary of the Department of Natural Resources or the Secretary’s designee;

2) The Secretary of the Department of Commerce or the Secretary’s designee;

3) Representatives from three companies within Maryland’s outdoor recreation manufacturing and retail industries;

4) Representatives from three companies representing small businesses that provide outdoor recreation services;

5) Representatives from three nonprofit organizations related to outdoor recreation;

6) Three local elected officials; and

7) Three citizen members with experience in economic development, planning, tourism, and/or marketing.

C. Chair.  The Commission shall be co-chaired by the Secretary of the Department of Natural Resources and the Secretary of the Department of Commerce.  Their designees may, at the request of the Secretaries, serve as acting co-chairs.

D. Committees.  The Commission may, in its discretion, establish working committees to support its mission, drawing committee members from any agency or department of State government or private / non-profit organization.

E. Staff.  The Department of Natural Resources and the Department of Commerce shall provide administrative and staff support to the Commission.

F. Purpose.  The Commission shall develop recommendations and an action plan to strengthen and enhance:

1) The business climate for the outdoor recreation industry so as to retain and grow Maryland jobs and Maryland’s economy;

2) Maryland’s brand as a premier destination for outdoor recreation and heritage tourism;

3) Development of world-class outdoor and heritage tourism experiences;

4) Stewardship of Maryland’s natural, cultural, historical, and recreational resources; and

5) Opportunities for workforce development and job creation in the outdoor recreation industry.

G. The Commission shall provide an interim report to the Governor by December 1, 2018 and a final report by December 1, 2019.

 

Given Under My Hand and the Great Seal of the State of Maryland in the City of Annapolis, this 13th Day of October, 2017.

LAWRENCE J. HOGAN, JR.
Governor

 

ATTEST:

JOHN C. WOBENSMITH
Secretary of State

[17-22-19]

 


Regulatory Review and Evaluation

Regulations promulgated under the Administrative Procedure Act will undergo a review by the promulgating agency in accordance with the Regulatory Review and Evaluation Act (State Government Article, §§10-130 — 10-139; COMAR 01.01.2003.20). This review will be documented in an evaluation report which will be submitted to the General Assembly’s Joint Committee on Administrative, Executive, and Legislative Review.  The evaluation reports have been spread over an 8-year period (see COMAR 01.01.2003.20 for the schedule).  Notice that an evaluation report is available for public inspection and comment will be published in this section of the Maryland Register.


 


MARYLAND DEPARTMENT OF HEALTH

Notice of Availability of Evaluation Reports

 

Pursuant to Executive Order 0l.0l.2003.20, Implementation of the Regulatory Review and Evaluation Act, notice is hereby given that the Evaluation Reports concerning COMAR 10.31—10.36 are available for public inspection and comment for a period of 60 days following the date of this notice.

These reports may be reviewed at the Office of Regulations Coordination, Maryland Department of Health, 20l West Preston Street, Room 512, Baltimore, Maryland 2l20l, Monday through Friday, 7 a.m. to 4 p.m., except State holidays, or on-line at https://health.maryland.gov/regs/Documents/EVALUATION%20REPORTS%20AND%20EXEMPTION%2010.31--10.36.pdf

Information may be obtained by contacting Michele Phinney at (410) 767-6499 or by email at mdh.regs@maryland.gov.

[17-22-11]

 

 


Final Action on Regulations

 

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 09
DEPARTMENT OF LABOR, LICENSING, AND REGULATION

Subtitle 03 COMMISSIONER OF FINANCIAL REGULATION

09.03.12 Foreclosure Procedures for Residential Property

Authority: Real Property Article, §§7-105.1 and 7-105.14, Annotated Code of Maryland

Notice of Final Action

[17-197-F]

On October 2, 2017, the Commissioner of Financial Regulation adopted amendments to Regulations .01 and .08 under COMAR 09.03.12 Foreclosure Procedures for Residential Property. This action, which was proposed for adoption in 44:17 Md. R. 840 (August 18, 2017), has been adopted as proposed.

Effective Date: November 6, 2017.

ANTONIO P. SALAZAR
Commissioner of Financial Regulation

 

Subtitle 16 BOARD OF BARBERS

09.16.01 General Regulations

Authority: Business Occupations and Professions Article, Title 4, Annotated Code of Maryland

Notice of Final Action

[17-124-F]

On September 11, 2017, the Board of Barbers adopted amendments to Regulations .04 and .05 under COMAR 09.16.01 General Regulations. This action, which was proposed for adoption in 44:10 Md. R. 489 (May 12, 2017), has been adopted as proposed.

Effective Date: November 6, 2017.

SHIRLEY LEACH
Executive Director

 

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 63 COMMUNITY-BASED BEHAVIORAL HEALTH PROGRAMS AND SERVICES

10.63.07 Outpatient Civil Commitment (OCC) Pilot Program

Authority: Health-General Article, §7.5-205.1, Annotated Code of Maryland

Notice of Final Action

[17-228-F]

On October 16, 2017, the Secretary of Health adopted new Regulations .01—.14 under a new chapter, COMAR 10.63.07 Outpatient Civil Commitment (OCC) Pilot Program. This action, which was proposed for adoption in 44:17 Md. R. 841—844 (August 18, 2017), has been adopted with the nonsubstantive changes shown below.

Effective Date: November 6, 2017.

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 .02B(4) and (15)(b) and Regulation .05A(4), (6), and (10): Grammatical errors corrected.

.02 Definitions.

A. (proposed text unchanged)

B. Terms Defined.

(1)—(3) (proposed text unchanged) 

(4) “Baltimore City resident” means an individual [[that]] who:

(a)(b) (proposed text unchanged) 

(5)—(14) (proposed text unchanged)

(15) “Outpatient civil commitment (OCC) pilot program” means the program established by the Behavioral Health Administration to provide community-based treatment and supports to:

(a) (proposed text unchanged)

(b) Individuals [[that]] who choose to participate in the OCC pilot program voluntarily after a settlement conference with an ALJ, the legal service provider, and a representative of the inpatient facility.

(16)(22) (proposed text unchanged)

.05 Admission Criteria.

A. To be involuntarily admitted to the program, an individual shall meet the following criteria:

(1)—(3) (proposed text unchanged)

(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) (proposed text unchanged)

(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)—(9) (proposed text unchanged)

(10) [[Treatment]] For whom treatment in the program is the least restrictive alternative appropriate for the individual.

DENNIS SCHRADER
Secretary of Health

 

Title 14
INDEPENDENT AGENCIES

Subtitle 22 COMMISSION ON CRIMINAL SENTENCING POLICY

14.22.02 Criminal Offenses and Seriousness Categories

Authority: Criminal Procedure Article, §6-211, Annotated Code of Maryland

Notice of Final Action

[17-232-F]

On October 17, 2017, the Maryland State Commission on Criminal Sentencing Policy adopted amendments to Regulation .02 under COMAR 14.22.02 Criminal Offenses and Seriousness Categories. This action, which was proposed for adoption in 44:18 Md. R. 872—79 (September 1, 2017), has been adopted as proposed.

Effective Date: December 1, 2017.

DAVID SOULE
Executive Director

 

Subtitle 28 CANAL PLACE PRESERVATION AND DEVELOPMENT AUTHORITY

Notice of Final Action

[17-231-F]

On October 17, 2017, the Canal Place Preservation and Development Authority adopted the repeal of:

(1) Regulations .01—.14 under COMAR 14.28.02 Public Information Requests; and

(2) Regulations .01—.07 under COMAR 14.28.07 State Economic Growth, Resource Protection, and Planning Policy Project Review.

This action, which was proposed for adoption in 44:18 Md. R. 879 (September 1, 2017), has been adopted as proposed.

Effective Date: November 6, 2017.

DEIDRA L. RITCHIE
Executive Director
Canal Place Preservation and Development Authority

Title 31
MARYLAND INSURANCE ADMINISTRATION

Subtitle 03 INSURANCE PRODUCERS AND OTHER INSURANCE PROFESSIONALS

31.03.02 Insurance Producers — Continuing Education Requirements

Authority: Insurance Article, §§2-109, 10-115, and 10-116, Annotated Code of Maryland

Notice of Final Action

[17-220-F]

On October 10, 2017, the Insurance Commissioner adopted amendments to Regulations .02 and .03 under COMAR 31.03.02 Insurance Producers — Continuing Education Requirements. This action, which was proposed for adoption in 44:17 Md. R. 845—846 (August 18, 2017), has been adopted as proposed.

Effective Date: November 6, 2017.

ALFRED W. REDMER, JR.
Insurance Commissioner

 

Notice of Final Action

[17-229-F]

On October 17, 2017, the Insurance Commissioner adopted:

(1) Amendments to Regulation .03 under COMAR 31.08.14 Coverage for Loss Caused by Water That Backs Up Through Sewers or Drains;

(2) New Regulations .01—.03 under a new chapter, COMAR 31.08.18 Homeowner's Insurance Notice; and

(3) Amendments to Regulation .04 under COMAR 31.15.10 Homeowner's Insurance and Private Passenger Motor Vehicle Insurance — Standards for Cancellation and Nonrenewal.

This action, which was proposed for adoption in 44:18 Md. R. 880 (September 1, 2017), has been adopted as proposed.

Effective Date: November 6, 2017.

ALFRED W. REDMER, JR.
Insurance Commissioner

 

Subtitle 08 PROPERTY AND CASUALTY INSURANCE

31.08.15 Underwriting Period

Authority: Insurance Article, §§2-109(a)(1) and 12-106(a), (b), (c), (d), and (f)(1) and (2), [and 19-406,] Annotated Code of Maryland

Notice of Final Action

[17-217-F]

On October 13, 2017, the Insurance Commissioner adopted amendments to Regulation .06 under COMAR 31.08.15 Underwriting Period. This action, which was proposed for adoption in 44:17 Md. R. 846—847 (August 18, 2017), has been adopted as proposed.

Effective Date: November 6, 2017.

ALFRED W. REDMER, JR.
Insurance Commissioner


Proposed Action on Regulations

 


 



Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 02 FISHERIES SERVICE

Notice of Proposed Action

[17-265-P]

The Secretary of Natural Resources proposes to:

(1) Amend Regulation .07 under COMAR 08.02.03 Crabs;

(2) Repeal Regulation .01 and amend Regulations .02 and .07 under COMAR 08.02.05 Fish;

(3) Amend Regulations .04 and .07 under COMAR 08.02.15 Striped Bass; and

(4) Repeal existing Regulations .04 and adopt new Regulations .04—.07 under COMAR 08.02.25 Gear.

Statement of Purpose

The purpose of this action is to allow harvesters to share gear. The Department has been contacted by fishermen about the possibility of allowing harvesters to share gear, which is currently prohibited by statute and regulation. After a review of current laws the Department has concluded that by clarifying what is intended by Natural Resources Article, §4-505, Annotated Code of Maryland, harvesters would be able to share gear. A small amount of reorganization and establishing additional requirements for pound nets was necessary to accomplish the purpose.

 

Proposed Change to COMAR 08.02.03 Crabs

The proposed action repeals the provision that prohibits someone from fishing a crab pot licensed to another individual. This is no longer necessary because new text is being added to COMAR 08.02.25 that clarifies Natural Resources Article, §4-505, Annotated Code of Maryland. The clarification in COMAR 08.02.25 will allow licensees to share gear under certain circumstances. This change will provide harvesters greater flexibility.

 

Proposed Changes to COMAR 08.02.05 Fish

The proposed action repeals Regulation .01 of COMAR 08.02.05 which mainly deals with pound nets and relocates the pound net text to a new regulation in the gear chapter. The relocation makes it easier to find information about specific gear. The text relating to the use of eels as bait was relocated to the regulation that covers general fishing prohibitions (COMAR 08.02.05.02). The proposed action modifies Regulation .07 to correct the citation that refers to the regulation being repealed.

 

Proposed Changes to COMAR 08.02.15 Striped Bass

The proposed action modifies two regulations in the striped bass chapter by correcting citations that refer to the regulation that is being repealed. The proposed action modifies Regulation .07 by repealing text related to using another licensee gill net or pound net. This text is no longer necessary because new text is being added to Chapter 25 that clarifies Natural Resources Article, §4-505, Annotated Code of Maryland. The clarification in Chapter 25 will allow licensees to share gear under certain circumstances. It will no longer just apply to striped bass.

 

Proposed Changes to COMAR 08.02.25 Gear

The proposed action modifies Regulation .04 by removing text related to archery equipment and finfish trotlines. This regulation will now be a general regulation for commercial gear. The proposed action creates new regulations for archery equipment, finfish trotlines and pound nets. The reorganization will make it easier to find information. The new regulations for archery equipment (Regulation .05) and finfish trotlines (Regulation .06) are simply relocated and renumbered; no changes to previous text were made.

The proposed action clarifies Natural Resources Article, §4-505, Annotated Code of Maryland, by establishing rules in Regulation .04 that allow licensees to share commercial gear. The intent of Natural Resources Article, §4-505, Annotate Code of Maryland is to prevent someone from stealing someone else’s catch or sabotaging someone else’s gear. An individual is not considered in violation of Natural Resources Article, §4-505, Annotated Code of Maryland if the individual is designated as an operator or co-user in accordance with regulation. The proposed action allows licensees and co-users the ability to share any piece of commercial gear for any species. The proposed action allows licensees and co-users to take others with them to harvest from a piece of gear and creates rules for when they are not on the same vessel.

The new regulation for pound nets is Regulation .07. The regulation text was relocated from COMAR 08.02.05.01. Except for the establishment of co-users, there are only slight modifications to the original text for organizational and clarity purposes. Specifically, the proposed action adds definitions for co-user and registrant to be clear what is meant in the regulation; removes duplicate language that is in statute and should not be repeated in regulation; and removes the specific registration form requirements because forms and information change. Registration is still required, but the sections are reorganized to reflect current requirements. The proposed action establishes the ability to name co-users for pound nets and creates rules for co-users. Rules for co-users include the ability to designate, remove or change one or more co-users and requirements for marking the pound net. Prior to interacting with gear or harvesting fish, the co-user must be designated by the owner of the pound net site to the Department as being authorized to use the specified pound net site. A co-user has the same permissions for the use of the pound net as the owner. The owner will still be responsible for the net and all of the associated requirements to ensure that the Department has one point of contact for the net.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. The proposed action has a positive economic impact for commercial harvesters.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure (E+/E-)

Magnitude

 


A. On issuing agency:

NONE

B. On other State agencies:

NONE

C. On local governments:

NONE

 

 

Benefit (+)

Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

(1) Commercial harvesters

(+)

Indeterminable

(2) Commercial industry

(+)

Indeterminable

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.)

D(1). The proposed action provides harvesters with greater flexibility in how they run their business and harvest fish. It is indeterminable how many harvesters will take advantage of sharing gear or if their harvest will increase or become more efficient because of it; therefore, the actual value that harvesters will benefit is indeterminable.

D(2). The value to the commercial industry (fish dealers, packers, store fronts and restaurants) increases when harvesters have greater flexibility, but that total value is indeterminable. It is indeterminable how many harvesters will take advantage of sharing gear or if their harvest will increase; therefore, it is indeterminable how the industry will benefit.

Economic Impact on Small Businesses

The proposed action has a meaningful economic impact on small business. An analysis of this economic impact follows.

The proposed action provides harvesters with greater flexibility in how they run their business and harvest fish. It is indeterminable how many harvesters will take advantage of sharing gear or if their harvest will increase or become more efficient because of it; therefore, the actual value that harvesters will benefit is indeterminable.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Sharing Gear Regulations, Regulatory Staff, Department of Natural Resources Fishing and Boating Services, 580 Taylor Avenue, B-2, Annapolis, MD 21401, or call 410-260-8300, or email to fisheriespubliccomment.dnr@maryland.gov, or fax to 410-260-8310. Comments will be accepted through November 27, 2017. A public hearing will be held, but the time and location are yet to be determined.

 

08.02.03 Crabs

Authority: Natural Resources Article, §§4-215 and 4-803, Annotated Code of Maryland

.07 Crab Pots.

A.—C. (text unchanged)

D. General Requirements.

(1)—(5) (text unchanged)

[(6) A person may not fish a crab pot licensed to another person.]

[(7)] (6) [(9)] (8) (text unchanged)

E.—H. (text unchanged)

 

08.02.05 Fish

Authority: Natural Resources Article, §4-215, Annotated Code of Maryland

Regulation

Section

[.01

4-221

.01A

4-510

.01B

4-710(g)

.01C

4-710(g)

.01D

4-704, 4-711

.01E

4-215

.01F

4-215]

.02 General Fishing Prohibitions.

A.—E. (text unchanged)

F. Bait.

(1) When using fish, crabs, or worms as bait, or processed bait, a person recreationally angling in the Susquehanna Flats and Northeast River during the period set forth in §E of this regulation shall use:

[(1)] (a) [(2)] (b) (text unchanged)

(2) A person may not use eels as bait while fishing with hook and line in the tidal waters of the Chesapeake Bay and its tributaries, except for a recreational, charter, or commercial hook and line fisherman authorized to participate in and fish during summer and fall striped bass seasons established in COMAR 08.02.15.

G.—P. (text unchanged)

.07 Atlantic Menhaden.

A.—C. (text unchanged)

D. Atlantic Menhaden Bycatch Allowance Landing Permits.

(1)—(3) (text unchanged)

(4) Operators.

(a)—(b) (text unchanged)

(c) An operator may only fish the pound nets that the permittee has:

(i) (text unchanged)

(ii) Notified the Department as being active in accordance with [Regulation .01C of this chapter] COMAR 08.02.25.07.

(d) (text unchanged)

(5)—(6) (text unchanged)

E.—F. (text unchanged)

 

08.02.15 Striped Bass

Authority: Natural Resources Article, §4-215, Annotated Code of Maryland

.04 Tidal Fish Licensee Intent to Fish.

A.—D. (text unchanged)

E. Pound Net Requirements to Participate in the Striped Bass Fishery.

(1) (text unchanged)

(2) A pound net used to harvest striped bass shall be registered as active with the Department in accordance with COMAR [08.02.05.01C] 08.02.25.07.

F.—G. (text unchanged)

.07 Commercial Fishery.

A.—D. (text unchanged)

E. Pound Net Fishery Limitations.

(1)—(2) (text unchanged)

(3) A commercial tidal fish licensee shall comply with all additional requirements in the pound net fishery as described in COMAR [08.02.05.01] 08.02.25.07.

F. General.

(1)—(6) (text unchanged)

[(7) Notwithstanding Natural Resources Article, §4-505, Annotated Code of Maryland, a tidal fish licensee may harvest striped bass from a gill net or pound net belonging to another licensee if:

(a) The licensee has permission of the gear owner;

(b) The gear owner is present at the net while the harvest occurs; and

(c) Both licensees are in possession of their tidal fish license.]

 

08.02.25 Gear

Authority: Natural Resources Article, §§4-215, 4-505, and 4-711, Annotated Code of Maryland

.04 Commercial Gear — General.

A. An individual is not considered in violation of Natural Resources Article, §4-505, Annotated Code of Maryland, if the individual:

(1) Is designated as an operator or co-user in accordance with this subtitle; or

(2) Harvests fish in accordance with §B of this regulation.

B. A licensee may harvest fish from gear belonging to another individual and is not considered in violation of Natural Resources Article, §4-505, Annotated Code of Maryland, if:

(1) The licensee has permission of the gear owner or designated co-user;

(2) The gear owner or designated co-user is present at the piece of gear while the harvest occurs;

(3) The licensee has obtained and is in possession of a valid permit necessary for the species being harvested; and

(4) Both licensees are in possession of their tidal fish license.

.05 Commercial — Archery Equipment.

A. Archery equipment shall have a retrieval line attached to any projectile.

B. An individual may use archery equipment to take any fish during an open commercial season except for the following species:

(1) All shark species;

(2) American lobster;

(3) Muskellunge;

(4) Muskellunge hybrids, including tiger musky;

(5) Northern pike;

(6) Snapping turtles;

(7) Striped bass;

(8) Striped bass hybrids;

(9) Walleye; and

(10) Any species listed as threatened or endangered under COMAR 08.03.08.

C. Additional Restrictions.

(1) Except as provided in §C(2) of this regulation, a person may not shoot archery equipment within 100 yards of any:

(a) Human being;

(b) Private or public swimming area;

(c) International diving flag;

(d) Occupied duck blind; or

(e) Vessel other than the vessel occupied by the individual using archery equipment.

(2) The distance restriction in §C(1) of this regulation does not apply if the person using the archery equipment receives permission from all affected parties within that area prior to engaging in fishing activities.

.06 Commercial — Finfish Trotlines.

A. An individual may not set or fish a finfish trotline within 100 feet of another individual’s set trotline.

B. The length of a finfish trotline is measured along the baited portion of the line.

C. A finfish trotline:

(1) May not exceed 1,200 feet in length;

(2) May not be baited with live bait; and

(3) Shall only be rigged with circle hooks with a minimum size of 5/0.

D. Float Requirements.

(1) A finfish trotline shall have a float of the same color, size, and shape attached to each end.

(2) Floats that have a round or spherical shape shall be at least 12 inches in diameter.

(3) Floats that do not have a round or spherical shape shall be at least 12 inches long and 10 inches wide.

(4) Floats shall be marked with the owner’s commercial license number.

E. Depth Requirements.

(1) During the period from June 16 through the end of February, a finfish trotline shall be set:

(a) At least 10 feet below the surface of the water, in waters that are at least 10 feet deep at mean low tide; or

(b) On the bottom of the water body in which they are set, in waters that are less than 10 feet deep at mean low tide.

(2) During the period from March 1 through June 15, finfish trotlines shall be set on the bottom of the water body in which they are set.

F. Area Restrictions. A finfish trotline:

(1) Shall only be set in the Chesapeake Bay and its tidal tributaries; and

(2) May not be set in the Chesapeake Bay south of the William Preston Lane, Jr. Memorial Bay Bridge, including Pocomoke Sound and Tangier Sound.

G. An individual shall be appropriately licensed to catch finfish under Natural Resources Article, §4-701, Annotated Code of Maryland, and permitted in accordance with this regulation in order to use a finfish trotline.

H. Finfish Trotline Permit.

(1) A finfish trotline permit may only be issued to a licensee who has met all reporting requirements as required by Natural Resources Article, §4-206, Annotated Code of Maryland, and this regulation.

(2) An individual may be issued only one finfish trotline permit.

(3) An individual shall have their finfish trotline permit in their possession while using a finfish trotline.

(4) A finfish trotline permit may not be transferred.

(5) Reporting and Penalties.

(a) In addition to the requirements of Natural Resources Article, §4-206, Annotated Code of Maryland, a finfish trotline permittee shall report in the manner specified by the Department.

(b) In addition to any other penalty established in COMAR 08.02.13, failure to comply with this regulation may result in the suspension of the current permit or the denial of a subsequent permit.

(c) Prior to suspending a permit under this regulation or denying an application for a permit, the Department shall give the licensee notice of its intended action and an opportunity to appear at a hearing conducted in accordance with the contested case procedures set forth in State Government Article, Title 10, Subtitle 2, Annotated Code of Maryland, and COMAR 08.01.04.

I. The provisions of this regulation shall be effective through June 30, 2019.

.07 Commercial — Pound Nets.

A. Definitions.

(1) For purposes of this regulation, the following terms have the meanings indicated.

(2) Terms Defined.

(a) “Co-user” means an individual who is:

(i) Properly licensed in accordance with Natural Resources Article, §4-701, Annotated Code of Maryland;

(ii) Designated in writing to the Department by the registrant; and

(iii) Authorized to harvest fish from the specified pound net site.

(b) “Registrant” means the individual who registered the pound net site and owns the pound net.

B. Pound Net Sites.

(1) An individual may not set a pound net in State waters unless:

(a) The individual has submitted a completed registration form provided by the Department;

(b) The individual is properly licensed in accordance with Natural Resources Article, §4-701, Annotated Code of Maryland;

(c) The site is approved by the Department;

(d) The site is registered in the individual’s name; and

(e) The individual has notified the Department of the setting of the net in compliance with §E of this regulation.

(2) An individual may not register more than eight pound net sites with the Department.

(3) The pound net site registrant shall notify the Department in writing to cancel a pound net site registration.

(4) A pound net set at a registered site by the registrant has priority over other commercial finfish gear with regard to any distance requirements set forth in Natural Resources Article, §4-711, Annotated Code of Maryland.

(5) A commercial tidal fish licensee that intends to use a pound net to harvest striped bass shall comply with the additional structural requirements described in COMAR 08.02.15.04.

(6) The Department may approve the permanent transfer of a registered pound net site upon completion of the appropriate transfer application and pound net site registration.

(7) The Department may revoke the registration of a pound net site for cause, including but not limited to, the revocation or lapse of the registrant’s commercial tidal fish license.

C. Co-Users.

(1) A registrant may designate one or more co-users for each pound net site by completing a form provided by the Department.

(2) A registrant may designate or remove a co-user at any time during the year.

(3) A co-user shall display their commercial identification number on the designated pound net.

(4) A co-user is authorized to harvest fish only from the specified pound net site.

D. Marking of Pound Nets. The registrant shall mark the pound net while the stakes are in the water, regardless of whether the nets are attached, as follows:

(1) The stake at the head of a pound net shall be marked by a light that is functional between sunset and sunrise, which shall be:

(a) Placed on the stake at least 6 feet above normal high water; and

(b) Visible in all directions for at least 1 mile on a clear night; or

(2) The stake of a pound net shall be marked with retro-reflective tape, as specified by the Department, which is placed on the stake at least 6 feet above normal high water in the following areas and manner:

(a) On all State waters, except for Potomac River tributaries:

(i) The stake at each end of the pound net shall be marked with three 4-inch bands of orange retro-reflective tape which do not overlap; and

(ii) The stakes between the two end stakes, at intervals not greater than 150 feet apart, shall be marked with a single 4-inch band of white retro-reflective tape; and

(b) On Potomac River tributaries:

(i) The end stake closest to the channel and on the right side of channel when entering from a seaward direction, shall be marked with three 4-inch bands of red retro-reflective tape, which do not overlap, and the opposite end stake shall be marked with three 4-inch bands of green retro-reflective tape which do not overlap;

(ii) The end stake closest to the channel and on the left side of the channel when entering from a seaward direction shall be marked with three 4-inch bands of green retro-reflective tape which do not overlap, and the opposite end stake shall be marked with three 4-inch bands of red retro-reflective tape which do not overlap; and

(iii) At least three stakes between the two end stakes, at intervals not greater than 150 feet apart, shall be marked with a single 4-inch band of white retro-reflective tape.

E. Pound Net Activity Notification.

(1) The registrant shall ensure that written notice is received by the Department at least 7 days prior to setting any pound net.

(2) The registrant shall ensure that written notice is received by the Department within 7 days of removing any pound net from the water.

(3) Notification shall be on a form provided by the Department.

F. Pound Net Soak Time Limits.

(1) During the time period of January through June, pound nets shall be fished at the interval set by the Department in a public notice, with all entrapped striped bass released.

(2) The Secretary shall publish such notice on the Department’s website no later than December 1 of the year preceding the soak time limit provision taking effect.

MARK J. BELTON
Secretary of Natural Resources

 

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 MEDICAL CARE PROGRAMS

Notice of Proposed Action

[17-259-P]

The Secretary of Health proposes to amend:

(1) Regulations .04, .05, and .07 under COMAR 10.09.04 Home Health Services;

(2) Regulations .04, .05, and .07 under COMAR 10.09.09 Medical Laboratories;

(3) Regulations .04, .05, and .07 under COMAR 10.09.53 Early and Periodic Screening, Diagnosis, and Treatment: Nursing Services for Individuals Younger than 21 Years Old;

(4) Regulations .04, .05, and .07 under COMAR 10.09.87 Free-Standing Independent Diagnostic Testing Facilities; and

(5) Regulations .04, .05, and .07 under COMAR 10.09.88 Portable X-ray Providers.

Statement of Purpose

The purpose of this action is to require providers of home health, medical laboratory, private duty nursing, diagnostic testing, and X-ray services to identify the ordering provider by National Provider Identifier (NPI) on the claim. In addition, the ordering provider shall be an individual enrolled in the Program with an active status on the date of service, in order for the claim to be paid.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

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 Michele Phinney, 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, or fax to 410-767-6483. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

 

10.09.04 Home Health Services

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.04 Covered Services.

A. The Program covers the services listed in §§B and C of this regulation when the services are:

(1) Provided upon the written order of the attending physician [and furnished];

(2) Furnished under the current plan of treatment;

(3) Ordered by an individual who is enrolled as a provider in the Program with an active status on the date of service;

[(2)] (4)[(9)] (11) (text unchanged)

B.—C. (text unchanged)

.05 Limitations.

The Program does not cover the following:

A.—R. (text unchanged)

S. Newborn early discharge services provided more than one time to a recipient; [and]

T. A newborn early discharge visit provided on the same day as another skilled nursing visit billed under this chapter[.]; and

U. Home health services ordered by an:

(1) Individual who is not enrolled as a provider in the Program with an active status on the date of service; and

(2) Entity, facility, or another provider that is not an individual.

.07 Payment Procedures.

A.—H. (text unchanged)

I. The home health provider shall identify the individual who ordered the home health services by recording the individual practitioner’s National Provider Identifier (NPI) number on the claim.

 

10.09.09 Medical Laboratories

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.04 Covered Services.

The Program covers the following services:

A. Medically necessary laboratory services, when the services are:

(1)—(3) (text unchanged)

(4) Adequately documented in the provider’s files; [and]

(5) Clinical and diagnostic services for which certification by the [Health Care Financing Administration (HCFA)] Centers for Medicare and Medicaid Services (CMS) under CLIA exists, if required; and

(6) Ordered by an individual who is enrolled as a provider in the Program with an active status on the date of service;

B.—C. (text unchanged)

.05 Limitations.

The following are not covered:

A. Services for which the medical laboratory provider cannot supply a properly completed order or standing order identifying the [authorized ordering practitioner] individual practitioner who ordered the laboratory services;

B.—F. (text unchanged)

G. Medical laboratory services related to autopsies; [and]

H. Medical laboratory services for which there was insufficient quantity of specimen, improper specimen handling, or other circumstances that would render the results unreliable; and

I. Laboratory services ordered by an:

(1) Individual who is not enrolled as a provider in the Program with an active status on the date of service; and

(2) Entity, facility, or another provider that is not an individual.

.07 Payment Procedures.

A. (text unchanged)

B. Medical laboratory providers shall identify the [authorized ordering practitioner who authorized the medical laboratory services by either:] individual who ordered the laboratory services by recording the individual practitioner’s National Provider Identifier (NPI) number on the claim.

[(1) Recording the Maryland Medical Assistance Program individual practitioner identification number on the invoice; or

(2) Recording the name of the authorized ordering practitioner on the invoice and attaching to the invoice a copy of the properly completed order that identifies the authorized ordering practitioner.]

C.—P. (text unchanged)

 

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

.04 Covered Services.

A.—H. (text unchanged)

I. The Program shall cover nursing services ordered by the participant’s primary medical provider when the primary medical provider is an individual who is enrolled as a provider in the Program with an active status on the date of service.

.05 Limitations.

A.—D. (text unchanged)

E. The Program does not cover nursing services ordered by an:

(1) Individual who is not enrolled as a provider in the Program with an active status on the date of service; and

(2) Entity, facility, or another provider that is not an individual.

.07 Payment Procedures.

A.—E. (text unchanged)

F. The nursing services provider shall identify the individual who ordered the nursing services by recording the individual practitioner’s National Provider Identifier (NPI) number on the claim.

 

10.09.87 Free-Standing Independent Diagnostic Testing Facilities

Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland

.04 Covered Services.

A. The Program covers medically necessary radiology services rendered to a recipient in an IDTF when the services are:

(1)—(3) (text unchanged)

(4) Ordered in writing by the treating physician or non-physician practitioner, in accordance with State law, who is enrolled as a provider in the Program with an active status on the date of service; and

(5) (text unchanged)

B.—C. (text unchanged)

.05 Limitations.

The Program does not cover the following:

A. Services for which the IDTF provider cannot supply a properly completed order identifying [by name,] the authorized ordering practitioner by National Provider Identifier (NPI);

B. IDTF services ordered by an:

(1) Individual who is not enrolled as a provider in the Program with an active status on the date of service; and

(2) Entity, facility, or another provider that is not an individual.

[B.] C.[J.] K. (text unchanged)

.07 Payment Procedures.

A. (text unchanged)

B. IDTF providers shall identify the [ordering] individual who [authorized] ordered the diagnostic services by either:

(1) — (2) (text unchanged)

C.—I. (text unchanged)

 

10.09.88 Portable X-ray Providers

Authority: Health-General Article, §§2-104(b) 15-103, and 15-105, Annotated Code of Maryland

.04 Covered Services.

A. The Program covers medically necessary services rendered to recipients, when the services are:

(1)—(2) (text unchanged)

(3) Ordered in writing by the treating physician or nurse practitioner who is enrolled as a provider in the Program with an active status on the date of service in accordance with State law.

B. (text unchanged)

.05 Limitations.

The Program does not cover the following:

A. Services for which the portable X-ray provider cannot provide a properly completed order identifying [by name,] the authorized ordering physician[,] or practitioner by National Provider Identifier (NPI);

B.—J. (text unchanged)

K. X-ray services ordered by an:

(1) Individual who is not enrolled as a provider in the Program with an active status on the date of service; and

(2) Entity, facility, or another provider that is not an individual.

.07 Payment Procedures.

A.—I. (text unchanged)

J. The portable X-ray provider shall identify the individual who ordered the portable X-ray services by recording the individual practitioner’s National Provider Identifier (NPI) number on the claim.

DENNIS SCHRADER
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.89 1915(i) Intensive Behavioral Health Services for Children, Youth, and Families

Authority: Health-General Article, §§2-104(b), Annotated Code of Maryland

Notice of Proposed Action

[17-262-P]

The Secretary of Health proposes to amend Regulations .10—.14 under COMAR 10.09.89 1915(i) Intensive Behavioral Health Services for Children, Youth, and Families.

Statement of Purpose

The purpose of this action is to update the listed rates for 1915(i) Intensive Behavioral Health Services for Children, Youth, and Families by 2 percent effective July 1, 2017. The fiscal 2018 State budget, approved under Senate Bill 170, Budget Bill (Fiscal Year 2018), Ch. 150, Acts of 2017, includes a 2 percent rate increase for community behavioral health providers.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. This proposed action will result in the increase of the rates for 1915(i) Intensive Behavioral Health Services for Children, Youth, and Families services. The State general funds impact is expected to be $45,616 for State fiscal year 2018. The federal funds impact is expected to be $45,616. The total funds impact is expected to be $91,232.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure

(E+/E-)

Magnitude

 


A. On issuing agency:

(E+)

$91,232

B. On other State agencies:

NONE

C. On local governments:

NONE

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

(+)

$91,232

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. and D. Estimated fiscal impacts are based on State Plan estimates of 200 children. The 1915(i) program is still in early implementation with currently only around 40 children enrolled. Actual fiscal impacts will be dependent on actual enrollment and service utilization during fiscal year 2018.

Economic Impact on Small Businesses

The proposed action has a meaningful economic impact on small business. An analysis of this economic impact follows.

Small businesses that could be impacted by this proposal include 1915(i) providers enrolled with Medicaid and offering family peer support, community-based and out-of-home respite, expressive and experiential behavioral services, mobile crisis response, and intensive in-home services. 1915(i) providers will receive Medicaid reimbursement rates that are increased by 2 percent for all 1915(i) services.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Michele Phinney, 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, or fax to 410-767-6483. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

.10 Covered Services — Family Peer Support Services.

Family peer support services:

A.—E. (text unchanged)

F. Effective [July 1, 2016] July 1, 2017, are reimbursed at the following rates:

(1) [$16.29] $16.62 per 15 minute unit for face-to-face services; or

(2) [$8.14] $8.30 per 15 minute unit for telephonic or other non- face-to-face activities.

.11 Covered Services — Respite Services.

Respite services:

A.—D. (text unchanged)

E. Effective [July 1, 2016] July 1, 2017, are reimbursed at the following rates:

(1) [$25.66] $26.18 per one hour unit of service for community-based respite services; or

(2) [$203.43] $207.50 per unit of out-of-home respite care.

.12 Covered Services — Expressive and Experiential Behavioral Services.

A.—B. (text unchanged)

C. Reimbursement. Effective [July 1, 2016] July 1, 2017, reimbursement for services described in this regulation shall be as follows:

(1) For individual therapy provided by a:

(a) Licensed mental health professional at a rate of:

(i) [$69.78] $71.17 per 45—50 minute session; or

(ii) [$91.41] $93.24 per 75—80 minute session;

(b) Non-licensed mental health professional at a rate of:

(i) [$63.43] $64.70 per 45-minute session; or

(ii) [$82.47] $84.12 per 75—80 minute session; and

(2) For group therapy provided by a:

(a) Licensed mental health professional at a rate of:

(i) [$27.74] $28.30 per 45—60 minute session; or

(ii) [$36.07] $36.79 per prolonged (75—90 minute) session;

(b) Non-licensed mental health professional at a rate of:

(i) [$24.64] $25.14 per 45—60 minute session; or

(ii) [$32.04] $32.68 per prolonged (75—90 minute) session.

.13 Covered Services — Mobile Crisis Response Services.

A.—C. (text unchanged)

D. Effective [July 1, 2016] July 1, 2017, MCRS are reimbursed at the following rates:

(1) [$26.13] $26.66 per 15 minute unit of service for crisis response or stabilization; and

(2) [$313.54] $319.81 per assessment.

.14 Covered Services — Intensive In-Home Services.

A.—E. (text unchanged)

F. Effective [July 1, 2016] July 1. 2017, reimbursement for IIHS services shall be provided at the rate of:

(1) [$253.88] $258.96 per week of service for EBP-IIHS providers; or

(2) [$201.42] $205.45 per week of service for non-EBP IIHS providers.

DENNIS SCHRADER
Secretary of Health

 

Subtitle 24 MARYLAND HEALTH CARE COMMISSION

10.24.11 State Health Plan for Facilities and Services: General Surgical Services

Authority: Health-General Articles, §§19-109(a)(1) [and 19-118], 19-114(b)(2) and (d)(1)(iv) and (viii), 19-118(a)(2)(i), and 19-120(j)(2)(iv), (k)(9), and (o)(1) and (3), Annotated Code of Maryland

Notice of Proposed Action

[17-264-P-I]

The Maryland Health Care Commission proposes to repeal existing Regulation .01 and adopt new Regulation .01 under COMAR 10.24.11 State Health Plan for Facilities and Services: General Surgical Services. This action was considered by the Commission at an open meeting held on September 19, 2017, notice of which was given through publication in the Maryland Register, under General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to establish COMAR 10.24.11 (Surgical Services Chapter), a replacement chapter in the State Health Plan for Facilities and Services that governs the establishment and relocation of surgical services. COMAR 10.24.11 was last updated in 2012. Subsequent legislative changes (Chapter 707 of 2016) and input that resulted in regulations proposed as COMAR 10.24.19, the Freestanding Medical Facility Chapter of the State Health Plan, permit the establishment of a freestanding medical facility that may include surgical services. In addition, the replacement Surgical Services Chapter creates a new process for exemption from CON review for the establishment of an ambulatory surgery facility (ASF) with two operating rooms, under circumstances that include: expanding an existing POSC, establishing a new ASF with two operating rooms, relocation of two operating rooms from a hospital to an ASF; or the establishment of an ASF with no more than two operating rooms at a freestanding medical facility established through the conversion of a general hospital. COMAR 10.24.11 also contains policies and standards that will guide the Certificate of Need review process for a general hospital that seeks to add surgical capacity, or relocate surgical capacity when an exemption is not an option, as well as for an applicant seeking to expand an existing ASF or establish an ASF with more than two operating rooms.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. This chapter of the State Health Plan for Facilities and Services: General Surgical Services is expected to have a minimal economic impact on the Maryland Health Care Commission (MHCC) and the Office of Health Care Quality (OHCQ) because MHCC anticipates that there will be few applicants each year for a CON exemption request from the office of one or more health care practitioners or a group practice to establish an ambulatory surgical facility (ASF) , or from a hospital that seeks to relocate two operating rooms from a hospital to establish an ASF, or from a hospital to establish an ASF in conjunction with the conversion of a general hospital to a freestanding medical facility. The affected regulated industries include hospitals, physician outpatient surgery centers (POSCs) and ASFs. By creating a less onerous process for establishing an ASF, a greater number of existing POSCs with one operating room may choose to add a second operating room and will be able to provide surgical services more efficiently. The increase in efficiency may potentially result in greater profits for these ASFs rather than benefiting consumers. However, consumers could benefit from lower prices or increased access to financial assistance. Hospitals may lose some outpatient surgical volume and revenue for other hospital services associated with those cases, such as preoperative testing or outpatient services after surgery, if the increase in ASFs pulls volume away from hospitals. Hospitals may then have excess space for pre- and post-operative care or underutilization of operating rooms. In some cases, converting the use of this space may not be feasible in the short term. However, hospitals may be able to avoid losing some outpatient surgical volume by relocating two operating rooms from the hospital and establishing an ASF through an exemption. The relocation of surgical capacity from hospitals is expected to result in lower costs for consumers and payers potentially because generally ambulatory surgery is much less expensive in a non-hospital setting.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure

(E+/E-)

Magnitude

 


A. On issuing agency:

Maryland Health Care Commission (MHCC)

(E+)

Minimal

B. On other State agencies:

Office of Health Care Quality (OHCQ)

(E+)

Minimal

C. On local governments:

NONE

No Impact

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

(1) Hospitals

(-)

Minimal

(2) Ambulatory surgical facilities

(+)

Minimal

E. On other industries or trade groups:

NONE

No impact

F. Direct and indirect effects on public:

(1)

(+)

Minimal

(2)

(-)

Minimal

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A. Staff will review CON exemption requests for establishment of an ASF with two operating rooms. Staff anticipates receiving only a small number of these requests. The review of these applications and requests can be accommodated by current staff within the Commission’s budget.

B. OHCQ will issue licenses for POSCs and ASFs. Due to the anticipated small number of requests for an exemption from CON to establish an ASF, staff anticipates the impact will be minimal for OHCQ.

C. Local governments are not involved with the provision of surgical services in ASFs. As a result, there will not be an impact on local government providers.

D(1). Hospitals. An ASF that is established in conjunction with the conversion of a general hospital is unlikely to have a negative impact on other hospitals in the area because outpatient surgical capacity already exists in the hospital that is converting to an FMF. Moving the provision of outpatient surgery formerly provided at a hospital to an ASF located at the same site or a site very close to the former hospital is unlikely to affect other hospitals, ASFs, or POSCs if, as is likely, the same types of outpatient surgery are performed. However, if the types of cases performed changes, there may be a negative impact on POSCs and ASFs in the same service area that provide similar surgical services.

An increase in the number of ASFs may cause hospitals to lose some outpatient surgical volume and revenue for other hospital services associated with those cases, such as preoperative testing or outpatient services after surgery, if the increase in ASFs pulls volume away from hospitals. Hospitals may then have excess space for pre- and post-operative care or underutilization of operating rooms. In some cases, converting the use of this space may not be feasible in the short term. However, hospitals may be able to avoid losing some outpatient surgical volume by relocating surgical capacity and establishing an ASF with two operating rooms.

D(2). Ambulatory Surgical Facilities. An ASF that is established in conjunction with the conversion of a general hospital is unlikely to have a negative impact on other hospitals in the area because outpatient surgical capacity already exists in the hospital that is converting to an FMF. Moving the provision of outpatient surgery formerly provided at a hospital to an ASF located at the same site or a site very close to the former hospital is unlikely to affect other hospitals, ASFs, or POSCs if, as is likely, the same types of outpatient surgery are performed. However, if the types of cases performed changes, there may be a negative impact on POSCs and ASFs in the same service area that provide similar surgical services.

An increase in the number of ASFs may cause hospitals to lose some outpatient surgical volume and revenue for other hospital services associated with those cases, such as preoperative testing or outpatient services after surgery, if the increase in ASFs pulls volume away from hospitals. Hospitals may then have excess space for pre- and post-operative care or underutilization of operating rooms. In some cases, converting the use of this space may not be feasible in the short term. However, hospitals may be able to avoid losing some outpatient surgical volume by relocating surgical capacity and establishing an ASF with two operating rooms.

E. Other industries are not expected to be affected.

F(1). Overall, the public may or may not benefit from allowing ASFs to be established through an exemption process because the efficiencies gained may result in primarily benefiting the owners of an ASF or may result in lower charges for surgical services and greater access to financial assistance.

F(2). The increase in efficiency may potentially result in greater profits for these ASFs rather than benefiting consumers (the public).

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 Eileen Fleck, Chief, Acute Care  Policy and Planning, Maryland Health Care Commission, 4160 Patterson Avenue, or call 410-764-3287, or email to eileen.fleck@maryland.gov, or fax to 410-358-1311. Comments will be accepted through 4:30 p.m. on November 27, 2017. A public hearing has not been scheduled.

 

Open Meeting

Final action on the proposal will be considered by the Maryland Health Care Commission during a public meeting to be held on December 21, 2017 at 1 p.m., at 4160 Patterson Avenue, Room 100, Baltimore, Maryland, 21215.

 

Editor’s Note on Incorporation by Reference

     Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the State Health Plan for Facilities and Services: General Surgical Services has been declared a document generally available to the public and appropriate for incorporation by reference.  For this reason, it will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR).  Copies of this document are filed in special public depositories located throughout the State.  A list of these depositories was published in 44:1 Md. R. 9 (January 6, 2017), and is available online at www.dsd.state.md.us.  The document may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401.

.01 Incorporation by Reference.

The State Health Plan for Facilities and Services:  General Surgical Services is incorporated by reference.

 

Subtitle 32 BOARD OF PHYSICIANS

10.32.13 Physician Licensure by Conceded Eminence

Authority: Health Occupations Article, §§14-205 and 14-307—14-319, Annotated Code of Maryland

Notice of Proposed Action

[17-214-P]

The Secretary of Health proposes to amend Regulations .02—.04, .06, and .08 under COMAR 10.32.13 Physician Licensure by Conceded Eminence. This action was considered at a public hearing held on April 26, 2017, notice of which was provided by posting on the Board’s website, http://www.mbp.state.us.forms/mar17FULLagenda.pdf, from April 12, 2017—April 26, 2017, pursuant to General Provisions Article, §3-302(c) Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to:

(1) Add a new definition;

(2) Revise the qualifications for a special license by conceded eminence by requiring the supervising institution to provide a detailed explanation of the applicant’s credentials and requiring that the applicant possess an active unrestricted license to practice medicine and has published original results of clinical research in a recognized medical journal;

(3) Revise the Limited Practice regulation to clarify the applicant’s practice is limited to their area of expertise;

(4) Revise the initial term to a period of 1 year and provide for two renewals and the opportunity to request additional renewals that documents the basis for that request;

(5) Require continuing medical education requirements for second renewals; and

(6) Establish a process for a new appointment at a different institution.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

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 Michele Phinney, 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, or fax to 410-767-6483. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(5) (text unchanged)

(6) “First author” means the first named author of a publication such as a research article or the author who served as the principal investigator for a research project.

[(6)] (7) (text unchanged)

(8) “Last author” means the last named author of a publication such as a research article or the senior author who served as the principal investigator for a research project.

[(7)] (9)[(13)] (15) (text unchanged)

.03 Qualifications for Special License by Conceded Eminence.

A. (text unchanged)

B. Recommendations. On a form supplied by the Board, the dean of a school of medicine in the State or the director of the National Institutes of Health shall recommend the applicant to the Board, by:

(1) Attesting to the fact that the applicant is to receive an appointment at the institution represented by the dean or director; [and]

(2) Presenting the Board with detailed evidence of the physician’s qualifications and competence including:

(a)—(b) (text unchanged)

(c) The degree of supervision[, if any,] under which the physician will function; and

(3) Presenting the Board with a detailed statement describing the applicant’s conceded eminence and authority in the profession.

C. Evidence of Teaching, Research, and Achievement. An applicant shall demonstrate eminence and authority in the profession by meeting [at least three of] the following qualifications [which are necessary, but not by themselves sufficient, for licensure under this chapter]:

[(1) Within 10 years before the application, have published original results of clinical research in a medical journal listed in the Index Medicus or in an equivalent scholarly publication, and have submitted these articles to the Board in English or in a foreign language with verifiable, certified translations in English; or]

[(2)] (1) (text unchanged)

[(3) Within 10 years before the application, have developed a treatment modality, surgical technique, or other verified original contribution to the field of medicine, which is attested to by the dean of a school of medicine in the State or by the director of the National Institutes of Health; ]

[(4)] (2) Have actively practiced medicine cumulatively for [15 years, which may include up to 5 years sabbatical during which the applicant was involved in research] 10 years after completion of postgraduate training, including clinical research; [and]

[(5)] (3) Be a member in good standing of a board of the American Board of Medical Specialties

or other equivalent specialty board[.];

(4) Possess a current, active, unrestricted license to practice medicine in another state or country, or be otherwise recognized under the laws of the other country or jurisdiction as a medical doctor in that jurisdiction; and

(5) Within 10 years before the application:

(a) Have:

(i) Published original results of clinical research, as first author or last author, in a medical journal listed in the Index Medicus or in an equivalent scholarly publication acceptable to the Board; and

(ii) Submitted these articles to the Board in English or in a foreign language with verifiable, certified translations in English; or

(b) Have developed a treatment modality, surgical technique, or other verified original contribution to the field of medicine, which is attested to by the dean of a school of medicine in the State or by the director of the National Institutes of Health.

D. Supervision. The Board [may] shall require an applicant to submit [the]:

(1) The name of a licensed physician who will supervise the medical services provided by the applicant for the first 6 months [after the license is granted,] of practice; and [a]

(2) A detailed description of the medical services, duties, and responsibilities that the applicant will perform. 

.04 Limited Practice.

An applicant for licensure is restricted so that the applicant shall:

A. Practice medicine only in the limited field approved by the Board that is consistent with the applicant’s area of conceded eminence experience;

[A.] B. For the first 6 months of practice, practice medicine only [within]:

(1) Within the [institutions] institution and [programs] program specified within the application[,]; and

(2) Under the supervision of a licensed physician;

[B.] C. Following the first 6 months of practice, practice medicine only [at]:

(1) At an institution similar to that named in the original application; and [after]

(2) After approval by the Board; and

[C.] D. (text unchanged)

.06 Term and Renewal of License by Conceded Eminence and Authority in the Profession.

A. Term and Tenure.

(1) The initial license is active for a period [of 6 months] 1 year, and, after that,[for 2 years or for another term established by the Board] may be renewed twice for a term established by the Board. After two renewals, a licensee seeking any additional renewals shall provide documentation to the Board 3 months before the expiration of the licensee’s license indicating the continued significance of the licensee’s work at the sponsoring institution that requires the license to be renewed for another term.

(2) (text unchanged)

B. Initial Renewal. [A license issued under this regulation may be renewed every 2 years on a date set by the Board and as specified in COMAR 10.32.01] As part of the initial renewal process:

(1) The supervising physician shall submit an attestation, approved by the Board, that the licensee was supervised for a period of at least 6 consecutive months; and

(2) The licensee shall complete a renewal application form, after Board approval of the attestation.

C. Second Renewal.

(1) A license issued under this chapter may be renewed in a second renewal:

(a) On a date set by the Board; and

(b) As specified in COMAR 10.32.01.

(2) A licensee for second renewal shall:

(a) Complete a renewal application form;

(b) Meet the requirements set out in COMAR 10.32.01.10, including completing at least 50 hours of continuing medical education units; and 

(c) Pay a renewal fee set by the Board in COMAR 10.32.01.12.

(3) A licensee shall inform the Board of the institution where the licensee plans on practicing for the renewal term.

D. Subsequent Renewal.

(1) A license issued under this chapter may be renewed in subsequent renewals:

(a) On a date set by the Board; and

(b) As specified in COMAR 10.32.01.12.

(2) A license for subsequent renewal shall:

(a) Complete a renewal application form;

(b) Meet the requirements set out in COMAR 10.32.01.10, including completing at least 50  hours of continuing medical education units;

(c) Provide documentation to the Board 3 months before the expiration of the licensee’s license indicating the continued significance of the licensee’s work at the sponsoring institution that requires the license to be renewed for another term; and

(d) Pay a renewal fee set by the Board in COMAR 10.32.01.12.

(3) A licensee shall inform the Board of the institution where the licensee plans on practicing for the renewal term.

.08 Termination and New Appointment.

A. On termination of the licensee’s approved appointment, the conceded eminence license terminates and becomes null and void.

B. A licensee has a duty to inform the Board of the termination of an appointment within 30 days of the termination.

[A.] C. [Duty to Inform of Termination.] Failure of the licensee to inform the Board of the termination of an appointment within 30 days constitutes unprofessional conduct under Health Occupations Article, §14-404(a)(3), Annotated Code of Maryland.

[B. New Appointment. An individual licensed under this chapter may not begin a new appointment without the approval of the Board.]

D. New Appointment. 

(1) If a licensee wishes to receive a conceded eminience license with another institution, the licensee shall apply for a new appointment with another institution.

(2) The Board may approve the new appointment at the Board’s discretion.

(3) Board approval shall be obtained before the individual may begin the appointment.

DENNIS SCHRADER
Secretary of Health

 

Subtitle 34 BOARD OF PHARMACY

10.34.34 Pharmacy Technicians

Authority: Health-Occupations Article, §§12-205 and 12-6B-01, Annotated Code of Maryland

Notice of Proposed Action

[17-261-P]

The Secretary of Health proposes to amend Regulation .05 under COMAR 10.34.34 Pharmacy Technicians. This action was considered by the Board of Pharmacy at an open meeting held on June 21, 2017, notice of which was given by publication on the Board’s website, http://health.maryland.gov/pharmacy/Pages/index.aspx from May 18, 2017 — June 21, 2017, pursuant to General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to exempt first-year pharmacy students from the training requirements for pharmacy technicians and allow first-year pharmacy students to perform delegated pharmacy acts under the supervision of a registered pharmacist in accordance with Ch. 764, Acts of 2017.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

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 Michele Phinney, 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, or fax to 410-767-6483. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

.05 Pharmacy Students — Exemptions.

A. Pharmacy students who are practicing in a pharmacy as part of a school of pharmacy sanctioned experiential learning rotation are not subject to the registration requirements of Regulation .04 of this chapter.

B. Pharmacy students who are currently completing the first year of a professional pharmacy education program and are not in a school of pharmacy sanctioned experiential learning rotation may perform delegated pharmacy acts provided that the pharmacy student:

(1) Submits to the Board a signed completed application for exemption from the registration requirements of Regulation .04 of this chapter; and

(2) Provides verification of enrollment and good standing at an accredited school of pharmacy.

C. A pharmacy student may begin work under this exemption upon compliance with §B of this regulation.

D. An exemption from registration granted under this regulation is effective only during the first year of the pharmacy student’s professional pharmacy education program.

E. Pharmacy students granted an exemption from registration under this regulation are not subject to renewal requirements as set forth in Regulation .08 of this chapter.

F. A pharmacy student granted an exemption from registration under this regulation shall perform delegated pharmacy acts under the direct supervision of a licensed pharmacist and in accordance with Health Occupations Article, Title 12, Subtitle 6B, Annotated Code of Maryland, and this chapter.

DENNIS SCHRADER
Secretary of Health

 

Subtitle 37 HEALTH SERVICES COST REVIEW COMMISSION

10.37.10 Rate Application and Approval Procedures

Authority: Health-General Article, §§19-207, 19-212, 19-216, 19-218,
19-219, 19-220, and 19-222, Annotated Code of Maryland

Notice of Proposed Action

[17-263-P]

The Health Services Cost Review Commission proposes to amend Regulations .03, .03-1, .04-1, .04-2, .04-3, and .11 under COMAR 10.37.10 Rate Application and Approval Procedures. This action was considered and approved for promulgation by the Commission at a previously announced open meeting held on September 13, 2017, notice of which was given pursuant to General Provisions Article, §3-302(c), Annotated Code of Maryland. If adopted, the proposed amendments will become effective on or about January 15, 2018.

Statement of Purpose

The purpose of this action is to set forth the process for filing a full rate application with the Commission; identify the methodologies to be used in approving permanent rates; describe the annual update factor vis-à-vis the All-Payer Model Agreement, including corrective action if necessary to maintain compliance with the All-Payer Model Agreement; and provide options to hospitals for Commission review of a full rate application.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. The economic impact of these amendments is uncertain. On the one hand, hospitals will now be in the same position they were before the moratorium was established by the Commission in November of 2015 on the filing of full rate applications as a vehicle for requesting a rate change. On the other hand, with the progression of the All-Payer Model, the Commission is now required to set rates in accordance with the more stringent requirements and standards inherent in the Model. Therefore, it is uncertain how many hospitals will file full rate applications with the new standards in place; of those that do file, how many will receive rate increases or a reduction to rates; and what the magnitude of those rate changes will be in light of the performance requirements associated with the Model.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure (E+/E-)

Magnitude

 


A. On issuing agency:

NONE

 

B. On other State agencies:

(1)

(E+)

Indeterminable

(2)

(E-)

Indeterminable

C. On local governments:

NONE

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

(1)

(+)

Indeterminable

(2)

(-)

Indeterminable

E. On other industries or trade groups:

 

(1)

(+)

Indeterminable

(2)

(-)

Indeterminable

F. Direct and indirect effects on public:

 

(1)

(+)

Indeterminable

(2)

(-)

Indeterminable

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

B. The assumption is based on the uncertainty of impact on Medicaid expenditures when the moratorium on full rate applications lifts and hospitals can avail themselves of the opportunity previously in place to file a full rate application for rate relief. What has changed, however, is the requirement that the Commission now set rates in accordance with the strict standards and requirements of the All-Payer Model.

D. The assumption is based on the uncertainty of impact on hospitals when the moratorium on full rate applications lifts and hospitals can avail themselves of the opportunity previously in place to file a full rate application for rate relief. What has changed, however, is the requirement that the Commission now set rates in accordance with the strict standards and requirements of the All-Payer Model.

E. The assumption is based on the uncertainty of impact on payers when the moratorium on full rate applications lifts and hospitals can avail themselves of the opportunity previously in place to file a full rate application for rate relief. What has changed, however, is the requirement that the Commission now set rates in accordance with the strict standards and requirements of the All-Payer Model.

F. The assumption is based on the uncertainty of impact on the public when the moratorium on full rate applications lifts and hospitals can avail themselves of the opportunity previously in place to file a full rate application for rate relief. What has changed, however, is the requirement that the Commission now set rates in accordance with the strict standards and requirements of the All-Payer Model.

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 Diana Kemp, Regulations Coordinator, Health Services Cost Review Commission, 4160 Patterson Avenue, Baltimore, MD 21215, or call 410-764-2576, or email to diana.kemp@maryland.gov, or fax to 410-358-6217. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

.03 Regular Rate Applications.

A. A hospital may [not] file a regular (i.e., full) rate application with the Commission [until rate efficiency measures are adopted by the Commission which are consistent with the all-payer model contract approved by the Centers for Medicare & Medicaid Services (CMS). During this interim period of time, a hospital may seek a rate adjustment under any other administrative remedy available to it under existing Commission, law, regulation, or policy. The rate efficiency measures shall be adopted by the Commission no later than October 31, 2017. Once the moratorium is lifted, a hospital may file a regular rate application with the Commission] at any time if:

(1) — (2) (text unchanged)

B. Full Rate Application.

(1) (text unchanged)

(2) In order for a full rate application to be docketed, it shall comply with a template for such applications as prescribed by the Commission staff and shall:

(a) (text unchanged)

(b) Be accompanied by appropriate supporting documents[;], including:

(i) The Annual Report of Revenues, Expenses, and Volumes projected and explained (e.g., how much of the requested increase relates to inflation, volumes, and other factors) for the period for which the hospital requests new rates;

(ii) Any audited financial statements over the most recent 5 years not yet filed with the Commission, plus the most recent unaudited financial statements for the current period, which are available at the time of the filing of the full rate application;

(iii) An Excel file listing and summarizing balance sheets, statements of operations and changes in net assets, and statements of cash flow for the last 5 years per the audited financial statements along with a narrative explaining any major changes;

(iv) An Excel file listing the information contained within the Annual Report RE schedules for the last 5 years breaking out regulated and unregulated revenues and expenses by category and in total;

(v) A detailed history of HSCRC-approved revenue and actual revenue for the hospital for the last 2 calendar years;

(vi) A detailed history for the most recent 4 Rate Years of HSCRC-approved GBR revenue and actual revenue and volumes, in addition to any approved and actual revenue and volumes available at the date of the filing of the full rate application. The history of approved and actual revenue changes should detail the basis of the changes in approved and actual revenue including allowed inflation and all other factors;

(vii) An identification of related organizations (i.e., an organization related to the hospital through some type of control or ownership), including subsidiaries of the hospital as well as hospitals that are part of the same hospital system as the applicant hospital. For applicant hospitals that are part of a system, the hospital may be required to submit financial and other information related to the system hospitals, including any system transactions among the system hospitals, which may affect the financial condition of the applicant hospital;

(viii) A listing of any services provided by related organizations including the amount charged to the applicant hospital for the services;

(ix) A listing of any transfers of funds to or from a related organization including an explanation of such transfers;

(x) Copies of the two most recent Medicare Cost Reports, including any home office cost report files — the Interns and Resident Information System report (IRIS) files, and the wage and occupational mix files, along with any adjustments and corrections;

(xi) Reconciliations of inpatient and outpatient volumes and revenue submitted in the HSCRC abstract data to the departmental revenue and statistics submitted monthly for the last 3 years;

(xii) In Excel, listing of Outpatient drugs accounting for at least 80 percent of the Hospital’s total outpatient drug expenses, with applicable HCPCS codes for last 3 years, including frequency of charges, amount of charges and units billed, Average Sales Price at the end of each year and applicable 340B discounts and an estimate of billed charges for unlisted drugs;

(xiii) For profits or losses associated with the support of physician practices, the applicant hospital may be required to provide a detailed accounting of those profits or losses over time. Additional information regarding compensation, subsidies and other forms of financial support provided to physicians may be required following staff’s initial review to the extent that these profits or losses have a material impact on the financial condition of the applicant hospital;

(xiv) A supporting document, in Excel, that compares the requested departmental rates of the applicant hospital to that hospital’s current departmental rates. The supporting document should also compare these current and requested departmental rates to those of other HSCRC-regulated hospitals located in the Primary Service Area (PSA) of the applicant hospital. If no other regulated hospitals are located in the applicant hospital’s PSA, then the comparison should be made to Statewide median departmental rates; and

(xv) An accounting of the amounts reported by the applicant hospital to the HSCRC regarding its uses of population health infrastructure money included in rates;

(c) Include a [complete] description [of what is] of the rate adjustments that are being requested in the full rate application; [and]

(d) Include specific detail and substantiation of any circumstances the applicant hospital cites as unique to its facility, [that] which would require revenue in excess of the amount [resulting from use of the ICC methodology set forth in Regulation .04-1 of this chapter] currently provided in its approved regulated revenue;

(e) Describe in detail what the applicant hospital has specifically done consistent with the All-Payer Model to reduce or eliminate unnecessary or potentially avoidable utilization. For purposes of this regulation, unnecessary or potentially avoidable utilization means the utilization of health care items and services, including care furnished to treat complications during a hospital admission, that may be avoided through improved efficiency, care coordination, or effective community-based care, or that is not medically necessary or evidence-based care. The Staff may request additional information as needed;

(f) Provide estimates for the next 5 years of reductions in utilization that will be accomplished through care redesign initiatives;

(g) Provide a history of denials for the most recent 3 years, including any year-to-date figures; and

(h) Any additional information the Staff may request that bears directly on the hospital’s request for rate relief and its financial condition.

[(3) Requests for special consideration of a full rate application shall be accompanied by supporting documentation in the format of applicable reports under COMAR 10.37.01.03H.]

[(4)] (3) The provisions of §B(2) [and (3)] of this regulation may be waived by staff if the application applies only to:

(a) A request filed [as a requirement of COMAR 10.37.03.06 (Hospital-based physician compensation source)] for a change in the applicant hospital’s uncompensated care allowance;

(b) A request for [a change in the applicant's uncompensated care allowance] rates to cover government-mandated or similar action affecting more than one previously approved rate for which the staff believes the provisions of §B(2) [and (3)] of this regulation are not necessary; or

(c) A request for rates [to cover government-mandated or similar action affecting more than one previously approved rate for which the staff believes the provisions of §B(2) and (3) of this regulation are not necessary] associated with a Certificate of Need-approved capital project, which request may be considered to be a “partial rate application” by staff.[; or

(d) A request for rates associated with a Certificate of Need — approved capital project.]

C. (text unchanged)

[D. Uncompensated Care Policy—Medicaid Day Limits.

(1) A hospital may request a change in its approved provision of uncompensated care by means of a partial rate application in response to action taken by the Secretary of Health to establish hospital day limits under the Medical Assistance Program.

(2) In evaluating such a request, the Commission shall consider the following factors before deciding whether to approve, deny, or modify the hospital's request:

(a) The hospital's actual uncompensated care and estimated uncompensated care from the Commission's most recent uncompensated care regression analysis;

(b) The hospital's cash position, operating margin, and net margin as shown on its latest audited financial statements and its most recent unaudited FS Schedules submitted to the Commission;

(c) Any other financial considerations that are presented to the Commission with the partial rate application;

(d) The hospital's position on the Commission's most recent Reasonableness of Charges analysis;

(e) Whether changing a hospital's approved provision of uncompensated care in response to the establishment of hospital day limits places the Medicare waiver in potential jeopardy; and

(f) Whether implementing such a change to a hospital's approved provision of uncompensated care is in the public interest.

(3) The review of a hospital's request for additional revenue in its approved provision of uncompensated care related to Medicaid's day limits shall be completed by the Commission as soon as practicable.

(4) Any action taken by the Commission on such a request may not be considered a final decision in a contested case under the Administrative Procedure Act, and a hospital retains the right to file a full rate application in accordance with Commission law and regulation.

(5) Any additional revenue approved by the Commission under such a request shall be removed from approved rates prospectively upon the expiration of the hospital day limits established by the Medical Assistance Program.]

.03-1 Partial Rate Application.

A. The provisions of Regulation .03B(2) [and (3)] of this chapter may be waived by staff in the review of a partial rate application.

B.—D. (text unchanged)

.04-1 [ICC] Rate Efficiency Methodology.

A. In evaluating the reasonableness of a hospital's permanent rate structure, the Commission shall [may] use [its] an Inter-hospital Cost Comparison (ICC) methodology [as a benchmark for reasonableness. Thus, the results of an ICC analysis do not constitute an absolute rule, and the Commission shall consider the individual circumstances of the subject hospital in determining the appropriate rate structure. The ICC methodology begins by establishing costs for the target hospital and its peer group. Under the methodology, costs are determined by calculating the hospitals' charges and then removing markup and profits. The methodology then compares the subject hospital's costs to the average costs of its peer group after adjusting for factors for which the hospital is not held accountable. These factors include, but need not be limited to, case mix, labor market cost differences, reasonable medical education costs, and special grants awarded by the Commission], which compares the costs of the hospital to those costs, including adjustments for reasonableness and efficiency, of its peer hospitals, with appropriate adjustments to reflect changes in the hospital’s volume since the beginning of the new All-Payer Model Agreement and the inception of the hospital’s revenue agreement, as the foundation of its review of the full rate application. The staff shall make modifications to the ICC which are needed to properly reflect any additional factors that are relevant to the determination of a reasonable cost level that should be reflected in the hospital’s approved regulated revenue. The ICC analysis does not constitute a strict, unalterable or absolute methodology. It shall be modified as needed to give proper attention to the particular circumstances of the hospital, and the staff shall give due consideration to information provided by the hospital in determining the appropriate rate levels and rate structure for the hospital. The ICC shall take into account, in the establishment of appropriate rate levels, those factors for which the hospital will not be held accountable such as special grants from the Commission, assessments, uncompensated care levels, and characteristics of the population in the hospital’s primary service area.

B. [The Commission shall fully describe and publicly disseminate the technical provisions of the methodology used to evaluate a hospital's permanent rate structure. Any Commission approved updates or changes to these provisions shall similarly be described and disseminated] Factors considered in the ICC methodology may evolve during the course of full rate reviews. The Commission shall take into account the specific circumstances of the applicant hospital, and staff shall make the key contents, analytic steps, and findings of such reviews available to all hospitals and the public.

C. [The final rates that are approved by the Commission for a nonprofit hospital's permanent rate structure shall allow the hospital to charge reasonable rates that will permit it to provide, on a solvent basis, effective and efficient service that is in the public interest] When reviewing a full rate application filed by a hospital that is owned or controlled by a hospital system that also owns other hospitals located in Maryland, the Commission may take into account the financial situation of the other hospitals in the system including their profitability and any shifts of services, volume, revenues or assets between the hospital and the other hospitals or related organizations of the system.

D. The final rates that are approved by the Commission for a [proprietary profit-making hospital's permanent rate structure shall allow the hospital to charge reasonable rates that will permit it to provide effective and efficient service that is in the public interest and include enough allowance for and provide a fair return to the owner of the hospital] nonprofit hospital’s permanent rate structure shall allow the hospital to charge reasonable rates that will permit it to provide, on a solvent basis, effective and efficient service that is in the public interest.

E. The final rates that are approved by the Commission for a proprietary profit-making hospital’s permanent rate structure shall allow the hospital to charge reasonable rates that will permit it to provide effective and efficient service that is in the public interest and include enough allowance for and provide a fair return to the owner of the hospital.

F. The Commission shall set rates for the applicant hospital consistent with the All-Payer Model approved by the federal Center for Medicare and Medicaid Innovation.

.04-2 [Case Target] Global Budget Revenue Methodology.

A. [Effective July 1, 2000, the Commission shall implement its case target methodology (CTM) for the purpose of establishing] The Global Budget Revenue (GBR) methodology implemented by the Commission effective January 1, 2014, establishes reasonable [rates] revenue levels for Maryland's general acute hospitals, which will enable them to improve quality and efficiency on a solvent basis within the constraints imposed by the All-Payer Model. [Effective July 1, 2008, the Commission shall expand its case target methodology to include outpatient services. This methodology is prospective in nature and designates a charge-per-admission target and a charge-per-visit target for each hospital.]

B. In setting [individual targets] reasonable revenue levels, the Commission shall take into account a number of [the following] factors. These may include, but are not limited to the following:

(1) The [case] casemix severity and reasonable utilization of the hospital’s patients;

(2) — (3) (text unchanged)

(4) The [payor] hospital’s payer mix;

(5) The reasonable uncompensated care requirements of the hospital;

(6) The reasonable Graduate [medical education] Medical Education (GME) costs of the hospital as determined by the Commission;

[(7) The screening position of the hospital;]

[(8)] (7) Appropriate adjustments, if any, associated with exceptional or outlier cases as defined by the Commission;

(8) Wage levels at the hospital and at other hospitals in the geographic area of the hospital and elsewhere in Maryland;

(9) Adjustments for quality improvement and value-based payment programs applicable to the hospital;

(10) Reasonable infrastructure funding for care management and care coordination for hospital patients;

[(9)] (11) The annual update factor;

[(10)] (12) [Appropriate adjustments associated with the hospital's relative adjusted charge per case] The proportion of unnecessary care, including Potentially Avoidable Utilization (PAU) at the hospital; and

(13) The performance of the State as a whole under the All-Payer Model.

C. The [CTM] GBR shall be implemented through [an] a written agreement entered into by the Commission and each individual general acute hospital. This agreement and any addenda thereto, which shall be annual and renewed automatically, shall set forth all relevant provisions [for achieving the charge-per-case target established, including, but not limited to, performance corridors, interim rate adjustments, the exclusion of certain cases, and the penalties associated with failure to comply with the terms of the agreement. A hospital that is a party to this agreement shall submit a signed copy of the agreement to the Commission's offices within 60 days of the issuance of the annual unit rate and charge-per-case target update rate order. Following the receipt of its inpatient charge-per-case agreement, a hospital will receive an addendum to the agreement that establishes the charge-per-visit target. The addendum, which shall be annual, shall set forth all relevant provisions for achieving the charge-per-visit target established, including, but not limited to, interim rate adjustments, the exclusion of certain cases, and the penalties associated with failure to comply with the agreement. A hospital that is a party to the addendum shall submit a signed copy of the addendum to the Commission's offices within 60 days of the issuance of the charge-per-visit target addendum. Failure to submit either the signed agreement or the signed addendum in a timely manner may subject the hospital to penalties under COMAR 10.37.01.03N] governing the GBR including, but not limited to, performance corridors; interim rate adjustments; the exclusion or special treatment of certain cases; the treatment of volume changes, including those involving residents of Maryland and other patients; the penalties associated with failure to comply with the terms of the GBR agreement; interim revenue limits; care redesign requirements; and other changes to the agreement that may be needed from time to time. A hospital that enters into a GBR agreement shall submit a signed copy of the agreement to the Commission’s offices within 60 days after it is initially approved by the Commission. A hospital that is party to the addendum shall submit a signed copy of the addendum to the Commission’s offices within 60 days from the issuance of the addendum. Failure to submit the signed GBR agreement or the signed addendum in a timely manner, absent an extension granted by staff, may subject the hospital to penalties under COMAR 10.37.01.03R. Thereafter, on an annual basis, the hospital shall receive an updated rate order. A hospital that disagrees with a proposed [target] GBR may file a full rate application with the Commission in accordance with Regulation .03 of this chapter.

[D. In lieu of a CTM agreement, a hospital may request that it be permitted to enter into a total patient revenue (TPR) agreement with the Commission. A TPR agreement establishes a revenue cap for qualifying hospitals. A qualifying hospital is one that typically is located in a rural area and has a well-defined catchment area with a stable population.]

.04-3 [Case Target Update] Global Budget Revenue Mechanism.

A. For purposes of this regulation, the following definitions apply:

(1) “[Factor cost inflation] Annual update factor” means [increases in the costs of goods, services, wages, and salaries experienced by the hospitals as calculated by the Commission for the most recent period for which data are available preceding the year for which the Commission calculates case target updates] the amount by which total State hospital revenue may increase in a rate year.

(2) “[Hospital update] Demographic adjustment” means the [amount by which an individual hospital’s charge per admission may increase in a rate year (that is, July 1—June 30)] percentage increase in allowed revenue related to changes in population and the age/sex mix of the population residing in the hospital’s primary service area, net of any reductions.

(3) “[National growth allowance] Factor cost inflation” means [one-half of the amount, if any, by which national growth in net revenue per adjusted admission exceeds factor cost inflation growth in any rate year] increases in the costs of goods, services, wages, and salaries experienced by the hospitals as calculated by the Commission for the most recent period for which data are available preceding the year for which the Commission calculates case target updates.

(4) “[National growth reduction] Hospital update” means the amount[, if any, by which factor cost inflation growth exceeds the growth in national net revenue per adjusted admission in any rate year] by which an individual hospital’s approved GBR revenue changes in a particular rate year (i.e., July 1 — June 30).

(5) “[Annual update factor] Market shift adjustment” means [the amount by which total State charge per admission may increase in a rate year] the rate adjustment applied by the Commission, which increases or decreases the approved GBR revenue of a hospital to reflect changes in volume at the hospital for which there was a corresponding change in volume at another Maryland hospital or other provider.

B. Annual Update Factor.

(1) On or before [April] July 1 of each year, the Commission shall establish an annual update factor for the purpose of adjusting the [rates] GBR revenue of each individual hospital. The annual update factor shall be [calculated on the basis of projected factor cost inflation adjusted by any national growth allowance or national growth reduction] designed to reflect projected factor cost inflation, an allowance for certain volume adjustments, productivity adjustments, the revenue constraints included in the All-Payer Model Agreement and other relevant factors, demographic adjustments, market shift adjustments, and other appropriate adjustments.

(2) If [Maryland hospitals exceed the annual update factor established by the Commission for a given year,] after approving an update factor for a given year, a hospital or hospitals collectively exceed their approved revenue, the annual update factor [shall] may be reduced in future years to recoup the excess revenue growth. Similarly, if a Maryland hospital or hospitals collectively fall below [the annual update factor for a given year,] their approved revenue for a given year, the annual update factor [shall] may be adjusted accordingly in future years.

(3) (text unchanged)

C. (text unchanged)

D. Corrective Action. If, at any time, the Commission estimates that the [relative Medicare waiver test cushion is established to be 5 percent or less (based on modeling using the Health Care Financing Administration actuary's most recent projections and Health Services Cost Review Commission casemix data adjusted for the historical relationship between charges and payments), the Commission may take immediate corrective action, as it deems necessary and proper, to restore the minimum waiver cushion and to reverse any further deterioration. The Commission shall provide sufficient notice and opportunity for comment before taking corrective action. This comment opportunity does not constitute a contested case within the meaning of the Administrative Procedure Act. Any reductions implemented to preserve the waiver are not subject to the limitation requiring the annual update factor to be at least 1 percent] financial constraints or other terms imposed by the All-Payer Model Agreement are at risk of being violated (based on modelling using the CMS actuary’s most recent projections and Health Services Cost Review Commission analysis of Medicare payments data), the Commission may take immediate and appropriate corrective action as it deems necessary and proper to meet the Medicare savings requirements and limits on growth in Medicare payments and prevent any further deterioration in compliance with the Model Agreement. The Commission shall provide sufficient notice and opportunity for comment before taking corrective action. This comment opportunity does not constitute a contested case within the meaning of the Administrative Procedure Act.

E. The provisions of this regulation apply to all Maryland's general acute care hospitals from July 1, [2000] 2014, and [after that] thereafter.

F. Compliance and Penalties. [CTM] GBR compliance shall be monitored during the agreement period. Penalties shall be assessed prospectively at the beginning of the next period. Penalties shall be based on the corridors specified in the GBR Agreement.

.11 Recommendations of the Commission's Staff to the Commission, Options for Commission Review.

A.—F. (text unchanged)

G. The Commission may prescribe a process for its consideration of a full rate application, which allows for written submissions in support of an application in lieu of an evidentiary hearing. A hospital that chooses this process for a Commission decision on its full rate application shall be afforded the right to submit to the Commission rebuttal information following any written response to the full rate application filed by Commission staff or designated interested parties. A hospital that chooses this written submission process waives its right to an evidentiary hearing. A hospital that chooses this written submission process does not waive its right to judicial review of a final Commission decision under the Administrative Procedure Act. As an additional alternative to an evidentiary hearing, a hospital may choose to enter into a binding arbitration process as prescribed by the Commission.

NELSON SABATINI
Chairman
Health Services Cost Review Commission

 

Title 20
PUBLIC SERVICE COMMISSION

Subtitle 90 TAXICABS

20.90.01 Taxicab Drivers of Baltimore City Taxicabs

Authority: Public Utilities Article, §10-104, Annotated Code of Maryland

Notice of Proposed Action

[17-252-P]

The Public Service Commission proposes to adopt new Regulation .19 under COMAR 20.90.01 Taxicab Drivers of Baltimore City Taxicabs. This action was considered by the Public Service Commission at a scheduled rule-making meeting held on Thursday, August 24, 2017, notice of which was given under General Provisions Article, §3-302, Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to establish driver screening standards for for-hire drivers.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

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 David J. Collins, Executive Secretary, Public Service Commission, 6 St. Paul Street, 16th Floor, Baltimore, MD 21202, or call 410-767-8067, or fax to 410-333-6495. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

.19 Licensure — Driver Screening Standards.

A. General. As used in this regulation, the terms “conviction” and “convicted of” include a finding of guilt in a criminal or motor vehicle proceeding, the entry of the plea of guilty or nolo contendere, a probation before judgment if the applicant has not yet completed the terms of the probation or if the applicant has been found to have violated the terms of probation, or has been found not criminally responsible pursuant to Maryland Rule 4-134. The terms of an applicant’s probation before judgment will be determined by referencing the sentencing and disposition date information contained in the background check or criminal history report provided with the application. Unless the background check or criminal history report indicates otherwise, there will be a presumption that the terms of the probation before judgment have been completed within the period indicated on the report and that the applicant has not violated the terms of the probation.

B. Criminal Offenses.

(1) Tier 1 Felony Offenses involving a Crime of Violence. An individual may be denied a license for an indefinite period if the individual has been convicted of a crime of violence, as defined by Criminal Law Article, §14-101, Annotated Code of Maryland, including any conspiracy, solicitation, attempt, or accessory to such crime of violence. Crimes of violence include:

(a) Abduction;

(b) Arson in the first degree;

(c) Kidnapping;

(d) Manslaughter, except involuntary manslaughter;

(e) Mayhem;

(f) Maiming;

(g) Murder;

(h) Rape;

(i) Robbery, as defined by Criminal Law Article, §3-402 or 3-403, Annotated Code of Maryland, including robbery with a deadly weapon;

(j) Carjacking;

(k) Armed carjacking;

(l) Sexual offense in the first degree;

(m) Sexual offense in the second degree;

(n) Use of a handgun in the commission of a felony or other crime of violence;

(o) Child abuse in the first degree under Criminal Law Article, §3-601, Annotated Code of Maryland;

(p) Sexual abuse of a minor under Criminal Law Article, §3-602, Annotated Code of Maryland, if:

(i) The victim is under the age of 13 years and the offender is an adult at the time of the offense; and

(ii) The offense involved vaginal intercourse, as defined in Criminal Law Article, §3-301, Annotated Code of Maryland; a sexual act, as defined in Criminal Law Article, §3-301, Annotated Code of Maryland;  an act in which a part of the offender’s body penetrates, however slightly, into the victim’s genital opening or anus; or the intentional touching, not through the clothing, of the victim’s or the offender’s genital, anal, or other intimate area for sexual arousal, gratification, or abuse;

(q) An attempt to commit any of the crimes as described in §B(1)(a)—(p) of this regulation;

(r) Continuing course of conduct with a child under Criminal Law Article, §3-315, Annotated Code of Maryland;

(s) Assault in the first degree;

(t) Assault with intent to murder;

(u) Assault with intent to rape;

(v) Assault with intent to rob;

(w) Assault with intent to commit a sexual offense in the first degree; and

(x) Assault with intent to commit a sexual offense in the second degree.

(2) Tier 2 Felony Offenses Other than Tier 1 Crimes of Violence. An individual may be denied a license if, within the 7-year period prior to the date of submission of the application, the individual has been convicted of any felony offense that is not defined as a crime of violence under Criminal Law Article, §14-101, Annotated Code of Maryland. Tier 2 felony offenses include:

(a) Any felony offense against a person including any assault or assault and battery that is not defined as a Tier 1 crime of violence as described in §B(1) of this regulation, or any threat to commit such crime, or any violation of a restraining order;

(b) Any felony offense involving the illegal use or possession of weapons;

(c) Any felony offense involving the possession, importation, manufacture, distribution, or registration of a controlled dangerous substance, prescription drug, or other substance;

(d) Any felony offense involving the manufacture, sale, transport, or possession of explosives, or the intent to create an explosive device;

(e) Any felony offense involving criminal sexual assault that is not defined as a Tier 1 crime of violence as described in §B(1) of this regulation, any type of sexual abuse, solicitation, pandering, prostitution, pimping, obscenity, pornography, possession of obscene material, exploitation, public indecency, sexual relations within families, or sexual misconduct;

(f) Any felony property offenses that are not defined as a Tier 1 crime of violence as described in §B(1) of this regulation, including arson and burning, burglary and related crimes including home invasion, malicious destruction and related crimes, trespass, or crimes against a railroad;

(g) Any felony theft and related offenses; fraud and related offenses; offenses against public administration; offenses against public health, conduct, and sensibilities; indecency and obscenity; or gaming.

(3) Misdemeanor Offenses — Crimes of Violence. Except for driving offenses as described in §B of this regulation, an individual may be denied a license if, within a 3-year period prior to the date of the submission of the application, the individual has been convicted of any crime classified as a misdemeanor in the state of Maryland that involves violence against a person, including any conspiracy, solicitation, attempt, or accessory to such crime of violence.

(4) Multiple Disqualifying Offenses. Individuals who have been convicted of multiple criminal offenses as described in §B(2) and (3) of this regulation shall be subject to the following exclusion periods.

(a) Two or more felonies offenses — An individual may be denied a license if, within 10 years prior to the date of submission of the application the individual has been convicted of two or more Tier 2 felony offenses as described in §B(2) of this regulation, provided these crimes arose out of separate incidents.

(b) Three or more misdemeanor crimes of violence — An individual may be denied a license if, within 7 years prior to the date of submission of the application, the individual has been convicted of three or more misdemeanors as described in §B(3) of this regulation, provided each of these offenses arose out of separate incidents.

C. Driving Offenses.

(1) Major Traffic Offenses Involving Fatalities. An individual may be denied a license for an indefinite period if the individual has been convicted of a traffic violation involving the negligent or reckless operation of a motor vehicle that resulted in a fatality, including but not limited to crimes of motor vehicle manslaughter, homicide by motor vehicle, and negligent homicide.

(2) Major Traffic Offenses Involving Alcohol or Controlled Substances.

(a) An individual may be denied a license if, within the 7-year period prior to the date of submission of the application, the individual has been convicted of a single major traffic violation involving the operation of a motor vehicle while under the influence of alcohol or a controlled substance; violating an interlock or alcohol restriction, leaving the scene of an accident, fleeing or evading police or resisting arrest while operating a motor vehicle or driving a motor vehicle when, as a result of a violation involving the use of alcohol or a controlled substance, the individual’s license is revoked, suspended, or canceled.

(b) If, within 15 years prior to the date of submission of the application, an individual has been convicted of 2 or more major traffic violations as described in §C(2)(a) of this regulation, the individual may be denied a license.

(3) Major Traffic Violations Not Related to Driving While Impaired by Alcohol or Controlled Substance.

(a) An individual may be denied a license if, within the 3-year period prior to the date of the application, the individual has been convicted of reckless or negligent driving, use of a text messaging device while driving or use of a handheld telephone while driving as described in the Maryland Transportation Article, §§21-1124.1 and 21-1124.2, Annotated Code of Maryland, if such use results in personal injury as noted on the applicant’s driving history report or Maryland Transportation Article, §21-1124.3, Annotated Code of Maryland, failure to stop for a police officer, speeding 31 MPH or more over the posted speed limit, street or drag racing, driving after the individual’s license has been withdrawn or revoked, driving with a counterfeit or altered license or making a material misrepresentation about a driving license or, as a result of the refusal of a chemical test, the individual’s license is revoked or suspended.

(b) An individual may be denied a license if, within the 5-year period prior to the date of the application, the individual has been convicted of two or more major traffic violations as described in §C(3) of this regulation.

(4) Multiple Moving Traffic Violations. An individual may be denied a license if, within the 4-year period prior to the date of the application, the individual has been convicted of four moving traffic violations.

D. Offenses in Other Jurisdictions. All criminal and driving offenses described in this regulation are to be construed as including all violations of Maryland law and like or substantially similar violations of the laws of another state, the United States, a military, territorial or Native American tribal authority, or any other jurisdiction.

E. Additional Factors — Mitigating or Aggravating. The Commission may consider the following factors in determining whether to grant a license prior to the expiration of the restriction periods as described in this section:

(1) The applicant’s age at the time of the commission of any crime or traffic violation;

(2) The circumstances surrounding the crime or traffic violation;

(3) The time elapsed since conviction;

(4) The nature of the crime or traffic violation;

(5) The number and frequency of convictions for criminal offenses or traffic violations;

(6) Documented character references;

(7) Documented treatment and/or rehabilitation records;

(8) Favorable parole/probation records;

(9) Documentation of favorable employment records;

(10) Family situation;

(11) Restitution made or being made to victims of the crime;

(12) Conduct since conviction;

(13) The applicant’s overall driving record during the restriction period; and

(14) The length of time the applicant has held a driving privilege. If the individual has been incarcerated, the applicant’s driving record since release from incarceration.

F. Open Charges in Pending Applications. The Commission may defer a decision on a pending application until any open Tier 1 or Tier 2 Criminal Offenses as described in §A of this regulation or major traffic violations as described in §B of this regulation  are resolved.

G. Sex Offender Registry. An individual may be denied a license for an indefinite period if the individual is listed on the national sex offender registry or the sex offender registry of any state.

DAVID J. COLLINS
Executive Secretary

 

Subtitle 95 TRANSPORTATION

20.95.01 General

Authority: Public Utilities Article, §§9-201, 9-203, 9-204, 10-101 — 10-104, 10-104.1, 10-105, 10-106, 10-108, and 10-404, Annotated Code of Maryland

Notice of Proposed Action

[17-251-P]

The Public Service Commission proposes to amend Regulations .03, .11, and .22 — .24 and adopt new Regulation .26 under COMAR 20.95.01 General. This action was considered by the Public Service Commission at a scheduled rule-making meeting held on Thursday, August 24, 2017, notice of which was given under General Provisions Article, §3-302, Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to establish driver screening standards for for-hire drivers, clarify the meaning of “inspection certificate” and “license”, revise standards for required equipment, clarify placement of required identification on transportation network company operator vehicles, and make related changes.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

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 David J. Collins, Executive Secretary, Public Service Commission, 6 St. Paul Street, 16th Floor, Baltimore, MD 21202, or call 410-767-8067, or fax to 410-333-6495. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

.03 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) — (2) (text unchanged)

(3) Inspection Certificate.

(a) “Inspection certificate” means a numbered certificate issued in a form authorized by the Maryland State Police and issued by a facility licensed by the Maryland State Police to perform motor vehicle safety inspections, or issued by a facility licensed by an adjacent state or the District of Columbia to perform motor vehicle safety inspections and in a form acceptable to the licensing authority of the adjacent state or the District of Columbia, if the Commission determines or has previously determined that the vehicle inspection standards of that jurisdiction are materially the same as those adopted by the Maryland State Police. 

(b) “Inspection certificate” does not include a vehicle inspection report or sticker.

(4) “License” includes a for-hire license issued by the Commission to provide passenger-for-hire services as defined in Public Utilities Article, §10-101(g), Annotated Code of Maryland, including a transportation network operator’s license.

[(3)] (5)[(14)](16) (text unchanged)

.11 Required Equipment, and Minimum Safety Standards.

A. A motor vehicle, including a leased or reserved motor vehicle, used by a carrier or Transportation Network Operator shall:

(1) — (5) (text unchanged)

(6) After [July 1, 2016] July 1, 2018, not exceed more than [10] 12 model years of age, unless the vehicle [already] has [a] an existing Commission permit, and proof of semi-annual safety inspections, conforming to the requirements of §B(2) of this regulation is submitted to the Commission, or the vehicle is an historic motor vehicle as defined in Transportation Article, §13-936, Annotated Code of Maryland, or the vehicle exceeds 10,000 pounds Gross Vehicle Weight Rating.

B. Inspection.

(1) Except for vehicles over 10,000 pounds Gross Vehicle Weight Rating (GVWR) or vehicles that exceed more than 10 model years of age, an owner of a motor vehicle or a Transportation Network Operator shall [have the motor vehicle inspected and certified annually by a facility licensed by the State to perform motor vehicle safety inspections,] provide an inspection certificate as part of the application for vehicle permit and annually thereafter.  The annual inspection certificate shall be dated no later than the annual anniversary of the date the vehicle permit was issued, or as otherwise directed by the Commission.

[(2) The Commission may accept an inspection certificate issued by a facility licensed by an adjacent state or the District of Columbia to perform motor vehicle safety inspections, if the Commission determines or has previously determined that the vehicle inspection standards of that jurisdiction are materially the same as those adopted by the Maryland State Police.]

(2) For vehicles under 10,000 pounds Gross Vehicle Weight Rating (GVWR) that exceed more than 10 model years of age, an owner of a motor vehicle or a Transportation Network Operator shall provide an inspection certificate on a semi-annual basis.

(3) For new vehicles not previously registered with less than 7,500 miles, a copy of the bill of sale and a copy of the certificate of origin may be substituted for the required inspection.

[(3)] (4)[(7)](8) (text unchanged)

.22 Transportation Network Operator. 

A Transportation Network Operator shall:

A. — E. (text unchanged)

F. Upon request, provide the Commission with a valid motor vehicle safety inspection certificate [issued by a licensed facility conforming to the requirements of Regulation .11B(1) and (2) of this chapter].

.23 Transportation Network Company Operator Vehicle Permits.

A. — B. (text unchanged)

C. The Commission shall issue a vehicle permit for a Transportation Network Operator Vehicle upon receipt and review of a complete application. An application will be deemed complete if it contains:

(1) (text unchanged)

(2) A copy of a valid safety inspection certificate [for the Transportation Network Operator Vehicle issued by a licensed facility conforming to the requirements of Regulation .11B(1) and (2) of this chapter]; and

(3) (text unchanged)

D. — E. (text unchanged)

.24 Transportation Network Company Operator Vehicle.

A Transportation Network Operator Vehicle shall:

A. — B. (text unchanged)

C. Not exceed more than [10] 12 model years age, except as provided in Regulation .11A(6) of this chapter;

D. — E. (text unchanged)

F. At all times while engaged on the TNC platform display on the [vehicle a] vehicle’s rear passenger side window, a consistent and distinctive TNC identification, approved by the Commission, consisting of a logo, insignia, or emblem. The TNC identification shall be:

(1) — (3) (text unchanged)

G. (text unchanged)

.26 Licensure — Driver Screening Standards.

A. General. As used in this regulation, the terms “conviction” and “convicted of” include a finding of guilt in a criminal or motor vehicle proceeding, the entry of the plea of guilty or nolo contendere, a probation before judgment if the applicant has not yet completed the terms of the probation or if the applicant has been found to have violated the terms of probation, or has been found not criminally responsible pursuant to Maryland Rule 4-134. The terms of an applicant’s probation before judgment will be determined by referencing the sentencing and disposition date information contained in the background check or criminal history report provided with the application. Unless the background check or criminal history report indicates otherwise, there will be a presumption that the terms of the probation before judgment have been completed within the period indicated on the report and that the applicant has not violated the terms of the probation.

B. Criminal Offenses.

(1) Tier 1 Felony Offenses involving a Crime of Violence. An individual may be denied a license for an indefinite period if the individual has been convicted of a crime of violence, as defined by Criminal Law Article, §14-101, Annotated Code of Maryland, including any conspiracy, solicitation, attempt, or accessory to such crime of violence. Crimes of violence include:

(a) Abduction;

(b) Arson in the first degree;

(c) Kidnapping;

(d) Manslaughter, except involuntary manslaughter;

(e) Mayhem;

(f) Maiming;

(g) Murder;

(h) Rape;

(i) Robbery, as defined by Criminal Law Article, §3-402 or 3-403, Annotated Code of Maryland, including robbery with a deadly weapon;

(j) Carjacking;

(k) Armed carjacking;

(l) Sexual offense in the first degree;

(m) Sexual offense in the second degree;

(n) Use of a handgun in the commission of a felony or other crime of violence;

(o) Child abuse in the first degree under Criminal Law Article, §3-601, Annotated Code of Maryland;

(p) Sexual abuse of a minor under Criminal Law Article, §3-602, Annotated Code of Maryland, if:

(i) The victim is under the age of 13 years and the offender is an adult at the time of the offense; and

(ii) The offense involved vaginal intercourse, as defined in Criminal Law Article, §3-301, Annotated Code of Maryland; a sexual act, as defined in Criminal Law Article, §3-301, Annotated Code of Maryland;  an act in which a part of the offender’s body penetrates, however slightly, into the victim’s genital opening or anus; or the intentional touching, not through the clothing, of the victim’s or the offender’s genital, anal, or other intimate area for sexual arousal, gratification, or abuse;

(q) An attempt to commit any of the crimes as described in §B(1)(a)—(p) of this regulation;

(r) Continuing course of conduct with a child under Criminal Law Article, §3-315, Annotated Code of Maryland;

(s) Assault in the first degree;

(t) Assault with intent to murder;

(u) Assault with intent to rape;

(v) Assault with intent to rob;

(w) Assault with intent to commit a sexual offense in the first degree; and

(x) Assault with intent to commit a sexual offense in the second degree.

(2) Tier 2 Felony Offenses Other than Tier 1 Crimes of Violence. An individual may be denied a license if, within the 7-year period prior to the date of submission of the application, the individual has been convicted of any felony offense that is not defined as a crime of violence under Criminal Law Article, §14-101, Annotated Code of Maryland. Tier 2 felony offenses include:

(a) Any felony offense against a person including any assault or assault and battery that is not defined as a Tier 1 crime of violence as described in §B(1) of this regulation, or any threat to commit such crime, or any violation of a restraining order;

(b) Any felony offense involving the illegal use or possession of weapons;

(c) Any felony offense involving the possession, importation, manufacture, distribution, or registration of a controlled dangerous substance, prescription drug, or other substance;

(d) Any felony offense involving the manufacture, sale, transport, or possession of explosives, or the intent to create an explosive device;

(e) Any felony offense involving criminal sexual assault that is not defined as a Tier 1 crime of violence as described in §B(1) of this regulation, any type of sexual abuse, solicitation, pandering, prostitution, pimping, obscenity, pornography, possession of obscene material, exploitation, public indecency, sexual relations within families, or sexual misconduct;

(f) Any felony property offenses that are not defined as a Tier 1 crime of violence as described in §B(1) of this regulation, including arson and burning, burglary and related crimes including home invasion, malicious destruction and related crimes, trespass, or crimes against a railroad;

(g) Any felony theft and related offenses; fraud and related offenses; offenses against public administration; offenses against public health, conduct, and sensibilities; indecency and obscenity; or gaming.

(3) Misdemeanor Offenses — Crimes of Violence. Except for driving offenses as described in §B of this regulation, an individual may be denied a license if, within a 3-year period prior to the date of the submission of the application, the individual has been convicted of any crime classified as a misdemeanor in the state of Maryland that involves violence against a person, including any conspiracy, solicitation, attempt, or accessory to such crime of violence.

(4) Multiple Disqualifying Offenses. Individuals who have been convicted of multiple criminal offenses as described in §B(2) and (3) of this regulation shall be subject to the following exclusion periods.

(a) Two or more felonies offenses — An individual may be denied a license if, within 10 years prior to the date of submission of the application the individual has been convicted of two or more Tier 2 felony offenses as described in §B(2) of this regulation, provided these crimes arose out of separate incidents.

(b) Three or more misdemeanor crimes of violence — An individual may be denied a license if, within 7 years prior to the date of submission of the application, the individual has been convicted of three or more misdemeanors as described in §B(3) of this regulation, provided each of these offenses arose out of separate incidents.

C. Driving Offenses.

(1) Major Traffic Offenses Involving Fatalities. An individual may be denied a license for an indefinite period if the individual has been convicted of a traffic violation involving the negligent or reckless operation of a motor vehicle that resulted in a fatality, including but not limited to crimes of motor vehicle manslaughter, homicide by motor vehicle, and negligent homicide.

(2) Major Traffic Offenses Involving Alcohol or Controlled Substances.

(a) An individual may be denied a license if, within the 7-year period prior to the date of submission of the application, the individual has been convicted of a single major traffic violation involving the operation of a motor vehicle while under the influence of alcohol or a controlled substance; violating an interlock or alcohol restriction, leaving the scene of an accident, fleeing or evading police or resisting arrest while operating a motor vehicle or driving a motor vehicle when, as a result of a violation involving the use of alcohol or a controlled substance, the individual’s license is revoked, suspended, or canceled.

(b) If, within 15 years prior to the date of submission of the application, an individual has been convicted of 2 or more major traffic violations as described in §C(2)(a) of this regulation, the individual may be denied a license.

(3) Major Traffic Violations Not Related to Driving While Impaired by Alcohol or Controlled Substance.

(a) An individual may be denied a license if, within the 3-year period prior to the date of the application, the individual has been convicted of reckless or negligent driving, use of a text messaging device while driving or use of a handheld telephone while driving as described in the Maryland Transportation Article, §§21-1124.1 and 21-1124.2, Annotated Code of Maryland, if such use results in personal injury as noted on the applicant’s driving history report or Maryland Transportation Article, §21-1124.3, Annotated Code of Maryland, failure to stop for a police officer, speeding 31 MPH or more over the posted speed limit, street or drag racing, driving after the individual’s license has been withdrawn or revoked, driving with a counterfeit or altered license or making a material misrepresentation about a driving license or, as a result of the refusal of a chemical test, the individual’s license is revoked or suspended.

(b) An individual may be denied a license if, within the 5-year period prior to the date of the application, the individual has been convicted of two or more major traffic violations as described in §C(3) of this regulation.

(4) Multiple Moving Traffic Violations. An individual may be denied a license if, within the 4-year period prior to the date of the application, the individual has been convicted of four moving traffic violations.

D. Offenses in Other Jurisdictions. All criminal and driving offenses described in this regulation are to be construed as including all violations of Maryland law and like or substantially similar violations of the laws of another state, the United States, a military, territorial or Native American tribal authority, or any other jurisdiction.

E. Additional Factors — Mitigating or Aggravating. The Commission may consider the following factors in determining whether to grant a license prior to the expiration of the restriction periods as described in this section:

(1) The applicant’s age at the time of the commission of any crime or traffic violation;

(2) The circumstances surrounding the crime or traffic violation;

(3) The time elapsed since conviction;

(4) The nature of the crime or traffic violation;

(5) The number and frequency of convictions for criminal offenses or traffic violations;

(6) Documented character references;

(7) Documented treatment and/or rehabilitation records;

(8) Favorable parole/probation records;

(9) Documentation of favorable employment records;

(10) Family situation;

(11) Restitution made or being made to victims of the crime;

(12) Conduct since conviction;

(13) The applicant’s overall driving record during the restriction period; and

(14) The length of time the applicant has held a driving privilege. If the individual has been incarcerated, the applicant’s driving record since release from incarceration.

F. Open Charges in Pending Applications. The Commission may defer a decision on a pending application until any open Tier 1 or Tier 2 Criminal Offenses as described in §A of this regulation or major traffic violations as described in §B of this regulation  are resolved.

G. Sex Offender Registry. An individual may be denied a license for an indefinite period if the individual is listed on the national sex offender registry or the sex offender registry of any state.

DAVID J. COLLINS
Executive Secretary

 

Title 30
MARYLAND INSTITUTE FOR EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

Subtitle 01 GENERAL

30.01.02 Documents Incorporated by Reference

Authority: Education Article, §13-516, Annotated Code of Maryland

Notice of Proposed Action

[17-207-P-I]

The State Emergency Medical Services Board proposes to amend Regulation .01 under COMAR 30.01.02 Documents Incorporated by Reference. This action was considered and approved by the State Emergency Medical Services Board at its regular meeting held on June 13, 2017, notice of which was given by publication in 44:11 Md. R. 570 (May 26, 2017) under General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to incorporate by reference the current Maryland Medical Protocols for Emergency Medical Services Providers and the current Maryland State Trauma Registry Data Dictionary for Adult Patients.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. The only significant fiscal impact to jurisdictions associated with the 2017 protocol changes would be the removal of terbutaline from the advanced life support formulary. Terbutaline retails for approximately $27 $30 a dose.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure

(E+/E-)

Magnitude

 


A. On issuing agency:

NONE

B. On other State agencies:

NONE

C. On local governments:

Removal of terbutaline from required formulary

(E-)

$27 per ambulance

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

Removal of terbutaline from required formulary

(+)

$27 per dose

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.)

C. Public safety advanced life support ambulances will no longer carry this medication.

D. Commercial advanced life support ambulances will no longer carry this medication.

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 E. Fremont Magee, Assistant Attorney General, Maryland Institute for Emergency Medical Services Systems, 653 West Pratt Street, Baltimore, MD 21201, or call 410-706-8531, or email to fmagee@miemss.org, or fax to 410-706-2138. Comments will be accepted through November 27, 2017. A public hearing has not been scheduled.

 

Editor’s Note on Incorporation by Reference

     Pursuant to State Government Article, §7-207, Annotated Code of Maryland, the following have been declared documents generally available to the public and appropriate for incorporation by reference:

     (1) The Maryland Medical Protocols for Emergency Medical Services Providers (MIEMSS July 1, 2017); and

     (2) Maryland State Trauma Registry Data Dictionary for Adult Patients (April 21, 2017 Edition).

     For this reason, they will not be printed in the Maryland Register or the Code of Maryland Regulations (COMAR). Copies of these documents are filed in special public depositories located throughout the State.  A list of these depositories was published in 44:1 Md. R. 9 (January 6, 2017), and is available online at www.dsd.state.md.us. These documents may also be inspected at the office of the Division of State Documents, 16 Francis Street, Annapolis, Maryland 21401. 

.01 Incorporation by Reference.

A. (text unchanged)

B. Documents Incorporated.

(1) “Maryland Medical Protocols for Emergency Medical Services Providers (MIEMSS July 1, [2016] 2017 Edition)”. This document can be obtained through the Maryland Institute for Emergency Medical Services Systems at 653 W. Pratt Street, Baltimore, Maryland 21201 (410-706-4449).

(2) “Maryland State Trauma Registry Data Dictionary for Adult Patients (MIEMSS [January 15, 2014] April 21, 2017 Edition)”. This document can be obtained through the Maryland Institute for Emergency Medical Services Systems at 653 W. Pratt Street, Baltimore, Maryland 21201 (410-706-4449).

(3) — (4) (text unchanged)

JEANNIE ABRAMSON
Chief Administrative Officer

 


Special Documents


 


DEPARTMENT OF THE ENVIRONMENT

SUSQUEHANNA RIVER BASIN COMMISSION

18 CFR Part 801 — General Policies

 

AGENCY:  Susquehanna River Basin Commission.

 

ACTION:  Notice of proposed rulemaking; notice of public hearing.

 

SUMMARY:  This document contains proposed rules that would codify in the regulations and strengthen the Susquehanna River Basin Commission’s (Commission) Access to Records Policy providing rules and procedures for the public to request and receive the Commission’s public records.

 

DATES:  Comments on the proposed rulemaking may be submitted to the Commission on or before November 13, 2017. The Commission has scheduled a public hearing on the proposed rulemaking on November 2, 2017, 2:30 p.m. to 5 p.m. or at the conclusion of public testimony, whichever is sooner.

 

ADDRESSES:  Comments may be mailed to: Jason E. Oyler, Esq., General Counsel, Susquehanna River Basin Commission, 4423 N. Front Street, Harrisburg, PA 17110-1788, or by e-mail to regcomments@srbc.net. The public hearing is located in Harrisburg, Pennsylvania, State Capitol (East Wing, Room 8E-B), Commonwealth Avenue, Harrisburg, PA 17120.

Those wishing to testify are asked to notify the Commission in advance, if possible, at the regular or electronic addresses given below.

 

FOR FURTHER INFORMATION CONTACT:  Jason E. Oyler, Esq., General Counsel, telephone:  (717) 238-0423, ext. 1312; fax:  (717) 238-2436; e-mail:  joyler@srbc.net.  Also, for further information on the proposed rulemaking, visit the Commission’s website at http://www.srbc.net.

 

SUPPLEMENTARY INFORMATION:

The Commission has long made its records available to the public but it has never formalized its open records policy in regulation.  The Commission first promulgated its “Freedom of Information Policy” on January 11, 1979.  As an interstate compact agency, no single member jurisdiction may subject the Commission to its open records law.  See C.T. Hellmuth & Associates v. Washington Metropolitan Area Transit Authority, 414 F. Supp. 408 (D. Md. 1976) (holding that Maryland could not unilaterally subject transit authority to the provision of the Maryland Public Information Act).  In recognition of this limitation, the Commission developed its policy “in line with Freedom of Information legislation enacted by all four signatory jurisdictions.” See Minutes of Commission Meeting (Jan. 11, 1979).  As noted in the January 11, 1979, meeting minutes of the Commission, the Policy “merely formalized the current Commission practice of making its records available to the furthest extent possible.”

The Commission updated its open records policy on September 10, 2009, by adopting its “Access to Records Policy,” Policy No. 2009-02 on September 10, 2009. 

This policy replaced the 1979 Freedom of Information Policy.  The updated policy reflected the practice of the Commission’s member jurisdictions, recognized records in electronic format as being subject to public access and added a formal procedure for the protection of confidential information submitted by project sponsors and a procedure for the public to challenge the designation of this information as confidential.  This revised policy also provided that the Commission “will endeavor to make as much information as possible available on its website…, in an effort to eliminate the need for many records requests.”  For example, the Commission provides all of its approved dockets on its website, as well as information summaries for each docket or project application pending before the Commission, policies, reports, publications and data from its water quality monitoring programs. 

The Commission believes the results of this policy have been successful.  From 2012 through 2016, the Commission provided records to 152 distinct records requests in writing for documents data or information, as well as innumerable informal requests.  The Commission website has been a well-used public resource and repository for records. In the past 12 months, the Commission website has received 121,213 visits from 26,522 unique visitors. The Commission Water Application and Approval Viewer, where the public can view Commission dockets and pending application information, was recently upgraded to increase its functionality and ease of use and received 16,593 unique page views over the past 12 months. Similarly, the Commission water quality network data landing page received 9,904 unique page views over this same time period.

The Commission wishes to continue this long tradition of transparency by further formalizing the key elements of its Access to Records Policy in duly promulgated regulations.  The Commission is not looking to replace the policy, but rather to memorialize the key tenets of the policy in regulation.  Through this action, the Commission will be codifying its commitment to public access to records in a way that imbues them with the status of law that can be enforceable against the Commission.

The Commission’s 2009 Access to Records Policy can be found at http://www.srbc.net/pubinfo/docs/2009-02_Access_to_Records_Policy_20140115.pdf. 

The Commission’s current records processing fee schedule can be found at:

http://www.srbc.net/pubinfo/docs/RecordsProcessingFeeScheduleUpdatedAddress.pdf.

 

List of Subjects in 18 CFR Part 801

Administrative practice and procedure, Water resources.

     Accordingly, for the reasons set forth in the preamble, the Susquehanna River Basin Commission proposes to amend 18 CFR part 801 as follows:

PART 801—GENERAL POLICIES

     1.  The authority citation for part 801 shall be amended to read as follows:

Authority:  Secs. 3.1, 3.4, 3.5(1), 15.1 and 15.2, Pub. L. 91-575 (84 Stat. 1509 et seq.)

     2.  Add § 801.14 to read as follows:

§ 801.14  Public Access to Records.

 

(a)  Purpose.  The Commission, as an independent compact agency, is not subject to any of its member jurisdictions’ laws regarding public access to records. Nevertheless, the Commission wishes to assure, to the maximum extent practicable, the availability of Commission records consistent with the Susquehanna River Basin Compact.  The Commission shall maintain an “Access to Records Policy” that outlines the details and procedures related to public access to the Commission’s records.  Any revisions to this policy shall be consistent with this section and undertaken in accordance with appropriate public notice and comment consistent with requirements of 18 CFR § 808.1.

 

(b)  Scope.  This section shall apply to all recorded information, regardless of whether the information exists in written or electronic format.  There is a strong presumption that records shall be public, except where considerations of privacy, confidentiality, and security must be considered and require thoughtful balancing.  The Commission shall identify types of records that are not subject to public access, including but not limited to:

(1)  Personnel or employment records;

(2)  Trade secrets, copyrighted material, or any other confidential business information;

(3)  Records exempted from disclosure by statute, regulation, court order, or recognized privilege;

(4)  Records reflecting internal pre-decisional deliberations;

(5)  Records reflecting employee medical information, evaluations, tests or other identifiable health information;

(6)  Records reflecting employee personal information, such as social security number, driver’s license number, personal financial information, home addresses, home or personal cellular numbers, confidential personal information, spouse names, marital status or dependent information;

(7)  Investigatory or enforcement records that would interfere with active enforcement proceedings or individual due process rights, disclose the identity of public complainants or confidential sources or investigative techniques or endanger the life or safety of Commission personnel; or

(8)  Records related to emergency procedures, facilities or critical infrastructure.

 

(c)  Procedures.  The Access to Records  Policy will detail the necessary procedures for requesting records and processing records requests.

(1)  Requests shall be in writing and shall be reasonably specific;

(2)  The Commission shall identify an Access to Records Officer to handle requests;

(3)  The Commission shall respond to a records request within a reasonable time and in consideration of available resources and the nature of the request;

(4)  The Commission shall not be required to create a record that does not already exist, or to compile, maintain, format or organize a public record in a manner in which the Commission does not currently do so;

(5)  A procedure shall be identified for electronic transfer, copying or otherwise providing records in a manner that maintains the integrity of the Commission’s files;

(6)  A procedure shall be identified for handling review of requests that seek access to information that has been identified as confidential and for notifying the person(s) who submitted the confidential information that it is subject to a records request.

 

(d)  Fees.  The Commission shall adopt and maintain a “Records Processing Fee Schedule.”  The fees shall be calculated to reflect the actual costs to the Commission for processing records requests and may include the costs of reproducing records and the cost to search, prepare and/or redact records for extraordinary requests.

 

(e)  Appeals.  Any person aggrieved by a Commission action on a records request shall have 30 days to appeal a decision in accordance with 18 CFR § 808.2

 

Dated: October 5, 2017.

STEPHANIE L. RICHARDSON
Secretary to the Commission

[17-22-10]

 

 


General Notices

 

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.

 


HALL OF RECORDS COMMISSION

Subject: Public Hearing

Date and Time: November 17, 2017, 12 — 2 p.m.

Place: Maryland State Archives, Annapolis, MD

Contact: Liz Coelho (410) 260-6401

[17-22-05]

 

MARYLAND DEPARTMENT OF HEALTH/OFFICE OF HEALTH SERVICES

Subject: Community Pathways Waiver — Proposal — Request for Public Comment

Date and Time: October 27, 2017

Add'l. Info: The Maryland Department of Health is renewing the Community Pathways Waiver program, which provides various home and community-based services to support participants as they work toward individually defined life outcomes, self-determination, community living, socialization, and economic self-sufficiency. 

The goals for the Community Pathways Waiver include: (1) innovative service options aimed at providing supports that build on the DDA’s existing Community of Practice related to Employment and Supporting Families; (2) participant and family self-direction opportunities; (3) new Supported Living and Housing Support Services to increase independent living opportunities; and (4) transitioning to new Employment Services and provider rates.  The DDA waiver application was developed with input from: (1) program participants; (2) individuals, families, advocates, and community-based services agencies; (3) Self-Directed Advocacy Network; (4) the development of the new Family Supports and Community Supports waivers and comments; (5) the Developmental Disabilities Coalition (“DD Coalition”), which is composed of leaders from the Maryland’s Developmental Disabilities Council, Maryland’s Protection and Advocacy Agency, People on the Go of Maryland (a self-advocate led organization), Maryland Association of Community Services (the largest community-based service agencies association in Maryland), and the Arc of Maryland; (6) various workgroups; (7) independent consultants; (8) national research; and (9) submitted public comments. 

The information regarding the Community Pathways Waiver renewal including the federal application will be posted to the Developmental Disabilities Administration (DDA) website on or before October 27, 2017 at: https://dda.health.maryland.gov/Pages/Community_Pathways_Waiver_Renewal_2018.aspx . 

Copies of the Community Pathways Waiver application are available for public review at the DDA Headquarter and Regional Offices. Public comments can be submitted to wfb.dda@maryland.gov October 27, 2017, through November 26, 2017.

Contact: Rebecca Oliver (410) 767-4902

[17-22-13]

 

MARYLAND INSURANCE ADMINISTRATION

Subject: Public Hearing

Date and Time: November 6, 2017, 1 — 4 p.m.

Place: Maryland Insurance Administration, 200 St. Paul Pl., 24th Fl. Hearing Rm., Baltimore, MD

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. The hearing will focus on several rate increase requests before the Maryland Insurance Administration. In the individual long-term care market, these include requests from John Hancock Life Insurance Company, Genworth Life Insurance Company, American General Life Insurance Company and Brighthouse Life Insurance Company. The purpose of the hearing is for insurance company officials to explain their reasons for the rate increases. Commissioner Redmer will also listen to comments from stakeholders at the hearing. Prior to the hearing, copies of each company’s actuarial memorandum will be posted to the Maryland Insurance Administration’s website.

     If you plan to attend, please RSVP to Nancy Muehlberger. Written comments and RSVPs should be sent to Nancy Muehlberger by October 30, 2017, 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 October 30, 2017, by email to Nancy.Muehlberger@maryland.gov.  For more information on the hearing please see the following link:

http://insurance.maryland.gov/Consumer/Pages/Long-Term-Care-Hearing-November-6-2017.aspx

Contact: Adam Zimmerman (410) 468-2048

[17-22-09]

 

MARYLAND STATE LOTTERY AND GAMING CONTROL COMMISSION

Subject: Public Meeting

Date and Time: November 16, 2017, 10 a.m. — 12 p.m.

Place: Montgomery Park Business Center, 1800 Washington Blvd., Ste. 330, Baltimore, MD

Contact: Kathy L. Lingo (410) 230-8790

[17-22-16]

 

MARYLAND HEALTH CARE COMMISSION

Subject: Public Meeting

Date and Time: November 16, 2017, 1 — 4 p.m.

Place: 4160 Patterson Ave., Rm. 100, Baltimore, MD

Contact: Valerie Wooding (410) 764-3570

[17-22-03]

 

MARYLAND HEALTH CARE COMMISSION

Subject: Receipt of Application

Add'l. Info: On October 6, 2017, the Maryland Health Care Commission (MHCC) received a Certificate of Need application submitted by:

     Thomas Johnson Surgery Center — (Frederick County) — Matter No. 17-10-2410 — Conversion of an existing procedure room into a second operating room at the surgery center located at 197 Thomas Johnson Drive, Frederick; Proposed Cost:  $183,031.

     The MHCC shall review the application under Health-General Article, §19-101 et seq., Annotated Code of Maryland, and COMAR 10.24.01.

     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.

     Please refer to the Matter No. listed above in any correspondence on the application. A copy of the applications are available, for review, in the office of the MHCC, during regular business hours by appointment, or on the Commission’s website at www.mhcc.maryland.gov.

     All correspondence should be addressed to Paul Parker, Deputy Director, Center for Health Care Facilities Planning & Development, MHCC, 4160 Patterson Avenue, Baltimore, Maryland  21215.

Contact: Ruby Potter (410) 764-3276

[17-22-17]

 

DEPARTMENT OF NATURAL RESOURCES/FISHING AND BOATING SERVICES

Subject: Public Notice — Commercial Striped Bass Common Pool Hook and Line Season Modification

Add'l. Info: The Secretary of the Maryland Department of Natural Resources, pursuant to Code of Maryland Regulations (COMAR) 08.02.15.12H, announces the opening of the 2017 commercial striped bass common pool hook and line fishery on Tuesday, October 3, 2017, one hour before sunrise, with a catch limit of 150 lbs/permittee/week and 300 lbs/vessel/day.  The common pool hook and line fishery will close on Tuesday, October 3, 2017, one hour before sunset.

     Mark J. Belton

     Secretary of Natural Resources

Contact: Tamara O'Connell (410) 260-8271

[17-22-06]

 

BOARD OF OCCUPATIONAL THERAPY PRACTICE

Subject: Public Meeting

Date and Time: November 17, 2017, 9 a.m. — 12 p.m.

Place: Spring Grove Hospital Campus, Bland Bryant Bldg., 55 Wade Ave., 4th Fl. Baltimore, MD

Add'l. Info: Health Occupations Article, Title 10, Annotated Code of Maryland, and COMAR 10.46 amendments, additions, and revisions, including fee changes, may be discussed/voted on. Budget information also may be discussed. An Executive Session is possible. Sign language interpreters and/or appropriate accommodations for qualified individuals with disabilities will be provided upon request. Please call 1-800-735-2255. The meeting may take place by teleconference. Please call the office for information.

Contact: Lauren Murray (410) 402-8556

[17-22-04]

 

STATE HOUSE TRUST

Subject: Public Meeting

Date and Time: November 13, 2017, 2:30 p.m.

Place: Governor's Reception Room, Maryland State House, Annapolis, MD

Contact: Elaine R. Bachmann (410) 260-6445

[17-22-18]

 

MARYLAND DEPARTMENT OF TRANSPORTATION/MARYLAND BOARD OF AIRPORT ZONING APPEALS (BAZA)

Subject: Public Hearing

Date and Time: November 11, 2017, 10 a.m.

Place: MDOT Headquarters, 7201 Corporate Center Dr., Hanover, MD

Add'l. Info: The Maryland Board of Airport Zoning Appeals will hold a hearing on Monday, November 13, 2017. The hearing will begin at 10 a.m. in the Board Room of the Maryland Department of Transportation located at 7201 Corporate Center Drive, Hanover, Maryland 21076.  The Board will hear the following case:

Docket Number 408

     D & M Painting Corporation is proposing to utilize a temporary crane for the renovations of a water tower located at 326 Benton Avenue, Linthicum, Maryland 21090.  This location is approximately 6,100 feet northeast of Runway 15L at Baltimore Washington Thurgood Marshall International Airport.  The proposed height of the temporary crane is 157 feet above ground level (AGL)/329 feet mean sea level (MSL). The temporary crane height will exceed the Code of Federal Regulations (FAR) Part 77, Objects Affecting Navigable Airspace by 36 feet. Code of Maryland Regulations (COMAR) 11.03.06.03 and 11.03.06.04, Height Limits in Airport Districts enables the proponent to seek a variance from the Board of Airport Zoning Appeals for any proposed penetration of FAR Part 77.  Therefore, the Maryland Aviation Administration will present BAZA Case 408 to the Board of Airport Zoning Appeals Monday, November 13, 2017 at 10 a.m.

     For additional information, please contact Deborah Mahoney-Fowler at 410-865-1233.

     Appropriate auxiliary aids and services for qualified individuals with disabilities will be provided upon request.  Please call 410-865-1233 (voice) or MD Relay (TTY Users).

Contact: Deborah Mahoney-Fowler (410) 865-1233

[17-22-08]

 

BOARD OF WELL DRILLERS

Subject: Public Meeting

Date and Time: November 15, 2017, 9 a.m. — 1:30 p.m.

Place: MDE, 1800 Washington Blvd., Baltimore, MD

Add'l. Info: A portion of this meeting may be held in closed session

Contact: Elaine Nolen (410) 537-4466

[17-22-02]

 

WORKERS' COMPENSATION COMMISSION

Subject: Public Meeting

Date and Time: November 9, 2017, 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 Lackington (410) 864-5300

[17-22-01]

 

DIVISION OF WORKFORCE DEVELOPMENT AND ADULT LEARNING/MARYLAND APPRENTICESHIP AND TRAINING COUNCIL

Subject: Public Meeting

Date and Time: November 14, 2017, 9 a.m. — 12 p.m.

Place: Baltimore JATC for the Electrical Industry, 2699 W. Patapsco Ave., Baltimore, MD

Add'l. Info: The Apprenticeship and Training Council will consider the approval and registration of new apprenticeship programs, revisions to presently approved apprenticeship programs, and other business which may come before the Council.

Contact: Christopher D. MacLarion (410) 767-2246

[17-22-12]