Capitol Building Maryland Register

Issue Date: November 6, 2020

Volume 47 •  Issue 23  • Pages 969 — 1016

IN THIS ISSUE

Judiciary

Regulations

Errata

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Pursuant to State Government Article, §7-206, Annotated Code of Maryland, this issue contains all previously unpublished documents required to be published, and filed on or before October 19, 2020 5 p.m.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 19, 2020.
 
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 .....................................................................  972

 

COMAR Research Aids

Table of Pending Proposals ...........................................................  973

 

Index of COMAR Titles Affected in This Issue

COMAR Title Number and Name                                                  Page

08        Department of Natural Resources .....................................  980

10        Maryland Department of Health ........................................  983

11        Department of Transportation ............................................  978

14        Independent Agencies .....................................................  1005

22        State Retirement and Pension System .............................  1007

26        Department of the Environment ........................................  978

30        Maryland Institute for Emergency Medical Services
Systems (MIEMSS) .......................................................  979

33        State Board of Elections ....................................................  976

 

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 Judiciary

COURT OF APPEALS OF MARYLAND

DISCIPLINARY PROCEEDINGS ..................................  975

 

Emergency Action on Regulations

33  STATE BOARD OF ELECTIONS

ABSENTEE BALLOTS

Applications .............................................................................  976

Canvass of Ballots — Procedures .  976

Canvass of Ballots — Rejecting Ballots .  976

PROVISIONAL VOTING

Canvass of Ballots — Rejecting Ballots ..................................  976

 

Final Action on Regulations

11  DEPARTMENT OF TRANSPORTATION

MARYLAND TRANSPORTATION AUTHORITY

Public Notice of Toll Schedule Revisions .  978

26  DEPARTMENT OF THE ENVIRONMENT

AIR QUALITY

Control of Methane Emissions from the Natural Gas
   Industry .  978

30  MARYLAND INSTITUTE FOR EMERGENCY
   MEDICAL SERVICES SYSTEMS (MIEMSS)

GENERAL

Documents Incorporated by Reference .  979

 

Proposed Action on Regulations

08  DEPARTMENT OF NATURAL RESOURCES

WILDLIFE

Threatened and Endangered Species .  980

10 MARYLAND DEPARTMENT OF HEALTH

MEDICAL CARE PROGRAMS

Pharmacy Services .  983

Home Health Services .  984

Pharmacists .  986

Urgent Care Centers .  986

BOARD OF NURSING

Examination and Licensure .  987

Nursing Education Programs .  988

BOARD OF PROFESSIONAL COUNSELORS AND
   THERAPISTS

General Regulations .  993

Licensed Clinical Professional Counselors — Requirements
   for Licensure .  993

BOARD OF NURSING — LICENSED DIRECT-ENTRY
   MIDWIVES

Code of Ethics for Licensed Direct-Entry Midwives .  1002

MARYLAND HEALTHCHOICE PROGRAM

Maryland Medicaid Managed Care Program: Managed Care
   Organizations .  1004

14  INDEPENDENT AGENCIES

COMMISSION ON CRIMINAL SENTENCING POLICY

General Regulations .................................................................  1005

MARYLAND STATE LIBRARY

Programs for Library Media Services .  1006

22  STATE RETIREMENT AND PENSION SYSTEM

OPTION AND ANNUITY TABLES

Option Factors and Annuity Values .  1007

 

Errata

COMAR 33.08.05.01 .  1010

 

Special Documents

DEPARTMENT OF THE ENVIRONMENT

SUSQUEHANNA RIVER BASIN COMMISSION

Projects Approved for Consumptive Uses of Water  1011

Grandfathering (GF) Registration Notice .  1012

Projects Approved for Minor Modifications .  1012

MARYLAND DEPARTMENT OF HEALTH/OFFICE OF
   HEALTH SERVICES

MARYLAND MEDICAID ENTERAL NUTRITIONAL
   SERVICES REIMBURSEMENT .........................................  1013

MARYLAND HEALTH CARE COMMISSION

MEDICAL CARE DATA BASE (MCDB) DATA
   SUBMISSION MANUAL
...........................................  1013

 

General Notices

CHESAPEAKE BAY TRUST

Public Meeting .  1014

MARYLAND DEPARTMENT OF HEALTH/STATE
   COMMUNITY HEALTH WORKER ADVISORY
   COMMITTEE

Public Meeting .  1014

MARYLAND INSURANCE ADMINISTRATION

Public Hearing .  1014

MARYLAND STATE LOTTERY AND GAMING CONTROL
   COMMISSION

Public Meeting .  1014

MARYLAND HEALTH CARE COMMISSION

Public Meeting .  1014

Receipt of Application .  1014

BOARD OF OCCUPATIONAL THERAPY PRACTICE

Public Meeting .  1015

STANDING ADVISORY COMMITTEE ON OPIOD
   ASSOCIATED DISEASE PREVENTION AND
   OUTREACH PROGRAMS (SYRINGE SERVICE
   PROGRAMS)

Public Meeting .  1015

RACING COMMISSION

Public Meeting .........................................................................  1015

BOARD OF WATERWORKS AND WASTE SYSTEMS
   OPERATORS

Public Meeting .  1015

BOARD OF WELL DRILLERS

Public Meeting .  1015

WORKERS’ COMPENSATION COMMISSION

Public Meeting .  1015

 

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 2021

 

Issue
Date

Emergency

and Proposed

Regulations

5 p.m.*

Notices, etc.

10:30 a.m.

Final

Regulations

10:30 a.m.

2020

November 20

November 2

November 9

November 10**

December 4

November 16

November 23

November 25

December 18

November 30

December 7

December 9

2021

January 4***

December 14

December 21

December 23

January 15

December 28

January 4

January 6

January 29

January 11

January 15**

January 20

February 12

January 25

February 1

February 3

February 26

February 8

February 12**

February 17

March 12

February 22

March 1

March 3

March 26

March 8

March 15

March 17

April 9

March 22

March 29

March 31

April 23

April 5

April 12

April 14

May 7

April 19

April 26

April 28

May 21

May 3

May 10

May 12

June 4

May 17

May 24

May 26

June 18

May 28**

June 7

June 9

July 2

June 14

June 21

June 23

July 16

June 28

July 2**

July 7

July 30

July 12

July 19

July 21

 

*   Deadlines are for submissions to DSD for publication in the Maryland Register and do not take into account the 15-day AELR review period. Due date for documents containing 8 to 18 pages is 48 hours before the date listed; due date for documents exceeding 18 pages is 1 week before the date listed.

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

** Note closing date changes.

***    Note issue 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

 

08.02.01.13 • 47:21 Md. R. 906 (10-9-20)

08.02.11.01,.03,.04 • 47:21 Md. R. 906 (10-9-20)

08.02.18.04—.06 • 47:22 Md. R. 938 (10-23-20)

08.03.08.01,.04—.09 • 47:23 Md. R. 980 (11-6-20)

 

09 MARYLAND DEPARTMENT OF LABOR

 

09.03.10.05 • 47:19 Md. R. 851 (9-11-20)

09.10.01.57 • 47:21 Md. R. 908 (10-9-20)

09.10.03.03,.08 • 47:21 Md. R. 909 (10-9-20)

09.11.07.01 • 46:26 Md. R. 1176 (12-20-19)

09.12.31 • 47:17 Md. R. 802 (8-14-20)

09.12.81.01-1,.04-1,.07,.08 • 47:2 Md. R. 80 (1-17-20)

09.26.02.06 • 46:21. R. 898 (10-11-19)

09.29.01.02 • 47:19 Md. R. 851 (9-11-20)

 

10 MARYLAND DEPARTMENT OF HEALTH

 

     Subtitles 01—08 (1st volume)

 

10.07.01.06 • 46:26 Md. R. 1178 (12-20-19)

10.07.02.01—.03,.33,.40 • 47:2 Md. R. 91 (1-17-20) (ibr)

 

     Subtitle 09 (2nd volume)

 

10.09.03.07 • 47:23 Md. R. 983 (11-6-20)

10.09.04.01,.03—.07 • 47:23 Md. R. 984 (11-6-20)

10.09.21.06 • 47:23 Md. R. 986 (11-6-20)

10.09.37.03-1 • 47:22 Md. R. 939 (10-23-20)

10.09.77.06 • 47:23 Md. R. 986 (11-6-20)

 

     Subtitles 10 — 22 (3rd Volume)

 

10.12.06.01—.10 • 47:1 Md. R. 24 (1-3-20)

10.14.08.01—.08 • 47:3 Md. R. 200 (1-31-20)

 

     Subtitles 23—36 (4th volume)

 

10.27.01.01,.05,.10 • 47:23 Md. R. 987 (11-6-20)

10.27.03.01—.03,.05,.08,.09,.11—.18 • 47:23 Md. R. 988 (11-6-20)

 

     Subtitles 37—68 (5th volume)

 

10.37.01.02 • 47:22 Md. R. 941 (10-23-20) (ibr)

10.38.07.02 • 47:22 Md. R. 941 (10-23-20)

10.58.01.01—.10 • 47:23 Md. R. 993 (11-6-20)

10.58.12.01—.10 • 47:23 Md. R. 993 (11-6-20)

10.62.01.01 • 47:22 Md. R. 942 (10-23-20)

10.62.15.06 • 47:22 Md. R. 942 (10-23-20)

10.62.17.02,.03 • 47:22 Md. R. 942 (10-23-20)

10.62.23.01 • 47:22 Md. R. 942 (10-23-20)

10.62.24.01 • 47:22 Md. R. 942 (10-23-20)

10.62.29.01 • 47:22 Md. R. 942 (10-23-20)

10.62.34.09 • 47:22 Md. R. 942 (10-23-20)

10.62.35.01 • 47:22 Md. R. 942 (10-23-20)

10.62.37.01—.21 • 47:22 Md. R. 942 (10-23-20)

10.64.02.01—.03 • 47:23 Md. R. 1002 (11-6-20)

10.67.04.03 • 47:23 Md. R. 1004 (11-6-20)

 

11 DEPARTMENT OF TRANSPORTATION

 

     Subtitles 01—10

 

11.06.04.01—.06 • 47:22 Md. R. 954 (10-23-20)

 

12 DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

 

12.04.01.04,.06 • 47:22 Md. R. 955 (10-23-20)

 

13A STATE BOARD OF EDUCATION

 

13A.03.02.02,.03,.06—.10,.12 • 46:24 Md. R. 1108 (11-22-19)

 

13B MARYLAND HIGHER EDUCATION COMMISSION

 

13B.08.10.02 • 47:3 Md. R. 222 (1-31-20)

 

14 INDEPENDENT AGENCIES

 

14.22.01.02,.09,.10,.14 • 47:23 Md. R. 1005 (11-6-20)

14.38.01.04 • 47:23 Md. R. 1006 (11-6-20)

 

15 MARYLAND DEPARTMENT OF AGRICULTURE

 

15.01.15.02—.04 • 47:21 Md. R. 909 (10-9-20)

 

20 PUBLIC SERVICE COMMISSION

 

20.79.01.02,.04,.05—.09 • 47:16 Md. R. 749 (7-31-20)

20.79.02.02 • 47:16 Md. R. 752 (7-31-20)

20.79.03.03—.05 • 47:16 Md. R. 754 (7-31-20)

 

21 STATE PROCUREMENT REGULATIONS

 

21.11.13.01—.11 • 47:14 Md. R. 689 (7-6-20)

21.11.14.01—.10 • 47:14 Md. R. 689 (7-6-20)

21.11.15.01—.03 • 47:14 Md. R. 689 (7-6-20)

 

22 STATE RETIREMENT AND PENSION SYSTEM

 

22.02.01.01,.03—.05 • 47:23 Md. R. 1007 (11-6-20)

 

31 MARYLAND INSURANCE ADMINISTRATION

 

31.01.02.02,.03,.06 • 47:20 Md. R. 878 (9-25-20)

31.03.02.03 • 47:19 Md. R. 852 (9-11-20)

31.03.19.01 • 47:19 Md. R. 853 (9-11-20)

31.08.03.04,.05,.07,.08 • 47:21 Md. R. 911 (10-9-20)

 

33 STATE BOARD OF ELECTIONS

 

33.19.02.01 • 47:19 Md. R. 853 (9-11-20)

 

The Judiciary

COURT OF APPEALS OF MARYLAND

DISCIPLINARY PROCEEDINGS

     This is to certify that by an Order of the Court of Appeals dated October 13, 2020, VANDY L. JAMISON, JR. (CPF # 9212160088), 11301 Wycombe Park Lane, Glenn Dale, Maryland 20769, has been placed on inactive status by consent, effective immediately, from the further practice of law in the State, and his name as an attorney at law has been stricken from the register of attorneys in this Court (Maryland Rule 19-761).

 

     This is to certify that by an Order of the Court of Appeals dated October 13, 2020, WILLIAM FRANKLIN BURTON (CPF # 0412280004), 11400 December Way, Apt. 102, Silver Spring, Maryland 20904, has been disbarred by consent, effective immediately, from the further practice of law in the State, and his name as an attorney at law has been stricken from the register of attorneys in this Court (Maryland Rule 19-761).

[20-23-19]

 

Emergency Action on Regulations

Symbol Key

   Roman type indicates text existing before emergency status was granted.

   Italic type indicates new text.

   [Single brackets] indicate deleted text.

 

Emergency Regulations

Under State Government Article, §10-111(b), Annotated Code of Maryland, an agency may petition the Joint Committee on Administrative, Executive, and Legislative Review (AELR), asking that the usual procedures for adopting regulations be set aside because emergency conditions exist. If the Committee approves the request, the regulations are given emergency status. Emergency status means that the regulations become effective immediately, or at a later time specified by the Committee. After the Committee has granted emergency status, the regulations are published in the next available issue of the Maryland Register. The approval of emergency status may be subject to one or more conditions, including a time limit. During the time the emergency status is in effect, the agency may adopt the regulations through the usual promulgation process. If the agency chooses not to adopt the regulations, the emergency status expires when the time limit on the emergency regulations ends. When emergency status expires, the text of the regulations reverts to its original language.

 

Title 33
STATE BOARD OF ELECTIONS

Notice of Emergency Action

[20-184-E]

The Joint Committee on Administrative, Executive, and Legislative Review has granted emergency status to amendments to:

(1) Regulation .05 under COMAR 33.11.02 Applications;

(2) Regulations .01 and .03 under COMAR 33.11.04 Canvass of Ballots — Procedures;

(3) Regulation .04 under COMAR 33.11.05 Canvass of Ballots — Rejecting Ballots; and

(4) Regulation .04 under COMAR 33.16.06 Canvass of Ballots — Rejecting Ballots.

Emergency status began: October 13, 2020.

Emergency status expires: December 31, 2020.

Comparison to Federal Standards

There is no corresponding federal standard to this emergency action.

Economic Impact on Small Businesses

The emergency action has minimal or no economic impact on small businesses.

 

Subtitle 11 ABSENTEE BALLOTS

33.11.02 Applications

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 9-303, 9-305,
9-306, 11-301, and 11-302;
Public Safety Article, §14–107(d); Annotated Code of Maryland

.05 Processing Applications — In General.

A. Date Stamp.

(1) (text unchanged)

(2) An application need not be stamped if:

(a) For the 2020 Presidential General Election held on November 3, 2020, it is received on or before October 18, 2020, provided that the election director stores the application in a container labeled with the date the application was received;

[(a)] (b)[(b)] (c) (text unchanged)

B. — D. (text unchanged)

 

33.11.04 Canvass of Ballots — Procedures

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 9-303, 11-301,
11-302, and 11-304; Public Safety Article, §14–107(d); Annotated Code of Maryland

.01 Conduct Generally.

A. — B. (text unchanged)

C. If a local board provides for:

(1) In person observation of a canvass, the local board may use one individual assigned by the election director in lieu of the team required in Regulations .05 and .07 of this chapter; or

(2) Remote observation of a canvass, the local board shall use a team as required in Regulations .05 and .07 of this chapter.

.03 Start of Canvass.

A. When Required.

[(1) Except as provided in §A(2) of this regulation, the] The board [shall] may start to canvass the absentee ballots [at 10 a.m. on the Thursday after the election] no earlier than 8 a.m. on October 1, 2020.

[(2) The board shall start the second absentee ballot canvass at 10 a.m. on the second Friday after an election.

(3) If the start of an absentee canvass falls on a legal holiday, the board shall convene the absentee canvass on the next regular business day.]

B. (text unchanged)

 

33.11.05 Canvass of Ballots — Rejecting Ballots

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 9-303, 11-301, [and] 11-302, and 11–303(d)(2)(iii); Public Safety Article, §14–107(d); Annotated Code of Maryland

.04 Ballot Rejection — Multiple Ballots from the Same Individual.

The local board shall reject multiple absentee ballots as follows:

A. — B. (text unchanged)

C. If an absentee ballot and provisional ballot are received from the same individual, the local board shall reject [both ballots] the provisional ballot.

 

Subtitle 16 PROVISIONAL VOTING

33.16.06 Canvass of Ballots — Rejecting Ballots

Authority: Election Law Article, §§2-102(b)(4), 2-202(b), 9-402, 9-403,
9-404, 9-406, and 11-303(c), (d)(2)(iii), and (e); Public Safety Article,
§14–107(d);
Annotated Code of Maryland

.04 Ballot Rejection — Multiple Ballots from the Same Individual.

A. (text unchanged)

B. If an absentee ballot and provisional ballot are received from the same individual, the local board shall reject [both ballots] the provisional ballot.

C. (text unchanged)

LINDA H. LAMONE
State Administrator of Elections

 

 

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 11
DEPARTMENT OF TRANSPORTATION

Subtitle 07 MARYLAND TRANSPORTATION AUTHORITY

11.07.05 Public Notice of Toll Schedule Revisions

Authority: Transportation Article, §§4-205, 4-312, 21-1401, 21-1414, and
27-110, Annotated Code of Maryland

Notice of Final Action

[20-146-F]

On October 23, 2020, the Executive Director of the Maryland Transportation Authority adopted amendments to Regulations .02 and .05 under COMAR 11.07.05 Public Notice of Toll Schedule Revisions. This action, which was proposed for adoption in 47:18 Md. R. 825—826 (August 28, 2020), has been adopted as proposed.

Effective Date: November 16, 2020.

JAMES F. PORTS, JR.
Executive Director
Maryland Transportation Authority

 

Title 26
DEPARTMENT OF THE ENVIRONMENT

Subtitle 11 AIR QUALITY

26.11.41 Control of Methane Emissions from the Natural Gas Industry

Authority: Environment Article, §§1-404, 2-103, 2-1202, and 2-1205, Annotated Code of Maryland

Notice of Final Action

[20-137-F]

On October 23, 2020, the Secretary of the Environment adopted new Regulations .01—.07 under a new chapter, COMAR 26.11.41 Control of Methane Emissions from the Natural Gas Industry. This action, which was proposed for adoption in 47:16 Md. R. 754—764 (July 31, 2020), has been adopted with the nonsubstantive changes shown below.

Effective Date: November 16, 2020.

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 .01B(3)(b): The amendment clarifies that certain operational activities do not qualify as a "blowdown". The use of the word “pressure” in the originally proposed definition for "blowdown" was an administrative error; "pressure seal" is not an actual term used in the natural gas industry. Instead, the definition of “blowdown” was intended to use the term “compressor seal”, which is defined in Regulation .01B(26). Therefore, the clarifying language is nonsubstantive and does not change the intent or impact of the regulation as originally proposed.

Regulation .07B(7): The amendment provides clarity on the standard of measure affected sources are required to utilize for reporting blowdown emissions. The Department's intent was to align the standard of measure in Regulation .07B(7) with the standard of measure contained in 40 CFR Part 98, Subpart W, §98.233. Therefore, the clarifying language is nonsubstantive and does not change the intent or impact of the regulation as originally proposed.

.01 Definitions.

A. (proposed text unchanged)

B. Terms Defined.

(1)—(2) (proposed text unchanged)

(3) Blowdown.

(a) (proposed text unchanged)

(b) “Blowdown” does not include natural gas pneumatics emissions, fugitive components emissions, or [[pressure]] compressor seal leakage.

(4)—(30) (proposed text unchanged)

.07 Record-Keeping and Reporting Requirements.

A. (proposed text unchanged)

B. Blowdown Events and Reports.

(1)—(6) (proposed text unchanged)

(7) Affected facilities shall report the following information to the Department of blowdown emissions in excess of 50 [[standard]] cubic feet within the facility’s fence line annually by April 1 of each year:

(a)—(c) (proposed text unchanged)

(8) (proposed text unchanged)

C.—D. (proposed text unchanged)

BENJAMIN H. GRUMBLES
Secretary of the Environment

 

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

Subtitle 01 GENERAL

30.01.02 Documents Incorporated by Reference

Authority: Education Article, §§13-509 and 13-516, Annotated Code of Maryland

Notice of Final Action

[20-136-F-I]

On October 13, 2020, the Maryland State Emergency Medical Services Board adopted amendments to Regulation .01 under COMAR 30.01.02 Documents Incorporated by Reference. This action was taken at a public meeting, notice of which was given by publication 47:19 Md. R. 858 (September 11, 2020) under General Provisions Article, §3-302(c), Code of Maryland. This action, which was proposed for adoption in 47:16 Md. R. 764 (July 31, 2020), has been adopted as proposed.

Effective Date: November 16, 2020.

THEODORE R. DELBRIDGE, M.D., M.P.H.
Executive Director

 

 

Proposed Action on Regulations

 

 


Title 08
DEPARTMENT OF NATURAL RESOURCES

Subtitle 03 WILDLIFE

08.03.08 Threatened and Endangered Species

Authority: Natural Resources Article, §§4-2A-01—4-2A-09 and 10-2A-01—10-2A-09, Annotated Code of Maryland

Notice of Proposed Action

[20-172-P]

The Secretary of Natural Resources proposes to amend Regulations .01 and .04—.09 under COMAR 08.03.08 Threatened and Endangered Species.

Statement of Purpose

The purpose of this action is to add four new species of animals to the lists of endangered, threatened or in need of conservation, and reclassify 56 species by changing the status of 12 species and removing 44 species. One insect is proposed to be added to the list as endangered. One mollusk and one bird species are proposed to be added to the list as threatened, and one mollusk species is proposed to be added to the list as in need of conservation.

A proposal to list a species may occur if it is determined that the species meets the criteria for endangered species, threatened species, or species in need of conservation, as stated in COMAR 08.03.08.01. Legal protection may be warranted due to any of the following factors: present or threatened alterations of the species’ habitat or range; overutilization; disease or predation; inadequacy of existing regulatory mechanisms; or other natural or manmade factors affecting its continued existence in the State.

Increased legal protection for the species to be added is warranted because populations are isolated, are limited in number, and may be habitat specific; population declines have been documented; and/or habitat alterations threaten the species’ continued existence in the State. The rusty-patched bumble bee (Bombus affinis) was recently listed as endangered by the U.S. Fish and Wildlife Service and its State status is proposed to conform with the new federal status. The yellow lance (Elliptio lanceolata) and a subspecies of the red knot (Calidris canutus rufa) were recently listed as threatened by the U.S. Fish and Wildlife Service and their State statuses are proposed to conform with the new federal statuses. The Appalachian springsnail (Fontigens bottimeri) is proposed as in need of conservation as it is highly specialized and vulnerable to threats that affect the high quality springs found in its limited range.

A change in status may occur if there is an increase in the population of a listed species or additional populations are found in the State for a given species. Intensive field inventories have documented enough new populations for one endangered mollusk species to be proposed as threatened and for two threatened finfish species to be proposed as in need of conservation. Six endangered plant species are proposed as threatened due to the discovery of additional populations, including on protected lands.

A mobile, migratory butterfly species that is an uncommon and irregular resident in the State is proposed to be removed from the State’s endangered species list because it is no longer a conservation target. Recent survey work confirms that one threatened butterfly species and two finfish species listed as in need of conservation are more widespread and less habitat-restricted than was previously thought, and these species are proposed to be removed from the State’s threatened and in need of conservation species lists, respectively. Recent survey work confirms that additional populations of one threatened plant species are present in the State on protected lands such that this species no longer warrants threatened species protection. Nine endangered plant species are no longer appropriate conservation targets due to evidence of expanding occurrence in the State, including in anthropogenic habitats. Three additional endangered plant species are proposed to be removed from the endangered species list because voucher specimens of one species were found to be misidentified, one species does not appear to be native to Maryland, and one species no longer meets the definition of a species.

Endangered extirpated species are those species that were once a viable component of the flora and fauna of the State but for which no naturally occurring populations were known since 1950. Upon the discovery of a viable, naturally occurring population or populations of a listed endangered extirpated species, the status of the species is evaluated. Three endangered extirpated plant species have been rediscovered in the State at single locations and are being proposed as endangered. Ten plant species are proposed to be removed from the endangered extirpated list due to additional field inventories. There is no evidence that nine plant species are part of Maryland’s native flora and they are proposed to be removed from the endangered extirpated list. Eight endangered extirpated plant species are proposed to be removed from the list because voucher specimens of four species were found to be misidentified, the status of three species is affected by taxonomic changes or uncertainty, and one species is a hybrid without conservation value.

Fish species designated as endangered or threatened appear both in lists maintained by the Fisheries Service and by the Wildlife and Heritage Service. The Fisheries Service’s list appears under COMAR 08.02.12 and the Wildlife and Heritage Service’s list appears under COMAR 08.03.08.

The scientific community has changed the scientific names of four dragonflies, five birds, and four plant species, and these names are changed to conform. The common names of two invertebrate species are corrected.

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 Gwenda Brewer, Science Program Manager, Wildlife and Heritage Service, Department of Natural Resources, 580 Taylor Avenue, E-1, Annapolis, MD 21401, or call 410-260-8558, or email to gwenda.brewer@maryland.gov, or fax to 410-260-8596. Comments will be accepted through December 7, 2020. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(12) (text unchanged)

(13) “Species” means any species of wildlife or plant and reptiles, amphibians, crustaceans, mollusks, and the following finfish: [Acantharchus pomotis,] Acipenser brevirostrum, Acipenser oxyrinchus, Catostomus catostomus, Centrarchus macropterus, Enneacanthus chaetodon, [Etheostoma fusiforme,] Etheostoma sellare, Etheostoma vitreum, Lethenteron appendix, Luxilus chrysocephalus, Margariscus margarita, Notropis bifrenatus, Notropis chalybaeus, Noturus flavus, Pararhinichthys bowersi, Percina bimaculata, Percina notogramma, Percopsis omiscomaycus, or any part, egg, offspring, or dead body of any of them.

(14)—(16) (text unchanged)

.04 Endangered Species of Wildlife, Reptiles, Amphibians, Mollusks, Crustaceans, and Finfish.

A.—B. (text unchanged)

C. Except for the smaller range which is indicated in §C(7)(d) and (8)(a) of this regulation, the following wildlife, reptile, amphibian, mollusk, crustacean, and finfish species are considered endangered throughout Maryland:

(1) (text unchanged)

(2) Mollusks:

(a) (text unchanged)

[(b) Triangle floater (Alasmidonta undulata);]

[(c)] (b)[(e)] (d) (text unchanged)

(3) (text unchanged)

(4) Insects:

(a) Rusty-patched bumble bee (Bombus affinis);

[(a)] (b)[(r)] (s) (text unchanged)

[(s) Compton tortoiseshell (Nymphalis vaualbum);]

(t)—(dd) (text unchanged)

(5)—(9) (text unchanged)

.05 Endangered Species of Plants.

A.—B. (text unchanged)

C. The following plant species are considered endangered throughout Maryland unless a smaller range is indicated:

(1)—(20) (text unchanged)

[(21) Black-stem spleenwort (Asplenium resiliens);]

[(22)] (21)[(45)] (44) (text unchanged)

[(46) Short’s sedge (Carex shortiana);]

[(47)] (45)[(51)] (49) (text unchanged)

[(52) Prickly hornwort (Ceratophyllum echinatum);]

[(53)] (50) (text unchanged)

[(54) Giant-seed goosefoot (Chenopodium simplex);

(55) Standley’s goosefoot (Chenopodium standleyanum);]

[(56)] (51)[(67)] (62) (text unchanged)

(63) Water pygmyweed (Crassula aquatica);

[(68)] (64)[(82)] (78) (text unchanged)

[(83) Small waterwort (Elatine minima);]

[(84)] (79)[(91)] (86) (text unchanged)

[(92) Hairy willowherb (Epilobium ciliatum);]

[(93)] (87)[(118)] (112) (text unchanged)

[(119) Small woodland sunflower (Helianthus microcephalus);]

[(120)] (113) (text unchanged)

(114) Crested coralroot (Hexalectris spicata);

[(121)] (115)[(153)] (147) (text unchanged)

[(154) Cylindric-fruit seedbox (Ludwigia glandulosa);]

[(155)] (148)[(159)] (152) (text unchanged)

[(160) Carolina anglepod (Matelea carolinensis);]

[(161)] (153)[(162)] (154) (text unchanged)

[(163) Creeping cucumber (Melothria pendula);]

[(164)] (155) (text unchanged)

[(165) Pinebarren sandwort (Minuartia caroliniana);

(166) Appalachian sandwort (Minuartia glabra);]

[(167)] (156) (text unchanged)

(157) Appalachian sandwort (Mononeuria glabra);

[(168)] (158)[(180)] (170) (text unchanged)

[(181) Horse-tail paspalum (Paspalum fluitans);]

[(182)] (171)[(185)] (174) (text unchanged)

[(186) Buttercup scorpionweed (Phacelia covillei);]

[(187)] (175)[(192)] (180) (text unchanged)

[(193) Leafy pondweed (Potamogeton foliosus);]

[(194)] (181)[(198)] (185) (text unchanged)

[(199) Whorled mountainmint (Pycnanthemum verticillatum);]

[(200)] (186)[(214)] (200) (text unchanged)

(201) Pinebarren sandwort (Sabulina caroliniana);

[(215)] (202)[(225)] (212) (text unchanged)

[(226) Veined skullcap (Scutellaria nervosa);]

[(227)] (213)[(232)] (218) (text unchanged)

(219) Prairie goldenrod (Solidago rigida);

[(233) Roan Mountain goldenrod (Solidago roanensis);]

[(234)] (220)[(252)] (238) (text unchanged)

[(253) Swollen bladderwort (Utricularia inflata);]

[(254)] (239)[(264)] (249) (text unchanged)

.06 Endangered Extirpated Species.

A.—B. (text unchanged)

C. The following plant species are considered endangered extirpated throughout Maryland:

(1)—(9) (text unchanged)

[(10) American barberry (Berberis canadensis);]

[(11)] (10)[(15)] (14) (text unchanged)

[(16) French mulberry (Callicarpa americana);]

[(17)] (15)[(20)] (18) (text unchanged)

[(21) Water pygmyweed (Crassula aquatica);

(22) Hazel dodder (Cuscuta coryli);]

[(23)] (19)[(28)] (24) (text unchanged)

[(29) Northern witchgrass (Dicanthelium boreale);

(30) Shaggy crabgrass (Digitaria villosa);]

[(31)] (25)[(37)] (31) (text unchanged)

[(38) Hairy alumroot (Heuchera villosa);

(39) Crested coralroot (Hexalectris spicata);

(40) Great St. John’s-wort (Hypericum ascyron);]

[(41)] (32)[(43)] (34) (text unchanged)

[(44) Small-head rush (Juncus brachycephalus);]

[(45)] (35)[(51)] (41) (text unchanged)

[(52) Twinflower (Linnaea borealis);

(53) Florida yellow flax (Linum floridanum);]

[(54)] (42)[(55)] (43) (text unchanged)

[(56) Large-flowered Barbara’s-buttons (Marshallia grandiflora);

(57) Old-field milkvine (Matelea decipiens);]

[(58)] (44) (text unchanged)

[(59) Thread-like naiad (Najas gracillima);]

[(60)] (45) (text unchanged)

[(61) Stout smartweed (Persicaria robustior);

(62) May grass (Phalaris caroliniana);]

[(63)] (46)[(64)] (47) (text unchanged)

[(65) Dwarf plantain (Plantago pusilla);]

[(66)] (48)[(67)] (49) (text unchanged)

[(68) American ipecac (Porteranthus stipulatus);

(69) Richardson’s pondweed (Potamogeton richardsonii);

(70) Flatleaf pondweed (Potamogeton robbinsii);]

[(71)] (50)[(72)] (51) (text unchanged)

[(73) Water-plantain spearwort (Ranunculus ambigens);

(74) Carolina buttercup (Ranunculus carolinianus);]

[(75)] (52)[(84)] (61) (text unchanged)

[(85) Smith’s bulrush (Schoenoplectus smithii);]

[(86)] (62) Chaffseed (Schwalbea americana);

[(87) Small skullcap (Scutellaria parvula);

(88) Prairie goldenrod (Solidago rigida);

(89) Rock goldenrod (Solidago rupestris);]

[(90)] (63) (text unchanged)

[(91) Smooth blue aster (Symphyotrichum laeve var. concinnum);]

[(92)] (64)[(93)] (65) (text unchanged)

[(94)] (66) Navel-shape corn-salad (Valerianella umbilicata); and

[(95)] (67) American purple vetch (Vicia americana)[;].

[(96) New England grape (Vitis novae-angliae); and

(97) Sword bogmat (Wolffiella gladiata).]

D. (text unchanged)

E. The following crustacean species is considered endangered extirpated throughout Maryland: Norden’s groundwater [amphipod] isopod (Caecidotea nordeni).

F. The following insect species are considered endangered extirpated throughout Maryland:

(1)—(3) (text unchanged)

[(4) Piedmont clubtail (Gomphus parvidens);]

[(5)] (4) Skillet clubtail ([Gomphus] Gomphurus ventricosus);

(5) Piedmont clubtail (Hylogomphus parvidens);

(6) (text unchanged)

(7) Tawny crescent [spot] (Phyciodes batesii);

(8)—(9) (text unchanged)

G.—H. (text unchanged)

I. The following bird species are considered endangered extirpated throughout Maryland:

(1)—(4) (text unchanged)

(5) Red-cockaded woodpecker (Dryobates borealis);

[(5)] (6)[(6)] (7) (text unchanged)

[(7) Red-cockaded woodpecker (Picoides borealis);]

(8)—(10) (text unchanged)

J. (text unchanged)

.07 Threatened Species of Wildlife, Reptiles, Amphibians, Mollusks, Crustaceans, and Finfish.

A. — B. (text unchanged)

C. The following species are considered to be threatened throughout Maryland unless a smaller range is indicated:

(1) Mollusks:

(a) Triangle floater (Alasmidonta undulata); and

(b) Yellow lance (Elliptio lanceolata);

[(1)] (2) Insects:

[(a) Great purple hairstreak (Atlides halesus);]

[(b)] (a)[(g)] (f) (text unchanged)

[(2)] (3) Finfish:

[(a) Flier (Centrarchus macropterus);]

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

[(c)] (b) American brook lamprey (Lethenteron appendix); and

[(d) Pearl dace (Margariscus margarita); and]

[(e)] (c) (text unchanged)

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

[(4)] (5) Birds:

(a) (text unchanged)

(b) Red knot (Calidris canutus rufa);

[(b)] (c) Nashville warbler ([Oreothlypis] Leiothlypis ruficapilla); and

[(c)] (d) (text unchanged)

[(5)] (6) (text unchanged)

.08 Threatened Species of Plants.

A.—B. (text unchanged)

C. The following plant species are considered threatened throughout Maryland unless a smaller range is indicated:

(1)—(12) (text unchanged)

(13) Giant-seed goosefoot (Chenopodiastrum simplex);

[(13)] (14)[(29)] (30) (text unchanged)

(31) Carolina anglepod (Matelea carolinensis);

[(30)] (32) (text unchanged)

[(31) Michaux’s stitchwort (Minuartia michauxii);]

[(32)] (33)[(33)] (34) (text unchanged)

(35) Horse-tail paspalum (Paspalum fluitans);

(36) Coville’s phacelia (Phacelia covillei);

[(34)] (37) (text unchanged)

[(35) Black-fruit mountain-ricegrass (Piptatherum racemosum);]

[(36)] (38)[(44)] (46) (text unchanged)

(47) Whorled mountainmint (Pycnanthemum verticillatum);

[(45)] (48)[(48)] (51) (text unchanged)

(52) Michaux’s stitchwort (Sabulina michauxii);

[(49)] (53)[(53)] (57) (text unchanged)

(58) Veined skullcap (Scutellaria nervosa);

[(54)] (59)[(70)] (75) (text unchanged)

.09 Species in Need of Conservation.

A.—B. (text unchanged)

C. The following species are considered to be in need of conservation throughout Maryland unless a smaller range is indicated:

(1) Mollusks:

(a) (text unchanged)

(b) Appalachian springsnail (Fontigens bottimeri);

[(b)] (c)[(c)] (d) (text unchanged)

(2) (text unchanged)

(3) Insects:

(a)—(c) (text unchanged)

[(d) Rapids clubtail (Gomphus quadricolor);

(e) Sable clubtail (Gomphus rogersi); and]

[(f)] (d) (text unchanged)

(e) Rapids clubtail (Phanogomphus quadricolor); and

(f) Sable clubtail (Stenogomphurus rogersi);

(4) Finfish:

[(a) Mud sunfish (Acantharchus pomotis);

(b) Swamp darter (Etheostoma fusiforme); and]

(a) Flier (Centrarchus macropterus);

(b) Pearl dace (Margariscus margarita); and

(c) (text unchanged)

(5)—(6) (text unchanged)

(7) Birds:

(a) Saltmarsh sparrow ([Ammodramus caudacutus] Ammospiza caudacuta);

(b) Henslow’s sparrow ([Ammodramus] Centronyx henslowii);

(c) Northern harrier (Circus [cyaneus] hudsonius);

(d)—(l) (text unchanged)

(8) (text unchanged)

JEANNIE HADDAWAY-RICCIO
Secretary of Natural Resources

 

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.03 Pharmacy Services

Authority: Health-General Article, §§2-104(b), 15-103, 15-103.1, 15-105,
15-118, and 15-148, Annotated Code of Maryland

Notice of Proposed Action

[20-177-P]

The Secretary of Health proposes to amend Regulation .07 under COMAR 10.09.03 Pharmacy Services.

Statement of Purpose

The purpose of this action is to increase the professional dispensing fees paid to Maryland Medicaid community participating pharmacy providers for covered services. This includes covered services rendered to participants in nursing facilities and covered services rendered to individuals who do not reside in nursing facilities, in order to comply with federal mandates established by CMS’ Covered Outpatient Drug Final Rule (CMS-2345-FC).

 

Comparison to Federal Standards

There is a corresponding federal standard to this proposed action, but the proposed action is not more restrictive or stringent.

Estimate of Economic Impact

I. Summary of Economic Impact. The proposed action increases the professional dispensing fee (PDF) paid to pharmacies effective February 1, 2021. In FY 2021, the total impact is $337,500.

 

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure

(E+/E-)

Magnitude

 


A. On issuing agency:

(E+)

$337,500

B. On other State agencies:

NONE

C. On local governments:

NONE

 

 

Benefit (+)
Cost (-)

Magnitude

 


D. On regulated industries or trade groups:

(+)

$337,500

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. This amount assumes:

·   The Maryland Medicaid Pharmacy Program is increasing the professional dispensing fees paid to pharmacies for covered services rendered to participants residing in nursing facilities from $11.49 to $11.67. It is also increasing the professional dispensing fee paid to pharmacies for covered services rendered to individuals other than residents in nursing facilities from $10.49 to $10.67.

·   Estimated magnitude is based on FY 2019 utilization (4,500,000 prescriptions), and utilization will remain consistent. The Department estimates Maryland Medicaid pharmacies will dispense 1,875,000 prescriptions between February 1, 2021 and June 30, 2021.

·   This amount is subject to 50 percent federal match ($168,750 federal and $168,750 general funds).

Economic Impact on Small Businesses

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

The proposed action increases the PDF paid to pharmacies for covered services rendered to participants residing in nursing facilities from $11.49 to $11.67 and increases the professional dispensing fee paid to pharmacies for covered services rendered to individuals other than residents in nursing facilities from $10.49 to $10.67. As such, all Maryland Medicaid-enrolled pharmacies that qualify as small businesses will benefit from increased reimbursement for covered services rendered to Maryland Medicaid participants.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

.07 Payment Procedures.

A.—H. (text unchanged)

I. Payment for Covered Services to a Pharmacy.

(1)—(9) (text unchanged)

(10) The professional dispensing fee for covered services rendered on or after [April 1, 2017] February 1, 2021 to a pharmacy for participants residing in nursing facilities shall be [$11.49] $11.67.

(11) The professional dispensing fee for covered services rendered on or after [April 1, 2017] February 1, 2021 to a pharmacy for individuals other than residents in nursing facilities shall be [$10.49] $10.67.

(12)—(13) (text unchanged)

J.—K. (text unchanged)

ROBERT R. NEALL
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.04 Home Health Services

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

Notice of Proposed Action

[20-180-P]

The Secretary of Health proposes to amend Regulations .01 and .03—.07 under COMAR 10.09.04 Home Health Services.

Statement of Purpose

The purpose of this action is to expand the provider types permitted to order home health services to include nurse practitioners. Additionally, the proposed action changes instances of the term “recipient” to “participant” throughout the chapter.

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 Jake Whitaker, Acting 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 800-735-225), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through December 7, 2020. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

(2)  “Attending [physician]” means [a person who is licensed to practice medicine in the jurisdiction in which the service is provided and] the role of an individual who establishes the plan of treatment and certifies the necessity for home health services for a [recipient] participant following a hospitalization.

(3) “Case coordinator” means a licensed health professional designated by a home health agency to coordinate the care of a [recipient] participant.

(4) “Certified nurse practitioner” means an individual who meets the licensing requirements and conditions for participation as a nurse practitioner set forth in COMAR 10.09.01.

[(4)] (5) (text unchanged)

[(5)] (6) “Health team” means the [attending] physician or nonphysician practitioner and the home health agency personnel who render services listed in Regulation .04B of this chapter to a [recipient] participant.

[(6)] (7) “Home” means the place of residence occupied by the [recipient] participant, including a domiciliary level facility, but other than a hospital, nursing facility, or other medical institution.

[(7)] (8)[(15)] (16) (text unchanged)

[(16)] (17) “Nonphysician practitioner” means an individual who:

(a) Is licensed as a certified nurse practitioner, clinical nurse specialist, a certified nurse-midwife, or a physician assistant in the jurisdiction in which the service is provided; and

(b) Works in collaboration with or under the supervision of the attending physician or certified nurse practitioner.

[(17)] (18) (text unchanged)

(19) “Participant” means a person who is certified as eligible for and is receiving Medical Assistance benefits.

[(18)] (20)[(19)] (21) (text unchanged)

(22) “Physician” means an individual who meets the licensure requirements and conditions for participation set forth in COMAR 10.09.02.

(23) “Physician assistant” means an individual who meets license requirements and conditions for participation set forth in COMAR 10.09.55.

[(20)] (24) (text unchanged)

[(21)] (25) “Progress note” means a dated, written notation by a member of the health team which summarizes facts about the care given and the patient’s response during a given period of time, specifically addresses the established goals of treatment, is consistent with the patient plan of care, is written immediately following each visit, and is part of the provider’s permanent record for the [recipient] participant.

[(22)] (26) “Provider” means a person or an organization who meets the requirements of Regulations .03 and .04 of this chapter and who, through an appropriate agreement with the Department, has been identified as a Program provider by the issuance of an individual account number.

[(23) “Recipient” means a person who is certified as eligible for, and is receiving Medical Assistance benefits.]

[(24)] (27)[(25)] (28) (text unchanged)

[(26)] (29) “Support system” means a family member, friend, neighbor, or any person who renders services, which would otherwise be covered under Regulation .04 of this chapter, to the [recipient] participant.

[(27)] (30) “Visit” means the time spent rendering a covered service to a [recipient] participant at home by an individual employed by a home health agency.

[(28)] (31) “Witness” means a person who on behalf of the [recipient] participant is able to personally verify at the time of service that the [recipient] participant received home health care.

.03 Conditions for Participation.

A. (text unchanged)

B. To participate in the Program, the home health agency shall:

(1)—(6) (text unchanged)

(7) Secure from the [recipient’s attending] participant’s physician or certified nurse practitioner a written plan of treatment which relates the items and services to the [recipient’s] participant’s medical condition;

(8) Maintain a patient plan of care based on the [attending] physician’s or certified nurse practitioner’s plan of treatment for the [recipient] participant;

(9) (text unchanged)

(10) Verify the [recipient’s] participant’s eligibility;

(11) Place no restriction on a [recipient’s] participant’s right to select his choice of providers under this subtitle;

(12) Agree that if the Program denies payment or requests repayment on the basis that an otherwise covered service was not medically necessary, the provider may not seek payment for that service from the [recipient] participant; and

(13) Agree that if the Program denies payment due to late billing, the provider may not seek payment from the [recipient] participant.

C. Plan of Treatment.

(1) The plan of treatment under [§C(8)] §B(8) shall include:

(a)—(p) (text unchanged)

(2) The plan of treatment shall be reviewed, updated, and signed at least every 60 days by the [attending] participant’s physician or certified nurse practitioner, in consultation with the registered nurse or the case coordinator.

(3) The [attending] physician or certified nurse practitioner shall:

(a) (text unchanged)

(b) Document that the [attending] physician [or nonphysician practitioner] or nonphysician practitioner, who is not employed by the home health agency, has had a face-to-face encounter with the [recipient] participant no more than 90 days before the home health start of care date or within 30 days of the start of the home health care, including the date of the encounter.

(4) For [recipients] participants admitted immediately to home health upon discharge from a hospital or post-acute setting, the attending acute or post-acute physician [or nonphysician practitioner,] shall document the clinical findings of the face-to-face encounter.

(5) The plan of treatment shall be part of the provider’s permanent record for the [recipient] participant.

D. Plan of Care.

(1)—(2) (text unchanged)

(3) The plan of care is a part of the provider’s permanent record for the [recipient] participant.

.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] a physician or certified nurse practitioner;

(2)—(3) (text unchanged)

(4) Consistent with the current diagnosis and treatment of the [recipient’s] participant’s condition;

(5) (text unchanged)

(6) Required by the medical condition rather than the convenience or preference of the [recipient] participant;

(7) Considered under accepted standards of medical practice to be a specific and effective treatment for the [recipient’s] participant’s condition;

(8) (text unchanged)

(9) Rendered in the [recipient’s] participant’s home, or other setting when normal life activities take the participant outside the home, by an approved provider;

(10) Received by the [recipient] participant as documented by the [recipient’s] participant’s signature or the signature of the [recipient’s] participant’s witness on the home health agency’s official forms; and

(11) (text unchanged)

B. The Program covers the following services:

(1)  Skilled nursing services provided by a licensed nurse when the complexity of the services, or the condition of a [recipient] participant, requires the judgment, knowledge, and skills of a licensed nurse;

(2) Home health aide services provided by a home health aide, that include:

(a)—(b) (text unchanged)

(c) Reporting of the [recipient’s] participant’s condition and needs; and

(d) (text unchanged)

(3) Physical therapy services, provided by a physical therapist:

(a) When the condition of a [recipient] participant requires the judgment, knowledge, and skills of a licensed or registered physical therapist;

(b) When the services are directly related to the [attending] physician’s or certified nurse practitioner’s plan of treatment, which specifies:

(i)—(iv) (text unchanged)

(c) When the services are of a diagnostic, rehabilitative, or therapeutic nature and:

(i) Are provided with the expectation, based on the assessment made by [the attending] a physician or certified nurse practitioner, that a [recipient] participant will improve significantly in physical functioning in a reasonable and generally predictable period of time; or

(ii) (text unchanged)

(4) Occupational therapy services, provided by an occupational therapist:

(a) When the condition of the [recipient] participant requires the judgment, knowledge, and skills of a licensed occupational therapist;

(b) When the services are provided with the expectation that there will be a significant practical improvement in a [recipient’s] participant’s level of physical functioning within a reasonable period of time; and

(c) When the services fall within one or more of the following categories:

(i) Evaluation and reevaluation of a [recipient’s] participant’s level of functioning by administering diagnostic and prognostic tests;

(ii)—(v) (text unchanged)

 (5) Speech-language pathology services performed by a licensed speech-language pathologist when the:

(a) Services are of a diagnostic, rehabilitative, or therapeutic nature and:

(i) Are provided with the expectation, based on the assessment made by [the attending] a physician or certified nurse practitioner, that a [recipient] participant will improve significantly in a reasonable and generally predictable period of time; or

(ii) (text unchanged)

(b) (text unchanged)

C. The Program covers a provider’s newborn early discharge assessment visit to a [recipient] participant when the assessment:

(1) (text unchanged)

(2) Is ordered by a physician or certified nurse practitioner;

(3) Is delivered to a [recipient] participant and a [recipient’s] participant’s mother who have been discharged within 48 hours after delivery;

(4)—(6) (text unchanged)

.05 Limitations.

The Program does not cover the following:

A.—D. (text unchanged)

E. Home health aide services unless biweekly supervisory visits by a registered nurse in the [recipient’s] participant’s home are made, every second visit of which shall include observations of the delivery of services by the aide to the [recipient] participant;

F. Home health aide services rendered to [recipients] participants with chronic conditions when those [recipients] participants require only assistance with activities of daily living as defined in Regulation .01B of this chapter unless preauthorized as specified in Regulation .06 of this chapter;

G.—L. (text unchanged)

M. A service not documented as received by the [recipient] participant as indicated by the [recipient’s] participant’s signature or the signature of a witness on the home health agency’s official form;

N.—O. (text unchanged)

P. Services provided for the convenience or preference of the [recipient] participant or primary caregiver rather than as required by the [recipient’s] participant’s medical condition;

Q. Services specified in Regulation .04 of this chapter which duplicate or supplant services performed by the [recipient] participant and those services rendered by the [recipient’s] participant’s family;

R. (text unchanged)

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

T.—U. (text unchanged)

.06 Preauthorization Requirements.

A. (text unchanged)

B. Preauthorization may be:

(1) (text unchanged)

(2) Denied when the Department, after taking into consideration the particular circumstances of the [recipient] participant, determines the payments to the provider for any service or combination of services rendered during any 30-day period would exceed the cost to the program of any alternative services which could be used for the same purpose.

.07 Payment Procedures.

A.—C. (text unchanged)

D. Payment Rates.

(1)—(2) (text unchanged)

(3) The Department shall pay home health providers for medical and other supplies which are used during a covered home health visit as part of the treatment ordered by the [recipient’s attending] participant’s physician or certified nurse practitioner at a rate that is the lesser of the:

(a)—(b) (text unchanged)

(4) (text unchanged)

E.—G. (text unchanged)

H. The Department shall reimburse for preauthorized home health services upon verification that a face-to-face encounter with the [recipient] participant was performed as described under Regulation .03C of this chapter.

I. (text unchanged)

ROBERT R. NEALL
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.21 Pharmacists

Authority: Health-General Article, §§2-104(b), 2-105(b), 15-103, and
15-148(c), Annotated Code of Maryland

Notice of Proposed Action

[20-179-P]

The Secretary of Health proposes to amend Regulation .06 under COMAR 10.09.21 Pharmacists.

Statement of Purpose

The purpose of this action is to update the pharmacist prescriber payment procedures regulation by adding a reference to the Professional Services Provider Manual and Fee Schedule, which is incorporated by reference under COMAR 10.09.02.07D.

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 Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

.06 Payment Procedures.

A.—B. (text unchanged)

C. The provider shall be reimbursed in accordance with COMAR 10.09.02.07D.

[C.] D.[E.] F. (text unchanged)

ROBERT R. NEALL
Secretary of Health

 

Subtitle 09 MEDICAL CARE PROGRAMS

10.09.77 Urgent Care Centers

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

Notice of Proposed Action

[20-182-P]

The Secretary of Health proposes to amend Regulation .06 under COMAR 10.09.77 Urgent Care Centers.

Statement of Purpose

The purpose of this action is to clarify payment procedures for professional and laboratory services provided in urgent care centers by adding references to the Professional Services Provider Manual and Fee Schedule, which is incorporated by reference under COMAR 10.09.02.07D.

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 Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

.06 Payment Procedures.

A.—B. (text unchanged)

C. The Department shall pay for covered services at the lesser of:

(1) (text unchanged)

(2) The Department’s fee[.] for:

(a) Professional services in accordance with COMAR 10.09.02.07D; and

(b) Laboratory services in accordance with COMAR 10.09.09.07D.

D.—J. (text unchanged)

ROBERT R. NEALL
Secretary of Health

 

Subtitle 27 BOARD OF NURSING

10.27.01 Examination and Licensure

Authority: Health Occupations Article, §§8-205(a)(1), (2), (5), and (6), 8-701, and 8-7A-01, Article III6(b)(2), Annotated Code of Maryland; Chs. 281 and 282, Acts of 2013

Notice of Proposed Action

[20-178-P]

The Secretary of Health proposes to amend Regulations .01, .05, and .10 under COMAR 10.27.01 Examination and Licensure. This action was considered at a public meeting of the Board of Nursing on September 26, 2018, notice of which was given by publication on the Board’s website beginning January 1, 2018, through September 26, 2018, pursuant to General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to:

(1) Amend the requirements for testing English competency of foreign nursing school graduates whose nursing education was not taught in English;

(2) Repeal the waiver for a clinical nursing education requirement for a nurse applying for a license by endorsement in this State;

(3) Define competency in reading, speaking, writing, and listening in accordance with the Nurse Licensure Compact.

(4) Define the minimal passing scores for the two English language competency tests that the Board recognizes; and

(5) Repeal, in accordance with the Sunset Provision, effective September 30, 2018, for Health Occupations Article, §8-307(c), Annotated Code of Maryland, the requirement that the Board waive the supervised clinical learning experience requirement for nurse endorsement applicants who attended a nursing program without a supervised clinical learning experience requirement.

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 Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)―(11) (text unchanged)

(12) “English language competency examination” means [a Board-approved] an examination [with a certain minimum score recognized by the Board for the purpose of determining proficiency in the oral and written communication of] that tests an individual’s written and oral competency in the English language.

(13)―(17) (text unchanged)

(18) “Substantially equivalent” has the meaning stated in [§C] §§C and D of this regulation.

(19) (text unchanged)

(20) “Written and oral competency in the English language” means the ability to demonstrate proficiency in listening, reading, speaking, and writing the English language.

C. (text unchanged)

D. “Substantially equivalent” does not mean a registered nurse or licensed practical nursing education program in another state or country that does not have a supervised clinical learning experience requirement.

.05 Qualifications of Applicants for Examination.

A.—B. (text unchanged)

C. Applicants who are unable to prove [proficiency] written and oral competency in the English language in accordance with Health Occupation Article, [§8-302(e)] §8-302(e)(2) or (4), Annotated Code of Maryland, [may be required to] shall submit evidence of [competency] proficiency in listening, reading, speaking, and writing the English language  by obtaining a minimum passing score on [a] one of  the following Board-approved English language competency [examination of] examinations:

[(1) 26 or higher on the spoken and written sections of the Test of English as a Foreign Language — Internet Based Test (TOEFL IBT); or

 

(2) For the International English Language Testing System (IELTS):

(a) 7 or higher on the speaking and 6 or higher an all other modules; and

(b) 6.5 or higher on the overall score.]

(1) Test of English as a Foreign Language Internet Based Test (TOEFL iBT) with minimum passing scores of:

(a) Listening — 22;

(b) Reading — 22;

(c) Speaking — 26; and

(d) Writing —24; or

(2) International English Language Testing System (IELTS) with minimum passing scores of:

(a) Listening — 6;

(b) Reading — 6;

(c) Speaking — 7;

(d) Writing — 6; and

(e) Overall score of at least 6.5.

D. (text unchanged)

.10 Licensure by Endorsement.

A. An applicant licensed to practice registered nursing or practical nursing in another state, territory, or country is eligible for licensure without examination if the applicant:

(1)―(2) (text unchanged)

(3) Submits the following verifications directly to the Board from the appropriate authority:

(a)―(d) (text unchanged)

(e) Proof of [oral and written] written and oral competency in the English language in accordance with Regulation .05C of this chapter.

[B. Supervised Clinical Learning Experience Requirement.

(1) A nursing education program approved in another state or country that does not have a supervised clinical learning experience requirement is not substantially equivalent to an approved nursing education program in this State.

(2) An applicant who graduated from a nursing education program in another state or country that did not have a supervised clinical learning requirement does not meet the educational qualifications required by the laws of this State.

(3) The Board may waive the supervised clinical learning experience requirement required by this State for an applicant for licensure by endorsement as a registered nurse who:

(a) Has an active unencumbered license to practice registered nursing from another state or country;

(b) Has graduated from a registered nursing program accredited by a nursing accreditation agency recognized by the Board;

(c) Submits to the Board evidence of completing 1,000 hours of active practice as a registered nurse within the 12-month period immediately preceding the date of the application; and

(d) Otherwise meets the requirements for licensure by endorsement as a registered nurse.

(4) The Board may waive the supervised clinical learning experience requirement required by this State for an applicant for licensure by endorsement as a licensed practical nurse who:

(a) Has an active unencumbered license to practice licensed practical nursing from another state or country;

(b) Has graduated from a licensed practical nursing program accredited by a nursing accreditation agency recognized by the Board;

(c) Submits to the Board evidence of 1,000 hours of active practice as a licensed practical nurse within the 12-month period immediately preceding the date of the application; and

(d) Otherwise meets the requirements for licensure by endorsement as a licensed practical nurse.

(5) The Board shall accept the following documentation as evidence of completing 1,000 hours of active practice as a registered nurse or licensed practical nurse within the 12-month period immediately preceding the date of the application:

(a) A letter from an employer on the facility’s letterhead, signed and mailed by the employer to the Board of Nursing that states the:

(i) Applicant’s name and license number;

(ii) Dates of employment;

(iii) Job description; and

(iv) Number of hours worked within the previous 12-month period immediately preceding the date of the application; and

(b) Pay stubs that indicate the hours of employment within the 12-month period immediately preceding the date of the application.

(6) The Board will accept pay stubs by mail from the applicant.]

[C.] B.[D.] C. (text unchanged)

ROBERT R. NEALL
Secretary of Health

 

Subtitle 27 BOARD OF NURSING

10.27.03 Nursing Education Programs

Authority: Health Occupations Article, §§8-205 and 8-401, Annotated Code of Maryland

Notice of Proposed Action

[20-183-P]

The Secretary of Health proposes to amend Regulations .01—.03, .05, .08, .09, and .11—.18 under COMAR 10.27.03 Nursing Education Programs. This action was considered the Board of Nursing at a public meeting held on July 22, 2020, notice of which was given by publication on the Board’s website at https://mbon.maryland.gov/Pages/default.aspx, pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to comply with the federal standards under Title VIII of the Public Health Services Act and maintain recognition by the United States Department of Education as a reliable authority on the quality of nursing education. These amendments are designed to clarify, reorganize, eliminate, and streamline existing language in order to reduce regulatory uncertainty and the overall regulatory burden on nursing education programs in Maryland.

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 Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) [“Approved”] Approval” means the status granted to a nursing education program that:

(a)—(b) (text unchanged)

(2) “Articulation” means the process by which a registered nurse or licensed practical nurse who is enrolled in a nursing education program is given credit for previous nursing education.

[(2)] (3) (text unchanged)

[(3)] (4) “Board-recognized nursing accreditation agency (BRNAA)” means a national or regional nursing education accreditation agency recognized by the:

(a)—(b) (text unchanged)

[(4)] (5) (text unchanged)

[(5)] (6) “Clinical nurse faculty” means an individual with at least a baccalaureate degree in nursing who is employed by the program solely for clinical learning of nursing students.

[(6)] (7) “Clinical preceptor” means a registered nurse employee of a cooperating clinical agency acting to facilitate and supervise student learning in a manner specified in a signed written agreement between the cooperating clinical agency and the educational institution.  

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

[(8)] (9) [“Conditionally approved”] Conditional approval” means a [program] limited-time status that:

(a) [Has] Is imposed by the Board if the Board finds evidence that the program has failed to meet or maintain the regulations or requirements, or both, set by the Board; and

(b) [Is approved] Allows the program to continue to operate subject to the [school or] program conforming to the Board’s requirements and recommendations within a time period set by the Board.

[(9)] (10) (text unchanged)

[(10)] (11) “Cooperating clinical agency” means an agency that provides the facilities and clinical resources for clinical learning experiences in nursing, with the nurse faculty or the clinical [instructor] nurse faculty of the program responsible for the planning, [implementing] implementation, and [evaluating] evaluation of these experiences.

[(11)] (12) (text unchanged)

[(12) “Faculty” means an individual with a graduate degree in nursing who is employed to teach full or part time in a nursing education program.]

(13) (text unchanged)

(14) “Generic student” means one who enters at the beginning of the nursing education program and plans to complete the entire curriculum.

[(14)] (15) “Initial approval” means [a newly established school or program that:

(a) Complies with the regulations of the Board; and

(b) Has not graduated its first class] the approval period from the first admission of nursing students to the program through the first full implementation of the curriculum and graduation.

[(15)] (16)—[18] (19) (text unchanged)

(20) “Nurse faculty” means an individual with a graduate degree in nursing who is employed to teach full-time or part-time in a nursing education program.

[(19)] (21) Program.

(a) “Program” means a [school or program of] registered nursing or licensed practical nursing educational program.

(b) “Program” includes any of the following:

(i) A college;

(ii) A school;

(iii) A division;

(iv) A department;

(v) An academic unit; or

(vi) A program.

[(20) “Recommendation” means a condition with which a school may elect to comply.]

(22) “Regional nursing education accrediting agency” means an accrediting agency that operates in a specific geographic region of the United States and accredits post-secondary institutions and primary and secondary schools.

[(21)] (23) (text unchanged)

[(22)] (24) “Requirement” means a mandatory condition that a [school or] program meets:

(a) For the [school] program to be approved; and

(b) To ensure that graduates of the [school or] program are eligible to take the NCLEX-RN® and NCLEX-PN®.

[(23)] (25) (text unchanged)

(26) “Transfer student” means a student who is permitted to apply nursing courses completed at another institution to a nursing education program of study.

[(24)] (27) (text unchanged)

.02 Approval of Programs Accredited by a Board-Recognized Nursing Accreditation Agency.

A.—C. (text unchanged)

[D. The Board and the BRNAA may make concurrent visits.]

[E.] D.—[G.] F. (text unchanged) 

[H.] G. On a [regular] periodic basis, the Board shall compare its regulations to those of the BRNAA and the USDOE to ensure that the Board standards for programs are being met.

[I.] H. (text unchanged)

.03 Board Approval of Nonaccredited Programs.

A. (text unchanged)

B. In institutions having both a licensed practical nursing education program and a registered nursing education program and when only one of the programs is accredited by a BRNAA:

(1) [The] Except as otherwise provided in Regulation .18 of this chapter, the Board and the BRNAA shall conduct concurrent visits; and

(2) (text unchanged)

C. (text unchanged)

.05 Administration and Organization.

A. The controlling institution shall:

(1) Be accredited by the appropriate national or regional accrediting agency; and

(2) (text unchanged)

B. (text unchanged)

C. The program shall have comparable status with other academic units within the controlling institution.

D. The controlling institution shall provide the financial support and resources needed to operate a program which:

(1) Meets the [legal and educational] requirements of the Board; and

(2) (text unchanged)

E.—F. (text unchanged)

G. When the nursing program administrator changes, the administrative officer of the controlling institution shall submit written notification to the Board of the change indicating that the new program administrator meets the Board’s requirements.

.08 Nurse Faculty and Clinical [Instructors] Nurse Faculty.

A. Qualifications of Nurse Faculty.

(1)—(2) (text unchanged)

(3) Non-nurse faculty, or nurses not meeting the requirements for nurse faculty, may teach selected portions of the nursing curriculum that relate to their areas of expertise.

B. Waiver of Graduate Degree in Nursing Requirement for Nursing Faculty.

(1) (text unchanged)

(2) The petition for a waiver of the graduate degree in nursing shall include documentation that the institution has attempted to hire nurse faculty with graduate degrees and a summary of those efforts.

(3) The petition in §B(1) of this regulation shall include documentation verifying that the nurse faculty applicant for whom the waiver is requested has:

(a)—(b) (text unchanged)

(4) If the graduate degree in nursing is waived by the Board:

(a) The nurse faculty member for whom a waiver has been granted shall complete a minimum of 9 graduate credits in nursing within 24 months of the issuance of the waiver; and

(b) The program shall [document] submit documentation to the Board of completion of the required credits [to the Board] by the nurse faculty member within 24 months of the date when the waiver was granted.

(5) If the nurse faculty member fails to complete the 9 graduate credits required in nursing within 24 months of the granting of the waiver, the Board may withdraw the waiver.

(6) If the waiver has been withdrawn, the program shall require that the nurse faculty member cease functioning as nurse faculty. If the program fails to do so, the Board may take action under Regulation .17 of this chapter.

(7) Once the nurse faculty member for whom the waiver was granted has met the 9 graduate credit waiver requirements, that nurse faculty member is considered to have met the educational requirements of §A(2) of this regulation.

(8) The Board shall grant a waiver for a nurse faculty member:

(a) (text unchanged)

(b) Who is within a semester of graduation [from] with a graduate degree in nursing.

C. Qualifications of Clinical Nurse Faculty.

(1) (text unchanged)

(2) A program may not, in any academic year, fill more than 25 percent of the program’s full-time nurse faculty equivalent positions with clinical nurse faculty whose highest nursing degree is at the baccalaureate level.

D. Responsibilities of Nurse Faculty and Clinical Nurse Faculty.

(1) Responsibilities of the nurse faculty include participation in the planning, [implementing] implementation, [evaluating] evaluation, and [revising] revision of the educational program.

(2) [Faculty] Nurse faculty shall:

(a)—(c) (text unchanged)

(d) Maintain clinical skills in the nurse faculty’s area of responsibility;

(e) (text unchanged)

(f) Participate in the recruitment, selection, and promotion of nurse faculty and the recruitment and selection of clinical nurse faculty;

(g) Participate in peer evaluation of nurse faculty and clinical nurse faculty performance; and

(h) (text unchanged)

(3) Clinical nurse faculty shall:

(a) (text unchanged)

(b) Evaluate student performance in clinical learning experiences.

.09 Faculty Policies.

A. There shall be written personnel policies for [nursing] nurse faculty and clinical [instructors] nurse faculty that [are in keeping with] conform to accepted educational standards.

B. (text unchanged)

.11 Faculty Development and Evaluation.

A. There shall be a formal plan for orientation of new nurse faculty and clinical [instructors] nurse faculty.

B. A program of faculty development shall be offered to encourage and assist nurse faculty members and clinical [instructors] nurse faculty in their professional growth and development.

C. A variety of means shall be used to evaluate nurse faculty and clinical [instructors’] nurse faculty’s effectiveness of teaching within the classroom and clinical setting.

.12 Resources, Facilities, and Services.

A.—C. (text unchanged)

D. [Clinical Facilities] Cooperating Clinical Agencies.

(1) The appropriate authorities shall approve cooperating clinical agencies and all facilities used for clinical learning experiences.

(2) (text unchanged)

(3) [Clinical] Cooperating clinical agencies shall meet the following requirements:

(a)—(d) (text unchanged)

E. Written Agreements.

(1) Written agreements between the program and the cooperating clinical agencies shall specify the responsibility of the program to the cooperating clinical agency and the responsibility of the cooperating clinical agency to the program.

(2) Written agreements shall:

(a) Be developed jointly with the cooperating clinical agency;

(b)—(c) (text unchanged)

.13 Curriculum.

A.—C. (text unchanged)

D. The curriculum of all programs shall:

(1) (text unchanged)

(2) Provide didactic and clinical learning experiences that are diverse and consistent with program objectives, outcomes, or competencies[:]; and

(3) Include:

(a)—(b) (text unchanged)

(c) Didactic and clinical instruction which includes, but is not limited to, the following areas:

(i) (text unchanged)

(ii) Preventive, rehabilitative, and curative aspects of health care; and

(iii) (text unchanged)

(d)—(i) (text unchanged)

E.—J. (text unchanged)

K. Evaluation methods and tools used for measuring students’ knowledge, skills, and abilities shall be developed and implemented in order to [assure] ensure satisfactory progression of students.

L. (text unchanged)

M. Clinical Preceptorships.

(1)—(2) (text unchanged)

(3) A bachelor’s degree in nursing is [preferred] recommended.

(4) Nothing in this section shall be construed to prohibit any cooperating clinical agency’s registered nurses from assisting with clinical activities selected by the program’s nurse faculty or clinical nurse faculty.

(5) The program’s nurse faculty or clinical nurse faculty may not be required to be in the cooperating clinical agency’s facilities but shall be immediately available by telephone.

.14 Students.

A. (text unchanged)

B. [It is recommended that students] Students shall have:

(1) Membership on selected faculty committees, as appropriate; and

(2) (text unchanged)

C. (text unchanged)

D. Each program shall have clearly defined written policies for the following:

(1) Admission of:

(a) Generic students;

(b) Transfer students; and

(c) Articulation;

(2) Oral and written English proficiency in reference to Health Occupations Article, §8-302(e), Annotated Code of Maryland, and COMAR 10.27.01.05;

(3) Withdrawals;

(4) Readmissions;

(5) Progression;

(6) Counseling and guidance;

(7) Representation on faculty governance;

(8) Graduation;

(9) Refund policies governing all fees and tuition paid by students; and

(10) Ethical practices for the performance of activities, including recruitment, admission, and advertising.

E. Each program shall have a written policy providing information to any student who may be subject to licensure denial under Health Occupations Article, §§8-308(c) and 8-316(a), Annotated Code of Maryland, and amendments applying to that citation. The information shall be provided before admission to the nursing education program.

.15 Program Evaluation.

A. The faculty shall develop and implement a Board-approved evaluation plan for evaluating the total nursing education program [at least 3 years] not less than:

(1) Every 10 years for programs that are accredited by a BRNAA; and

(2) 5 years for programs without BRNAA accreditation.

B. The evaluation plan shall include:

(1)—(2) (text unchanged)

(3) Student, graduate, faculty, cooperating clinical agencies, and administration participation;

(4) (text unchanged)

(5) Evidence that prior recommendations from the Board have been acted upon.

C.—D. (text unchanged)

[E. The Board shall review each program 3 years following a survey visit by means of an interim report submitted by the faculty of the program.

F. Following a review of the interim report, the Board shall:

(1) Determine if a survey visit is required at that time; or

(2) Approve the program for an additional 2 years.

G. The Board shall make a survey visit to a program not less than every 5 years.]

.16 Annual Review.

A. Annually, a program shall submit the following to the Board:

(1) An annual report on the form that the Board requires;

[(1)] (2)[(3)] (4) (text unchanged)

[(4)] (5) A summary of practices followed in safeguarding the health and well-being of students; [and]

(6) An audited fiscal report covering the previous 2 years, including a statement of income and expenditures; and

[(5)] (7) (text unchanged)

B. Annually, the Board shall:

(1) Review each program’s annual report, supporting documentation, and the licensure examination performance of first-time candidates from each program; [and]

(2) Notify each program achieving less than 90 percent of the national success rate[.]; and

(3) If necessary, conduct a survey or site visit, issue recommendations, place a program on conditional approval, or issue a formal notice of violation and withdraw approval in accordance with Regulation .17 of this chapter.

C. Approval may be reduced to conditional status for the following reasons:

(1) Noncompliance with this chapter;

(2) Failure to hire faculty who meet the qualifications as stated in Regulation .08 of this chapter;

(3) Noncompliance with the school’s stated philosophy, program design, objectives, or policies;

(4) Failure to submit records and reports to the Board in a timely manner;

(5) Failure to implement the approved curriculum;

(6) In accordance with §D of this regulation, failure to maintain the required passing rate on the licensing examination by first-time candidates;

(7) Failure to annually document that all faculty have current licenses; and

(8) Other activities or situations, as determined by the Board, that indicate a program is in jeopardy of violating statutory and regulatory requirements and standards.

[C.] D. Unacceptable Performance on Licensure Examination.

(1) The Board shall issue a warning to a program when the pass rate of first-time candidates does not comply with [§B] §B(2) of this regulation.

(2) For the first year a program does not meet the requirements of [§B] §B(2) of this regulation and following the warning in [§C(1)] §D(1) of this regulation, the program shall, within 30 calendar days, provide to the Board:

(a)—(b) (text unchanged)

(3) Second Successive Year Not in Compliance.

(a) For the second successive year that a program is not in compliance with [§B] §B(2) of this regulation, the program shall be placed on conditional approval and shall:

(i)—(ii) (text unchanged)

(b) The Board’s professional staff shall conduct a survey visit to the school and provide a report to the Board.

(4) If compliance with [§C(3) of this regulation] the minimum licensure examination performance standard for first-time candidates is not made by the program within 1 examination year from the date of conditional approval, approval may be withdrawn.

.17 Removal from Approved List.

A. Pursuant to Health Occupations Article, §8-404, Annotated Code of Maryland, at least 30 days before issuing a formal notice of violation of regulations to [an institution] a program, the Board shall notify the chief administrator of the controlling institution and the chief administrator of the nursing education program that the Board is considering issuing a formal notice of violation.

B. During the 30-day period, the Board shall provide the chief administrator of the controlling institution and the nursing education program with an opportunity to meet with representatives of the Board to discuss the Board’s proposed action against the [institution] program.

C.—F. (text unchanged)

G. Approval may be [reduced to conditional status or] withdrawn for the following reasons:

(1)—(5) (text unchanged)

(6) Failure to comply with the Board’s requirements [with] within the specified time [frame] frames;

(7)—(8) (text unchanged)

(9) Other activities or situations, as determined by the Board, that indicate a [school] program is not meeting [legal] statutory and regulatory requirements and standards.

H. (text unchanged)

.18 New Programs and Continuing Approval Requirements.

A. [Approval] New Program Requirements.

(1) An institution wishing to establish a nursing program shall submit to the Board:

(a) (text unchanged)

(b) Proof [of] that the institution is accredited by the appropriate national or regional [accreditation] accrediting agency;

(c)—(f) (text unchanged)

(2)—(4) (text unchanged)

B. [Approval Process] New Program Review.

(1) (text unchanged)

(2) The Board may:

(a)—(b) (text unchanged)

(c) Authorize a site visit by the Board’s professional staff and, following a report of the site visit by the Board’s professional staff, [approve] grant initial approval, defer action, or deny the request.

(3) (text unchanged)

C. (text unchanged)

D. [Full] Approval.

(1) Following graduation of the first class, the Board shall evaluate the [school or] program for [full] approval, considering the:

[(1)] (a) Report of a survey of the [school or] program by the Board’s professional staff, scheduled before graduation of the first class;

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

[(3)] (c) [Demonstrated] Program’s demonstrated continued ability to provide an educational program that meets the standards set by the Board.

(2) Upon review of the survey report, the results of graduate performance on the National Council Licensure Examination, and an assessment of the program’s continued ability to meet the standards set forth in this chapter, the Board may:

(a) Grant approval;

(b) Place the program on conditional approval; or

(c) Withdraw initial approval in accordance with Regulation .17 of this chapter.

(3) Approval, if granted, shall be valid for not more than:

(a) 10 years for a program accredited by a BRNAA; and

(b) 5 years for a program without BRNAA accreditation.

E. Reapproval Requirements.

(1) The Board shall evaluate a program for reapproval:

(a) Every 5 years if the program is without BRNAA accreditation; and

(b) Not more than 10 years after approval is granted if the program has BRNAA accreditation.

(2) Evaluation of continuing compliance shall include the submission of a self-study report by the program and a survey visit by the Board’s professional staff. The self-study report shall be submitted to the Board no less than one month prior to the survey visit.

(3) If the program is accredited by a BRNAA, the reapproval survey visit may be made in coordination with a BRNAA visit.

(4) Unscheduled survey or site visits may be conducted at the discretion of the Board.

(5) A program that is accredited by a BRNAA and is subsequently placed on warning or whose accreditation by the BRNAA is withdrawn shall be scheduled immediately for a survey visit.

(6) During each survey or site visit, the nurse administrator of the program shall make the following information available:

(a) Data about the program, including the following:

(i) The number of students;

(ii) The legal body responsible for policy and support of the program;

(iii) The organizational chart; and

(iv) An audited fiscal report covering the previous 2 years, including a statement of income and expenditures;

(b) The nurse administrator’s job description;

(c) For each faculty member and clinical preceptor, the following:

(i) Job descriptions;

(ii) Selection policies;

(iii) Orientation plan;

(iv) Faculty organization by-laws;

(v) Number of full-time and part-time faculty and non-nursing faculty with academic credentials and assignments; and

(vi) Faculty-student clinical ratio;

(d) Degree plan;

(e) A copy of the current curriculum and course catalog with the date of last revision;

(f) The testing process with test analysis and the written test procedure;

(g) A description of education facilities, including classrooms, offices, libraries, and computers;

(h) A list of clinical facilities and cooperating clinical agencies;

(i) The number of students by classes; and

(j) The policies for students as listed in Regulation .14D of this chapter.

(7) During each survey or site visit, the nurse administrator shall make available the following:

(a) The program’s administrators, faculty, support services personnel, and students;

(b) Staff members of selected cooperating clinical agencies;

(c) Faculty minutes for at least the previous 3 years;

(d) Faculty and student handbooks;

(e) Student records;

(f) Policies and procedures;

(g) Curriculum materials;

(h) Cooperating clinical agency contractual agreements;

(i) Program evaluation plan and evidence of program effectiveness; and

(j) The program’s current catalog.

(8) Upon review of the survey report and the results of graduate performance on the National Council Licensure Exam, and an assessment of the program’s continued ability to meet the standards set forth in this chapter, the Board may:

(a) Grant reapproval;

(b) Place the program on conditional approval; or

(c) Withdraw approval in accordance with Regulation .17 of this chapter.

(9) Reapproval, if granted, shall be valid for not more than:

(a) 10 years for a program accredited by a BRNAA; and

(b) 5 years for a program without BRNAA accreditation.

ROBERT R. NEALL
Secretary of Health

 

Subtitle 58 BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS

Notice of Proposed Action

[20-175-P]

The Secretary of Health proposes to:

(1) Amend Regulations .01—.04, repeal existing Regulations .05, .07, .09, and .10, and amend and recodify existing Regulations .06 and .08 to be Regulations .05 and .06, respectively, under COMAR 10.58.01 General Regulations; and

(2) Repeal existing Regulations .01—.08 under COMAR 10.58.12 Supervision Requirements and adopt new Regulations .01—.10 under COMAR 10.58.12 Licensed Clinical Professional Counselors — Requirements for Licensure.

This action was considered by the Board of Professional Counselors and Therapists at a public meeting held on October 18, 2019, notice of which was given by publication on the Board’s website at https://health.maryland.gov/bopc/Pages/index.aspx pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to:

(1) Reorganize and add clarifying language to COMAR 10.58.01 to make it applicable to all licenses, certificate holders, and alcohol and drug trainees;

(2) Repeal the existing chapter, COMAR 10.58.12, and replace it with a new chapter exclusively for licensed clinical and graduate professional counselors;

(3) Clarify certain procedures for the administrative processing of applications; and

(4) Remove from regulations the requirement that the Board issue paper licenses and certificates.

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 Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

 

10.58.01 General Regulations

Authority: Health Occupations Article, §§17-101, 17-205, 17-301, 17-304, 17-307, 17-308, and 17-509, Annotated Code of Maryland

.01 Scope.

This chapter [applies]:

A. Applies to graduate and clinical professional counselors, graduate and clinical marriage and family therapists, graduate and clinical art therapists, [and] graduate, clinical, and certified alcohol and drug counselors, and alcohol and drug trainees in Maryland[.]; and

B. Does not supersede the regulations set forth under:

(1) COMAR 10.58.07;

(2) COMAR 10.58.08;

(3) COMAR 10.58.12; and

(4) COMAR 10.58.17.

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

[(1) “Accredited institution of higher education” means a college or university accredited by a national or regional accrediting body recognized by the Council on Post-Secondary Accreditation.

(2) “Applicant” means an individual who has submitted a Board application and paid the application fee for certification or licensure.

(3) “Appraisal” means:

(a) Selecting, administering, scoring, and interpreting instruments designed to assess an individual’s aptitudes, attitudes, abilities, achievements, interests, and personal characteristics; and

(b) Using nonstandardized methods and techniques for understanding human behavior in relation to coping with, adapting to, or changing life situations.

(4) “Approved supervisor” means a licensed clinical professional counselor or other health care provider certified or licensed under the Health Occupations Article, Annotated Code of Maryland, as approved by the Board.

(5) “Board” means the State Board of Professional Counselors and Therapists.]

[(6)] (1)—[(7)] (2) (text unchanged)

[(8) “Counseling” means assisting an individual or group through the counseling relationship to:

(a) Develop an understanding of intrapersonal and interpersonal problems;

(b) Define goals;

(c) Make decisions;

(d) Plan a course of action reflecting the needs, interests, and abilities of the individual, family, or group; and

(e) Use informational and community resources as these procedures are related to personal, social, emotional, educational, and vocational development and adjustment.

(9) “Face-to-face client contact hour” means at least 45 minutes of direct session time with clients present.

(10) “Face-to-face clinical supervision hour” means at least 45 minutes of direct supervision time with the supervisee present.]

[(11)] (3) “License” means a license issued by the Board to practice:

(a)—(c) (text unchanged)

(d) Clinical professional art therapy (LCPAT);

[(d)] (e) Graduate alcohol and drug counseling (LGADC);

[(e)] (f) Graduate marriage and family therapy counseling (LGMFT); [or]

[(f)] (g) Graduate professional counseling (LGPC); or

(h) Graduate professional art therapy (LGPAT).

[(11-1) “Licensed graduate professional counselor” means an individual approved by the Board to practice graduate professional counseling under the supervision of an approved supervisor while fulfilling the supervised clinical experience for licensure under Health Occupations Article, §17-3A-02(h), Annotated Code of Maryland, and Regulation .05B(2) or (3) of this chapter.

(12) “National Board for Certified Counselors, Inc.” means the private testing agency which prepares an examination approved by the Board.

(13) “Nationally recognized certification agency” means a governmental or nongovernmental organization determined by the Board to be:

(a) Nationally recognized as having the expertise to set minimum standards for a particular area of specialization in the practice of professional counseling;

(b) Having a valid, reliable instrument for the evaluation of the training of persons seeking its recognition; and

(c) Having affiliates, certificants, members, or persons whom it officially recognizes as meeting its standards in at least 36 states, and whose members meet specified qualifications.

(14) “Practice clinical professional counseling” means to engage professionally and for compensation in professional counseling and appraisal activities by providing services involving the application of counseling principles and methods in the diagnosis, prevention, treatment, and amelioration of psychological problems, emotional conditions, or mental conditions of individuals or groups.

(15) “Practice of professional counseling” means to engage in counseling and appraisal activities for compensation.

(16) “Professional counselor” means an individual who practices professional counseling.

(17) “Psychotherapy” means providing clinical services which involve:

(a) The professional application of psychotherapy and counseling theories and methods in psychodynamic, cognitive, behavioral, humanistic, or systems theories to assist the client in:

(i) Improving functioning;

(ii) Obtaining symptom relief;

(iii) Preventing psychosocial dysfunction; or

(iv) Changing personality;

(b) Situations in which the principle discourse involves:

(i) Diagnosis of psychopathology based on standard diagnostic criteria;

(ii) Psychotherapeutic treatment of mental disorders, emotional disorders, and adjustment reactions utilizing standard treatment modalities;

(iii) Childhood trauma and abuse;

(iv) Identifying and changing self-defeating patterns of behaving, thinking, feeling, believing, or interacting with others in systems;

(v) Developmental issues;

(vi) Personality development; or

(vii) Problems related to disorders of thinking, emotional suffering, addictions, behavior, or interpersonal dysfunctions; and

(c) Adjunctive psychotherapy areas such as:

(i) Creative arts counseling, such as visual arts, writing, music, texture, dance, movement, and drama;

(ii) Hypnotherapy;

(iii) Play therapy;

(iv) School guidance counseling;

(v) Career counseling;

(vi) Rehabilitation counseling;

(vii) Hospice and grief counseling;

(viii) Assessment and testing;

(ix) Crisis intervention; or

(x) Support therapy services including referral, intake assessment, leadership in self-help groups, supervision, consultation, treatment planning and file notes, or hospital rounds.

(18) “Related field” means a profession using counseling whose academic requirements include degree programs from an accredited college or university that has curricula in areas such as gerontology, human services, marriage and family therapy, mental health, pastoral counseling, psychology, psychotherapy, social work, and other areas approved by the Board.

(19) “Supervised clinical experience in professional counseling” means counseling services conducted under the supervision of an approved supervisor.

(20) “Under the supervision of an approved supervisor” means engaging in an ongoing process of receiving direction from an approved supervisor that includes:

(a) Monitoring the performance of a trainee; and

(b) Documented and direct consultation, guidance, and instruction with respect to clinical skill and competency.

(21) “Workshop” means a meeting or meetings of general sessions and face-to-face groups with a leader, an expert in the defined content area, who imparts information to participants who have an ample opportunity to interact.]

.03 General.

A. Unless certified, [or] licensed, or granted trainee status by the Board, an individual may not use:

[(1) Certified professional counselor (CPC);

(2) Certified professional counselor — marriage and family therapist (CPC—MFT);

(3) Certified professional counselor — alcohol and drug (CPC—AD);

(4) Certified associate counselor — alcohol and drug (CAC—AD);

(5) Certified supervised counselor — alcohol and drug (CSC—AD);

(6) Licensed clinical alcohol and drug counselor (LCADC);

(7) Licensed clinical marriage and family therapist (LCMFT);

(8) Licensed clinical professional art therapist (LCPAT);

(9) Licensed clinical professional counselor (LCPC);

(10) Licensed graduate alcohol and drug counselor (LGADC);

(11) Licensed graduate professional art therapist (LGPAT);

(12) Licensed graduate marriage and family therapist (LGMFT); or

(13) Licensed graduate professional counselor (LGPC);]

[A.] (1) [Use the] The title alcohol and drug trainee (ADT)[:]; or

(2) Any other:

(a) Title;

(b) Initials;

(c) Abbreviations;

(d) Representation; or

(e) Description as specified under Health Occupations Article, §§17-601—17-603, Annotated Code of Maryland.

B. [Use the initials CPC, CPC—MFT, CPC—AD, CAC—AD, CSC—AD, LCADC, LCMFT, LCPAT, LCPC, LGADC, LGPAT, LGMFT, or LGPC after the name of the individual; or] An individual who violates this regulation may be subject to sanctions pursuant to Health Occupations Article, §§17-513 and 17-604, Annotated Code of Maryland.

[C. Represent to the public that the individual is a:

(1) Certified professional counselor (CPC);

(2) Certified professional counselor — marriage and family therapist (CPC—MFT);

(3) Certified professional counselor — alcohol and drug (CPC—AD);

(4) Certified associate counselor — alcohol and drug (CAC—AD);

(5) Certified supervised counselor — alcohol and drug (CSC—AD);

(6) Licensed clinical alcohol and drug counselor (LCADC);

(7) Licensed clinical marriage and family therapist (LCMFT);

(8) Licensed clinical professional art therapist (LCPAT);

(9) Licensed clinical professional counselor (LCPC);

(10) Licensed graduate alcohol and drug counselor (LGADC);

(11) Licensed graduate professional art therapist (LGPAT);

(12) Licensed graduate marriage and family therapist (LGMFT); or

(13) Licensed graduate professional counselor (LGPC).]

.04 Application Process.

A. In order to obtain a certificate or license, [a person] an applicant shall:

(1) Complete and return the [Board] Board-approved application;

(2) Submit an official transcript from [the] an accredited educational institution awarding the highest degree attained in counseling or a related field;

(3) Pay [the application fee] all applicable fees set forth in COMAR 10.58.02; [and]

(4) Provide at least three references from persons familiar with the work of the applicant[.];

(5) Submit to a criminal history background check in accordance with Health Occupations Article, §17-501.1, Annotated Code of Maryland;

(6) Be of good moral character; and

(7) Be at least 18 years old.

B. [The closing date for acceptance of applications shall be 10 weeks before the respective examination date.] Applications shall be acted upon as follows:

(1) Within 30 days after receipt of an application, the Board shall determine whether the application is complete;

(2) If the Board determines that the application is not complete, the Board shall send a notice of deficiency to the applicant;

(3) Upon receipt of the notice, the applicant shall correct the deficiency within 90 days, or other period specified in the notice;

(4) If the applicant fails to correct the deficiency within the required period, the application may lapse and the applicant shall be required to:

(a) Submit a new application; and

(b) Pay the nonrefundable fee set forth in COMAR 10.58.02;

(5) If the Board determines that an applicant is eligible to take the required examinations, the Board shall send a notice of approval to the applicant;

(6) Upon receipt of the approval notice, the applicant shall have 1 year from the date of the notice to take the examinations; and

(7) If the applicant fails to take the examinations within 1 year from the date of the approval notice, the requirements set forth under §B(4) of this regulation shall apply.

[C. At least 30 days before the next scheduled examination, the Board shall notify the applicant whether the applicant qualifies to sit for the examination.

D. An applicant who fails to appear for examination without prior notification shall forfeit the examination fee.

E. Upon receiving notification under §C of this regulation, an applicant shall complete and return to the Board a form indicating intent to take an examination given by the Board or its designee.

F. The Board shall announce the location of each examination.]

[.06] .05 Reexamination.

An applicant who fails an examination for certification or licensure [may take a reexamination.]:

A. May retake the exam if:

(1) It is within the time frame set by the applicable testing authority; or

(2) A waiver is approved by the Board to extend the testing deadline upon proof of exceptional circumstances; or

B. Shall be required to:

(1) Submit a new application; and

(2) Pay the nonrefundable fee set forth in COMAR 10.58.02.

[.08] .06 Certification and Licensure.

A. The Board shall [present]:

(1) Issue a certificate or license [with an assigned serial] number to an applicant who has met the requirements [of this chapter or COMAR 10.58.07 or 10.58.08] as set forth under this subtitle; and

(2) Provide licensure, certification, or trainee status verification:

(a) On the Board’s website; and

(b) From the Board’s office.

[B. The Board shall maintain official files which include assigned serial numbers.

C. The Board shall include the full name of the certificate holder or the licensee in addition to the assigned serial number on the certificate or license. The presiding Chairperson and the Secretary of the Board shall sign the certificate or license.

D. The certificate holder or the licensee shall display the certificate or license at the certificate holder’s or licensee’s principal place of practice.

E. While the certificate is in effect, the certificate authorizes the person to whom the certificate is issued to be called a certified professional counselor, certified professional counselor—marriage and family therapist (CPC — MFT), certified associate counselor—alcohol and drug (CAC—AD), certified professional counselor—alcohol and drug (CPC—AD), or certified supervised counselor—alcohol and drug (CSC—AD).

F. While the license is in effect, the license authorizes the person to whom the license is issued to be called a licensed clinical professional counselor (LCPC), licensed clinical alcohol and drug counselor (LCADC), or licensed clinical marriage and family therapist (LCMFT).

G. Upon the written request of a certificate holder or licensee whose certificate or license has been lost, destroyed, or mutilated, and the payment of the certificate or license replacement fee established in COMAR 10.58.02, the Board shall issue a replacement certificate or license bearing the same serial number previously issued.]

B. Renewal — Certified Professional Counselor.

(1) To renew as a certified professional counselor, the applicant shall:

(a) Complete a Board-approved renewal application;

(b) Pay the required application fee set forth in COMAR 10.58.02; and

(c) Attest to completion of continuing education activities as specified in COMAR 10.58.05.05 and .06.

(2) The Board may not:

(a) Renew the certification of any certified professional counselor who fails to complete all requirements for renewal before the expiration date of the current certification; or

(b) Reinstate the certification of a certified professional counselor who has failed to renew for any reason.

 

10.58.12 Licensed Clinical Professional Counselors — Requirements for Licensure

Authority: Health Occupations Article, §§17-101, 17-205, 17-301, 17-304, 17-307, 17-308, and 17-509, Annotated Code of Maryland

.01 Scope.

This chapter:

A. Establishes the requirements for an individual to practice clinical professional counseling;

B. Establishes standards of supervision and the responsibilities of supervisors and supervisees in the practice of clinical professional counseling;

C. Applies to licensees who:

(1) Practice clinical professional counseling; and

(2) Provide supervision for licensed graduate professional counseling; and

D. Applies to licensed graduate professional counselors who are in the process of obtaining the supervised clinical experience required by Health Occupations Article, §17-304.1, Annotated Code of Maryland.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Accredited educational institution” means a Board-approved college or university accredited by a national or regional accrediting body recognized by the Council on Post-Secondary Accreditation or through one of the following bodies recognized by the U.S. Department of Education:

(a) The Middle States Association of Colleges and Schools — the Commission on Higher Education;

(b) The New England Association of Schools and Colleges;

(c) The North Central Association of Schools and Colleges;

(d) The Northwest Association of Schools and of Colleges and Universities;

(e) The Southern Association of Colleges and Schools; or

(f) The Western Association of Colleges and Schools.

(2) “Appraisal” means:

(a) Selecting, administering, scoring, and interpreting instruments designed to assess an individual’s aptitudes, attitudes, abilities, achievements, interests, and personal characteristics; and

(b) Using nonstandardized methods and techniques for understanding human behavior in relation to coping with, adapting to, or changing life situations.

(3) “Board-approved supervisor” means:

(a) A licensed clinical professional counselor, licensed clinical marriage and family therapist, licensed clinical professional art therapist, or licensed clinical alcohol and drug counselor who meets the requirements for licensure under this chapter, and has been approved by the Board; or

(b) An individual who is authorized by law to practice a health occupation, which includes the diagnosis, prevention, treatment, and amelioration of psychological problems and emotional or mental conditions of individuals or groups, and has been approved by the Board.

(4) “Client contact hour” means at least 45 minutes of direct session time with a client present.

(5) “Clinical supervision hour” means at least 45 minutes of direct supervision time with the supervisee present.

(6) “Direct clinical counseling services” means the provision of face-to-face clinical professional counseling services to clients and their significant others that includes, but is not limited to the following:

(a) Individual counseling;

(b) Group counseling;

(c) Family counseling;

(d) Couples counseling;

(e) Evaluation;

(f) Intake or Assessment;

(g) Diagnosis;

(h) Treatment planning with a client; and

(i) Crisis management or intervention.

(7) Face-to-Face.

(a) “Face-to-face” means in the physical presence of an individual or using video conferencing which allows individuals to hear and see each other in synchronous points of time.

(b) “Face-to-face” does not include:

(i) Telephone communication; or

(ii) Internet communication that does not involve synchronous video conferencing, such as instant messaging services and social networking sites.

(8) “Indirect clinical counseling services” means all case management and professional development activities related to the provision of clinical professional counseling services to a client that include, but are not limited to, the following:

(a) Referral;

(b) Intake or assessment by telephone or other means when client is not face-to-face;

(c) Receiving individual and group supervision at site or at the university;

(d) Consultation with other professionals;

(e) Treatment planning with other professionals;

(f) Case staffing;

(g) Staff meetings;

(h) Related trainings and seminars;

(i) Record keeping;

(j) Report writing;

(k) Case note taking;

(l) Providing clinical training;

(m) Telephone triage;

(n) Case management;

(o) Program development; and

(p) Other clinical professional counselor administrative duties as required by the setting in which the clinical hours are accrued.

(9) “Licensed clinical professional counselor” means an individual approved by the Board to practice clinical professional counseling.

(10) “Licensed graduate professional counselor” means an individual approved by the Board to practice graduate professional counseling:

(a) Under the supervision of a Board-approved supervisor; and

(b) While fulfilling the supervised clinical experience for licensure under:

(i) Health Occupations Article, §17-304, Annotated Code of Maryland; and

(ii) Regulation .04 of this chapter.

(11) “Practice clinical professional counseling” means:

(a) To engage professionally and for compensation in clinical professional counseling and appraisal activities by providing services involving the application of clinical professional counseling principles and methods in the diagnosis, crisis management, prevention, treatment, and amelioration of psychological problems, and emotional or mental conditions of individuals or groups; and

(b) The use of instruments that require specialized psychological training for administration and interpretation as described in Health Occupations Article, §17-310, Annotated Code of Maryland.

(12) “Practice graduate professional counseling” means to practice clinical professional counseling:

(a) Under the supervision of a Board-approved supervisor; and

(b) While fulfilling the requirements for supervised experience under:

(i) Health Occupations Article, §17-304, Annotated Code of Maryland; and

(ii) Regulation .04 of this chapter.

(13) “Psychotherapy” means providing clinical services which involve:

(a) The professional application of psychotherapy and counseling theories and methods, including but not limited to psychodynamic, cognitive, behavioral, humanistic, systems theories, or trauma informed care to assist the client in:

(i) Improving functioning;

(ii) Obtaining symptom relief;

(iii) Preventing psychosocial dysfunction;

(iv) Changing personality; or

(v) Maintaining improved functioning; and

(b) Situations in which the principal discourse involves, but is not limited to:

(i) Diagnosis of psychopathology based on standard diagnostic criteria;

(ii) Psychotherapeutic treatment of mental disorders, emotional disorders, and adjustment reactions utilizing clinically appropriate treatment modalities;

(iii) Childhood trauma and abuse;

(iv) Identifying and changing self-defeating patterns of behaving, thinking, feeling, believing, or interacting with others in systems;

(v) Developmental issues;

(vi) Personality development; or

(vii) Problems related to disorders of thinking, emotional suffering, addictions, behavior, or interpersonal dysfunctions.

(14) “Related field” means a profession using counseling whose academic requirements include degree programs from an accredited college or university that has curricula in areas such as expressive therapy, gerontology, human services, marriage and family therapy, mental health, pastoral counseling, psychology, psychotherapy, social work, and other areas approved by the Board.

(15) “Relative” means an individual connected to another by:

(a) Blood;

(b) Marriage;

(c) Guardianship; or

(d) Domestic partnership.

(16) “Supervised clinical experience in clinical professional counseling” means counseling services conducted under the supervision of a Board-approved supervisor.

(17) “Supervisee” means a licensed graduate professional counselor obtaining the supervised experience required by Health Occupations Article, §17-304, Annotated Code of Maryland.

(18) “Supervision” means a formalized professional relationship between a supervisor and supervisee in which the supervisor directs, guides, monitors, instructs, and evaluates the supervisee’s clinical professional counseling practice while promoting development of the supervisee’s knowledge, skills, and abilities to provide clinical professional counseling services in an ethical and competent manner and includes an acceptance of direct responsibility for the client services rendered by the supervisee.

(19) Supervision Training.

(a) “Supervision training” means a course or program designed to provide information regarding the clinical supervision process utilized by licensed clinical professional counselors in a variety of settings.

(b) “Supervision training”  includes training obtained through:

(i) Graduate-level course work;

(ii) Continuing education units (CEUs); or

(iii) Other training hours approved by the Board.

(20) “Under the supervision of a Board-approved supervisor” means engaging in an ongoing process of receiving direction from a Board-approved supervisor that includes:

(a) Monitoring the performance of a supervisee; and

(b) Documented and direct consultation, guidance, and instruction with respect to clinical skill and competency.

(21) “Written contract for supervision” means a Board-approved agreement between the supervisee and approved supervisor that is initiated before beginning supervision and that details the scope of supervision and includes at a minimum the following:

(a) Name and credentials of the supervisor and the supervisee;

(b) Primary purpose, goals, and objectives of the supervision process;

(c) Details of provisions, including frequency, format, and case or chart review;

(d) Methods of documentation;

(e) Duties and responsibilities of the supervisor and the supervisee;

(f) Procedural considerations in the case of the supervisor’s absence; and

(g) Information regarding the supervisor’s scope of competence.

.03 Application Process for Licensure.

A. In order to obtain a license, an applicant shall:

(1) Complete and return the Board-approved application;

(2) Submit an official transcript from an accredited educational institution awarding the highest degree attained in a clinical professional counseling or related field;

(3) Pay all applicable fees set forth in COMAR 10.58.02;

(4) Submit to a criminal history background check in accordance with Health Occupations Article, §17-501.1, Annotated Code of Maryland;

(5) Be of good moral character; and

(6) Be at least 18 years old.

B. Applications shall be acted upon as follows:

(1) Within 30 days after receipt of an application, the Board shall determine whether the application is complete;

(2) If the Board determines that the application is not complete, the Board shall send a notice of deficiency to the applicant;

(3) Upon receipt of the notice, the applicant shall correct the deficiency within 90 days, or other period specified in the notice;

(4) If the applicant fails to correct the deficiency within the required period, the application may lapse and the applicant shall be required to:

(a) Submit a new application; and

(b) Pay the nonrefundable fee set forth in COMAR 10.58.02;

(5) If the Board determines that an applicant is eligible to take the required examinations, the Board shall send a notice of approval to the applicant;

(6) Upon receipt of the approval notice, the applicant shall have 1 year from the date of the notice to take the examinations; and

(7) If the applicant fails to take the examinations within 1 year from the date of the approval notice, the requirements set forth under §B(4) of this regulation shall apply.

.04 Licensed Graduate Professional Counselors.

A. To qualify for licensure as a graduate professional counselor, an applicant shall have:

(1) Completed one of the following from an accredited educational institution:

(a) A master’s degree in a clinical professional counseling or related field with:

(i) A minimum of 60 graduate semester credit hours, or, if the master’s program provides less than 60 graduate semester credit hours, requirements may be met by completing additional graduate courses as approved by the Board; or

(ii) 90 graduate quarter credit hours; or

(b) A doctoral degree in a clinical professional counseling or related field with:

(i) A minimum of 90 graduate semester credit hours; or

(ii) 135 graduate quarter credit hours;

(2) Completed a minimum of 3 semester credit hours or the equivalent quarter credit hours of course work in each of the following course content areas:

(a) Human growth and personality development;

(b) Social and cultural foundations of counseling;

(c) Counseling theory;

(d) Counseling techniques;

(e) Group dynamics, processing, and counseling;

(f) Lifestyle and career development;

(g) Appraisal;

(h) Research and evaluation;

(i) Professional, legal, and ethical responsibilities;

(j) Marriage and family therapy;

(k) Supervised field experience that includes a:

(i) Supervised clinical internship, externship, field experience, or practicum placement; and

(ii) Minimum of 125 direct clinical counseling service hours;

(l) Alcohol and drug counseling;

(m) Psychopathology; and

(n) Diagnosis and treatment of mental and emotional disorders;

(3) Achieved a passing score on:

(a) A national certification exam approved by the Board; and

(b) An examination of:

(i) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(ii) This subtitle;

(4) Met all of the requirements set forth under Regulation .03 of this chapter; and

(5) Complied with:

(a) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(b) The code of ethics as set forth in COMAR 10.58.03.

B. An applicant who fails an examination for licensure:

(1) May retake the exam if:

(a) It is within the time frame set by the applicable testing authority; or

(b) A waiver is approved by the Board to extend the testing deadline upon proof of exceptional circumstances; or

(2) Shall be required to:

(a) Submit a new application; and

(b) Pay the nonrefundable fee set forth in COMAR 10.58.02.

C. The Board shall act upon applications as set forth under Regulation .03B of this chapter.

D. A licensed graduate professional counselor shall practice clinical professional counseling under the supervision of a Board-approved supervisor.

E. A licensed graduate professional counselor may not:

(1) Practice independent of supervision; or

(2) Provide supervision.

F. Expiration and Extension.

(1) The graduate professional counselor license expires 2 years after the date issued.

(2) If the graduate professional counselor licensee is unable to accumulate the required clinical hours for licensure as a clinical professional counselor in 2 years, the graduate professional counselor may apply on a Board-approved form for a 2-year extension before the current license expiration, up to a maximum of 6 years, except as provided in §F(4) of this regulation.

(3) For a graduate professional counselor who has been granted a 2-year extension, CEUs are not required for the first 2-year extension. Subsequent extensions approved by the Board shall be subject to the continuing education requirements in COMAR 10.58.05.

(4) A graduate professional counselor shall submit a written request for an extension beyond the 6-year maximum, which the Board may grant in certain circumstances.

G. Reinstatement.

(1) Within 5 calendar years after the license renewal date, the Board may reinstate the license of a licensed graduate professional counselor otherwise entitled to reinstatement under Health Occupations Article, §17-505(b), Annotated Code of Maryland, whose license was not renewed for any reason, if the licensee:

(a) Completes within that 5-year period the minimum of 20 CEUs required for each year; and

(b) Pays the reinstatement fee set by the Board in COMAR 10.58.02.

(2) CEUs which are acquired in order to reinstate under COMAR 10.58.05.05 and.06 may be credited only once and may not be credited for any future renewals.

(3) For any licensed graduate professional counselor whose license has expired more than 5 calendar years before the request for reinstatement, a new application for licensure shall be completed and the current licensure requirements shall be met.

(4) An individual who fails to reinstate licensure is not authorized to and may not practice graduate professional counseling.

.05 Licensed Clinical Professional Counselors.

A. To qualify for licensure as a clinical professional counselor the applicant shall have:

(1) A graduate professional counselor license or other credential approved by the Board;

(2) For an applicant holding a master’s degree, completed a minimum of 3 years and 3,000 hours of experience in clinical professional counseling, of which:

(a) A minimum of the 1,500 hours shall be direct clinical counseling services;

(b) A maximum of 1,500 hours may consist of indirect clinical counseling services;

(c) A minimum of 2,000 hours of supervised clinical experience as a licensed graduate professional counselor shall be completed after the awarding of the master’s degree under a Board-approved supervisor;

(d) A maximum of 1,000 hours of supervised clinical experience may be acquired as supervised field experience as defined under Regulation .04A(2)(k) of this chapter;

(e) At least half of the requisite direct and indirect hours included as supervised clinical experience hours shall be completed under the supervision of a Board-approved supervisor who is a licensed clinical professional counselor;

(f) No more than half of the requisite direct and indirect hours included as supervised clinical experience hours shall be completed under a Board-approved supervisor as defined in Regulation .02Bof this chapter; and

(g) 100 hours of face-to-face clinical supervision hours shall be completed within 2 years of the awarding of the master’s degree, of which:

(i) A minimum of 50 hours shall be individual face-to-face clinical supervision; and

(ii) A maximum of 50 hours may be face-to-face group clinical supervision;

(3) For an applicant holding a doctoral degree, completed a minimum of 2,000 hours of experience in clinical professional counseling, of which:

(a) A minimum of 1,000 hours shall be face-to-face direct clinical counseling services and a maximum of 1,000 hours may consist of indirect clinical counseling services;

(b) 1,000 hours shall be acquired after the doctoral degree has been awarded;

(c) A maximum of 1,000 hours of clinical experience may be acquired before the awarding of the doctoral degree;

(d) At least half of the requisite direct and indirect hours included as supervised clinical experience hours shall be completed under the supervision of a Board-approved supervisor who is a licensed clinical professional counselor;

(e) No more than half of the requisite direct and indirect hours included as supervised clinical experience hours shall be completed under a Board-approved supervisor as defined in Regulation .02Bof this chapter; and

(f) 50 hours of face-to-face clinical supervision hours shall be completed within 1 year of the awarding of the doctoral degree, including:

(i) 25 hours shall be individual face-to-face clinical supervision; and

(ii) A maximum of 25 hours may be face-to-face group clinical supervision;

(4) Completed the required course work set forth under Regulation .04A(2) of this chapter;

(5) Achieved a passing score on:

(a) A national certification exam approved by the Board; and

(b) An examination of:

(i) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(ii) This subtitle;

(6) Met all of the requirements set forth under Regulation .03 of this chapter; and

(7) Complied with:

(a) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(b) The code of ethics as set forth in COMAR 10.58.03.

B. An applicant who fails an examination for licensure:

(1) May retake the exam if:

(a) It is within the time frame set by the applicable testing authority; or

(b) A waiver is approved by the Board to extend the testing deadline upon proof of exceptional circumstances; or

(2) Shall be required to:

(a) Submit a new application; and

(b) Pay the nonrefundable fee set forth in COMAR 10.58.02.

C. The Board shall act upon applications as set forth under Regulation .03B of this chapter.

D. The Board may include hours of clinical supervised experience obtained in another jurisdiction toward the total 3,000 required hours of supervised experience required for the licensed clinical professional counselor, if the clinical experience hours:

(1) Were obtained in accordance with the rules and regulations of that jurisdiction; and

(2) Included the course work requirements set forth under Regulation .06D of this chapter.

E. Renewal.

(1) To renew a clinical professional counselor license, the applicant shall:

(a) Submit a completed Board-approved application;

(b) Pay the required application fee set forth in COMAR 10.58.02; and

(c) Attest to completion of continuing education activities as specified in COMAR 10.58.05.05 and .06.

(2) A licensed clinical professional counselor shall comply with the renewal requirements as provided in Health Occupations Article, §17–504, Annotated Code of Maryland.

(3) An individual who fails to renew licensure is not authorized to and may not practice clinical professional counseling.

F. Reinstatement.

(1) Within 5 calendar years after the license renewal date, the Board may reinstate the license of a licensed clinical professional counselor otherwise entitled to reinstatement under Health Occupations Article, §17-505(b), Annotated Code of Maryland, whose license was not renewed for any reason, if the licensee:

(a) Completes within that 5-year period the minimum of 20 CEUs required for each year; and

(b) Pays the reinstatement fee set by the Board in COMAR 10.58.02.

(2) CEUs which are acquired in order to reinstate under COMAR 10.58.05.05 and .06 may be credited only once and may not be credited for any future renewals.

(3) For any licensed clinical professional counselor whose license has expired more than 5 calendar years before the request for reinstatement, a new application for licensure shall be completed and the current licensure requirements shall be met.

(4) An individual who fails to reinstate licensure is not authorized to and may not practice clinical professional counseling.

G. Inactive Status.

(1) In accordance with Health Occupations Article, §17-505, Annotated Code of Maryland, a request to transfer a license to inactive status shall be granted upon receipt of the:

(a) Completed Board-approved application; and

(b) Payment of the required, nonrefundable, annual fee set forth in COMAR 10.58.02.

(2) An individual may apply for inactive status only if the individual’s license is still active at the time application for inactive status is made.

(3) An individual on inactive status is not authorized to and may not practice clinical professional counseling.

(4) Within 5 calendar years after being placed on inactive status, an individual seeking to be reinstated to active status shall be required, as a condition of reinstatement, to submit proof of having completed 20 CEUs for each year of inactive status, at least 40 of which shall have been obtained within the 2-year period immediately preceding the application for reinstatement.

(5) If an individual on inactive status seeks to be reinstated beyond the required 5-year period and conditions set forth under § G(4) of this regulation, the individual shall be required to:

(a) Submit a new application; and

(b) Pay the nonrefundable fee set forth in COMAR 10.58.02.

.06 Licensure Eligibility: Out-of-State Applicants.

A. An applicant licensed as a clinical professional counselor or its equivalent, as established by the Board, in another state, territory, or jurisdiction is eligible for licensure if the applicant:

(1) Provides:

(a) A completed Board-approved application;

(b) An official transcript from the educational institution which awarded the master’s or doctoral degree;

(c) A copy of a current license from each state, territory, or jurisdiction in which the applicant has been licensed, registered, or otherwise authorized to practice clinical professional counseling;

(d) Documentation, satisfactory to the Board, that the applicant is currently licensed in good standing to practice clinical professional counseling in another state, territory, or jurisdiction; and

(e) Verification that the applicant has:

(i) No history of disciplinary action, past or pending, in a state, territory, or jurisdiction in which the applicant holds a license to practice clinical professional counseling; and

(ii) Not committed any act or omission that would be grounds for discipline or denial of licensure under Health Occupations Article, §17-509, Annotated Code of Maryland;

(2) Pays the application fee set forth in the COMAR 10.58.02;

(3) Has achieved a passing score on:

(a) A national certification examination approved by the Board; and

(b) An examination of:

(i) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(ii) COMAR 10.58;

(4) Submits to a criminal history background check in accordance with Health Occupations Article, §17-501.1, Annotated Code of Maryland;

(5) Meets the educational requirements for licensure in this State as a clinical professional counselor:

(a) As established in Regulation .05 of this chapter; or

(b) By providing documentation of the substitute educational and experience requirements outlined in §§B—E of this regulation;

(6) Is of good moral character; and

(7) Complies with:

(a) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(b) The code of ethics as set forth in COMAR 10.58.03.

B. Waiver of Examination. The Board may waive any examination requirements for an applicant who satisfies the Board that the applicant:

(1) Obtained licensure in a state or country that grants a similar endorsement to licensees of this State;

(2) Became licensed in another state or country after passing an examination approved by the Board; and

(3) Meets the qualifications otherwise required by Health Occupations Article, Title 17, Annotated Code of Maryland, and this chapter.

C. Equivalent Educational Requirements. The applicant shall provide documentation or transcripts confirming completion of a master’s or doctoral degree in a professional counseling field from an accredited educational institution.

D. Waiver of Course Requirements. The Board may waive one or more course requirements specified in Regulation .04 of this chapter, except for documentation showing completion of a minimum of 3 graduate semester credit hours or the equivalent graduate quarter hours covering each of the following primary topics or content areas:

(1) Diagnosis and psychopathology;

(2) Psychotherapy and treatment of mental and emotional disorders, as described in Regulation .02Bof this chapter; and

(3) Professional, legal, and ethical responsibilities.

E. Equivalent Experience Requirements. The Board may waive the clinical experience requirements specified in Regulation .04 of this chapter as follows:

 

(1) The applicant shall provide documentation, satisfactory to the Board, of one of the following for an applicant with:

(a) A master’s degree consisting of:

(i) A minimum of 60 graduate credit hours; and

(ii) Not less than 3 years, with a minimum of 3,000 hours, of supervised clinical experience in clinical professional counseling, 2 years of which shall be completed after the award of the master’s degree;

(b) A master’s degree consisting of:

(i) Less than 60 graduate credit hours; and

(ii) Not less than 3 years’ experience practicing as a licensed clinical professional counselor, with a minimum of 3,000 hours of clinical professional counseling experience; or

(c) A doctoral degree consisting of:

(i) Not less than 2 years practicing as a clinical professional counselor; or

(ii) A minimum of 2,000 hours of clinical professional counseling experience; and

(2) The applicant shall provide verification, on a Board-approved form, from employers, supervisors, or colleagues that the applicant has practiced clinical professional counseling for the length of time stated in §E(1) of this regulation.

.07 Standards for Supervision.

A. Except as otherwise specified in this chapter, this chapter does not apply to personnel or management practices associated with contractual relationships or employment.

B. A supervisor shall:

(1) Supervise only in those areas within the supervisor’s competence as determined by education, training, and experience;

(2) Provide supervision appropriate to the particular level of licensure being applied for or maintained;

(3) Provide supervision in the general content areas established in Health Occupations Article, §17-304, Annotated Code of Maryland; and

(4) Ensure that a supervisee has read and is knowledgeable about:

(a) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(b) This subtitle, with special emphasis on the code of ethics under COMAR 10.58.03.

C. In addition to the requirements of §B of this regulation, the supervisor shall specifically instruct and provide guidance:

(1) Relating to the supervisee’s scope of practice of clinical professional counseling under Health Occupations Article, §17-101, Annotated Code of Maryland;

(2) For services involving the application of therapy principles and methods in the diagnosis, prevention, treatment, and amelioration of psychological problems, emotional conditions, or mental conditions of individuals, families, couples or groups, as stated in Health Occupations Article, §17-308, Annotated Code of Maryland; and

(3) To supervisees in appropriate billing practices, if applicable to the practice site, including:

(a) Record keeping;

(b) Disclosure of fees and financial arrangements; and

(c) Appropriate maintenance and destruction of clinical and financial records.

D. The following individuals may not provide clinical supervision for a licensed graduate professional counselor supervisee:

(1) A relative; or

(2) An individual with whom there could be a conflict of interest, including, but not limited to:

(a) An employee supervising their own employer; or

(b) A student supervising their own teacher.

.08 Supervisor Qualifications.

A. Licensure. An individual providing supervision shall be approved by the Board and licensed by the Board as a:

(1) Clinical professional counselor;

(2) Clinical professional art therapist;

(3) Clinical alcohol and drug counselor;

(4) Clinical marriage and family therapist; or

(5) Mental health care provider as defined in Regulation .02Bof this chapter.

B. Experience, Education, and Training.

(1) A Board-approved supervisor shall have completed 2 years of active clinical practice experience:

(a) In clinical professional counseling, marriage and family therapy, professional art therapy, or alcohol and drug counseling;

(b) As a clinical professional counselor, marriage and family therapist, professional art therapist, or alcohol and drug counselor licensed or certified in another state, territory or jurisdiction that has requirements that are equivalent to or exceed the requirements of Health Occupations Article, §§17-302—17-304.1, Annotated Code of Maryland; or

(c) As another licensed mental health care provider as defined in Regulation .02Bof this chapter.

(2) A Board-approved supervisor shall have completed one of the following education and training experiences:

(a) At least 3 graduate semester credit hours or the equivalent quarter credit hours of academic course work in clinical supervision;

(b) A Board-approved continuing education program that includes a minimum of 18 continuing education units (CEUs) in:

(i) Clinical professional counseling supervision; or

(ii) Another behavioral health profession that is authorized to diagnose and treat mental and emotional disorders;

(c) The National Board of Certified Counselors (NBCC) Approved Clinical Supervisor (ACS) credential; or

(d) Supervision training as defined in Regulation .02Bof this chapter.

(3) Supervision training required by this section may be obtained in a graduate course or a continuing education program as required under §B(2)(b) of this regulation that may include, but is not limited to:

(a) The role and responsibilities of the supervisor;

(b) The needs of the supervisee, supervisor, and the agency setting while maintaining a clear ethical perspective, including:

(i) The maintenance of appropriate boundaries; and

(ii) Making clinically appropriate diagnoses;

(c) The role of the supervisor as gatekeeper to the profession;

(d) Methods for building effective and appropriate relationships with clients;

(e) Models for group supervision; and

(f) Models and modalities for practice intervention.

C. Pre-Supervision Responsibilities of a Supervisor. In addition to meeting the requirements of this regulation, the Board-approved supervisor shall:

(1) File the completed Board-approved supervisor application form;

(2) Provide the supervisee with a copy of the Board’s licensed clinical professional counselor supervisor letter; and

(3) Have an active license that is without restrictions or conditions due to disciplinary action for the 2 years preceding an application for Board-approved supervisor status.

D. A supervisor may be:

(1) An agency-designated supervisor; or

(2) An independent supervisor in private practice.

.09 Supervisor Responsibilities.

A supervisor shall:

A. Agree to and sign a written contract for supervision before initiating supervision;

B. Ensure that the supervisee is practicing within the scope of the supervisee’s license;

C. Determine the skill level at which the supervisee may practice;

D. Focus on primary data from the supervisee’s practice;

E. Maintain documentation of supervisory sessions for at least 7 years, including:

(1) Dates;

(2) Duration; and

(3) Focus of the supervisory sessions;

 

F. Ensure that a supervisee has read and is knowledgeable about:

(1) Health Occupations Article, Title 17, Annotated Code of Maryland; and

(2) This subtitle with special emphasis on the code of ethics under COMAR 10.58.03;

G. Within a reasonable period of time before the conclusion of supervision, provide the supervisee and employer with a notice of termination to avoid or minimize any harmful effect on the supervisee’s clients or patients;

H. Be responsible for the clinical professional practices of supervisees;

I. Provide:

(1) For emergency supervision of and direction to a supervisee by a Board-approved supervisor;

(2) A written evaluation of progress to the supervisee on a regular basis or as needed; and

(3) A copy of the documentation required by §E of this regulation on request by the:

(a) Supervisee; or

(b) Board or its authorized agent; and

J. Comply with a Board audit of a Board-approved supervisor’s compliance with regard to the supervisory requirements and responsibilities.

.10 Supervisee Responsibilities.

A. A supervisee shall:

(1) Verify that the supervisor has been approved by the Board;

(2) Agree to and sign a Board-approved contract before initiating supervision;

(3) Attend and participate in supervision as agreed to in the supervision contract;

(4) Prepare for supervision using case materials related to the supervisee’s clinical professional counseling practice; 

(5) Maintain documentation of supervisory sessions for at least 7 years, to be available for verification to the Board or its authorized agent, including:

(a) Dates;

(b) Duration; and

(c) Focus of the supervision; and

(6) Follow all terms of the written contract for supervision.

B. A supervisee may not engage in the practice of clinical professional counseling independent of supervision.

C. A supervisee shall give the client a copy of a professional disclosure statement as described in Health Occupations Article, §17-507, Annotated Code of Maryland, that:

(1) Clearly states the counseling services are provided under clinical supervision; and

(2) Provides the name of the supervisor with address and contact information.

D. A supervisee shall obtain from the client a signed:

(1) Release of information; and

(2) Informed consent for treatment which indicates that the client:

(a) Is aware that counseling services are being provided under clinical supervision;

(b) Consents to the recording of counseling sessions with the knowledge that the recording may only be shared with the supervisor; and

(c) Consents to the sharing of client information between the licensed graduate professional counselor and the named clinical supervisor.

ROBERT R. NEALL
Secretary of Health

 

Subtitle 64 BOARD OF NURSING — LICENSED DIRECT-ENTRY MIDWIVES

10.64.02 Code of Ethics for Licensed Direct-Entry Midwives

Authority: Health Occupations Article, §§8-205(a)(1) and (2) and
8-6C-12(a)(7), Annotated Code of Maryland

Notice of Proposed Action

[20-174-P]

The Secretary of Health proposes to adopt new Regulations .01—.03 under a new chapter, COMAR 10.64.02 Code of Ethics for Licensed Direct-Entry Midwives. This action was considered by the Licensed Direct-Entry Midwife Advisory Committee at a public meeting held on October 12, 2018, and approved by the Board at its public meeting held on November 14, 2018, notice of which was given by publication on the Board’s website, https://mbon.maryland.gov/Pages/Direct-Entry-Midwife-Advisory-Committee.aspx, from January 1, 2018, through November 14, 2018, pursuant to General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to provide a Code of Ethics for Licensed Direct-Entry Midwives that will guide them in their practice, add additional regulatory requirements for safe practice, and provide a general framework for their ethical practice.

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 Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

.01 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Abandonment” means:

(a) The unilateral termination of the licensed direct-entry midwife-client relationship by the direct-entry midwife without reasonable notice;

(b) Failure of the licensed direct-entry midwife to:

(i) Provide the client with a referral to an appropriate health care professional; or

(ii) Make reasonable arrangements with an appropriate and qualified healthcare professional to assume care for the client; and

(c) Leaving a client in the intrapartum period without properly terminating care and ensuring adequate care for the mother and unborn child.

(2) “Board” means the Maryland Board of Nursing.

(3) “Client” means:

(a)  An individual for whom a licensed direct-entry midwife performs services; and

(b) The individual’s newborn for the purpose of perinatal or postpartum care.

(4) “Electronic devices” means, but is not limited to, any of the following:

(a) Telephones with recording and picture-taking ability;

(b) Digital cameras or any other device that can record pictures and data;

(c) Facsimile machines, photocopiers, and scanners for copying; and

(d) Recording devices.

(5) “Licensee” means a holder of a license issued by the Board to practice direct-entry midwifery in Maryland in accordance with Health Occupations Article, §8-6C-01, Annotated Code of Maryland.

(6) “Social media” means any form of electronic communication, including, but not limited to, communication by use of websites for social networking and blogging through which users create online communities to share information, ideas, personal messages, and other content such as videos.

.02 Ethical Responsibilities.

A. A licensed direct-entry midwife shall:

(1) Provide services with respect for human dignity and the uniqueness of a client unrestricted by consideration of social or economic status, religious affiliation, personal attributes, or the nature of health problems;

(2) Safeguard a client’s right to privacy by maintaining confidentiality of information;

(3) Act to safeguard a client and the public if health care and safety are affected by the incompetent, unethical, or illegal practice of any individual;

(4) Promptly report a breach of confidentiality or privacy;

(5) Assume responsibility and accountability for one’s judgments and actions while providing direct-entry midwifery services;

(6) Maintain competence in direct-entry midwifery;

(7) Exercise informed judgment and use individual competence and qualifications as criteria in seeking consultation, accepting responsibilities, and delegating direct-entry midwifery activities to others;

(8) Inform the Board regarding unethical conduct by another licensed direct-entry midwife;

(9) Provide information about fees upon request by a client;

(10) Notify the Board in writing within 30 days if any license, certificate, permit, or registration granted by another state or territory for the practice of direct-entry midwifery or certified professional midwifery is restricted, suspended, revoked, or subjected to other disciplinary action by a licensing or certifying authority; and

(11) Make a client’s record available to the client upon request, complying with all applicable State and federal laws and regulations governing disclosure of medical records.  

B. A licensed direct-entry midwife may not, when acting in the capacity or identity of a licensed direct-entry midwife:

(1) Knowingly participate in or condone dishonesty, fraud, deceit, or misrepresentation;

(2) Engage or participate in an action that violates or diminishes the civil or legal rights of a client;

(3) Perform new techniques and procedures without adequate education and practice;

(4) Assume duties and responsibilities in the practice of direct-entry midwifery without adequate preparation or without maintaining competency;

(5) Practice direct-entry midwifery if unfit to perform procedures or make decisions because of a physical or mental impairment including, but not limited to, a substance use disorder or the effects of prescription drugs;

(6) If engaged in research, coerce or pressure a subject to participate or continue to participate in the research;

(7) Knowingly or willfully destroy, damage, alter, obliterate, or otherwise obscure a medical record or billing record or other information about a client to conceal the information from use as evidence in an administrative, civil, or criminal proceeding; or

(8) Abandon a client.

C. A licensed direct-entry midwife may not engage in behavior that dishonors the profession, whether or not acting in the capacity or identity of a licensed direct-entry midwife, including, but not limited to:

(1) Verbal abuse, including use of racial or ethnic slurs, directed toward a client, client ‘s family member, coworker, employer, Board staff member, or third party;

(2) Physically abusing, threatening, or intimidating a client, client’s family member, coworker, employer, Board staff member, or third party;

(3) Deceiving, defrauding, or stealing from a client, client’s family member, coworker, employer, or third party;

(4) Diverting any medication or providing false or misleading information to an authorized prescriber or a pharmacist to obtain or attempt to obtain any medication;

(5) Performing acts beyond the authorized scope of practice for which the individual is licensed;

(6) Obtaining or copying any part of a client’s health record for purposes other than:

(a) Providing health care to the client;

(b) Conducting quality improvement activities;

(c) Complying with legal requirements such as a subpoena; or

(d) Allowing a direct-entry midwifery student to use records for educational purposes if client identification has been redacted or disguised;

(7) Using, possessing, supplying, administering, or attempting to use, possess, supply, or administer prescription drugs or controlled dangerous substances without valid medical indication;

(8) Reporting to work under the influence of alcohol or a controlled dangerous substance or submitting a pre-employment sample that is positive for alcohol or a controlled dangerous substance without having provided evidence of valid prescriptions for all controlled dangerous substances in the sample;

(9) Reporting to work under the influence of an illicit drug or submitting a pre-employment sample that is positive for an illicit drug;

(10) Using the power, influence, or knowledge inherent in or obtained during the direct-entry midwife-client relationship for the direct-entry midwife’s personal gratification or benefit;

(11) Engaging in unprofessional or immoral conduct;

(12) Misrepresenting or concealing a material fact in obtaining a license, renewing a license, or reinstating a license; or

(13) Committing an act of moral turpitude, dishonesty, or corruption when the act directly or indirectly affects the health, welfare, or safety of the citizens of this State, and, if the act constitutes a crime, conviction thereof in a criminal proceeding is not a condition precedent to disciplinary action.

D. A licensed direct-entry midwife may not engage in sexual misconduct. Sexual misconduct includes, but is not limited to:

(1) Sexual behavior with a client in the context of a professional evaluation, treatment, procedure, or service to the client, regardless of the setting in which the professional service is rendered;

(2) Sexual behavior with a client under the pretext of diagnostic or therapeutic intent or benefit;

(3) Solicitation of a sexual relationship, whether consensual or nonconsensual, with a client;

(4) Sexual advances toward, or the request of sexual favors from, a coworker, student, employer, client, or client’s family member;

(5) Discussion of nontherapeutic sexual matters while treating a client;

(6) Taking photographs of a client for a sexual purpose;

(7) Sexual harassment of a coworker, student, employer, client, or client’s family member;

(8) Sexual contact with an incompetent or unconscious client;

(9) Intentionally exposing any of the direct-entry midwife’s sexual body parts; and

(10) Intentionally exposing any of the client’s sexual body parts for a nontherapeutic purpose.

E. Electronic devices, including but not limited to telephones, may not be used to record medical records or take pictures or videos of clients for purposes not directly related to client care without written client authorization.

F. A licensed direct-entry midwife:

(1) May not make use of electronic devices and social media to transmit or place any client information online for public viewing without written client authorization; and

(2) Shall adhere to the following principles for the use of electronic devices and social media:

(a) Every licensed direct-entry midwife has an obligation to understand the nature, benefits, and consequences of the use of electronic devices and participating in social media networking;

(b) Licensed direct-entry midwives are bound to observe ethically prescribed direct-entry midwife-client boundaries online as in any other setting;

(c) Client information in electronic format shall be maintained in secured files;

(d) A licensed direct-entry midwife has an obligation to report any electronically generated material that could harm a client’s privacy rights; and

(e) The standards of professionalism are the same when using electronic devices and social media as in any other circumstance.

.03 Penalties.

Violation of this chapter may result in the Board taking disciplinary action against a licensee pursuant to Health Occupations Article, §8-6C-20, Annotated Code of Maryland.

ROBERT R. NEALL
Secretary of Health

Subtitle 67 MARYLAND HEALTHCHOICE PROGRAM

10.67.04 Maryland Medicaid Managed Care Program: Managed Care Organizations

Authority: Health-General Article, §§15-101 and 15-103(b), Annotated Code of Maryland

Notice of Proposed Action

[20-181-P]

The Secretary of Health proposes to amend Regulation .03 under COMAR 10.67.04 Maryland Medicaid Managed Care Program: Managed Care Organizations.

Statement of Purpose

The purpose of this action is to implement the CY 2021 MCO value-based purchasing (VBP) core performance measures.

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 Jake Whitaker, Acting 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 December 7, 2020. A public hearing has not been scheduled.

.03 Quality Assessment and Improvement.

A. (text unchanged)

B. An MCO shall participate in all quality assessment activities required by the Department to determine if the MCO is providing medically necessary enrollee health care. These activities include, but are not limited to:

(1)—(2) text unchanged

(3) The annual collection and evaluation of a set of performance measures with targets as determined by the Department as follows:

(a)—(c) (text unchanged)

[(d) Effective January 1, 2014, the core performance measures are:

(i) Adolescent well care visits;

(ii) Adult Body Mass Index (BMI) assessment;

(iii) Ambulatory care for Supplemental Security Income (SSI) adults;

(iv) Ambulatory care for Supplemental Security Income (SSI) children;

(v) Breast cancer screening;

(vi) Childhood immunizations — Combo 3;

(vii) Comprehensive diabetes care — HbA1c testing;

(viii) Controlling high blood pressure;

(ix) Immunization for adolescents;

(x) Lead screening for children 12—23 months old;

(xi) Medication management for people with asthma — 75 percent grouping;

(xii) Postpartum care; and

(xiii) Well child visits, 3—6 years old;]

[(e)] (d)—[(f)] (e) (text unchanged)

(f) Effective January 1, 2021, the core performance measures are:

(i) Adolescent well care visits;

(ii) Ambulatory care for SSI adults;

(iii) Ambulatory care for SSI children;

(iv) Asthma medication ratio;

(v) Breast cancer screening;

(vi) Comprehensive diabetes care — HbA1c control (<8.0%);

(vii) Controlling high blood pressure;

(viii) Lead screening for children 12 through 23 months old;

(ix) Postpartum care; and

(x) Well child visits in the first 15 months of life;

[(g) Starting with the 2014 performance measures, the Department shall implement the following methodology for imposing penalties and incentives: 

(i) There shall be three levels of performance;

(ii) Performance shall be evaluated separately for each measure, and each measure shall have equal weight;

(iii) On any of the measures in §B(3)(d)(i)—(xiii) of this regulation for which the MCO does not meet the minimum target, as determined by the Department, a penalty of 1/13 of 1 percent of the total capitation amount paid to the MCO during the measurement year shall be collected;

(iv) The total amount of the penalties as described in §B(3)(g)(iii) of this regulation may not exceed 1 percent of the total capitation amount paid to the MCO during the same measurement year;

(v) On any of the measures in §B(3)(d) of this regulation for which the MCO meets or exceeds the incentive target, as determined by the Department, the MCO shall be paid an incentive payment of up to 1/13 of 1 percent of the total capitation paid to the MCO during that measurement year;

(vi) The total amount of the incentive payments as described in §B(3)(g)(v) of this regulation paid to the MCOs each year may not exceed the total amount of the penalties as described in §B(3)(g)(iii) of this regulation collected from the MCOs in that same year, plus any additional funds allocated to the Department for a quality initiative; and

(vii) Any funds remaining after the payment of the incentives due under §B(3)(g)(v) of this regulation shall be distributed to the MCOs receiving the four highest normalized scores for Value Based Purchasing for all thirteen performance measures at a rate calculated by multiplying each MCO’s adjusted enrollment as of December 31 of the measurement year by a per enrollee amount;]

[(h)] (g) (text unchanged)

(h) Starting with the 2021 performance measures, the Department shall implement the following methodology for imposing penalties and incentives:

(i) There shall be three levels of performance;

(ii) Performance shall be evaluated separately for each measure, and each measure shall have equal weight;

(iii) On any of the measures in §B(3)(f) of this regulation for which the MCO does not meet the minimum target, as determined by the Department, a penalty of 1/10 of 1 percent of the total capitation amount paid to the MCO during the measurement year shall be collected if the conditions in §B(3)(h)(iv) of this regulation do not apply;

(iv) If the Department’s actuary determines that the MCO’s total capitation amount for the measurement year does not meet the actuarial soundness definition described in 42 CFR §438.4 after collection of the total penalty amount described in §B(3)(h)(iii) of this regulation, the Department’s actuary shall calculate the maximum penalty the Department shall apply that results in the MCO’s total capitation for the measurement year remaining actuarially sound;

(v) If the MCO’s penalty amount is reduced as described in §B(3)(h)(iv) of this regulation, the Department may impose any of the additional sanctions described in COMAR 10.67.10;

(vi) The total amount of the penalties as described in §B(3)(h)(iii) of this regulation may not exceed 1 percent of the total capitation amount paid to the MCO during the same measurement year;

(vii) On any of the measures in §B(3)(f) of this regulation for which the MCO meets or exceeds the incentive target, as determined by the Department, the MCO shall be paid an incentive payment of up to 1/10 of 1 percent of the total capitation paid to the MCO during that measurement year;

(viii) The total amount of the incentive payments as described in §B(3)(h)(vii) of this regulation shall be paid to the MCOs with total amount of the penalties as described in §B(3)(h)(iii) of this regulation collected from the MCOs in that same year, plus additional reserves in the HealthChoice Performance Incentive Fund if the total amount of the penalties collected is insufficient to pay the total amount of the incentive payments;

(ix) 40 percent of any funds remaining after the payment of the incentives due under §B(3)(h)(vii) of this regulation shall be distributed to the MCOs earning net incentives with the four highest normalized scores, at a rate calculated by multiplying each MCO’s adjusted enrollment as of December 31 of the measurement year by a per-enrollee amount;

(x) MCOs earning net disincentives are ineligible to receive the funds described in §B(3)(h)(ix) of this regulation;

(xi) 25 percent of any funds remaining after the payment of the incentives due under §B(3)(h)(vii) of this regulation shall be distributed to the MCOs that the Department determines have demonstrated performance improvement in the measurement year, provided that the MCOs use the funding to target performance improvement in areas defined by the Department;

(xii) 25 percent of any funds remaining after the payment of the incentives due under §B(3)(h)(vii) of this regulation shall be retained for health improvement programs under the Maryland Medicaid Managed Care Program;

(xiii) 10 percent of any funds remaining after the payment of the incentives due under §B(3)(h)(vii) of this regulation shall be used to establish a reserve in the HealthChoice Performance Incentive Fund, to be used in any calendar year when the amount of penalties collected is insufficient to pay incentives earned by MCOs; and

(xiv) If the amount in the HealthChoice Performance Incentive Fund exceeds $5,000,000, the Department shall equally allocate the remaining 10 percent of funds for use in items B(3)(h)(ix) —(xii);

(i) The adjusted enrollment amount in §§B(3)(g)(vii) and [B(3)(h)(vii)] B(3)(h)(ix) of this regulation shall be calculated by:

(i)—(iii) (text unchanged)

(iv) Using the actual enrollment of the MCO with the fourth highest normalized score; and

(j) The per enrollee amount in §§B(3)(g)(vii) and [B(3)(h)(vii)] B(3)(h)(ix) of this regulation shall be calculated by dividing the sum of the calculations in [§§B(3)(g)(i)—(iv) and B(3)(h)(i)—(iv)] §B(3)(i)(i)—(iv) of this regulation into the funds remaining as described in §§B(3)(g)(vii) and [B(3)(h)(vii)] B(3)(h)(ix) of this regulation;

(4)—(7) (text unchanged)

C.— D. (text unchanged)

ROBERT R. NEALL
Secretary of Health

 

Title 14
INDEPENDENT AGENCIES

Subtitle 22 COMMISSION ON CRIMINAL SENTENCING POLICY

14.22.01 General Regulations

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

Notice of Proposed Action

[20-185-P]

The Maryland State Commission on Criminal Sentencing Policy proposes to amend Regulations .02, .09, .10, and .14 under COMAR 14.22.01 General Regulations.

Statement of Purpose

The purpose of this action is to indicate modifications to the definition of special vulnerability of victim in Regulation .02 under COMAR 14.22.01 General Regulations, replacing the term “handicap” with “disability” and providing examples of a temporary physical or mental limitation. The examples include instances when the offender knew or should have known the victim was pregnant, unconscious, asleep, and/or intoxicated. Additionally, the purpose of this action is to clean up the language in Regulations .09, .10, and .14 under COMAR 14.22.01 General Regulations. These modifications remove language in Regulation .09 that is duplicative of language in Regulation .08 and thus not necessary. These modifications also add missing language to Regulation .10 concerning the seriousness category for uncategorized offenses with a maximum penalty of 1 year or less and the seriousness category for conspiracy to commit a lawful act by unlawful means. Finally, the modifications simplify the language in Regulation .14 concerning the adjusted guidelines range for first degree murder, removing the terms “mandatory suspendable” when describing the adjusted range of “life to life.” These modifications to Regulations .09, .10, and .14 are consistent with existing sentencing guidelines rules and do not indicate changes to the calculation of the guidelines.

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 Soule, Executive Director, Maryland State Commission on Criminal Sentencing Policy, 4511 Knox Rd, Suite 309, College Park, MD 20742, or call 301-403-4165, or email to dsoule@umd.edu. Comments will be accepted through December 7, 2020. A public hearing has not been scheduled.

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(18) (text unchanged)

(19) “Special vulnerability of victim” means cases in which the relative status of the victim tends to render the actions of the perpetrator more serious. A vulnerable victim is anyone:

(a)—(b) (text unchanged)

(c) Having a temporary or permanent physical or mental [handicap] disability, including an individual who is physically or mentally limited in a material way. Examples of a temporary physical or mental limitation include, but are not limited to, instances when the offender knew or should have known the victim was pregnant, unconscious, asleep, or intoxicated.

(20)—(22) (text unchanged)

.09 Offense Score.

A. (text unchanged)

B. Elements of the Offense Score.

(1) (text unchanged)

(2) Seriousness Category of the Convicted Offense.

(a)—(b) (text unchanged)

[(c) Unless placed in a different category or specifically addressed by separate statute, the individual completing the worksheet shall consider a conspiracy, attempt, or solicitation in the same seriousness category as the substantive offense.

(d) Accessoryship.

(i) If the accessory after the fact has a penalty of 5 years or greater under CR, §1-301, a seriousness category V shall be assigned, unless the underlying offense has a seriousness category of less than V, in which case the accessory after the fact shall be assigned the same seriousness category as the underlying offense.

(ii) If the accessory after the fact has a penalty of less than 5 years under CR, §1-301, the seriousness category shall be the same category as the underlying offense.

(e) For conspiracy, attempt, solicitation, or accessoryship, the individual completing the worksheet shall specify the substantive illegal activity involved, and the substantive offense’s Annotated Code of Maryland article and section number, if any.

(f) If a Maryland offense has not been assigned a seriousness category and the offense has a maximum penalty of 1 year or less, the offense shall be assigned the lowest seriousness category (VII).

(g) If a Maryland offense has not been assigned a seriousness category and the offense has a maximum penalty greater than 1 year, the individual completing the worksheet shall use the closest analogous offense and the sentencing judge and the parties shall be notified.]

(3)—(5) (text unchanged)

C. (text unchanged)

.10 Computation of the Offender Score.

A. (text unchanged)

B. Four Components of the Offender Score.

(1)—(2) (text unchanged)

(3) Prior Adult Criminal Record.

(a) In General.

(i)—(ii) (text unchanged)

(iii) If a Maryland offense has not been assigned a seriousness category and the offense has a maximum penalty of 1 year or less, the offense shall be assigned the lowest seriousness category (VII).

[(iii)] (iv) (text unchanged)

(b)—(g) (text unchanged)

(h) Conspiracies, Attempts, Solicitations, and Accessoryships.

(i) (text unchanged)

(ii) For conspiracy to commit a lawful act by unlawful means, the seriousness category and offense type classification shall be the same as the most serious unlawful means by which the lawful act was to be accomplished. If there is a question as to the seriousness category or offense type classification for the conspiracy to commit a lawful act by unlawful means, that question shall be brought to the attention of the judge at sentencing.

[(ii)] (iii)[(iii)] (iv) (text unchanged)

(4) (text unchanged)

C. (text unchanged)

.14 Mandatory Sentences.

If the guidelines sentence range exceeds the statutory maximum for a given offense, the statutory maximum is the upper limit of the guidelines range. If the guidelines range is below the nonsuspendable mandatory minimum, that minimum is the lower limit of the guidelines range. The adjusted guidelines range for first degree murder is always a [mandatory suspendable] term of “life to life” and should replace the calculated guidelines range.

DAVID SOULE
Executive Director

 

Subtitle 38 MARYLAND STATE LIBRARY

14.38.01 Programs for Library Media Services

Authority: Education Article, §23-105(c), Annotated Code of Maryland

Notice of Proposed Action

[20-173-P]

The Maryland State Library proposes to repeal existing Regulation .04 and adopt new Regulation .04 under COMAR 14.38.01 Programs for Library Media Services.

Statement of Purpose

The purpose of this action is to change the name of the Maryland State Library for the Blind and Physically Handicapped to the Maryland Library for the Blind and Print Disabled. This name change and related amendments will reflect a more inclusive scope of eligibility with a clear definition, and, because the Library is a cooperating network library of the National Library Service for the Blind and Print Disabled, part of the Library of Congress, the new name will help align the library with the national entity.

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 Irene Padilla, State Librarian, Maryland State Library, 25 S. Charles Street, Baltimore, MD 21201, or call 667-219-4800, or email to irene.padilla@maryland.gov. Comments will be accepted through December 7, 2020. A public hearing has not been scheduled.

.04 Special Library Services.

A. Definitions.

(1) In this regulation, the following terms have the meanings indicated.

(2) Terms Defined.

(a) “LBPD” means the Maryland Library for the Blind and Print Disabled.

(b) “MSL” means the Maryland State Library Agency.

(c) “NLS” means the National Library Service for the Blind and Print Disabled of the Library of Congress.

B. Responsibilities of MSL and LBPD.

(1) MSL shall provide specialized library services to the blind and print disabled individuals in this State through the LBPD.

(2) LBPD shall:

(a) Serve as the primary source of books, periodicals, and other information in formats such as Braille, large print, recorded books and digital material;

(b) Provide reading material, information, programming, and instruction, in cooperation with local organizations and agencies, to eligible citizens; and

(c) Coordinate library services to the blind and print disabled with those of public libraries and other educational institutions so as to provide an effective Statewide program.

C. Population Served. The population served by LBPD includes all Maryland citizens who are unable to read standard-sized print due to conditions including blindness, low vision, learning disorders, or physical conditions.

D. Services Provided.

(1) LBPD shall provide reading material, information, programming, and instruction, in cooperation with local organizations and agencies, to eligible citizens.

(2) LBPD is responsible for the Maryland Accessible Textbook Program under Education Article, §§11-901—11-906, Annotated Code of Maryland. The Program coordinates the Statewide availability of textbooks and supplementary materials in electronic format to eligible blind or print disabled students who are enrolled in institutions of higher education and institutions of postsecondary education in the State. The population served includes students with print disabilities attending postsecondary educational institutions in the State.

E. Funding for Expenses.

(1) MSL shall receive and utilize the resources of federal agencies, including the National Library Service for the Blind and Print Disabled of the Library of Congress, in accordance with the policies governing these resources.

(2) LBPD shall receive funding from the State as outlined in Education Article, §23-205(e), Annotated Code of Maryland.

IRENE PADILLA
State Librarian

 

Title 22
STATE RETIREMENT AND PENSION SYSTEM

Subtitle 02 OPTION AND ANNUITY TABLES

22.02.01 Option Factors and Annuity Values

Authority: State Personnel and Pensions Article, §§20-202, 21-108, 21-110, 21-125, and 21-402, Annotated Code of Maryland

Notice of Proposed Action

[20-170-P]

The Board of Trustees for the State Retirement and Pension System proposes to amend Regulations .01, .03, and .05, repeal existing Regulation .04, and adopt new Regulation .04 under COMAR 22.02.01 Option Factors and Annuity Values. This action was considered by the Board of Trustees and Pension System at an open meeting held on September 22, 2020, notice of which was given by publication on the website for the Maryland State Retirement and Pension System pursuant to General Provisions Article, §3-302, Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to update the option factors and annuity values used by the State Retirement Agency when making calculations related to benefits payable upon the commencement of a retirement allowance, vested allowance, or allowance payable on the death of an active member. These proposed regulations are also being amended to make technical and clarifying changes to the existing regulations and to explain when certain updated factors will apply to the Agency’s calculations.

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 Anne Gawthrop, Director, Legislative Affairs, State Retirement Agency, 120 East Baltimore Street, Baltimore, MD 21202, or call 410-625-5602, or email to agawthrop@sra.state.md.us, or fax to 410-468-1710. Comments will be accepted through December 7, 2020. A public hearing has not been scheduled.

Open Meeting

Final action on the proposal will be considered by the Board of Trustees for the State Retirement Agency during a public meeting to be held on January 19, 2021, at 9:30 a.m., via live stream from the Agency’s website. Please check the website closer to the meeting date for further details.

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

(2) “Post-reform COLA rate” means the assumed cost-of-living adjustment rate under Regulation .03 or .04 of this chapter, for creditable service that is subject to State Personnel and Pensions Article, §29-408, Annotated Code of Maryland.

(3) “Pre-reform COLA rate” means the assumed cost-of-living adjustment rate under Regulation .03 or .04 of this chapter, for creditable service that is not subject to State Personnel and Pensions Article, §29-408, Annotated Code of Maryland.

(4) (text unchanged)

.03 Option and Annuity Factors [on or after] from July 1, 2017, until June 30, 2021.

A. This regulation applies to an effective date of retirement [on or after] from July 1, 2017, until June 30, 2021.

B. General option factors and annuity values, which are established by the System’s actuary and are based on the actuarial assumptions adopted by the Board of Trustees as set forth in [§E] §F of this regulation, shall be applicable to the Correctional Officers’ Retirement System, Employees’ Pension System, Employees’ Retirement System, Judges’ Retirement System, Teachers’ Pension System, and Teachers’ Retirement System.

C. Law Enforcement option factors and annuity values, which are established by the System’s actuary and based on the actuarial assumptions adopted by the Board of Trustees as set forth in [§E] §F of this regulation, shall be applicable to the Law Enforcement Officers’ Pension System, Local Fire and Police System, and State Police Retirement System.

D. Legislative plan option factors and annuity values, which are established by the System’s actuary and based on the actuarial assumptions adopted by the Board of Trustees as set forth in §F of this regulation, shall be applicable to the Legislative Pension Plan.

[D.] E. (text unchanged)

[E.] F. Actuarial Assumptions.

Interest Rate

Pre-reform
COLA Rate

Post-reform
COLA Rate

Mortality

Disabled Mortality

Unisex Mix

General Option Factors and Annuity Values —

Law Enforcement Option Factors and Annuity Values

(text unchanged)

Legislative Plan Option Factors and Annuity Values

5.85%

3.20%

3.20%

RP 2014 Combined Annuitant Mortality

RP 2014 Disabled Annuitant Mortality, Set Forward 1 / 3 Years for Males / Females

75% / 25% Male / Female

 

.04 Option and Annuity Factors on or After July 1, 2021.

A. This regulation applies to an effective date of retirement on or after July 1, 2021.

B. Employee option factors and annuity values, which are established by the System’s actuary and are based on the actuarial assumptions adopted by the Board of Trustees as set forth in §I of this regulation, shall be applicable to the Employees’ Pension System and Employees’ Retirement System.

C. Judicial option factors and annuity values, which are established by the System’s actuary and based on the actuarial assumptions adopted by the Board of Trustees as set forth in §I of this regulation, shall be applicable to the Judges’ Retirement System.

D. Legislator option factors and annuity values, which are established by the System’s actuary and based on the actuarial assumptions adopted by the Board of Trustees as set forth in §I of this regulation, shall be applicable to the Legislative Pension Plan.

E. Public safety option factors and annuity values, which are established by the System’s actuary and based on the actuarial assumptions adopted by the Board of Trustees as set forth in §I of this regulation, shall be applicable to the Correctional Officers’ Retirement System, Law Enforcement Officers’ Pension System, Local Fire and Police System, and State Police Retirement System.

F. Teacher option factors and annuity values, which are established by the System’s actuary and based on the actuarial assumptions adopted by the Board of Trustees as set forth in §I of this regulation, shall be applicable to the Teachers’ Pension System and Teachers’ Retirement System.

G. For mortality and disabled mortality table assumptions, the base table rates (with scaling) are projected from the year 2010 using the MP-2018 generational mortality projection scales and birth year based on age in 2023.

H. Upon request, the Retirement Agency shall make the option factors and annuity values established by the System’s actuary available to a participant.

I. Actuarial Assumptions.

Interest Rate

Pre-reform
COLA Rate

Post-reform
COLA Rate

Mortality

Disabled Mortality

Unisex Mix

Employee Option Factors and Annuity Values

6.15%

2.19%

1.42%

PubG-2010 Healthy Mortality (for General Employees), sex distinct, with rates scaled by 111% for males and 109% for females

PubG-2010 Disabled Mortality (for General Employees), sex distinct, with rates scaled by 134% for males and 99% for females

50% / 50% Male / Female

Judicial Option Factors and Annuity Values

6.15%

3.10%

3.10%

PubG-2010 Healthy Above Median Mortality (for General Employees), sex distinct, with rates scaled by 97% for males and 99% for females

PubG-2010 Healthy Above Median Mortality (for General Employees), sex distinct, with rates scaled by 97% for males and 99% for females

75% / 25% Male / Female

Legislator Option Factors and Annuity Values

6.15%

3.10%

3.10%

PubG-2010 Healthy Mortality (for General Employees), sex distinct, with rates scaled by 111% for males and 109% for females

PubG-2010 Disabled Mortality (for General Employees), sex distinct, with rates scaled by 134% for males and 99% for females

75% / 25% Male / Female

Public Safety Option Factors and Annuity Values

6.15%

2.60%

1.42%

PubS-2010 Healthy Mortality (for Safety Employees), sex distinct, with rates scaled by 108% for males and 103% for females

PubS-2010 Disabled Mortality (for Safety Employees), sex distinct, with rates scaled by 122% for males and 121% for females

85% / 15% Male / Female

Teacher Option Factors and Annuity Values

6.15%

2.19%

1.42%

PubT-2010 Healthy Mortality (for Teachers), sex distinct, with rates scaled by 105% for males and 110% for females

PubT-2010 Disabled Mortality (for Teachers), sex distinct, with rates scaled by 105% for males and 113% for females

25% / 75% Male / Female

 

A. (text unchanged)

B. If the effective date of retirement is 6 months or more [from] after the previous birth date of the member, former member, or designated beneficiary, the Retirement Agency shall increase the age of the member, former member, or designated beneficiary to the next full year.

C. For the recalculation of an allowance payable under State Personnel and Pensions Article, §21-403(b), (c), (e), or (f), Annotated Code of Maryland ([Options] Option 2, 3, 5, or 6), to determine the applicable option factor, the Retirement Agency shall use:

(1) The option factors and annuity values described under Regulation [.02 or .03] .02, .03, or .04 of this chapter, which are applicable to the retiree as of the effective date of retirement; and

(2) (text unchanged)

R. DEAN KENDERDINE
Executive Director

 

 

Errata

 

COMAR 33.08.05.01

At 47:22 Md. R. 934 (October 23, 2020), column 1, line 9 from the bottom:

For:        defined in .01 of this chapter, and an early voting center in

Read:     defined in this section, and an early voting center in

[20-23-21]

 

Special Documents

 

DEPARTMENT OF THE ENVIRONMENT

SUSQUEHANNA RIVER BASIN COMMISSION

Projects Approved for Consumptive Uses of Water

 

AGENCY:  Susquehanna River Basin Commission.

 

ACTION:  Notice.

 

SUMMARY:  This notice lists the projects approved by rule by the Susquehanna River Basin Commission during the period set forth in “DATES.”

 

DATES:  September 1-30, 2020

 

ADDRESSES:  Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA  17110-1788.

 

FOR FURTHER INFORMATION CONTACT:  Jason E. Oyler, General Counsel and Secretary to the Commission, telephone:  (717) 238-0423, ext. 1312; fax:  (717) 238-2436; e-mail:  joyler@srbc.net. Regular mail inquiries May be sent to the above address.

 

SUPPLEMENTARY INFORMATION:  This notice lists the projects, described below, receiving approval for the consumptive use of water pursuant to the Commission’s approval by rule process set forth in 18 CFR §806.22 (f)(13) and 18 CFR §806.22 (f) for the time period specified above:

 

Water Source Approval – Issued Under 18 CFR 806.22(e):

Warrior Trail Properties, LLC; Project Schooner; ABR-202009005; Hazle Township, Luzerne County, Pa.; Consumptive Use of Up to 1.400 mgd; Approval Date:  September 4, 2020.

 

Water Source Approval – Issued Under 18 CFR 806.22(f):

Chief Oil & Gas, LLC; Pad ID: Allen Drilling Pad #1; ABR-201009002.R2; Asylum Township, Bradford County, Pa.; Consumptive Use of Up to 2.0000 mgd; Approval Date:  September 3, 2020.

Chesapeake Appalachia, L.L.C.; Pad ID: Alberta; ABR-201009007.R2; Albany Township, Bradford County, Pa.; Consumptive Use of Up to 7.50000 mgd; Approval Date:  September 3, 2020.

Diversified Production, LLC; Pad ID: Phoenix C; ABR-201006114.R2; Duncan Township, Tioga County, Pa.; Consumptive Use of Up to 3.0000 mgd; Approval Date:  September 3, 2020.

Blackhawk Energy LLC; Pad ID: Shannon Todd Pad A; ABR-201009006.R2; Todd Township, Huntingdon County, Pa.; Consumptive Use of Up to 3.0000 mgd; Approval Date:  September 3, 2020.

ARD Operating, LLC; Pad ID: COP Tr 344 Pad A; ABR-20100694.R2; Noyes Township, Clinton County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 3, 2020.

Rockdale Marcellus, LLC; Pad ID: Zeafla 747; ABR-20100682.R2; Jackson Township, Lycoming County, Pa.; Consumptive Use of Up to 4.9900 mgd; Approval Date:  September 3, 2020.

ARD Operating, LLC; Pad ID: COP Tr 342 A; ABR-20100695.R2; Beech Creek Township, Clinton County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 7, 2020.

XTO Energy, Inc.; Pad ID:  MARQUARDT 8534H; ABR-20100664.R2; Penn Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 8, 2020.

Seneca Resources Company, LLC; Pad ID: C09-J; ABR-201507002.R1; Shippen Township, Cameron County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 8, 2020.

Chesapeake Appalachia, L.L.C.; Pad ID: Connell; ABR-201009084.R2; Cherry Township, Sullivan County, Pa.; Consumptive Use of Up to 7.50000 mgd; Approval Date:  September 10, 2020.

Chesapeake Appalachia, L.LC.; Pad ID: Decker Farms; ABR-201009037.R2; Rush Township, Susquehanna County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date:  September 10, 2020.

ARD Operating, LLC; Pad ID: Robert C. Ulmer Pad A; ABR-201007049.R2; Watson Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 14, 2020.

Repsol Oil & Gas (USA), LLC; Pad ID: YURKANIN (03 014) J; Columbia Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date:  September 14, 2020.

ARD Operating, LLC; Pad ID:  COP 551 Pad B; ABR-202009001; Cascade Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 14, 2020.

ARD Operating, LLC; Pad ID:  Chapman Bohlin Pad A; ABR-202009002; Cascade Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 14, 2020.

Cabot Oil & Gas Corporation; Pad ID: RozellC P1; ABR-20100542.R2; Jessup Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date:  September 16, 2020.

Cabot Oil & Gas Corporation; Pad ID: HullR P2; ABR-20100612.R2; Springville Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date:  September 16, 2020.

LPR Energy, LLC; Pad ID: Shannon Land & Mining Drilling Pad #1; ABR-20100628.R2; Lawrence Township, Clearfield County, Pa.; Consumptive Use of Up to 2.0000 mgd; Approval Date:  September 25, 2020.

ARD Operating, LLC; Pad ID:  Ann M. Mercier Pad A; ABR-201007071.R2; Cogan House Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date:  September 25, 2020.

LPR Energy, LLC; Pad ID: Lightner Drilling Pad #1; ABR-201007045.R2; Juniata Township, Blair County, Pa.; Consumptive Use of Up to 2.0000 mgd; Approval Date:  September 28, 2020.

SWN Production Company, LLC; Pad ID: Robinson; ABR-20100653.R2; Stevens Township, Bradford County, Pa.; Consumptive Use of Up to 4.9990 mgd; Approval Date:  September 28, 2020.

Cabot Oil & Gas Corporation.; Pad ID: Griffiths J P1; ABR-202009004; Rush Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date:  September 28, 2020.

 

 

Approvals By Rule – Revoked Under 18 CFR 806.22(f):

EQT Production Company; Pad ID: Phoenix B; ABR-201511003; Morris Township, Tioga County, Pa.; Revocation Date:  September 22, 2020.

Rockdale Marcellus, LLC; Pad ID: Zeafla 747; ABR-20100682.R2; Jackson Township, Lycoming County, Pa.; Revocation Date:  September 28, 2020.

 

AUTHORITY:  Pub. L. 91-575, 84 Stat. 1509 et seq., 18 CFR Parts 806, 807, and 808.

 

DATED: October 15, 2020.

JASON E. OYLER
General Counsel and Secretary to the Commission

[20-23-11]

 

SUSQUEHANNA RIVER BASIN COMMISSION

Grandfathering (GF) Registration Notice

 

AGENCY:  Susquehanna River Basin Commission.

 

ACTION:  Notice.

 

SUMMARY:  This notice lists Grandfathering Registration for projects by the Susquehanna River Basin Commission during the period set forth in DATES.

 

DATES:  September 1-30, 2020.

 

ADDRESSES:  Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA  17110-1788.

 

FOR FURTHER INFORMATION CONTACT:  Jason E. Oyler, General Counsel and Secretary to the Commission, telephone: (717) 238-0423, ext. 1312; fax: (717) 238-2436; e-mail: joyler@srbc.net. Regular mail inquiries May be sent to the above address.

 

SUPPLEMENTARY INFORMATION:  This notice lists GF Registration for projects, described below, pursuant to 18 CFR 806, Subpart E for the time period specified above:

 

Grandfathering Registration Under 18 CFR part 806, Subpart E:

Federal Bureau of Prisons – Federal Correctional Institution at Loretto, GF Certificate No. GF-202009111, Allegheny Township and Borough of Loretto, Cambria County, Pa.; Well 1 and consumptive use; Issue Date:  September 10, 2020. 

Troy Borough – Troy Borough Water Department, GF Certificate No. GF-202009112, Troy Borough, Bradford County, Pa.; Wells 1, 2, and 3; Issue Date:  September 10, 2020.

Weaverland Valley Authority – Blue Ball Water System, GF Certificate No. GF-202009113, East Earl Township, Lancaster County, Pa.; Wells 1, 2, and 3; Issue Date:  September 10, 2020.

Virginia and Larry Morton – Virginia and Larry Morton Farms, GF Certificate No. GF-202009114, Porter Township, Schuylkill County, Pa.; Wiconisco Creek; Issue Date:  September 10, 2020.

City of Oneonta – Public Water Supply System, GF Certificate No. GF-202009115, City and Town of Oneonta, Otsego County, N.Y.; Wilber Lake/Lower Reservoir; Issue Date:  September 10, 2020.

The Municipal Authority of the Borough of Berlin – Public Water Supply System, GF Certificate No. GF-202009116, Allegheny Township, Somerset County, Pa.; Well 6; Issue Date:  September 18, 2020.

Iron Masters Country Club, GF Certificate No. GF-202009117, Bloomfield Township, Bedford County, Pa.; Wells 10 and 14; Issue Date:  September 18, 2020.

Sinking Valley Country Club, GF Certificate No. GF-202009118, Tyrone Township, Blair County, Pa.; 14th Fairway Well and 8th Tee Well; Issue Date:  September 18, 2020.

 

AUTHORITY:  Pub. L. 91-575, 84 Stat. 1509 et seq., 18 CFR parts 806 and 808.

 

DATED:  October 15, 2020

JASON E. OYLER
General Counsel and Secretary to the Commission

[20-23-14]

 

SUSQUEHANNA RIVER BASIN COMMISSION

Projects Approved for Minor Modifications

 

AGENCY:  Susquehanna River Basin Commission.

 

ACTION:  Notice.

 

SUMMARY:  This notice lists the minor modifications approved for a previously approved project by the Susquehanna River Basin Commission during the period set forth in “DATES.”

 

DATES:  September 1-30, 2020.

 

ADDRESSES:  Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA  17110-1788.

 

FOR FURTHER INFORMATION CONTACT:  Jason E. Oyler, General Counsel, telephone: (717) 238-0423, ext. 1312; fax: (717) 238-2436; e-mail: joyler@srbc.net. Regular mail inquiries may be sent to the above address.

 

SUPPLEMENTARY INFORMATION:  This notice lists previously approved projects, receiving approval of minor modifications, described below, pursuant to 18 CFR 806.18 or to Commission Resolution Nos. 2013-11 and 2015-06 for the time period specified above:

 

Minor Modification Issued Under 18 CFR § 806.18

Tulpehocken Spring Water, Inc., Docket No. 20200315, Sugarloaf and Benton Townships, Columbia County, Pa.; approval authorizing the additional water use purpose of bulk supply for hydrostatic testing; Approval Date:  September 1, 2020. 

 

AUTHORITY:  Pub. L. 91-575, 84 Stat. 1509 et seq., 18 CFR Parts 806, 807, and 808.

 

DATED:  October 15, 2020.

JASON E. OYLER
General Counsel and Secretary to the Commission

[20-23-13]

 


MARYLAND DEPARTMENT OF HEALTH/OFFICE OF HEALTH SERVICES

MARYLAND MEDICAID ENTERAL NUTRITIONAL SERVICES REIMBURSEMENT

Pursuant to 42 CFR §440.70 — Home Health Services, enteral nutritional services must be covered by the Medicaid Agency's Disposable Medical Supplies/Durable Medical Equipment (DMS/DME) benefit. As such, the Maryland Department of Health (the Department) is transitioning Maryland Medicaid enteral nutritional services from the Pharmacy Program, where Medicaid covered it, to the DMS/DME program. Therefore, the Department must transition its reimbursement methodology from its Pharmacy Program to align with its DMS/DME program. This change is merely procedural; it does not result in a change in coverage for Maryland Medicaid participants.

Previously the Pharmacy Program reimbursed for these services using a methodology based on the Average Wholesale Price (AWP) plus a Professional Dispensing Fee (PDF). Going forward, the DMS/DME program will reimburse for enteral nutritional services based on Medicare rates where available. Effective January 1, 2021 the Department will reimburse for enteral nutritional products given by nasogastric, jejunostomy, or gastrostomy tube in the home at the following rates per unit:

 

HCPCS

HCPCS Unit

Per Unit Rate

B4102

500 ml

$3.56

B4103

500 ml

$3.33

B4149

100 cal

$1.77

B4150

100 cal

$0.69

B4152

100 cal

$0.57

B4153

100 cal

$2.03

B4154

100 cal

$1.20

B4155

100 cal

$1.19

B4158

100 cal

$0.69

B4159

100 cal

$0.69

B4160

100 cal

$0.85

B4161

100 cal

$2.03

B4162

100 cal

$3.31

 

The total impact of this change in FY 2021 is a $202,040.50 projected savings. This amount is subject to a 55.9 percent federal match ($112,940.64 federal funds and $89,099.86 general funds). The current reimbursement rates are available on the Department's website at: health.maryland.gov/providerinfo

Copies of the proposed changes are available for public review, and written comments may be submitted by contacting Katia Fortune at katia.fortune@maryland.gov. Comments will be accepted through December 7, 2020.

[20-23-20]

 

MARYLAND HEALTH CARE COMMISSION

MEDICAL CARE DATA BASE (MCDB) DATA SUBMISSION MANUAL

As required under COMAR 10.25.06, the Maryland Health Care Commission (MHCC) publishes the MCDB Data Submission Manual annually. This manual provides information to each reporting entity such as technical specifications, layouts, required reports, and definitions. A draft of the 2021 MCDB Data Submission Manual is currently on the MHCC website at the following link: http://mhcc.maryland.gov/mhcc/pages/apcd/apcd_mcdb/apcd_mcdb_data_submission.aspx. Final approval of the Data Submission Manual by the MHCC Commissioners will be on November 19, 2020.

Comments on the Data Submission Manual can be sent to Shankar Mesta, Chief, Cost and Quality, Center for Analysis and Information Systems, via email at shankar.mesta@maryland.gov, no later than 5:00 pm on November 12, 2020. 

[20-23-16]

 

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.


 

CHESAPEAKE BAY TRUST

Subject: Public Meeting

Date and Time: November 18, 2020, 3 — 6 p.m.

Place: Virtual — please see details below.

Add’l. Info: Please call Sarah Higgins for link to conference call. 410-974-2941 x113.

Contact: Sarah Higgins (410) 974-2941 x113

[20-23-03]

 

MARYLAND DEPARTMENT OF HEALTH/STATE COMMUNITY HEALTH WORKER ADVISORY COMMITTEE

Subject: Public Meeting

Date and Time: November 16, 2020, 1 — 3 p.m.

Place: This is a virtual meeting held via Google Hangout. The meeting hangout link and call in line are available on the Maryland CHW State Advisory Committee webpage at https://pophealth.health.maryland.gov/Community-Health-Workers/Pages/Advisory-Committee.aspx, MD

Add’l. Info: The Maryland CHW State Advisory Committee meets quarterly. Members of the public are welcome to attend, but must pre-register with this link. Link: https://docs.google.com/forms/d/e/1FAIpQLSenbz-qRQYU_TQoF6LQJiP4-q0a1EvWPKz4R4RS2GG5KvxT4g/viewform?gxids=7757

Contact: Tina Backe (410) 767-5971

[20-23-17]

 

MARYLAND INSURANCE ADMINISTRATION

Subject: Public Hearing

Date and Time: November 18, 2020, 12 — 3 p.m.

Place: Via conference call — please see details below.

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 MedAmerica Insurance Company and Genworth Life Insurance Company. In the group long-term care market, these include requests from Genworth Life Insurance Company. The purpose of the hearing is for insurance company officials to explain their reasons for the rate increases. Interested stakeholders will also have the opportunity to provide comments at the hearing. Prior to the hearing, copies of each company’s actuarial memorandum will be posted to the Maryland Insurance Administration’s website.

Given the current COVID-19 situation, to protect the public health, safety, and welfare, the hearing will be held via conference call.

Conference Call Line: Number: (415) 655-0001 Code: 172 754 3386. Information about the Maryland Relay Service can be found at doit.maryland.gov/mdrelay

For those who would like to participate via their computer, the web link is: https://marylandinsurance.webex.com/marylandinsurance/onstage/g.php?MTID=e98b548c0fe32c4f7be6a4120a51076e1

If you will be dialing into the public hearing, and wish to provide oral testimony, please RSVP to Nancy Muehlberger. Testimony will only be heard via the telephone from those who have RSVP’d in advance of the public hearing. Written comments and RSVPs should be sent to Nancy Muehlberger by November 11, 2020, 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 November 11, 2020, by email to Nancy.Muehlberger@maryland.gov. For more information on the hearing please see the following link:

https://insurance.maryland.gov/Consumer/Pages/Long-Term-Care-Hearing-November-18-2020.aspx

Contact: Adam Zimmerman (410) 468-2048

[20-23-09]

 

MARYLAND STATE LOTTERY AND GAMING CONTROL COMMISSION

Subject: Public Meeting

Date and Time: November 19, 2020, 10 a.m. — 12 p.m.

Place: Via live stream audio — please see details below.

Add’l. Info: due to COVID the meeting will be held via live stream available on the lottery gaming website https://www.mdgaming.com/commission/meeting-minutes-documents/

Contact: Kathy Lingo (410) 230-8790

[20-23-07]

 

MARYLAND HEALTH CARE COMMISSION

Subject: Public Meeting

Date and Time: November 19, 2020, 1 — 4 p.m.

Place: Virtual meeting — please see details below.

Add’l. Info: This is a virtual meeting held via GoToMeeting. Please register at www.mhcc.Maryland.gov under Meeting Schedule.

Contact: Valerie Wooding (410) 764-3570

[20-23-05]

 

MARYLAND HEALTH CARE COMMISSION

Subject: Receipt of Application

Add’l. Info: On October 9, 2020 the Maryland Health Care Commission (MHCC) received a Certificate of Need application submitted by:

Shady Grove Adventist Hospital. — Matter No. 20-15-2443

New construction of a six-floor patient care tower and renovation of existing space to enhance patient safety, patient experience and clinical efficiency. The project will result in all-private medical/surgical inpatient rooms; a modern Emergency Department (ED) with private treatment bays; an appropriately sized Intensive Care Unit (ICU); and a Clinical Decision Unit (CDU) to facilitate patient transitions from the ED to inpatient care, observation or discharge. Proposed Cost: $180,011,359.

The MHCC shall review the applications 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 application is 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 and Development, MHCC, 4160 Patterson Avenue, Baltimore, Maryland 21215.

Contact: Ruby Potter (410) 764-3276

[20-23-10]

 

BOARD OF OCCUPATIONAL THERAPY PRACTICE

Subject: Public Meeting

Date and Time: November 20, 2020, 9 a.m. — 12 p.m.

Place: Via Google Meet — please see details below.

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 may also be discussed. It may be necessary to go into executive session. Sign language interpreters and/or appropriate accommodations for qualified individuals with disabilities will be provided upon request. Please call 1-800-735-2255.

Contact: Lauren Murray (410) 402-8556

[20-23-06]

 

STANDING ADVISORY COMMITTEE ON OPIOD ASSOCIATED DISEASE PREVENTION AND OUTREACH PROGRAMS (SYRINGE SERVICE PROGRAMS)

Subject: Public Meeting

Date and Time: December 4, 2020, 10 a.m. — 12 p.m.

Place: Virtual meeting — please see details below.

Add’l. Info: Attend virtually: meet.google.com/rcp-ixti-dfe;

Attend by phone: (US) +1 386-603-2345, PIN: 682 731 496#

Contact: Allison Thomson (443) 801-5747

[20-23-18]

 

RACING COMMISSION

Subject: Public Meeting

Date and Time: December 3, 2020, 12:30 — 1 p.m.

Place: Laurel Park, Laurel, MD

Contact: J. Michael Hopkins (410) 428-2391

[20-23-08]

 

BOARD OF WATERWORKS AND WASTE SYSTEMS OPERATORS

Subject: Public Meeting

Date and Time: November 19, 2020, 10 a.m. — 2 p.m.

Place: Howard County Bureau of Utilities, 8250 Old Montgomery Rd., Columbia, MD

Add’l. Info: A portion of this meeting may be held in closed session.

Contact: Dee Settar (410) 537-4162

[20-23-02]

 

BOARD OF WELL DRILLERS

Subject: Public Meeting

Date and Time: November 18, 2020, 9 a.m. — 1 p.m.

Place: Maryland Dept. of the Environment, 1800 Washington Blvd., Baltimore, MD

Add’l. Info: A portion of this meeting may be held in closed session.

Contact: Dee Settar (410) 537-4162

[20-23-01]

 

WORKERS’ COMPENSATION COMMISSION

Subject: Public Meeting

Date and Time: December 10, 2020, 9:30 — 10:30 a.m.

Place: 10 E. Baltimore St., Baltimore, MD

Add’l. Info: Portions of this meeting may be held in closed session.

Contact: Amy S. Lackington (410) 864-5300

[20-23-04]