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32.03.04.00.htm 32.03.04.00. Title 32 MARYLAND DEPARTMENT OF AGING Subtitle 03 GRANTS AND SUBSIDIES Chapter 04 Congregate Housing Services Program Authority: Human Services Article, §10-209 and 10-210, Annotated Code of Maryland
32.03.04.01.htm 32.03.04.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) Allowable Medical Expenses.. a) "Allowable medical expenses" means the total recurring, nonreimbursable medical expenses an individual or a couple reasonably expects to pay out-of-pocket during the 12 months following the date on which a calculation is made to determine a subsidy amount.b) "Allowable medical expenses" does not include expenses:. i) Paid by a source other
32.03.04.02.htm 32.03.04.02. 02 Congregate Housing Services Certificate.. A. Certificate Required. An individual or other legal entity shall obtain a certificate from the Department before representing that it is a part of the Program or a Department-approved congregate housing services provider. The requirements of this chapter shall be met in order for a provider to obtain a certificate.B. Application. In order to obtain a certificate, an individual or legal entity that wants to be cer
32.03.04.03.htm 32.03.04.03. 03 Certificate Requirements.. A. An applicant for a certificate shall submit to the Department:. 1) Documentation that verifies that:. a) The facility in which the applicant proposes to provide congregate housing services is owned, leased, or otherwise under the control of the applicant; orb) The applicant has entered into a written agreement with the owner or management of the facility that specifies that the applicant is to be the sole congregate housing servi
32.03.04.04.htm 32.03.04.04. 04 Issuance of a Certificate.. The Department may not issue a certificate until:. A. A completed application for certification has been submitted to the Department;. B. The Department has verified that the requirements in Regulation .03 of this chapter have been met; andC. The Department has inspected and approved the facility..
32.03.04.05.htm 32.03.04.05. 05 Waiver.. A. The Department may waive any requirement in this chapter if a waiver request from a provider:. 1) Is submitted to the Department in writing and contains specific facts upon which the waiver is requested;2) Demonstrates that:. a) Compliance with the regulation for which a waiver is requested will impose a hardship; or. b) The waiver, if granted, will improve the operation of the Program;. 3) Demonstrates that an alternative procedure proposed by the provider will
32.03.04.06.htm 32.03.04.06. 06 Annual Renewal of Certificate.. A. A provider with a certificate, including a certificate issued before the adoption of these regulations, may apply to have the certificate renewed. An updated application for renewal shall be submitted on forms approved by the Department.B. An application for renewal shall be filed with the Department by a date specified annually by the Department.C. The Department shall renew a certificate if:.
32.03.04.07.htm 32.03.04.07. 07 Change of Provider During Term of Subsidy Services Agreement.. A. A certificate is not transferable. An entity other than the current provider may become the certificate holder and the new provider for a facility, only if:1) The Department agrees to the change; and. 2) The proposed new provider obtains a certificate for the facility.. B. An existing provider seeking to have a new entity become the provider for a facility shall notify the Department at least
32.03.04.08.htm 32.03.04.08. 08 Qualifications of Provider or Supervisor.. A. An individual employed by a provider to work in a supervisory position in a facility and, if the provider is an individual, the provider, shall have at least the minimum qualifications set forth in §B of this regulation.B. To qualify to work in a supervisory position for a provider, an individual:. 1) Shall be 21 years old or older;. 2) Shall be literate and able to communicate effectively with participants;. 3) Shall have sufficient
32.03.04.09.htm 32.03.04.09. 09 Staffing.. A. A provider shall have a staff-to-participant ratio which is adequate to provide the services required in Regulation .14 of this chapter.B. The provider shall provide or assure that its staff participates in training, as necessary, to ensure that each participant obtains quality congregate housing services consistent with the participant's needs.C. If a provider provides services to individuals with Alzheimer's disease or related disorders:. 1) The provider shall pro
32.03.04.10.htm 32.03.04.10. 10 Participant Rights.. A. In addition to any other rights, a participant shall have the right to:. 1) Be treated with consideration, respect, and full recognition of human dignity and individuality;. 2) Receive care and services that are adequate and appropriate;. 3) Privacy;. 4) Be free from emotional and physical abuse;. 5) Practice the religion of the participant's choice or to abstain from religious practice;.
32.03.04.11.htm 32.03.04.11. 11 Provider-Participant Service Agreement.. A. A provider shall enter into a written agreement with a participant on a form provided or approved by the Department that specifies the obligations of both parties, including:1) The services to be provided;. 2) The fees to be charged by the provider;. 3) If applicable, the amount of subsidy to be paid on behalf of the participant; and. 4) That the provider give at least 30 days notice of any proposed change in a fee charged by the pro
32.03.04.12.htm 32.03.04.12. 12 Termination of Provider-Participant Service Agreement.. A. A provider-participant service agreement shall allow termination by a provider only for the following reasons:1) A change in the health status or behavior of the participant that constitutes a substantial threat to the health or safety of a participant, other residents, or the provider's staff;2) Chronic disruptive behavior that is offensive and threatens participants' peaceful enjoyment of their apartments;
32.03.04.13.htm 32.03.04.13. 13 Record Keeping.. A. A provider shall maintain on-site an accurate and current file for each participant.. B. A participant's file shall contain the following:. 1) A completed copy of the following forms prescribed by the Department:. a) Participant assessment form;. b) Application form;. c) Provider-participant service agreement and any addenda; and. d) Subsidy application, if any;. 2) Personal data of participant including:. a) Name;. b) Date of birth;.
32.03.04.14.htm 32.03.04.14. 14 Mandatory and Optional Services.. A. A provider shall elect to participate in either the Standard Congregate Housing Services Plan or the Individualized Congregate Housing Services Plan.B. Meals.. 1) A Standard Congregate Housing Services Plan provider shall provide at least two nutritionally balanced meals daily.2) An Individualized Congregate Housing Services Plan provider shall offer a service package that includes at least one nutritionally balanced meal daily.
32.03.04.15.htm 32.03.04.15. 15 Award of Subsidies to a Provider.. A. The Department may award subsidies to a provider if:. 1) The Department has certified the facility;. 2) Sufficient State funds for congregate housing service subsidies are available in the Department's budget;3) The cost of services to be provided and the amount of subsidies required per participant are consistent with costs in comparable facilities; and4) The provider and the Department have entered into a purchase of services
32.03.04.16.htm 32.03.04.16. 16 Renewal of Subsidy Award.. A subsidy award may be renewed annually if:. A. Sufficient State funds for subsidies are available in the Department's budget;. B. The provider's budget for the next fiscal year has been approved by the Department;. C. The Department and the provider have executed a subsidy services agreement for the next fiscal year; andD. The provider and facility are in compliance with this chapter..
32.03.04.17.htm 32.03.04.17. 17 Award of Subsidies to New Sites.. If funds are made available in the Department’s budget to award subsidies to more facilities than the budget supported in the past, the Department shall issue a request for proposals to persons who want to be providers that are eligible to receive subsidies.
32.03.04.18.htm 32.03.04.18. 18 Subsidy Services Agreement.. A. A provider that is approved by the Department to receive State subsidies shall enter into a written subsidy services agreement with the Department.B. The Department shall give a copy of the executed agreement to the provider..
32.03.04.19.htm 32.03.04.19. 19 Administration of Subsidy Award.. A. If funds are available the Department shall advance subsidy payments to a provider in good standing on a quarterly basis.B. For the term of a subsidy services agreement, the Department shall:. 1) During the first quarter, advance to the provider a subsidy payment equal to 1/4 of the total subsidy award; and2) During each subsequent quarter, advance an amount equal to the total amount of subsidies earned during the previous quarter.
32.03.04.20.htm 32.03.04.20. 20 Eligibility For Services.. A. To be eligible to be a participant and receive congregate housing services, an individual shall:. 1) Be 62 years old or older;. 2) Be physically or mentally impaired;. 3) Need assistance with one or more of the essential activities of daily living;. 4) Need one or more of the congregate housing services available in the facility; and. 5) Be able to function in the facility if provided with those services.. B. The spouse of a partic
32.03.04.21.htm 32.03.04.21. 21 Determination of Eligibility to Receive Services.. A. An individual who wants to apply to be a participant in the Program shall file an application with the provider from which the individual wants to receive services. The Department shall provide an application form that individuals applying for the Program shall use.B. Upon receipt of an application to receive services, the provider shall determine if the applicant meets the requirements of Regulation .20 of this chapter.
32.03.04.22.htm 32.03.04.22. 22 Participant Application for Subsidy.. If an individual resides in a facility that has a subsidy services agreement with the Department, the individual may file an application for a subsidy with the provider at the facility on a form provided by the Department.An application for a subsidy may be filed at the same time as an application for eligibility is filed or may be filed after an application for eligibility is filed.
32.03.04.23.htm 32.03.04.23. 23 Participant Eligibility for Subsidy.. A. An individual in a facility whose provider has a subsidy services agreement for a Standard Congregate Housing Services Plan is eligible to receive a subsidy if:1) The individual has been determined to be eligible to be a participant and receives services in the facility;2) The individual’s net monthly income is insufficient to pay the full monthly fee approved by the Department in the subsidy services agreement with the provider;
32.03.04.24.htm 32.03.04.24. 24 Enrollment of Participant for Subsidy.. A. A provider shall enroll an individual or couple as subsidized participants if:. 1) The individual or couple has been determined to be eligible to receive services according to the requirements of Regulation .21 of this chapter and to receive a subsidy according to the requirements of Regulation .23 of this chapter; and2) State funds are available to pay the subsidy..
32.03.04.25.htm 32.03.04.25. 25 Notification of Ineligibility to Receive a Subsidy.. A. If an individual or couple is determined to be ineligible to receive a subsidy or no longer eligible to receive a subsidy, a provider shall notify the individual or couple in writing of the ineligibility determination within 10 days.B. A notice of ineligibility for a subsidy shall include:. 1) The decision;. 2) The reason for denial of eligibility;. 3) The participant's right to request a review of the decision; and.
32.03.04.26.htm 32.03.04.26. 26 Determination of Participant Subsidy Amount.. A. In the Standard Congregate Housing Services Program, the amount of the subsidy to be paid monthly on behalf of an eligible participant shall equal the difference between the participant’s projected monthly income, less approved allowances set forth in §B of this regulation, and the monthly fee for congregate housing services as approved by the Department in the subsidy services agreement.B. Approved allowances are:.
32.03.04.27.htm 32.03.04.27. 27 Monitoring.. A. The Department or its designee may conduct reviews of a provider's administration of the Program and conduct announced or unannounced on-site visits of a facility at any time.B. The Department may designate another entity to perform monitoring.. C. The Department shall have the right to review a provider's records to ensure compliance with this chapter, including participant files and files that contain the results of the background checks re
32.03.04.28.htm 32.03.04.28. 28 Notification of Intent Not to Renew Subsidy Services Agreement.. A. If a provider does not intend to seek the award of another subsidy services agreement after the current one expires, the provider shall give the Department written notice of that intention at least 120 days before the expiration of the current agreement.B. A notice provided to satisfy §A of this regulation shall include:. 1) The provider's reasons for ending its participation in the Program;.
32.03.04.29.htm 32.03.04.29. 29 Violations.. A. If the Department determines that a provider violated or is violating a regulation of this chapter, the Department shall prepare a written notice of violation.B. A notice of violation shall include:. 1) A description of each condition, action, or inaction that constitutes a violation;. 2) A citation to each regulation violated;. 3) The date by which an ongoing violation shall be corrected; and.
32.03.04.30.htm 32.03.04.30. 30 Suspension of Certificate.. A. The Department may suspend a provider's certificate if the provider has violated a regulation of this chapter, and the violation has not been corrected within the time specified in the notice of violation.B. The Department may immediately suspend a provider's certificate if a violation of a regulation of this chapter results in conditions that pose an imminent danger to the health or safety of a participant.C. The Department shall n
32.03.04.31.htm 32.03.04.31. 31 Revocation or Denial of a Certificate.. A. The Department may revoke, deny, or refuse to renew a certificate for cause. Cause for revocation of a certificate, denial of a certificate, or refusal to renew a certificate includes, but is not limited to, the following:1) Conditions that present an imminent danger to the life, safety, health, or welfare of the participants;2) Failure to meet the initial certification or renewal requirements of this chapter;.
32.03.04.32.htm 32.03.04.32. 32 Civil Money Penalties.. A. Violations Warranting Penalties. The Secretary, or the Secretary’s designee, may impose a civil money penalty against a provider of congregate housing services for:1) A violation of this chapter or the provider’s subsidy services agreement that results in conditions presenting an imminent danger or substantial probability of death or serious physical harm to a p2) A violation of a participant's rights specified in Regulation .10 of this chapter; or.
32.03.04.33.htm 32.03.04.33. 33 Appeals.. A. A person aggrieved by a denial of a certificate, a revocation of a certificate, a suspension of a certificate, a refusal to renew a certificate, or by any other action of the Department or the Secretary under this chapter may file a written appeal.B. An appeal of any action taken by the Department or the Secretary under this chapter shall be conducted in accordance with COMAR 32.01.01 and the Administrative Procedure Act, State Government Artic
32.03.04.9999.htm 32.03.04.9999. Administrative History Effective date: July 1, 2005 (32:10 Md. R. 926). Regulation .01B amended effective June 4, 2018 (45:11 Md. R. 580). Regulation .07 amended effective June 4, 2018 (45:11 Md. R. 580). Regulation .14B amended effective June 4, 2018 (45:11 Md. R. 580). Regulation .16C amended effective June 4, 2018 (45:11 Md. R. 580). Regulation .17 amended effective June 4, 2018 (45:11 Md. R. 580). Regulation .18 amended effective June 4, 2018 (45:11 Md. R. 580).
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