Md. Code Regs. 10.01.18.02

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.01.18.02 - Definitions

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

B. Terms Defined.

(1) "Admission" means the process by which an individual is accepted as a resident or patient in a State facility and includes the physical act of the individual entering the State facility.

(2) "Central coordinator" means an individual or individuals designated by the Deputy Secretary for the unit of the Department responsible for the operations of each State facility to:

(a) Oversee development of policies and materials;

(b) Monitor compliance; and

(c) Identify and make recommendations for improving a State facility's prevention and detection of, and response to, inappropriate sexual behavior in State facilities.

(3) "Covered program" means any of the following facilities and programs:

(a) A State facility as defined in §B(22) of this regulation;

(b) Non-State operated residential treatment centers for emotionally disturbed children and adolescents, licensed under COMAR 10.07.04;

(c) Vocational and day services programs, licensed by the Developmental Disabilities Administration under COMAR 10.22.02 and 10.22.07; and

(d) The following programs licensed by the Behavioral Health Administration:

(i) Psychiatric rehabilitation programs for adults licensed under COMAR 10.63.03.09;

(ii) Residential rehabilitation programs licensed under COMAR 10.63.04.05;

(iii) Supported employment programs licensed under COMAR 10.63.03.16; and

(iv) Psychiatric rehabilitation programs for minors licensed under COMAR 10.63.03.10.

(4) "Department" means the Maryland Department of Health.

(5) External Law Enforcement Agency.

(a) "External law enforcement agency" means the Department of State Police or a police agency of a county or municipal corporation.

(b) "External law enforcement agency" does not include the police force of the Maryland Department of Health.

(6) "Inappropriate sexual behavior" means:

(a) Sexual abuse as defined in §B(17) of this regulation; and

(b) Any sexual act, as defined in §B(18) of this regulation, between a staff member of a covered program and an individual receiving services at the covered program.

(7) "Individual" means a person receiving services or treatment at a State facility.

(8) "Initial plan of care" means the first plan of care created for an individual by the treatment team and is created at the first treatment team meeting.

(9) "Internal complaint process" means a written policy and procedure for a covered program 's handling and investigation of reports of inappropriate sexual behavior, as defined in §B(3) of this regulation, and appropriate actions in response to verified incidents of inappropriate sexual behavior, occurring within the covered program.

(10) "Licensed" means being licensed by the Department or approved by the Department to receive funding to provide services in Maryland.

(11) "Peer training" means awareness and prevention training regarding inappropriate sexual behavior that is provided by a peer of the individual receiving services.

(12) "Plan of care" means a written document addressing the needs of the individual receiving services from a covered program, and the covered program's plan for provision of services and treatment to meet those needs, developed in accordance with applicable State and federal laws and regulations.

(13) "Program director" means the individual who is responsible for the daily operations of a covered program as outlined in the chapter under the appropriate subtitle that delineates the requirements for a specific program.

(14) "Protection plan" means a document created to address the individual's needs, with respect to the individual's:

(a) Risk of being subjected to the perpetrator of inappropriate sexual behavior at the facility; and

(b) Treatment team's plan for mitigating the individual's risk.

(15) Reasonable Safety Precautions.

(a) "Reasonable safety precautions" means an established set of measures, procedures, and protocols taken in order to maintain the safety of individuals upon admission to the State facility.

(b) Reasonable safety precautions may include but are not limited to:

(i) Unit restriction, including dining on the unit;

(ii) Increased nursing contacts or more frequent observation by nurses;

(iii) Restrictions on activities;

(iv) Increased staffing assigned to the individual; and

(v) Similar or additional measures implemented.

(c) The type of reasonable safety precautions implemented and the reason for the reasonable safety precautions shall be documented in the individual's records.

(16) "Risk assessment screen" means a uniform tool, developed by the Department, used by a facility to:

(a) Screen an individual for a history of being subjected to, or perpetrating, inappropriate sexual behavior, and related trauma; and

(b) Assess an individual's risk of being subjected to, or perpetrating, inappropriate sexual behavior while at the facility.

(17) Sexual Abuse.

(a) "Sexual abuse" means any sexual act, as defined in §B(18) of this regulation, that is made or threatened to be made without the consent of an individual who is the recipient of the action, or without the consent of an individual solicited to take the action, which occurs on the premises of a covered program or at any off-premises activity sponsored by the covered program.

(b) "Sexual abuse" includes sexual harassment and sexual assault.

(c) "Sexual abuse" does not include an action taken reasonably related to the provision of care, treatment, or services to an individual including:

(i) The performance of an accepted medical or behavioral procedure pursuant to and in accordance with orders of an appropriately qualified licensed health care professional; and

(ii) An action taken by a staff member that complies with applicable laws and policies on the use of physical intervention.

(18) "Sexual act" means any of the following, if it can reasonably be construed to be for sexual arousal or gratification, or for the abuse of either party, and not for an accepted medical or behavioral purpose:

(a) An act in which an object or part of an individual's body penetrates, however slightly, into another individual's genital opening or anus;

(b) Intentional physical contact, or an attempt to make physical contact, either directly or through clothing, between the genitals, finger or fingers, hand or hands, or mouth of one individual and the genitals, groin, inner thigh, buttocks, anus, breast, or mouth of another individual;

(c) Intentional physical contact, or an attempt to make physical contact, between the tongue or mouth of one individual and any part of the body of another individual;

(d) The following nonphysical contacts:

(i) The intentional exposure by an individual to another of the individual's naked genitals, groin, inner thigh, buttocks, anus, or breast;

(ii) The intentional exposure by an individual to another of photographs of an individual's naked genitals, groin, inner thigh, buttocks, anus, or breast;

(iii) The intentional observation by an individual of another individual's naked genitals, groin, inner thigh, buttocks, anus, or breast;

(iv) Verbal or written description of, questions or suggestions regarding, or requests for any of the physical contacts described in §B(18)(a)-(c) of this regulation;

(v) Photographing, drawing, transmitting an image of, saving an image of, or recording the naked body or body parts of another individual;

(vi) Intentionally exposing an individual to photographs, pictures, drawings, diagrams, or other graphic depictions of naked body or body parts of an individual; and

(vii) Intentionally causing another individual to make or attempt any of the physical contacts described in §B(18)(a)-(c) of this regulation; and

(e) Other intentional acts directed to another individual and performed for the purpose of arousing sexual thoughts or feelings and not for purposes related to the provision of care.

(19) "Sexual assault" means any of the following:

(a) A sexual offense as defined in Criminal Law Article, Title 3, Annotated Code of Maryland; and

(b) Any other sexual act that is a crime under State or federal law.

(20) "Sexual harassment" means intimidation, bullying, or coercion of a sexual nature or unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature that tends to create a hostile or offensive environment.

(21) "Staff member" means any individual employed by a covered program, whether contractually or permanently and any individual who volunteers with, is a contractor for or consultant to, works as an intern or resident for, or otherwise is engaged by, the covered program at any facility or location in which services are provided to individuals.

(22) "State facility" means the following institutions operated by the Department:

(a) A psychiatric hospital, licensed pursuant to COMAR 10.07.01;

(b) An intermediate care facility for individuals with developmental disabilities licensed pursuant to COMAR 10.07.20;

(c) A forensic residential center, licensed pursuant to COMAR 10.07.13; and

(d) Regional institutes for children and adolescents licensed and operated pursuant to COMAR 10.07.04 and COMAR 10.21.06.

(23) "Treatment team" means the group of individuals at the covered program who, in accordance with applicable State and federal law and regulations, are responsible for the development and implementation of a plan of care for an individual receiving services from the covered program.

Md. Code Regs. 10.01.18.02

Regulation .02 adopted effective 42:23 Md. R. 1433, eff.11/23/2015; amended effective 48:26 Md. R.1110, eff. 12/27/2021