Md. Code Regs. 10.09.36.03-1

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

Section 10.09.36.03-1 - Conditions for Participation - Home and Community-Based Settings

A. Providers of services under COMAR 10.09.84 shall comply with the provisions of §§D - F of this regulation and 42 CFR 441.301(c)(4).

B. Effective January 1, 2018, to be enrolled as a provider of services authorized under §§ 1915(c) or 1915(i) of the Social Security Act, the provider shall comply with the provisions of §§D - F of this regulation and 42 CFR 441.301(c)(4).

C. Providers of services authorized under §§ 1915(c) or 1915(i) of the Social Security Act that are enrolled Maryland Medicaid providers before January 1, 2018, shall comply with the provisions of §§D - F of this regulation on or before March 17, 2022.

D. The setting in which services are provided shall:

(1) Be integrated in and support full access to the greater community for individuals receiving Medicaid home and community-based services to the same degree of access as individuals not receiving Medicaid home and community-based services;

(2) Be selected by the individual from among setting options, including nondisability specific settings;

(3) Be identified and documented in the person-centered service plan and is based on the individual's needs and preferences;

(4) Ensure an individual's rights of:

(a) Privacy;

(b) Dignity and respect; and

(c) Freedom from coercion and restraint;

(5) Optimize, but not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to:

(a) Daily activities;

(b) Physical environment; and

(c) With whom to interact; and

(6) Facilitate individual choice regarding services and supports, and who provides them.

E. In addition to the provisions of §D of this regulation, provider-owned or controlled settings shall meet the following conditions:

(1) The unit or dwelling is a specific physical place that can be owned, rented, or occupied under a legally enforceable agreement by the individual receiving services and the individual has, at a minimum, the same responsibilities and protections from eviction that tenants have under the landlord tenant law of the State, county, city, or other designated entity;

(2) Each individual has privacy in their sleeping or living unit, as evidenced by the following:

(a) Units have entrance doors lockable by the individual, with only appropriate staff having keys to doors;

(b) Individuals sharing units have a choice of roommates; and

(c) Individuals have the freedom to furnish and decorate their sleeping or living units within the lease or other agreement;

(3) Individuals have the freedom and support to control their own schedules and activities;

(4) Individuals have access to food at any time;

(5) Individuals are able to have visitors of their choosing at any time; and

(6) The setting is physically accessible to the individual.

F. Any modification of the conditions under §§D and E of this regulation shall be supported by a specific assessed need and justified in the person-centered services plan in accordance with 42 CFR 441.301(c)(2) (xiii).

Md. Code Regs. 10.09.36.03-1

Regulation .03-1 adopted effective 45:4 Md. R. 206, eff. 2/26/2018