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    PROPOSAL
    Maryland Register
    Issue Date:  October 28, 2016
    Volume 43 • Issue 22 • Pages 1229—1230
     
    Title 10
    DEPARTMENT OF HEALTH AND MENTAL HYGIENE
    Subtitle 21 MENTAL HYGIENE REGULATIONS
    10.21.25 Fee Schedule — Mental Health Services — Community-Based Programs and Individual Practitioners
    Authority: Health-General Article, §§10-901, 15-103, and 15-105; Title 16, Subtitles 1 and 2; Annotated Code of Maryland
    Notice of Proposed Action
    [16-280-P]
    The Secretary of Health and Mental Hygiene proposes to amend Regulations .03 and .08 under COMAR 10.21.25 Fee Schedule — Mental Health Services — Community-Based Programs and Individual Practitioners.
    Statement of Purpose
    The purpose of this action is to add cross-references to COMAR 10.63 and update the definitions to align with COMAR 10.63, which is the new community-based behavioral health programs and services subtitle.
    Comparison to Federal Standards
    There is no corresponding federal standard to this proposed action.
    Estimate of Economic Impact
    The proposed action has no economic impact.
    Economic Impact on Small Businesses
    The proposed action has minimal or no economic impact on small businesses.
    Impact on Individuals with Disabilities
    The proposed action has no impact on individuals with disabilities.
    Opportunity for Public Comment
    Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Department of Health and Mental Hygiene, 201 West Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to dhmh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through November 28, 2016. A public hearing has not been scheduled.
    .03 Definitions.
    A. In this chapter, terms have the meanings stated in COMAR 10.21.17, COMAR 10.63.01.02, and this regulation.
    B. Terms Defined.
    (1) (text unchanged)
    (2) 'Administration' means the [Mental Hygiene] Behavioral Health Administration.
    (2-1) (text unchanged)
    (3) 'Core service agency (CSA)' [means the county or multicounty authority, designated under Health-General Article, Title 10, Subtitle 12, Annotated Code of Maryland, and approved by the Department, that is responsible for planning, managing, and monitoring publicly funded mental health services] has the meaning stated in COMAR 10.63.01.02.
    (3-1)—(4) (text unchanged)
    (5) 'Enhanced support' means [an in-home service provided, in addition to other services to an individual, by a program that is approved by the Administration, to support the individual to remain in the community, and approved under] short-term, in-home services, in addition to other services to an individual, provided by a program to support the individual to remain in the community:
    (a) For mobile treatment services:
    (i) Under COMAR 10.21.19 if approved; and
    (ii) Under COMAR 10.63.03.04 if licensed;
    (b) For adult psychiatric rehabilitation services:
    (i) Under COMAR 10.21.21 if approved; and
    (ii) Under COMAR 10.63.03.09 if licensed; or
    (c) For outpatient mental health services;
    (i) Under COMAR 10.21.20 if approved; and
    (ii) Under COMAR 10.63.03.05 if licensed.
    (5-1)—(6) (text unchanged)
    (7) 'Individual practitioner' means:
    (a)—(b) (text unchanged)
    (c) A certified registered nurse practitioner—[psychiatric (CRNP—P)] psychiatric mental health (CRNP-PMH) who is:
    (i)—(ii) (text unchanged)
    (d)—(h) (text unchanged)
    (7-1)—(7-4) (text unchanged)
    (7-5) 'Local behavioral health authority (LBHA)” has the meaning stated in COMAR 10.63.01.02.
    (8) Mental Health Program.
    (a) 'Mental health program' means a program that provides a plan of mental health treatment or mental health rehabilitation, consisting of various therapeutic modalities, that is:
    (i)—(ii) (text unchanged)
    (b) 'Mental health program' includes:
    (i) Non-hospital-based partial hospitalization (psychiatric day treatment) services under COMAR 10.21.02 if approved, and COMAR 10.63.03.08 if licensed;
    (ii) (text unchanged)
    (iii) Mobile treatment services under COMAR 10.21.19 if approved, and COMAR 10.63.03.04 if licensed;
    (iv) Outpatient mental health clinic (OMHC) services under COMAR 10.21.20 if approved, and COMAR 10.63.03.05 if licensed;
    (v) Psychiatric rehabilitation programs for adults under COMAR 10.21.21 if approved, and COMAR 10.63.03.09 if licensed, including supported living services;
    (vi) Residential rehabilitation programs under COMAR 10.21.22 if approved, and COMAR 10.63.04.05 if licensed;
    (vii) (text unchanged)
    (viii) Supported employment programs under COMAR 10.21.28 if approved, and COMAR 10.63.03.16 if licensed;
    (ix) Respite care programs under COMAR 10.21.27 if approved, and COMAR 10.63.03.15 if licensed;
    (x) Residential crisis services programs under COMAR 10.21.26 if approved, and COMAR 10.63.04.04 if licensed; and
    (xi) Therapeutic and psychiatric rehabilitation services for minors under COMAR 10.21.29 if approved, and COMAR 10.63.03.10 if licensed.
    (9) Mobile Treatment.
    (a) 'Mobile treatment' means a program approved under COMAR 10.21.19, or licensed under COMAR 10.63.03.04.
    (b) (text unchanged)
    (10)—(11) (text unchanged)
    (11-1) Other Mental Health Professional.
    (a) (text unchanged)
    (b) “Other mental health professional” includes a:
    (i)—(iv) (text unchanged)
    (v) Certified registered nurse practitioner — psychiatric mental health (CRNP-PMH).
    (12) 'Outpatient mental health clinic (OMHC)' means a program approved under COMAR 10.21.20 or licensed under COMAR 10.63.03.05.
    (13) 'Partial hospitalization program' means a program approved under COMAR 10.21.02 or licensed under COMAR 10.63.03.08.
    (14)—(15) (text unchanged)
    (16) 'Psychiatric rehabilitation program for adults (PRP)' means a program approved under COMAR 10.21.21 or licensed under COMAR 10.63.03.09.
    (16-1) 'Residential crisis services (RCS)' means [intensive mental health and support services that are:
    (a) Provided to a child or an adult with mental illness who is experiencing, or is at risk of, a psychiatric crisis that would impair the individual's ability to function in the community;
    (b) Designed to prevent a psychiatric inpatient admission, provide an alternative to psychiatric inpatient admission, or shorten the length of inpatient stay; and
    (c) Provided, out of the individual's residence, on a short-term basis in a community-based residential setting] a program approved under COMAR 10.21.26 or licensed under COMAR 10.63.04.04.
    (16-2) (text unchanged)
    (17) 'Residential rehabilitation program (RRP)' means a program approved under COMAR 10.21.22 or licensed under COMAR 10.63.04.05.
    (17-1) 'Respite care' means services that are [:
    (a) Provided for an adult with serious and persistent mental illness or a child with serious emotional disturbance;
    (b) Provided on a short-term basis in a community-based setting; and
    (c) Designed to support an individual's remaining in the individual's home by:
    (i) Providing the individual with enhanced support or a temporary alternative living situation, or
    (ii) Assisting the individual's home caregiver by temporarily freeing the caregiver from the responsibility of caring for the individual] approved under COMAR 10.21.27 or licensed under COMAR 10.63.03.15
    (18)—(20) (text unchanged)
    (21) 'Therapeutic and psychiatric rehabilitation services for minors' means a program approved under COMAR 10.21.29 or licensed under COMAR 10.63.03.10.
    .08 Fee Schedule — Treatment Services — Programs.
    A.—B. (text unchanged)
    C. Partial Hospitalization. For programs approved under COMAR 10.21.02 or licensed under COMAR 10.63.03.08, the Department shall reimburse:
    (1)—(4) (text unchanged)
    D.—E. (text unchanged)
    VAN T. MITCHELL
    Secretary of Health and Mental Hygiene