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    Maryland Department of Health
    Regulations

    ​
    PROPOSAL
    Maryland Register
    Issue Date:  January 6, 2017
    Volume 44 • Issue 1 • Pages 34—36
     
    Title 10
    DEPARTMENT OF HEALTH AND MENTAL HYGIENE
    Subtitle 22 DEVELOPMENTAL DISABILITIES
    Notice of Proposed Action
    [17-021-P]
    The Secretary of Health and Mental Hygiene proposes to amend:
    (1) Regulation .01 under COMAR 10.22.01 Definitions; and
    (2) Regulation .04 under COMAR 10.22.18 Community Supported Living Arrangements Payment System.
    Statement of Purpose
    The purpose of this action is to incorporate Personal Support services as part of Community Supported Living Arrangements (CSLA) services under COMAR 10.22.01.01 and adopt FY17 reimbursement rates for Personal Support services as part of CSLA services under COMAR 10.22.18.04.
    Comparison to Federal Standards
    There is no corresponding federal standard to this proposed action.
    Estimate of Economic Impact
    I. Summary of Economic Impact. The proposed action increases the rate paid to providers.
     
     
    Revenue (R+/R-)
     
    II. Types of Economic Impact.
    Expenditure
    (E+/E-)
    Magnitude
     
     
    A. On issuing agency:
    (E+)
    $3,994,813
    B. On other State agencies:
    NONE
    C. On local governments:
    NONE
     
     
    Benefit (+)
    Cost (-)
    Magnitude
     
     
    D. On regulated industries or trade groups:
    (+)
    $3,994,813
    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. A 3.5 percent increase in rates will cause the expenditures of the Developmental Disabilities Administration (DDA) for community services to increase by an estimated $3,994,813 in total funds. The total general funds impact of these changes is $2,291.004.
    D. Regulated provider agencies will benefit from increases to rates by an estimated $3,994,813 in total funds ($2,291,004 in general funds).
    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 February 6, 2017. A public hearing has not been scheduled.
     
    10.22.01 Definitions
    Authority: Health-General Article, §§2-104(b) and 7-904, Annotated Code of Maryland
    .01 Definitions.
    A. (text unchanged)
    B. Terms Defined.
    (1)—(13) (text unchanged)
    (14) Community Supported Living Arrangements.
    (a) (text unchanged)
    [(b) “Community supported living arrangements (CSLA)” include:
    (i) Personal assistance services;
    (ii) Supports that enhance the individual’s opportunity for community participation and to exercise choice and control over the individual’s own life;
    (iii) Training and other services necessary to assist the individual in achieving and maintaining increased integration, interdependence, and productivity;
    (iv) 24-hour emergency assistance;
    (v) Assistive technology;
    (vi) Adaptive equipment;
    (vii) Resource coordination;
    (viii) Environmental modifications;
    (ix) Respite services; and
    (x) Other services as approved by the Secretary or the Secretary’s designee.]
    (b) “Community supported living arrangements (CSLA)” includes personal support services, as defined under the Administration’s Home and Community-Based Services Waiver with the Centers for Medicare and Medicaid Services, including but not limited to the following services:
    (i) Personal assistance services;
    (ii) Supports that enhance the individual’s opportunity for community participation and to exercise choice and control over the individual’s own life;
    (iii) Training, habilitation, and other services necessary to assist the individual in achieving and maintaining increased integration, interdependence, and productivity; and
    (iv) 24-hour emergency assistance.
    (c) “Community supported living arrangements (CSLA)” also includes other services set forth in the Administration’s Home and Community-Based Services Waiver with the Centers for Medicare and Medicaid Services as distinct from personal support services, including but not limited to the following:
    (i) Assistive technology;
    (ii) Adaptive equipment;
    (iii) Resource coordination;
    (iv) Environmental modifications;
    (v) Respite; and
    (vi) Other services as approved by the Secretary or the Secretary’s designee.
    (15)—(64) (text unchanged)
    0.22.18 Community Supported Living Arrangements Payment System
    Authority: Health-General Article, §§2-104(b), 7-306.1, 7-307, 15-105, and 15-107, Annotated Code of Maryland
    .04 Rates.
    A.—H. (text unchanged)
    [I.]—[K.] (proposed for repeal)
    I. Fiscal Year 2017 Tables for CSLA’s Personal Supports Hourly Rates.
    (1) State Fiscal Year 2017 CSLA’s Personal Supports Rates: Table for One Individual in a Dwelling Receiving CSLA Services.
    Hourly Rate Per Individual
    Hours of Service Per Week
    Baltimore City and Allegany, Anne Arundel, Baltimore, Caroline, Carroll, Dorchester, Garrett, Harford, Howard, Kent, Queen Anne’s, St. Mary’s, Somerset, Talbot, Washington, Wicomico, and Worcester Counties
    Cecil County
    Calvert, Charles, Frederick, Montgomery,
    and Prince George’s Counties
    1—19
    $28.99
    $30.00
    $30.26
    20—22
    $27.72
    $28.69
    $28.94
    23-24
    $26.79
    $27.73
    $27.97
    25
    $25.93
    $26.84
    $27.07
    26
    $25.11
    $25.99
    $26.22
    27
    $24.37
    $25.22
    $25.45
    28—82
    $24.01
    $24.85
    $25.07
    (2) State Fiscal Year 2017 CSLA’s Personal Supports Rates: Table for Two Individuals in a Dwelling Receiving CSLA Services.
     
    Hourly Rate Per Individual
    Hours of Service Per Week
    Baltimore City and Allegany, Anne Arundel, Baltimore, Caroline, Carroll, Dorchester, Garrett, Harford, Howard, Kent, Queen Anne’s, St. Mary’s, Somerset, Talbot, Washington, Wicomico, and Worcester Counties
    Cecil County
    Calvert, Charles, Frederick, Montgomery,
    and Prince George’s Counties
    1—19
    $26.97
    $27.91
    $28.16
    20—22
    $25.99
    $26.90
    $27.13
    23—24
    $25.11
    $25.99
    $26.22
    25
    $24.30
    $25.15
    $25.37
    26
    $23.54
    $24.36
    $24.57
    27
    $22.83
    $23.63
    $23.84
    28—82
    $22.50
    $23.29
    $23.49
    (3) State Fiscal Year 2017 CSLA’s Personal Supports Rates: Table for Three Individuals in a Dwelling Receiving CSLA Services.
     
    Hourly Rate Per Individual
    Hours of Service Per Week
    Baltimore City and Allegany, Anne Arundel, Baltimore, Caroline, Carroll, Dorchester, Garrett, Harford, Howard, Kent, Queen Anne’s, St. Mary’s, Somerset, Talbot, Washington, Wicomico, and Worcester Counties
    Cecil County
    Calvert, Charles, Frederick, Montgomery,
    and Prince George’s Counties
    1—19
    $21.61
    $22.37
    $22.56
    20—22
    $20.82
    $21.55
    $21.75
    23—24
    $20.11
    $20.81
    $20.99
    25
    $19.47
    $20.15
    $20.33
    26
    $18.87
    $19.53
    $19.70
    27
    $18.29
    $18.93
    $19.10
    28—82
    $18.04
    $18.67
    $18.84
    J. State Fiscal Year 2017 CSLA’s Personal Supports Rates: Table for 1:1 Support or Not More than 8 Hours of Awake-Overnight Support per Residence for Individuals Receiving CSLA Services Regardless of the Number of Individuals in a Dwelling.
     
    Hourly Rate Per Individual
    Hours of Service Per Week
    Baltimore City and Allegany, Anne Arundel, Baltimore, Caroline, Carroll, Dorchester, Garrett, Harford, Howard, Kent, Queen Anne’s, St. Mary’s, Somerset, Talbot, Washington, Wicomico, and Worcester Counties
    Cecil County
    Calvert, Charles, Frederick, Montgomery,
    and Prince George’s Counties
    Hours in Excess of 82
    $18.04
    $18.67
    $18.84
    K. State Fiscal Year 2017 CSLA’s Personal Supports Rates: Table for Professional Services for Individuals Receiving CSLA Services Regardless of the Number of Individuals in a Dwelling.
     
    Hourly Rate Per Individual
    Hours of Service Per Week
    Baltimore City and Allegany, Anne Arundel, Baltimore, Caroline, Carroll, Dorchester, Garrett, Harford, Howard, Kent, Queen Anne’s, St. Mary’s, Somerset, Talbot, Washington, Wicomico, and Worcester Counties
    Cecil County
    Calvert, Charles, Frederick, Montgomery, and Prince George’s Counties
    As preauthorized and approved
    $31.51
    $32.61
    $32.89
    VAN T. MITCHELL
    Secretary of Health and Mental Hygiene