Sec. 10.09.33.05. Health Home Provider Staff

A. Health Home Staffing Requirements.

(1) Health Home Care Manager.

(a) At minimum, the health home shall maintain health home care manager staff at a ratio of .5 FTE per 125 participants.

(b) Up to a staffing level of 1 FTE, the health home care manager shall be a:

(i) Nurse practitioner meeting the conditions of COMAR 10.27.07; or

(ii) Registered nurse licensed pursuant to COMAR 10.27.01 and meeting the conditions of COMAR 10.27.09.

(c) A health home employing more than 1 FTE health home care manager may employ a physician’s assistant licensed pursuant to COMAR 10.32.03.04 to fulfill the additional care manager roles.

(2) Health Home Director.

(a) At minimum, the health home shall maintain a health home director at a ratio of .5 FTE per 125 health home participants.

(b) A health home requiring a health home director and health home care manager of .5 FTE eachmay employ 1 FTE individual to serve in both roles, provided that individual meets the requirements for both positions.

(c) A health home requiring more than .5 FTE health home director, may choose to designate a lead health home director and fulfill the additional FTE requirement with key management staff who meet the requirements of §A(2)(d)(i) or (ii) of this regulation.

(d) The health home director shall:

(i) Possess a Bachelor’s degree from an accredited university and 2 years experience in health administration;

(ii) Possess a Master’s degree from an accredited university in a related field;

(iii) Be licensed as a Registered Nurse with the Maryland Board of Nursing; or

(iv) Be licensed as a Physician or be licensed as a Nurse Practitioner.

(3) Physician or Nurse Practitioner Consultant.

(a) At minimum, the health home shall maintain physician or nurse practitioner services at a ratio of one and one half (1.5) hours per health home participant per 12-month period.

(b) The physician shall meet the conditions of COMAR 10.32.01.

(c) The nurse practitioner shall meet the conditions of COMAR 10.27.07.

(4) Administrative Support Staff.

(a) The health home shall maintain administrative support at a level sufficient to meet the service provision and reporting requirements of the health home.

(b) Administrative support for the health home may be one or a combination of the following:

(i) Administrative support staff; or

(ii) An electronic care management tool that addresses the administrative health home tasks.

B. A health home with fewer than 125 participants may form a consortium to share health home staff and costs, contingent upon geographic proximity and Department approval of a plan detailing the proposed collaboration.

C. Should staffing levels drop below the levels required by this regulation for more than 60 days, the health home shall:

(1) Report this to the Department; and

(2) Demonstrate that steps have been taken to reach the required staffing levels.

D. Health home staff members shall be dedicated to health home duties at a level of .5 FTE minimally, and staffing requirements may not be divided among staff at levels below .5 FTE each.

E. To begin offering health home services, a provider shall have in place a health home director and health home care manager at levels of .5 FTE each, minimally. Additional staff required to meet the staffing levels specified in §§A-D of this regulation shall be hired within 30 days of beginning service provision.