Sec. 10.21.16.04. Application Process

A. Consultation. Before submitting an application, an applicant for approval of a program may request assistance from the Department's designated approval unit or the appropriate core service agency (CSA) director regarding the proper compilation of application materials and completion of the application.

B. Lead CSA Determination. For programs providing services in multiple jurisdictions, the Administration, in collaboration with the appropriate CSAs, shall determine the lead CSA.

C. Application. An applicant for approval of a program shall:

(1) Submit an application to the Department’s designated approval unit;

(2) Submit the application on the written or electronic form approved by the Department, with all questions answered and all required documents attached;

(3) Include in the application, at a minimum, the following information:

(a) Documentation of the applicant's program service plan, as outlined in Regulation .05 of this chapter;

(b) A written business plan that clearly demonstrates the program's ability to provide services in accordance with applicable Maryland regulations and Medicaid and Medicare funding requirements;

(c) Information to demonstrate the program's financial viability, including, but not limited to:

(i) Salary structure;

(ii) Client mix;

(iii) Anticipated administrative expenses;

(iv) Necessary cash reserves to maintain the program during the start-up phase and a financial crisis;

(v) Identification of the individual responsible for providing the required financial information; and

(vi) Other information deemed necessary by the Department;

(d) A summary of the program's demonstrated experience in the field of mental health;

(e) Prior licensing reports issued within the previous 10 years from any in-State or out-of-State entities associated with the program, including deficiency reports and compliance records from which the Department may make reasoned decisions about the qualifications of the program;

(f) Disclosure of:

(i) Any license or approval revocation within the previous 10 years by the Department or other licensing agency;

(ii) Whether the program, or corporation or entity associated with the program, has surrendered or defaulted on its license or approval for reasons related to disciplinary action, within the previous 10 years; and

(iii) Any corporate officer who has served as a corporate officer for a corporation or entity that has had a license revoked, or has surrendered or defaulted on its license or approval for reasons related to disciplinary action within the previous 10 years;

(g) A written quality assurance plan that addresses how the organization will ensure the health and safety of the individuals served by the program and the quality of services provided to individuals by the program; and

(h) For 26 U.S.C. §501(c)(3) organizations, a statement of how the organization intends to satisfy its charitable mission; and

(4) Forward a copy of the:

(a) Completed application to the:

(i) CSA of the jurisdiction where the program services are to be delivered; or

(ii) For programs providing services in multiple jurisdictions, lead CSA identified under §B of this regulation; and

(b) Application cover letter to the Administration and all CSAs of the jurisdictions where the program plans to deliver services.

D. Action by the CSA or Lead CSA. The CSA, or lead CSA identified under §B of this regulation, shall submit to the Department's designated approval unit:

(1) Verification that:

(a) The program agrees to collaborate with all CSAs where the program proposes to provide services, according to the provisions of COMAR 10.21.17.06; and

(b) The financial information submitted under §C of this regulation appears to demonstrate potential financial viability of the program; and

(2) Comments, if any, on the content of the application.

E. Application Modification.

(1) A program that proposes to change its program sites by adding, closing, or moving locations shall submit an application modification, on the form required by the Department, to the Department's designated approval unit.

(2) If the Department's designated approval unit approves the application modification, the existing program approval shall extend to the additional site, as applicable.