Sec. 14.31.06.03. Definitions

A. In this chapter, the definitions in COMAR 14.31.05 apply, and the following terms have the meanings indicated.

B. Terms Defined.

(1) “Administration” means the licensing agency.

(2) “Behavior intervention plan” means a plan that is based on the functional behavioral assessment, designed to address challenging behaviors through the use of positive behavioral interventions, strategies, and supports, developed by a human services professional as defined in §B( 21) of this regulation, who has training and expertise in conducting a behavior functional assessment.

(3) “Behavioral consultation” means on-site observation, assessment, and evaluation of the child within the context of the child’s existing program. Behavioral consultation may include:

(a) Recommendations regarding structure of the program;

(b) Appropriate activities and services; or

(c) Consultation with human services professionals.

(4) “Behavioral health” means treatment of mental illness, emotional disorders, drug abuse, or alcohol abuse.

(5) “Behavioral respite” means relief services provided by a community-based residential program that meets a child’s behavioral needs.

(6) “Board” means the board of directors of a residential child care program responsible for the planning and oversight of the operation of the residential child care program.

(7) “Certified residential child and youth care practitioner” means an individual who is certified by the Maryland State Board for the Certification of Residential Child Care Program Professionals as defined in COMAR 10.57.01.02B(7).

(8) “Challenging behavior” means those behaviors exhibited by a child which are harmful, destructive, or socially unacceptable and necessitate being addressed in the child’s individual plan of care and behavior intervention plan.

(9) “Chemical restraint” means the use of medication that is not the current treatment for a child’s condition to control behavior or restrict the child’s movement.

(10) “Chief administrator” means the individual, regardless of title, who is appointed by the Board as having responsibility for the overall administration of the organization.

(11) “Chief financial officer” means the program executive with the primary responsibility for overseeing the financial activities of the program including financial planning, budget preparation, monitoring cash-flow, record keeping, and reporting to the Board.

(12) “Children's Cabinet” means those agencies directed by Executive Order 01.01.2006.03:

(a) To examine Maryland's system of services to children and their families; and

(b) To facilitate ongoing improvements to this service delivery system.

(13) “Contractual and temporary staff” in this chapter are those human services professionals and direct care staff who work at the residential child care program on a contractual or temporary basis or who are placed by a staffing organization with whom the licensee has a contract to perform those duties specified in the job description.

(14) “Cordless window covering” has the meaning stated in Family Law Article, §5-505, Annotated Code of Maryland.

(15) “Custodial agency” means the agency having primary legal responsibility, which may result from an order of shelter, commitment, limited guardianship, full guardianship, or voluntary placement, time limited, for the child in placement, and may include a child with disabilities.

(16) Direct Care Staff.

(a) "Direct care staff" means staff assigned to perform direct responsibilities related to activities of daily living, self-help and socialization skills.

(b) "Direct care staff" does not include human services professionals, except when a human services professional is specifically assigned to perform the duties of direct care staff as specified in Regulation .06B(1) of this chapter.

(17) “Emergency placement” means residential services provided to a child who requires immediate placement in a residential child care program because the child is:

(a) Abandoned;

(b) At risk of serious immediate danger; or

(c) At risk for long-term, out-of-home placement without use of placement as a short-term intervention.

(18) “Family” has the meaning stated in Human Services Article, §8-101, Annotated Code of Maryland.

(19) “Functional behavior assessment” means the systematic process of gathering information to guide the development of an effective and efficient behavior intervention plan for the problem behavior.

(20) “Group home” means a residential child care program, including:

(a) Shelter care, including:

(i) Emergency; or

(ii) Structured;

(b) Mother-baby programs;

(c) Programs for adolescent girls who are pregnant;

(d) Psychiatric respite care;

(e) Secure care;

(f) Programs for children who are medically fragile;

(g) Programs for children with developmental disabilities;

(h) Residential crisis services;

(i) Residential respite care services;

(j) Wilderness programs; and

(k) Diagnostic evaluation treatment programs.

(21) “Human services professional” means:

(a) A social worker licensed under Health Occupations Article, Title 19, Annotated Code of Maryland;

(b) A psychologist licensed under Health Occupations Article, Title 18, Annotated Code of Maryland;

(c) A professional counselor certified under Health Occupations Article, Title 17, Annotated Code of Maryland;

(d) A nurse licensed under Health Occupations Article, Title 8, Annotated Code of Maryland;

(e) A psychiatrist licensed under Health Occupations Article, Title 14, Annotated Code of Maryland;

(f) A guidance counselor certified under COMAR 13A.12.03.02 or a school psychologist certified under COMAR 13A.12.03.10;

(g) A certified counselor meeting the requirements under COMAR 10.58.07 to practice alcohol or drug counseling; or

(h) For programs serving children with developmental disabilities, an individual with a bachelor’s degree in a human services field who has a minimum of 1 year of full-time experience working directly with persons with developmental disabilities.

(22) “Individual plan of care” means an individualized written plan as detailed in Regulation .17C of this chapter.

(23) “Licensee” has the meaning stated in COMAR 14.31.05.03B(20).

(24) "Mechanical restraint" means any mechanical device that restricts the free movement of an individual.

(25) “Medication management” means the facilitation of the safe and effective use of prescription and over-the-counter medications. The management of medications encompasses the way medications are procured, delivered, prescribed, self-administered or staff-administered, documented, and monitored.

(26) “Office” means the Governor’s Office for Children.

(27) "Permanency plan" means a design for services articulated by the placing agency that specifies:

(a) Where and with whom a child shall live; and

(b) The proposed legal relationship between the child and the child's permanent caretaker.

(28) "Physical restraint" means the use of physical force, without the use of any device or material, to restrict the free movement of all or a portion of a child's body, not including:

(a) Briefly holding a child in order to calm or comfort the child;

(b) Holding the child by the hand or arm to escort the child safely from one area to another;

(c) Moving a disruptive child who is unwilling to leave the area when other methods such as counseling have been unsuccessful; or

(d) Breaking up a fight.

(29) “Policy” means a set of basic principles adopted by the Board used to enforce procedures and which are in accordance with the requirements for residential child care programs under this chapter.

(30) “Positive behavioral interventions, strategies, and supports” means a therapeutic intervention that uses a broad range of systemic and individualized strategies for enhancing positive social and emotional results while preventing or reducing challenging behaviors.

(31) “Procedure” means a detailed explanation of how policies will be implemented.

(32) “Program administrator” means the individual, regardless of title, certified under Health Occupations Article, Title 20, Annotated Code of Maryland, who is designated by the Board as having the day-to-day responsibility for the overall administration and operation of a program and for assuring the care, treatment, safety, and protection of children.

(33) “Prone restraint” means a specific type of restraint in which a child is placed face down on the floor or another surface and physical pressure is applied to the child’s body to keep the child in the prone position. Use of prone restraint is prohibited in Maryland.

(34) Protective or Stabilizing Device.

(a) "Protective or stabilizing device" means any device or material attached or adjacent to the child’s body for the purpose of enhancing functional skills, preventing unintentional harm to self or others, or ensuring safe positioning of an individual.

(b) "Protective or stabilizing device" is limited to:

(i) Adaptive equipment prescribed by a health professional, if used for the purpose for which the device is intended by the manufacturer;

(ii) Seat belts; or

(iii) Other safety equipment to secure children during transportation.

(35) “Residential child and youth care practitioner (RCYCP)” has the meaning stated in Health Occupations Article, Title 20, Annotated Code of Maryland. An RCYCP is direct care staff as defined in COMAR 14.31.06.04B(15).

(36) “Restraint” means a technique that is implemented to impede a child’s physical mobility or limit free access to the environment, including chemical, mechanical or physical restraints.

(37) “Seclusion” means the confinement of a child alone in a room from which the child is physically prevented from leaving. Use of seclusion is prohibited in residential child care programs in Maryland.

(38) “Self-administration of medication” has the meaning stated for “self-administer” in Education Article, §7-421(a)(4), Annotated Code of Maryland.

(39) Severe Injury.

(a) “Severe injury” means a medical emergency that requires immediate assessment and intervention by a somatic health care provider.

(b) “Severe injury” includes, but is not limited to, fractures, dislocations, third-degree burns (destruction of tissue), electric shock, loss or tearing of body parts, all eye emergencies, ingestion of toxic substance or sharp or dangerous objects, and any injury with loss of consciousness or head injuries.

(40) “Somatic health care” means medical care that addresses an individual’s physical health care needs.

(41) "Structural barrier" means any inanimate object.

(42) “Time-out” means the removal of a child to a supervised area, which is unlocked and free of structural barriers that prevent egress for a limited period of time during which the child has an opportunity to regain self-control and is not participating in program activities.

(43) “Trauma-informed care” means a person-centered approach which includes assessment, prevention of re-traumatization, and development and implementation of a safe environment plan. It is a system that reduces the risk of exposure, is strengths-based and resilience-focused, promotes respect, and supports cultural and developmental factors.