Sec. 14.31.07.08. Programs for Children With Developmental Disabilities

A. Additional Requirements. In addition to the requirements set out in COMAR 14.31.05 and 14.31.06, a program for children with developmental disabilities also shall meet the requirements of this regulation.

B. Quality Assurance. The licensee shall conform to the quality assurance standards established in COMAR 10.22.02.14.

C. Standing Committee. The licensee shall establish a standing committee or committees to:

(1) Perform the quality assurance functions set forth in COMAR 14.31.05;

(2) Review the licensee's protocol for identifying, reporting, documenting, investigating, and reviewing of incidents to ensure compliance with the licensing agency's procedures;

(3) Monitor implementation of the licensee's protocol identified in §C(2) of this regulation, including a review of all incidents in an effort to identify deficient practices and recommend necessary corrective action;

(4) Approve all behavior plans that use restrictive techniques to ensure that the behavior plan complies with the requirements of COMAR 10.22.10, 10.22.04.03A, and 14.31.05.15;

(5) Review, approve, and establish the time frame for the restriction of a right if it is not related to a challenging behavior, in accordance with COMAR 10.22.04.03A, or other requirements appropriate to the licensing agency;

(6) Review the licensee's policies and procedures and practices to ensure that they adequately protect the legal and human rights of each child served by the licensee; and

(7) Unless otherwise provided for, be organized to perform the functions set forth in §A of this regulation for one or more licensees.

D. Standing Committee Composition.

(1) For programs licensed by the Maryland Department of Health, the committee or committees shall include an equal number of licensee staff, and child proponents or members of the community who are not employed by the licensee. For a committee member who is remunerated only to serve as a member of the committee, that member is not counted as staff or as a member of the community.

(2) For programs serving children with developmental disabilities licensed by other licensing agencies, the committee shall be established in accord with the licensing agency's policy.

E. Consultation. The committee or committees may consult with a licensed health professional such as a social worker, psychologist, physician, physician's assistant, nurse practitioner, or board-certified clinical pharmacist, as needed.

F. Conflict of Interest. A committee member may not participate in the decision making process of any:

(1) Incident in which the committee member was involved; or

(2) Behavior plan that the committee member has developed.

G. Meetings. The committee or committees shall meet as needed to perform the functions identified in §E of this regulation, with at least a majority of members present.

H. Confidentiality. The committee or committees shall ensure confidentiality of information regarding the child in accordance with Health-General Article, §7-1010, Annotated Code of Maryland, and COMAR 14.31.06.18.

I. Use of Restraints. For licensees of the Maryland Department of Health, appropriate methods of preventing or managing challenging behaviors may include the use of mechanical restraints.

J. Change in Licensure Status.

(1) A licensee may voluntarily surrender its license in accordance with COMAR 10.22.02.02F.

(2) A licensee wishing to open, close, or relocate a site shall meet the requirements of COMAR 14.31.05.05.

(3) If a licensee is required to open, close, or relocate a site due to an emergency and the notice requirements set forth in COMAR 14.31.05.09E cannot be met, the licensee shall notify the regional director who shall notify the licensing agency to ensure compliance with all relevant regulations.

K. Policies and Procedures. A licensee shall develop and adopt written policies and procedures in addition to those policies and procedures required in COMAR 14.31.06 to ensure:

(1) The fundamental rights of residents in accordance with Health-General Article, §7-1002, Annotated Code of Maryland;

(2) Confidentiality for each individual in accordance with Health-General Article, §7-1010, Annotated Code of Maryland;

(3) The implementation of a grievance process with safeguards that protect against retaliatory actions for the filing of any grievance;

(4) The reporting and investigation of all incidents, including those involving life-threatening conditions, in accordance with the Developmental Disabilities Administration's procedures on reportable incidents;

(5) The administration of medications in accordance with the practices established by the curriculum of the Developmental Disabilities Administration on medication training;

(6) Compliance with COMAR 10.27.11;

(7) Assurance that, before a child is to be required to pay for property damage caused by the individual's actions, the child's individual plan shows evidence that:

(a) The child has a history of destructive behavior that has been documented in the child's behavior plan;

(b) The child has a behavior plan that addresses the destructive behavior;

(c) The child's family has the ability to pay for damages;

(d) The licensee's standing committee has reviewed and approved the damage payment; and

(e) The licensee has reported this approval to the regional director of the Developmental Disabilities Administration;

(8) Compliance with Health-General Article, §5-605, Annotated Code of Maryland; and

(9) The absence of a financial or personal conflict of interest for members of the governing body, staff, care providers, volunteers, and standing committee members in their work with the program.