Title 7-1001

In this subtitle, "licensee" means:

(1) A person who is licensed by the Administration to provide services; and

(2) A State residential center.

Title 7-1002

(a) "Qualified developmental disability professional" shall be defined by rule and regulation.

(b) It is the policy of this State that, in addition to any other rights, each individual who receives any services provided by the Administration or by a licensee has the following basic rights:

(1) The right to be treated with courtesy, respect, and full recognition of human dignity and individuality;

(2) The right to receive treatment, services, and habilitation in the least restrictive environment that is available, adequate, appropriate, and in compliance with relevant laws and regulations;

(3) The right to be free from mental and physical abuse;

(4) The right to be free from chemical restraints, except for minimal restraints that a physician authorizes, in writing, for a clearly indicated medical need and makes a permanent part of the individual's record;

(5) The right to be free from physical restraints except for minimal restraints that are authorized in writing and made a permanent part of the record by a physician or qualified developmental disability professional and which are clearly indicated for the protection of the individual with developmental disability or others;

(6) The right to privacy;

(7) The right to worship as the individual chooses; and

(8) The right to an accounting of any funds of the individual.

(9) THE RIGHT TO BE INFORMED OF ALL LESS RESTRICTIVE SERVICE OPTIONS LICENSED THROUGH THE ADMINISTRATION.

(d) Each licensee shall:

(1) Post, conspicuously in a public place, the policy stated in this section;

(2) Give a copy of the policy:

(i) On admittance, to the individual;

(ii) To the guardian, next of kin, or sponsoring agency of the individual; and

(iii) To a representative payee of the individual;

(3) Keep a receipt for the copy that is signed by the person who received the copy; and

(4) Provide appropriate staff training to carry out the policy.

7-1003.

(a) To carry out the policy stated in § 7-1002 of this subtitle, the following procedures are required for all services covered under this title.

(b) Each licensee shall:

(1) On or before acceptance of an individual for services, give the individual a written statement of:

(i) The services provided by the licensee, including each service that is required to be offered on an as-needed basis; and

(ii) All charges, including any charges for services that are not covered by Medicare, Medicaid, or reimbursement by a State or local public agency; and

(2) Keep a written receipt for the statement that is signed by the individual or, if the individual is a minor, the parent or guardian of the person.

(c) If a licensee provides an individual with a service, the licensee shall give the individual or the guardian of the person information about the diagnosis, treatment, and prognosis of the individual.

(d) (1) Unless it is medically inadvisable, an individual, or the guardian of the person:

(i) Shall participate in the planning of the medical treatment;

(ii) May refuse medication or treatment; and

(iii) Shall be informed of the medical consequences of these actions.

(2) The licensee shall keep a written acknowledgment of the individual or guardian that the medical consequences are known.

(e) (1) Any case discussion, consultation, examination, or medical treatment of an individual who receives services under this title:

(i) Is confidential; and

(ii) Is not open to a person who is not involved directly in the treatment of the individual who receives services under this title unless the individual or the guardian of the person permits the individual to be present.

(2) Except as necessary for the transfer of an individual from one health care institution to another or as required by law or a 3rd party payment contract, the personal, medical, psychological, and individual treatment and developmental information about an individual is confidential and may not be released without the consent of the individual or the guardian of the person to any individual who:

(i) Is not associated with a licensee; or

(ii) Is associated with a licensee, but does not have a demonstrated need for the information.

(f) If it is feasible to do so and not medically contraindicated, spouses who are both residents of a licensed residential facility shall be given the opportunity to share a room.

(g) An individual who receives services under this title from a licensee alone or with other individuals is entitled to present any grievance or recommend a change in a policy or service to the licensee, the Administration, or any other person, without fear of reprisal, restraint, interference, coercion, or discrimination.

(h) (1) An individual shall have reasonable access to a telephone.

(2) An individual shall have reasonable access to writing instruments, stationery, and postage and may use them to write to anyone.

(3) The correspondence of an individual shall be sent to the addressee without delay and, except under the direction of the addressee, without being opened.

(i) (1) An individual shall be entitled to receive visits:

(i) From a lawyer that the individual chooses;

(ii) From a clergyman that the individual chooses; and

(iii) During reasonable visiting hours that the licensee sets, from any other visitor.

(2) Each married individual in a licensed residential facility shall have privacy during a visit by the spouse.

(3) If, for the welfare of the individual, visits are restricted, the restriction shall be:

(i) Signed by the executive officer or administrative head of the licensee; and

(ii) Made a permanent part of the individual's record.

(4) Visits of an individual's lawyer or clergyman may not be restricted.

(j) (1) An individual shall have the right to possess and use clothing and other personal effects.

(2) For essential medical and safety reasons, the executive officer or administrative head of a licensee may take temporary custody of the personal effects and promptly shall make the action a part of the individual's record.

(k) (1) An individual with developmental disability may not be assigned to do any work for a licensee without personal consent and without written approval of the attending physician or the executive officer or administrative head of the licensee.

(2) This subsection does not apply to the performance of an individual's share of household duties or other tasks ancillary to the individual's habilitation program.

(l) The executive officer or administrative head of a licensee is responsible for carrying out this section.

(m) (1) A person who believes that the rights of an individual with developmental disability have been violated shall report the alleged violation to the executive director or administrative head of a licensee.

(2) The executive officer or administrative head of the licensee shall:

(i) Promptly send the report:

1.To the Director; and

2. To the State-designated protection and advocacy agency;

(ii) Investigate the report; and

(iii) After the investigation, report the findings:

1. To the complainant;

2. To the State-designated protection and advocacy agency; and

3. To the Director.

(8) The State-designated protection and advocacy agency shall seek redress of a violation of the rights stated in this section

7-1004.

An individual may not be deprived of the right to vote or to receive, hold, and dispose of property solely because the individual has developmental disability or receives services under this title.

7-1005.

(a) (1) In this section, "abuse" means:

(i) Any physical injury that is inflicted willfully or with gross recklessness;

(ii) Inhumane treatment; or

(iii) Any of the following kinds of sexual abuse:

1. A sexual act, as defined in § 3-301 of the Criminal Law Article;

2. Sexual contact, as defined in § 3-301 of the Criminal Law Article; or

3. Vaginal intercourse, as defined in § 3-301 of the Criminal Law Article.

(2) In this section, "abuse" does not include the performance of:

(i) An accepted medical procedure that a physician orders; or

(ii) An accepted behavioral procedure that a licensed psychologist or psychiatrist, as appropriate, orders.

(b) (1) In addition to any other reporting requirement of law, a person who believes that an individual with developmental disability has been abused promptly shall report the alleged abuse to the executive officer or administrative head of the licensee.

(2) The executive officer or administrative head shall report the alleged abuse to an appropriate law-enforcement agency.

(3) A report to the executive officer or administrative head:

(i) May be oral or written; and

(ii) Shall contain as much information as the reporter is able to provide.

(i) Investigate thoroughly each report of an alleged abuse; and

(ii) Attempt to ensure the protection of the alleged victim.

(2) The investigation shall include:

(i) A determination of the nature, extent, and cause of the abuse;

(ii) The identity of the alleged abuser or abusers; and

(iii) Any other pertinent fact or matter.

(d) As soon as possible, but no later than 10 working days after the completion of the investigation, the law-enforcement agency shall submit a written report of its findings to the State's Attorney, the Director, the State-designated protection and advocacy agency, and the executive officer or administrative head of the licensee.

(e) The Administration shall maintain a central registry of abuse reports and their disposition and shall take appropriate remedial action.

(f) A person shall have the immunity from liability described under § 5-625 of the Courts and Judicial Proceedings Article for:

(1) Making a report under this section;

(2) Participating in an investigation arising out of a report under this section; or

(3) Participating in a judicial proceeding arising out of a report under this section.

7-1006.

(a) The professional and supportive staff of a licensee who provides residential or day habilitation services shall make a written plan of habilitation for each individual with developmental disability who has been accepted for service by the licensee. The plan shall meet applicable federal standards. At least once a year, the staff shall reevaluate the effectiveness and adequacy of each plan in consultation with the individual with developmental disability and any person authorized to act on behalf of the individual, and shall revise the plan as needed. THE REEVALUATION WILL INCLUDE A DETERMINATION OF WHETHER THE INDIVIDUAL’S NEEDS COULD BE MET THROUGH LESS-RESTRICTIVE SERVICES. AT THIS TIME, EACH INDIVIDUAL WITH DEVELOPMENTAL DISABILITY WILL BE PROVIDED A RANGE OF LESS RESTRICTIVE SERVICE OPTIONS THAT MAY BE APPROPRIATE. THIS INFORMATION WILL BE GIVEN IN A MANNER APPROVED BY THE DEVELOPMENTAL DISABILITIES. At least once a year, the Administration shall review the licensee's execution of the plan of habilitation, and compliance with the rules, regulations, and standards which the Secretary adopts.

(b) Each individual plan of habilitation shall be reviewed and approved, disapproved, or modified by:

(1) The executive officer or administrative head of the licensee or a qualified developmental disability professional, as defined in § 7-1002(a) of this subtitle, whom the executive officer or administrative head designates; and

(2) One other professional individual who is responsible for carrying out a major program but does not participate in the individual plan of habilitation.

(c) Approval of a plan of habilitation shall be based on the current needs of the individual with developmental disability.

(d) The Secretary shall:

(1) Adopt rules and regulations to carry out the intent of this section;

(2) Provide appropriate support and technical assistance to the licensee in developing a plan of habilitation required by this section; and

(3) With respect to State residential centers, provide the professional and supportive staff and equipment that are necessary to carry out the plans of habilitation required by this section.

7-1007.

On request, the licensee shall give to the Director or a designee of the Director:

(1) Any information that the licensee has about an individual served by the licensee;

(2) Access to the records of the licensee;

(3) Access to any individual served;

(4) Access to the records of individuals served by the licensee; and

(5) Access to any part of the premises of the licensee

7-1008.

(a) (1) Each licensee shall keep complete records for each individual who is served by the licensee under this title.

(2) The record shall contain all of the information that is required by this title or the Administration.

(b) A licensee shall keep records in a secure area and available for the inspection by any person with the right of access to the records under this title.

7-1009.

Within 14 days after an individual with developmental disability asks a licensee for information about its records on that individual, the licensee shall advise the individual, in writing, about the records and the procedures for their disclosure.

7-1010.

(a) Except as otherwise expressly provided in this section, a licensee may not disclose any record that the licensee keeps on an individual who has been served by the licensee, unless the individual gives written, informed consent to the disclosure.

(b) (1) Subject to the limitations of this subsection, a licensee shall disclose a record of an individual who is served by a licensee to:

(i) The individual with developmental disability, if:

1. A person is not authorized to act on behalf of the individual with developmental disability; and

2. The executive officer or administrative head of the licensee determines that disclosure would not be detrimental to the individual with developmental disability;

(ii) A parent or guardian of the person with developmental disability who is:

1. A minor; or

2. Unless the individual with developmental disability asks that disclosure to the parent or guardian not be allowed, an adult;

(iii) A lawyer or other individual who is authorized:

1. By the individual with developmental disability; or

2. By another individual to whom, on behalf of the individual with developmental disability, disclosure of the record is authorized; or

(iv) To the executive director or a designee of the executive director of the State-designated protection and advocacy agency, if:

1. The agency has received a request for an investigation; and

2. There is no other person to whom, on behalf of the individual with developmental disability, the record may be disclosed under this paragraph; or

3. The individual with developmental disability is unable to give written informed consent and the Director determines that disclosure is necessary to protect the rights of the individual with developmental disability.

(2) A licensee shall comply within 14 days after an individual with developmental disability or a person who is authorized to act on behalf of that individual, asks in writing:

(i) To receive a copy of a record; or

(ii) To see and copy the record disclosed.

(c) If a licensee refuses to disclose a record under subsection (b)(1)(i) of this section, the executive officer or administrative head of a licensee shall apply, within 10 working days after the refusal, to the circuit court for the county where the individual making the request resides or where the site of services to the individual occurred for an order to permit the executive officer or administrative head of the licensee to continue to refuse disclosure to the individual with developmental disability.

(d) A licensee shall disclose a record that is sought:

(1) By the staff of the licensee to carry out a purpose for which the record is kept;

(2) By any other person who provides or coordinates services in accordance with the individual's plan of habilitation;

(3) By the Director or a designee of the Director; and

(4) By a person to further the purposes of:

(i) A medical review committee;

(ii) An accreditation board or commission;

(iii) A licensing agency that is authorized by statute to review records;

(iv) A court order;

(v) A representative of the Division of Reimbursement of the Department;

(vi) An auditor of the Department;

(vii) An auditor of the Office of Legislative Audits of the Department of Legislative Services; or

(viii) The Clients' Rights Committee of the licensee unless the individual with developmental disability objects.

(e) (1) A licensee may require a person who asks for a copy of a record to pay a reasonable fee.

(2) The fee may not exceed the cost of copying the record.

(f) (1) Except for a disclosure that is made to the staff for its routine use under subsection (d)(1) of this section, a licensee shall keep a list of all disclosures of a record.

(2) The list shall state:

(i) The date, nature, and purpose of each disclosure; and

(ii) The name and address of each person to whom the disclosure is made.

7-1011.

(a) An individual with developmental disability or person who is authorized to act on behalf of the individual may:

(1) Contest a record that the licensee keeps on the individual;

(2) Ask for an addition to or other change in the record; and

(3) Contest disclosure of the record.

(b) Within 14 days after a licensee receives a request to change a record, the licensee shall acknowledge receipt of the request.

(i) Make or refuse to make the requested change; and

(ii) Give the person who requested the change written notice of the licensee's action.

(2) A notice of refusal shall contain:

(i) Each reason for the refusal; and

(ii) Any procedures that the Director has set for review of the refusal.

(d) (1) An individual with developmental disability or person who is authorized to act on behalf of the individual may ask the Director to review the refusal.

(2) Within 45 days after the request for review, the Director shall:

(i) Complete the review;

(ii) Make a final determination; and

(iii) Give the individual with developmental disability or person who is authorized to act on behalf of the individual written notice of the final determination.

(e) If the final determination of the Director is a refusal to change a record, the written notice shall include:

(1) Each reason for the refusal;

(2) The procedure for inserting in the record a concise statement of the reason that the individual with developmental disability or person who is authorized to act on behalf of the individual disagrees with that refusal; and

(3) Information on the right to seek judicial review of the decision of the Director.

FACT SHEET

SB776, Lead Sponsor Senator Sharon Grosfeld

HB988, Lead Sponsor Delegate James Hubbard

Individuals with Developmental Disabilities - Additional Rights and Services

The Right to Be Informed

Whereas, Federal Medicaid Law 42 CFR S 441.302 (d) provides that recipients be informed of any feasible alternatives available under the waiver; and given the choice of either institutional or home and community-based services;

Whereas, Maryland Health-General S 7-102 states that it is the policy of this State to promote, protect, and preserve the human dignity, constitutional rights and liberties, social well-being, and general welfare of individuals with developmental disability in this state;

Whereas, Maryland Health-General S 7-1002 provides persons with developmental disabilities with certain basic rights;

Whereas, COMAR 10.22.04/.02 defines values to be considered in the development of an IP and fundamental rights for individuals receiving services in the community and state residential centers;

Legislation to:

A. Right to be informed

Adds to the basic rights of individuals who receive any services provided by the Administration or by a licensee the right to be informed of all less restrictive service options.

B. IP and Planning

Requires all licensees to provide information on the range of service options in a manner approved by the DDA at the time of annual planning.