(a) The County Council finds from reports, hearings, and community groups that certain County residents: (1) in the course of formal rehabilitation therapy, benefit from a group home environment; (2) prefer, and benefit from, living in a residential environment with individuals with similar needs; and (3) can reside in a non-institutional environment with appropriate care and services. (b) Essential features of a group home are the quality of the services provided, the provision of a safe and sanitary environment, and the home's appropriateness for the individuals served. (c) The County government must provide a timely, coordinated procedure to review applications for group home licenses and assure that services delivered to residents are appropriate and meet residents' needs.

(a) This Chapter must be liberally construed and applied to reflect the findings in Section 23A-1. (b) The intent of this Chapter is to: (1) simplify and clarify the laws governing the use of group homes for residents who require supportive care; (2) assist applicants in establishing group homes; (3) ensure the quality of group home programs; and (4) provide an integrated County/State licensing procedure and administrative process for group homes.

This Chapter does not apply to a: (a) facility which holds a valid license for institutional care, such as a nursing home, hospital, child or adult day care facility, or domiciliary care home for 5 or more residents; (b) foster or respite care home for children which is approved by the County Department of Health and Human Services, the State Department of Juvenile Services, or any licensed child placement agency, in accordance with standards set by the appropriate State agencies; (c) foster care or respite care home for adults for 3 or fewer elderly persons or persons with disabilities, which is approved by the Department of Health and Human Services; (d) licensed residential or institutional facility whose total number of residents at any one time will exceed 16 or the number of persons allowed under a license for the facility issued by a state agency, whichever is less; (e) group home which does not routinely provide more than 50 hours of on-site supervision a week, but a home exempted under this subsection may apply for a license and be licensed if it meets the requirements of this Chapter; or (f) group home for developmentally disabled adults which is licensed by the Maryland Department of Health; or (g) group of persons, not related by blood or marriage, living together in a dwelling unit as a household as defined in Chapter 59. Supportive care services and treatment for individual residents or the group may be provided by a person or agency that does not assume responsibility for acquiring those services or treatments or for supervising, directing, or controlling the residents.

In this Chapter, the following words and phrases have the following meanings: Activities of daily living (ADL): Routine daily activities, such as: (a) Mobility. Providing physical support to enable a resident to move about in or outside a group home. (b) Personal hygiene. (1) Bathing: Assembling towels, soaps, and other necessary supplies; helping a resident in and out of the bathtub or shower; turning the water on and off; adjusting water temperatures; washing and drying portions of the body which are difficult for a resident to reach; and being available while a resident is bathing. (2) Grooming: Helping a resident with shaving, oral care, hair care, and nail care. (c) Dressing. Helping a resident choose, put on, and remove appropriate clothing. (d) Eating. Helping a resident cut food and pour beverages, and feeding a resident who is unable to feed himself or herself. (e) Toileting. Reminding a resident about using the toilet; assisting a resident to the bathroom; helping a resident to undress; positioning a resident on the commode; and helping a resident with related personal hygiene, including assistance with changing of adult briefs. (f) Interpersonal interaction. Helping a resident identify social needs and interests and engage in activities to satisfy those needs and interests; creating activities in the home to encourage resident-to-resident and resident-to-staff socializing. Applicant: A person applying for a group home license or license renewal. Board: A program review board that meets on an ad hoc basis to consider a program statement filed by an applicant for a license. COMAR: The Code of Maryland Regulations. Day care is defined in COMAR regulations governing day care for the elderly and medically handicapped adults. Department: The Department of Health and Human Services. Director: The Director of the Department of Health and Human Services or the Director's designee. Domiciliary care is defined in COMAR regulations governing domiciliary care homes. Group home: A residence which houses 3 to 16 unrelated persons receiving group residential care, but not more than the number of persons allowed under a license issued by a state agency. Group residential care: The provision of shelter, board, facilities, resources for daily living, personal guidance and direction, and related supportive care and services in a residential environment. Group senior assisted housing is defined in COMAR regulations governing Group Sheltered Housing for the Elderly. Licensee: The person to whom a facility license is issued under this Chapter. Person: Any individual, partnership, or firm; corporation, public or private, profit or nonprofit; association; government agency; or any other legal entity. Primary care giver: A supportive staff person who is responsible for providing group residential care services for residents under the supervision of the home's staff director. Program statement: A document approved by the Director that describes: (a) a group home's scope of services; (b) the nature, purpose, objectives, policies, and procedures of the proposed program; (c) the background and experience of the organization or person sponsoring the home; (d) the experience and qualifications of the applicant and personnel operating the home; (e) the needs and capabilities of the residents to be served; and (f) the budget, resources and procedures for meeting those needs. Resident: An individual who resides in a group home in order to receive group residential care. Staff director: A person who is authorized to direct, manage, and supervise the activities of the staff at a group home. The staff director may be the licensee or a person designated by the licensee to operate and manage the group home as the licensee's agent. Supportive care: 24-hour supervision, 3 meals a day, housekeeping services, medication supervision, and assistance with personal care or the activities of daily living. Unrelated individual: Any person who is not a son, daughter, grandson, granddaughter, father, mother, grandfather, grandmother, brother, sister, aunt, uncle, stepmother, stepfather, stepson, stepdaughter, husband or wife, or in-law of any listed person, or of the owner, operator, or lessee of the group home.

This Chapter is administered and enforced by the Department of Health and Human Services.

(a) The County Executive may adopt regulations under method (2) to implement this Chapter. The regulations must not conflict with any provisions of this Chapter or be less restrictive than the provisions of Chapter 26. (b) The Director may waive any requirement of this Chapter or any regulation issued under this Chapter for good cause. (c) Regulations issued to implement this Chapter must set standards for: (1) program and administrative requirements for group residential care, such as the qualifications of the licensee and staff, adequate staffing and supervision, health and other records pertaining to group home residents, medication management, telephone service, minimum space per resident, transportation resources, and the scope of the services to be provided; (2) when a program statement or a criminal background check is required; (3) evacuation plans; (4) coordination of the administration and enforcement of this Chapter with appropriate State and local agencies, under which the County must accept regulatory standards, inspections, and reviews by State and local agencies to fulfill County licensure requirements when the population being served and the standards of care are substantially identical; (5) health and sanitation; (6) handling complaints of violations of this Chapter, and procedures to refer complaints not related to this Chapter to the licensee and any public agency with jurisdiction over the complaint; (7) time and schedule requirements to approve or disapprove a license application, not including any time needed to obtain a special exception; and (8) admission and retention of residents.

Any violation of this Chapter or a regulation issued under this Chapter is a Class A violation. This Chapter does not limit the right of any person to seek damages or other judicial relief because of injury to persons or property.

(a) A building must not be advertised or used as a group home until the Director issues an annual license. A building must not be advertised or used as a group home after a license has expired or has been revoked or suspended. (b) A group home registered with but not licensed and inspected by a State agency must be licensed as a group home under this Chapter.

(a) Each applicant must submit on a form provided by the Director: (1) the name, address, and telephone number of the applicant and staff director; (2) the address of the group home; (3) the maximum number of residents who will reside at the home at any one time; (4) the number of staff on each shift and the number of staff who will reside on the premises; (5) the steps the staff director will take to receive, investigate, and respond to inquiries and complaints from non-residents; (6) the name of the State agency that licenses, certifies, or registers the group home or from which a license, certificate, or registration was requested; (7) a program statement, when one is required; and (8) any other information the Director may require. The Director must not accept a license application unless it is complete. (b) Any reference or other personnel information submitted as part of an application for a license must be treated as confidential and used only for review by a program review board and for the oversight of operations by the Director. (c) The Director must give each applicant information necessary to contact other relevant agencies about applicable licenses, permits, special exceptions, and other regulatory requirements. (d) A separate program statement must be submitted as part of an application if an applicable regulation adopted under Section 23A-6 requires the statement, or when the regulation does not establish County standards or incorporate State standards governing residential care and services for the population to be served. Each program statement must specify: (1) the program purpose, goals and objectives; (2) the means to accomplish the goals and objectives; (3) the needs and capabilities of the population to be served; (4) the proposed budget, resources, and procedures to meet those needs; (5) the proposed operating methods and procedures for medication management, transportation, social and recreational services, 24-hour supervision, personal care services, and food service; (6) client admission and retention criteria; (7) qualifications and experience of the applicant and the personnel operating the group home; and (8) any other information the Director may require. (e) A separate license application, supporting documentation, and, if required, program statement must be submitted for each group home to be licensed. (f) Each applicant must pay a license fee set by executive regulation adopted under method (3) in an amount that does not exceed the prorated costs of administering this Chapter. (g) Before a license is issued, the proposed group home must be inspected for compliance with County health and safety standards. (h) The Director must not issue or renew a group home license unless the following documents have been filed with the Department not more than 60 days before the license is issued or 30 days before the license is renewed: (1) a certificate from the Department of Permitting Services stating that the facility complies with applicable County building, housing, electrical, fire, and zoning codes. A certificate is not required when a license is renewed, but may be required at any time physical or structural changes are made to a group home or the number of residents increases; (2) a statement from the Fire Marshal, if required, that the group home meets appropriate Life Safety Code standards; (3) a statement from the Department that the group home complies with all applicable health and sanitation requirements; (4) a statement from the Director that the group home program meets the requirements of this Chapter; and (5) when a program is regulated by a state agency with quality of care standards, a certificate from that agency that the group home is licensed, certified, or registered; or a certificate from the Director indicating that the program statement is acceptable.

(a) Term of license and renewal. Each license issued under this Chapter expires one year after issuance. A complete application for renewal must be submitted to the Director at least 60 days before a license expires. If the applicant has timely filed a complete renewal application and the existing license is not suspended or revoked, the existing license remains in effect for up to 90 days after its expiration date, until the Director acts on the application for renewal. (b) Proof of licensure. The current license must be kept at the group home available for inspection. (c) Notice of legal proceedings. Each licensee must file a written report with the Director, within 10 days after receiving notice of the initiation of the action, on any civil or criminal action and any action by a state agency to deny, suspend, or revoke any license, brought against the licensee or any employee or volunteer, if the action involves or affects the care of residents or the operation of the group home. (d) Change of name, ownership, or location. A license must not be transferred from one person to another, from one group home to another, or from one location to another. The licensee must notify the Director before a change in ownership of a group home. Before a change in location, the licensee must notify the Director in writing and apply for a license for the group home at the new location. (e) Appropriateness of admissions. Each licensee or staff director must determine the appropriateness of a resident for the group home and assure that the resident's needs are identified and met. (f) Responsibility for compliance. Each licensee is responsible for the overall operation of the group home and for compliance with all applicable laws and regulations. (g) Residents' rights. Each licensee must implement and enforce all residents' rights required by State Regulations for the population served, and must actively support residents who assert those rights. (h) Discrimination. A group home provider must not discriminate in admitting or providing care to an individual because of the individual’s race, color, religion, national origin, or disability, as defined in Chapter 27. (i) Resident capacity. A group home must not exceed its licensed resident capacity. (j) Relative as residents. When a relative of a licensee, or a relative of an employee of the licensee, resides in a group home and receives care and services from staff other than the licensee, with or without compensation, the relative must be considered a resident for purposes of assuring that the care received complies with this Chapter. (k) Day care or respite care. Day care or respite care must not be provided to a non-resident unless the licensee obtains the appropriate day care or respite care license and zoning approval. In providing this care, a group home must not exceed its licensed resident capacity. (l) Compliance. The licensee or staff director must comply with all requirements of this Chapter and relevant State and County Regulations.

(a) Right of entry; inspection. The Director may, at any reasonable time, visit or inspect any group home to determine compliance with applicable laws and regulations, and investigate complaints of non-compliance. The Director must conduct an annual inspection of each licensed group home. The Director may establish a procedure to accept State agency oversight of the program of services offered to residents instead of County inspections. (b) Deficiency correction orders. When an inspection reveals that a licensed group home is not in compliance with any licensing requirement of this Chapter or a regulation, the Director may order the licensee to correct the deficiency. The order must include a statement of the deficiency, the time period within which the deficiency must be corrected, a citation of the applicable law or regulation, and an explanation of the licensee's appeal rights under this Chapter. (c) Failure to comply with a directive. If the licensee fails to correct the deficiency within the time period prescribed, the Director may restrict new admissions until the deficiency is corrected, or move to suspend or revoke the license. (d) Restriction on admissions; suspension, revocation, or denial of license. (1) The Director may restrict admissions to a group home, or suspend, revoke, or deny a group home license, if the Director finds that: (A) the group home does not comply with this Chapter; (B) the licensee has violated applicable laws or regulations, or deficiency correction orders; (C) the licensee operated a previous group home and the license of that home was revoked or is suspended, or a regulatory agency has issued an order restricting admissions to that home; (D) the license was obtained by fraud; or (E) issuance or retention of the license is not in the best interest of the health, safety or welfare of the residents. (2) If a group home license issued by a State agency with quality of care standards is restricted, suspended, or revoked, the group home's County license is automatically restricted, suspended, or revoked, respectively, without further notice or action by the Director. (3) Notice of any restriction on admissions, suspension, revocation, or denial proposed by the Director must be in writing, specify the basis for the action, and be delivered to the applicant or licensee by certified mail or personal service. The notice must give the applicant or licensee an opportunity to appear and show cause before the Director why the license should not be restricted, suspended, revoked or denied. Nothing in this Section prohibits the Director from proceeding directly under Section 23A-7. (e) Immediate suspension in emergency. The Director may immediately suspend a license when failure of the licensee to comply with any applicable law, regulation, approved program statement, or deficiency correction order, or the suspension, revocation, or denial of a license by a State agency, results in an emergency situation which immediately threatens the health, safety, or welfare of a resident in the group home. The Director must give the licensee notice of the basis for the suspension and the time and place of a hearing to be held within one work day. At the hearing the licensee may show cause why the license should not continue to be suspended. The hearing may be postponed up to 72 hours at the written request of the licensee, during which time the license remains suspended. (f) Notice to placement agencies. The Director must notify appropriate placement agencies of the suspension, revocation, or denial of a license and may ask the agencies to find alternative placements for the residents, depending on the nature of the notice given. Any agency that receives this notice must be notified if the order is rescinded. (g) Appeal from deficiency correction order, suspension, revocation, or denial of license. A person aggrieved by an action of the Director under this Section may appeal that action to the County Board of Appeals within 10 days after the date of notice of the Director's action. The filing of an appeal does not stay the Director's order unless the Board of Appeals grants a stay on motion of the appellant.

(a) An applicant or licensee must submit a program statement when a regulation requires one, or when the regulation does not establish County standards or incorporate State standards governing residential care and services for the population to be served. The Director must certify that the proposed program of services submitted by an applicant is adequate and appropriate to meet the residents' needs. If the proposed program already has been reviewed and approved by another agency responsible for licensing or certifying programs for the population to be served, the Director may accept that review and certify the program. (b) When a program statement is required, the Director must convene an ad hoc program review board to review the program statement of an applicant for a license except when the Director accepts a review that has been conducted by another agency. Each board must consist of representatives from: (1) government agencies involved with the group home program being considered; and (2) professional, charitable and social service organizations with experience in providing care for the residents to be served by the program. (c) If an application to renew a group home license is pending, a board may be convened for program evaluation if the Director finds the program, number of residents, or needs of residents have changed sufficiently to require an additional evaluation or the needs of the residents have not been met by the existing program statement. (d) Each board must consist of not less than 5 and not more than 7 members. A simple majority of the board constitutes a quorum. The board must keep minutes of its proceedings and meetings. Meetings of the board must be closed to the public to the extent allowed by State law. All decisions and recommendations of the board must be made by resolution in which at least a majority of those present or polled concur. (e) The board must review and evaluate the program statement and give the Director its recommendations. In developing its recommendations, the board must examine: (1) the nature, purpose, objectives, policies and procedures of the proposed program; (2) the background and experience of the applicant; (3) the experience and qualifications of the personnel operating and providing care in the group home; (4) the needs and capabilities of the residents to be served, and the applicant's resources and procedures for meeting those needs; and (5) any other information the Director considers necessary to accomplish the objectives of this Chapter. The board must review the elements of the program statement and evaluate each application in accordance with the requirements stated in the applicable regulation. (f) The board may request technical service, advice, data, or factual evidence from other agencies as necessary to develop its recommendations. (g) The Director may approve or disapprove the program after considering the board's recommendations. The Director may or may not accept the review of another agency, as authorized in this Chapter.