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<section article="ghg" article_name="Health - General" number="19-4A-11" title_number="19" title_name="Health Care Facilities" subtitle_number="4A" subtitle_name="Residential Service Agencies">
  <level label="a">
    <level label="1">
      <text>On or before December 30, 2021, the Office of the Attorney General, in consultation with the Department and the Maryland Department of Labor, shall produce a guidance document concerning the application of employee protection laws in the Labor and Employment Article, to the use of personal care aides by residential service agencies.</text>
    </level>
    <level label="2">
      <text>The guidance document required under paragraph (1) of this subsection shall:</text>
      <level label="i">
        <text>Describe with specific reference to the residential service care industry:</text>
        <level label="1">
          <text>Relevant definitions of “employ”, “employee”, “employer”, and “independent contractor”;</text>
        </level>
        <level label="2">
          <text>The concept of independent contractor misclassification and the potential for legal liability including monetary damages for employees; and</text>
        </level>
        <level label="3">
          <text>Steps a residential service agency may take to ensure compliance with the Labor and Employment Article;</text>
        </level>
      </level>
      <level label="ii">
        <text>Be three pages or fewer and, to the extent feasible, written in plain language; and</text>
      </level>
      <level label="iii">
        <text>Be revised and updated on an annual basis.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>As a condition of obtaining an initial license from the Department to operate as a residential service agency and every 3 years thereafter, a residential service agency shall certify to the Department, on a form developed by the Department and through the signature of an individual with authority over the residential service agency’s pay or employment practices, that:</text>
      <level label="i">
        <text>The individual has read and understood the guidance document produced under subsection (a) of this section; and</text>
      </level>
      <level label="ii">
        <text>The residential service agency will comply with the relevant requirements of the Labor and Employment Article.</text>
      </level>
    </level>
    <level label="2">
      <text>On an annual basis, the Secretary shall provide the most current version of the guidance document to each licensed residential service agency.</text>
    </level>
    <level label="3">
      <text>A form developed by the Department for use under paragraph (1) of this subsection shall include a checkbox by which a residential service agency that receives Medicaid reimbursement for the provision of home care or similar services by a personal care aide shall indicate whether the residential service agency uses personal care aides designated as independent contractors.</text>
    </level>
  </level>
  <level label="c">
    <text>On or before October 1 each year, each residential service agency receiving Medicaid reimbursement for the provision of home care or similar services by a personal care aide shall report to the Department, on a form or in an electronic manner developed by the Department, the number of personal care aides classified by the residential service agency as:</text>
    <level label="1">
      <text>Employees; and</text>
    </level>
    <level label="2">
      <text>Independent contractors.</text>
    </level>
  </level>
  <level label="d">
    <level label="1">
      <text>On or before July 1 each year, the Department shall use the information reported under subsection (c) of this section to create a report concerning:</text>
      <level label="i">
        <text>Medicaid reimbursement rates;</text>
      </level>
      <level label="ii">
        <text>The cost of delivering services; and</text>
      </level>
      <level label="iii">
        <text>Aggregated employment classifications of individuals who provide personal care.</text>
      </level>
    </level>
    <level label="2">
      <text>Data included in the report under this subsection:</text>
      <level label="i">
        <text>May only be in aggregate; and</text>
      </level>
      <level label="ii">
        <text>May not identify a specific residential service agency.</text>
      </level>
    </level>
    <level label="3">
      <text>The Department shall submit each report created under paragraph (1) of this subsection to the Senate Finance Committee and the House Health and Government Operations Committee in accordance with § 2–1257 of the State Government Article.</text>
    </level>
  </level>
</section>
