The Secretary shall adopt rules and regulations that contain criteria for: Appropriate evaluations; Allocation of services; and Acceptance of individuals for services. The rules and regulations for individuals with developmental disability and for individuals without developmental disability, but who are eligible solely for individual support services, shall be separate.

Application for services may be made as provided in this subtitle: By the individual, if the individual is an adult; or By any other person who has a legitimate interest in the welfare of the individual.

Except as otherwise provided in this title, an applicant for services provided or funded, wholly or partly, by this State shall submit an application to the Department in writing. The application shall contain the information that the Department requires. Within 60 days after the Department receives an application for services for an individual, the Secretary, on the basis of the application, shall: Determine whether there is a reasonable likelihood that the individual: Has developmental disability; or Does not have developmental disability, but may be eligible for individual support services under subsection (c) of this section; and If a positive determination is made under item (1)(i) or (ii) of this subsection: Approve the application; Determine the nature of the disability; Determine the nature of services that the individual may require; Determine the type of environment in which any needed services could be provided with the least restriction on the liberty of the individual; Determine what types of evaluations, if any, the individual requires; Inform the individual of these determinations; and Inform the individual that these determinations are preliminary and may be subject to modification as a result of further evaluation. To be eligible for individual support services, an individual shall have a severe chronic disability that: Is attributable to a physical or mental impairment, other than the sole diagnosis of mental illness, or to a combination of mental and physical impairments; and Is likely to continue indefinitely. If the Secretary determines, based on the application, that the individual has a sole diagnosis of mental disorder, the Secretary shall refer the individual to the Behavioral Health Administration.

Before an individual whose application for services has been approved by the Secretary is accepted for services, the individual is required to receive an evaluation in accordance with the rules and regulations adopted under § 7-401(a)(1) of this subtitle. The Secretary may not accept an individual for services unless the results of the evaluation are that the individual: Has developmental disability; or Does not have developmental disability, but does meet the eligibility requirements for individual support services. From among the individuals whose applications for services have been approved and who have been found eligible for services as a result of the required evaluation, the Secretary shall determine in accordance with the rules and regulations adopted under § 7-401(a)(2) and (3) of this subtitle the nature, extent, and timing of the services to be provided to individuals. In making a determination under paragraph (1) of this subsection, the Secretary shall consider: The results of the required evaluation; The needs of the individual; and The needs of the family unit of the applicant.

In this section, “legal resident” means an individual who maintains the State as the individual’s principal establishment, home of record, or permanent home and to where, whenever absent due to uniformed services obligation, the individual intends to return. A dependent of a legal resident of the State who is determined eligible to receive services from the Administration under this title shall retain eligibility for the services: Regardless of whether the legal resident leaves the State due to the legal resident’s uniformed services assignment outside the State; and If the dependent is otherwise eligible for the services. If a dependent of a legal resident is on a waiting list for services to be provided under this title, the Administration shall allow the dependent to remain on the waiting list for services while the legal resident is outside the State due to the legal resident’s uniformed services assignment outside the State. The Administration shall reinstate services provided under this title to a dependent of a legal resident who resides with the legal resident while the legal resident is outside the State due to the legal resident’s uniformed services assignment outside the State: On the relocation of the dependent to the State; and If a request for services is made.

Acceptance for services under this title does not affect an individual’s eligibility for services provided by any other public or private agencies. If the Secretary determines that an individual who is eligible for services under this title also may be eligible for services provided by another agency, the Secretary shall refer the individual to that agency.

The Secretary shall provide notice and an opportunity for a Medicaid fair hearing in accordance with Title 10, Subtitle 2 of the State Government Article and federal Medicaid law to: An applicant for Administration Medicaid waiver services who is denied eligibility for the services; An applicant for Administration Medicaid waiver services who contests the priority category assigned to the applicant for the services; and A recipient of Administration Medicaid waiver services: Whose claim for Administration Medicaid waiver services is denied or is not acted on with reasonable promptness; or Who believes the Administration has taken an action erroneously. Except as provided in subsection (a) of this section, an applicant for services or a recipient of services under this title may: Request an informal hearing before the Secretary’s designee on any action or inaction of the Secretary made under this title; and Request the Secretary to review the decision of the informal hearing. After the Secretary receives a request for a review, the Secretary shall conduct the review in accordance with Title 10, Subtitle 2 of the State Government Article.

Any person aggrieved by a final decision of the Secretary in a contested case, as defined in § 10-202 of the State Government Article, may take an appeal as allowed in §§ 10-222 and 10-223 of the State Government Article.

The Administration, in consultation with stakeholders, shall establish and provide training materials to coordinators of community services specifically on the self–directed services model of receiving services, including training materials on self–directed services, procedures, policies, and resources. As part of the process of developing a person–centered plan of service for a recipient, a coordinator of community services shall educate the recipient on all models of service available to the recipient, including self–directed services, traditional services, and provider–managed services, to assist the recipient and the recipient’s family or representative in making an informed choice on which services the recipient would like to receive: When the individual begins receiving services from a coordinator of community services; and At least once each year that the individual is receiving services from a coordinator of community services. A coordinator of community services shall report to the Administration, in the form and manner required by the Administration, that the coordinator provided information on self–directed services, traditional services, and provider–managed services to an individual in accordance with this section.

The Administration shall provide to a recipient who receives self–directed services: Individual–directed and family–directed goods and services in an amount based on the recipient’s needs and included in the recipient’s person–centered plan of service as calculated: On an annual basis; and Within the limits of the approved annual budget generated by the Department’s Long Term Services and Supports software system or its replacement system; Access to the recipient’s plan of service and budgets for the plan of service through the Department’s Long Term Services and Supports software system or its replacement system; Up to 30 hours of support broker services each month, as needed by the recipient and within the recipient’s total approved annual budget; An option for a family member or legal guardian of the recipient to provide services for the recipient, if: The recipient or an individual authorized to make care decisions on behalf of the recipient chooses the family member to provide the services; and The recipient also hires a support broker; Reimbursement paid on a per–mile basis to the owner of a specialized, modified, or accessible vehicle driven by an employee of the recipient and for the purpose of the recipient engaging in activities specified in the recipient’s person–centered plan of service; A budget for self–directed services that provides the ability to use funds from the recipient’s approved annual budget for the purpose of funding at least one position to assist the recipient in managing the recipient’s home, staff, and other administrative duties and pay administrative expenses needed to operate the recipient’s plan of service, including Internet service and office equipment; An option for a recipient who has a demonstrated need for overnight supports provided through personal support services carried out using the recipient’s employer or budget authority to direct and choose the employee, vendor, or provider of the overnight supports; The choice of a vendor to provide fiscal management services from at least three options; The option to employ a representative, support broker, or team of individuals to support the recipient in directing services; and Training for a representative, support broker, or team of individuals on self–directed services. Subject to subsection (a)(3) of this section, the Administration shall provide to a recipient of self–directed services any support broker services that are: Authorized by regulations adopted or guidance issued by the Centers for Medicare and Medicaid Services in § 1915(c) of the Social Security Act; and Selected by the recipient. Subject to paragraph (2) of this subsection, the Administration may not establish a limit on the number of hours of personal support services provided to a recipient who receives self–directed services that: Are necessary for the health and safety of the recipient; and Are authorized by regulations adopted or guidance issued by the federal Centers for Medicare and Medicaid Services under § 1915(c) of the Social Security Act. A recipient may not receive services or supports in excess of the recipient’s annual approved budget. The State may not require a recipient to demonstrate competency before the Administration authorizes the recipient to receive self–direct services.

The Administration shall provide up to 30 hours of support broker services each month to a recipient of waiver services, as needed by the recipient and within the recipient’s total approved annual budget. Subject to subsection (a) of this section, the Administration shall provide to a recipient of waiver services any support broker services that are authorized by regulations adopted or guidance issued by the Centers for Medicare and Medicaid Services under § 1915(c) of the Social Security Act.