In this subtitle, “recipient of individual support services” means an individual who receives individual support services.

This subtitle does not limit the right of any person to practice a health occupation that the individual is licensed or otherwise authorized to practice under the Health Occupations Article.

In addition to any other license required by law, a person shall be licensed by the Department before the person may provide services to an individual with developmental disability or a recipient of individual support services. The Department shall adopt regulations providing for the services requiring licensure under paragraph (1) of this subsection. If a person is licensed or certified by another State agency or accredited by an organization approved by the Secretary in accordance with § 19–2302 of this article to provide services to an individual with a developmental disability or a recipient of individual support services, the Deputy Secretary may waive the requirement for a license by the Department. Upon a showing by the Deputy Secretary that the licensed, certified, or accredited person is out of compliance with licensing regulations adopted by the Secretary, the Deputy Secretary may revoke the waiver.

The Secretary shall adopt rules and regulations for the licensing of services for an individual with developmental disability or a recipient of individual support services. The rules and regulations shall ensure that services to an individual with developmental disability or a recipient of individual support services are provided in accordance with the policy stated in Subtitle 1 of this title. The rules and regulations shall require that: At least 75% of the governing body of a licensee shall be residents of the State or reside within a 100–mile radius of the administrative offices of the licensee, which shall be located in the State; and No employee of a licensee or immediate family member of an employee of a licensee may serve as a voting member of the governing body of a licensee unless: The employee receives services from the licensee; or The Department explicitly approves the composition of the governing body through an innovative program service plan in accordance with COMAR 10.22.02.09.F. The requirements of paragraph (1)(i) of this subsection may be waived if a community–based advisory board or committee is established by the licensee and approved by the Department. The rules and regulations shall also require that an applicant for a license under this section shall demonstrate to the Department the applicant’s capability to provide for or arrange for the provision of all applicable services required by this title by submitting, at a minimum, the following documents to the Department: A business plan that clearly demonstrates the ability of the applicant to provide services in accordance with Maryland regulations and funding requirements; A summary of the applicant’s demonstrated experience in the field of developmental disabilities, in accordance with standards developed by the Department; Prior licensing reports issued within the previous 10 years from any in–State or out–of–state entities associated with the applicant, including deficiency reports and compliance records on which the State may make reasoned decisions about the qualifications of the applicant; and A written quality assurance plan, approved by the Developmental Disabilities Administration, to address how the applicant will ensure the health and safety of the individuals served by the applicant and the quality of services provided to individuals by the applicant.

An applicant for a license shall submit an application to the Department on the form that the Department requires. The application shall provide the information that the Department requires.

When an application for a license is filed, the Department promptly shall investigate the applicant.

An applicant for a license shall meet all requirements in rules and regulations adopted under § 7–904 of this subtitle to be issued a license. The Department may deny a license: To any entity that has had a license revoked by the Department within the previous 10 years; or To any entity that has a corporate officer who has served as a corporate officer for an entity that has had a license revoked by the Department within the previous 10 years.

A license authorizes the licensee to provide services while the license is effective.

In this section, the word “licensee” means a person who is licensed by the Department under this title to provide services. The Department shall inspect each site or office operated by a licensee at least once annually and at any other time that the Department considers necessary. The Department shall evaluate periodically the performance of surveyors who carry out inspections under this subsection to ensure the consistent and uniform interpretation and application of licensing requirements. The Department shall keep a report of each inspection. The Department shall bring any deficiencies to the attention of: The executive officer of the licensee; or In the case of an intermediate care facility–intellectual disability, the State Planning Council and the State–designated protection and advocacy agency. The Department shall adopt regulations that establish a system of prioritization to respond to and investigate serious reportable incidents, as defined by the Department, in the areas of abuse, neglect, serious injury, and medication errors that threaten the health, safety, and well–being of individuals receiving services funded by the Department in State–operated and in community programs licensed by the Department. The Department shall seek input from individuals with disabilities and their families, licensees, and advocacy organizations in developing the regulations, prior to publishing the regulations in the Maryland Register for public comment. The regulations shall define and address: The procedures and timelines that providers must follow when reporting serious reportable incidents and deaths to the Department; The Department’s protocol to determine the necessity to investigate a serious reportable incident that takes into account: The severity of the incident; The quality of the licensee’s internal investigation; and The number and frequency of serious reportable incidents reported by the licensee to the Department; The specific roles and responsibilities of each governmental unit involved in any follow–up investigations that may occur due to a licensee’s report of a serious reportable incident or death; Methods of investigations, including on–site investigations; Timelines for response to serious reportable incidents and deaths and investigation of serious reportable incidents and deaths; Timelines for issuing specified reports, including corrective action plans, to the Department, licensee, Mortality and Quality Review Committee, Medicaid Fraud Unit, individuals receiving services from the licensee involved in the incident and their guardians or family members, and others; and Follow–up protocols for the Department to ensure that corrective action has been implemented by the licensee.

The Department shall deny a license to any applicant or suspend or revoke a license if the applicant or licensee fails to comply with the applicable laws, rules, or regulations of this State. The Department may impose sanctions, including a civil money penalty, for failure by a licensee to substantially comply with applicable State laws, regulations, or rules. The Department shall adopt rules and regulations providing for the sanctions to be imposed under this subsection. A civil money penalty imposed under this subsection may not exceed $5,000. In establishing the amount of a civil money penalty imposed under this subsection, the Department shall consider, under guidelines established in the regulations adopted under paragraph (2) of this subsection: The number, nature, and seriousness of the violations; The degree of risk caused by the violations to the health, life, or safety of the individual served by the licensee; The efforts made by the licensee to correct the violations; Any history of similar violations; Whether the amount of the proposed civil money penalty will jeopardize the financial ability of the licensee to continue serving individuals; and Any other reasonable factors as determined by the Department. If a civil money penalty is proposed, the Department shall offer the licensee an opportunity for informal dispute resolution. If, following the opportunity for informal dispute resolution, a civil money penalty is imposed, the Department shall provide: Written notice of: The basis on which the order is made; The deficiency on which the order is based; The amount of the civil money penalty to be imposed; and The manner in which the amount of the civil money penalty was calculated; and An opportunity for a hearing as provided under subsection (e) of this section. The Department shall have the burden of proof with respect to the imposition of a civil money penalty under this subsection. Any applicant or licensee who knowingly and willfully makes a false statement in connection with an application under this subtitle shall be guilty of a misdemeanor and upon conviction shall be subject to a fine not to exceed $1,000, or imprisonment not exceeding 1 year, or both. The Department may impose a penalty not exceeding $500 per day per violation for each day a violation occurs on a licensee that fails to comply with the reporting requirements established under § 7–306.1(l) of this title. Except as otherwise provided in § 10–226 of the State Government Article and subsection (f) of this section, before the Department takes any action against an applicant or a licensee under this section, the Department shall give the applicant or licensee notice and an opportunity for a hearing. If the Department finds that the public health, safety, or welfare of individuals with disabilities receiving services from a licensee imperatively requires emergency action, the Department may suspend the license or order a licensee to remedy immediately the situation requiring the emergency action. The order to remedy immediately the situation shall be effective immediately and shall remain in effect until: The Department rescinds the order; or There is a resolution through the administrative hearing process. If the Department issues an order under paragraph (1) of this subsection, the Department promptly shall give the licensee: Written notice of the order, the finding, and the reasons that support the finding; and An opportunity to be heard.