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<regulation prefix="Regulation" num=".06" citation="COMAR 10.01.18.06" title_num="10" subtitle_num="01" chapter_num="18" heading="Reporting Requirements for State Facilities.">
  <paragraph num="A.">
    <text>This regulation applies to State facilities.</text>
  </paragraph>
  <paragraph num="B.">
    <text>For purposes of this regulation, “discovery” means staff observes, receives a complaint from an individual or other source, or otherwise has reason to believe that inappropriate sexual behavior has occurred.</text>
  </paragraph>
  <paragraph num="C.">
    <text>A State facility shall comply with the reporting requirements of:</text>
    <paragraph num="(1)">
      <text>COMAR 07.02.16.04;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>COMAR 07.02.07.04;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>This chapter; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Any other applicable law or regulation requiring the reporting of inappropriate sexual behavior.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Policies and Training.</text>
    <paragraph num="(1)">
      <text>The facility shall adopt and enforce written policies and procedures for the reporting and investigation of inappropriate sexual behavior in accordance with the requirements set forth in this regulation and Regulation .03 of this chapter.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The facility shall provide training to staff members, upon hire and annually thereafter, regarding facility policies and procedures governing the prevention, reporting, and investigation of allegations of inappropriate sexual behavior in accordance with this regulation and Regulation .04 of this chapter, including:</text>
      <paragraph num="(a)">
        <text>Understanding the provisions of the memorandum of understanding;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Transporting individuals for medical care or to a SAFE exam, including how to support the individual during transportation and actions that may be taken to avoid the use of restraint;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Preservation of evidence; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Counseling alleged victims, including regarding emergency contraception, prophylaxes for HIV or other sexually transmitted infections, and follow-up medical care or appointments.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Reporting and Investigation of Inappropriate Sexual Behavior.</text>
    <paragraph num="(1)">
      <text>Facility staff members shall notify the administrative head of the facility, or the designee, of an allegation of inappropriate sexual behavior, immediately, but no later than 24 hours, from staff’s discovery of the allegation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The notification required in §E(1) of this regulation shall be made on the form or in the manner designated by the Department.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Upon receipt of the notification in §E(1) of this regulation, the administrative head of the facility, or their designee, shall, within 24 hours of staff’s discovery of the allegation, provide written notice of the allegation to the:</text>
      <paragraph num="(a)">
        <text>Office of Health Care Quality;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Central coordinator;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>State-designated protection and advocacy agency;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Treatment teams of the individuals involved in the allegation; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Appropriate law enforcement agency as set forth in §F of this regulation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>If the administrative head of the facility or the central coordinator has a conflict of interest in receiving the notification, facility staff members shall report the incident to another individual designated by the facility in the event of such conflict of interest.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Notification to Law Enforcement.</text>
    <paragraph num="(1)">
      <text>The facility shall notify the appropriate external law enforcement agency, within 24 hours of discovery by the facility, of:</text>
      <paragraph num="(a)">
        <text>An allegation of sexual assault occurring on the facility premises or at any off-premises activity sponsored by the facility between individuals served by the facility or an individual served by the facility and another individual; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>An allegation of inappropriate sexual behavior between a staff member and an individual served by the State facility, regardless of the location of the incident.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Except as provided in §F(1)(b) of this regulation, allegations of inappropriate sexual behavior that are not criminal shall be reported to the Department’s police force for further investigation.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The Department’s police force shall refer the allegations to the administrative head of the facility for further investigation as appropriate.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>An individual shall be permitted to report an allegation of inappropriate sexual behavior that is not criminal to an external law enforcement agency or complete a statement of charges with the District Court commissioner.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>The Department police force may not investigate a report of inappropriate sexual behavior made to an external law enforcement agency in accordance with §F(1) of this regulation unless the external law enforcement agency declines to investigate the report or requests the assistance of the Department police force.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Upon the receipt of the notification made under §E of this regulation, the treatment team or teams of the alleged victim and alleged perpetrator, if applicable, shall:</text>
      <paragraph num="(a)">
        <text>Review and, if appropriate, update the risk assessment screens and protection plans of the individuals involved in the allegation in accordance with Regulation .07G of this chapter;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Review and, if appropriate, revise the plans of care of the individuals involved in the allegation in accordance with Regulation .07G of this chapter;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Notify the central coordinator of the results of the treatment team’s review and assessment under this subsection;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Take other appropriate action to ensure:</text>
        <paragraph num="(i)">
          <text>The safety, privacy, and emotional support of the individual or individuals involved; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>That any medically appropriate and necessary care is provided to the individual or individuals involved; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>Document the reported allegations and the results of any investigation of the allegations in the record of the individuals involved.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>The facility and Department police shall investigate allegations of inappropriate sexual behavior in accordance with the following requirements:</text>
      <paragraph num="(a)">
        <text>A facility staff member or Department police officer may not participate in, or conduct, an investigation of an allegation of inappropriate sexual behavior if that staff member or officer, or the staff member’s immediate family member, was involved in the incident or incidents underlying the allegation; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The facility shall comply with applicable laws and regulations governing the confidentiality of an individual’s information.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>Promptly after completing an investigation of a report of inappropriate sexual behavior, the facility shall report the results of the facility’s investigation to the:</text>
      <paragraph num="(a)">
        <text>Appropriate unit of the Department as required by applicable statutes or regulations;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Office of Health Care Quality; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>State’s designated protection and advocacy agency.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Regional Institutes for Children and Adolescents.</text>
    <paragraph num="(1)">
      <text>Allegations of inappropriate sexual behavior on the premises of a regional institute for children and adolescents that are not criminal shall be referred to the administrative head of the regional institute for children and adolescents for further investigation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Allegations of sexual assault and inappropriate sexual behavior between an individual and a staff member shall be reported under §F(1) of this regulation.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The regional institute for children and adolescents shall report allegations of inappropriate sexual behavior to Child Protective Services pursuant to COMAR 07.02.07.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Annual Report.</text>
    <paragraph num="(1)">
      <text>The central coordinator shall report annually to the Deputy Secretary for the unit within the Department which oversees the operations of each State facility on the following:</text>
      <paragraph num="(a)">
        <text>Development of polices and materials to implement the requirements of this regulation and Regulation .07 of this chapter;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Suggested revisions to the uniform assessment and reporting forms required in this regulation and Regulation .07 of this chapter;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Compliance with the assessment and reporting requirements of this regulation and Regulation .07 of this chapter;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Compliance with the training requirements of this regulation and Regulation .07 of this chapter;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Identification of barriers to compliance with the requirements of this regulation and Regulation .07 of this chapter; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Recommendations to improve prevention, detection, and response by State facilities to inappropriate sexual behavior.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>A copy of the report shall be provided to the State designated protection and advocacy agency.</text>
    </paragraph>
  </paragraph>
</regulation>