# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 20 — Community Personal Assistance Services

#### Regulation .05 Specific Conditions for Provider Participation — Personal Assistance.

*COMAR 10.09.20.05*

A. Personal assistance service providers shall:

  (1) Be licensed as a residential service agency under COMAR 10.07.05 to provide Level Two or Level Three home care services;

  (2) Employ a registered nurse who shall:

    (a) Assess each new participant who requires personal assistance services;

    (b) Participate in developing the worker instructions and in assigning appropriate personnel;

    (c) Delegate nursing tasks, as appropriate, to a CNA or a CMT in accordance with COMAR 10.27.11; and

    (d) Participate in instructing the workers who will provide the assistance, when indicated;

  (3) Employ workers who will accept instruction on the personal assistance services required in the participant’s plan of service from the following:

    (a) The participant or, when applicable, the participant’s representative;

    (b) The nurse monitor;

    (c) A treating physician or nurse practitioner; or

    (d) An individual from the Department;

  (4) Provide services directly through their workers under the direction of the participant or, when applicable, the participant’s representative;

  (5) Allow participants to have a significant role in the delivery of their specific care including:

    (a) Directing the services and supports identified in their plan of service; and

    (b) Exercising as much control as desired to select, train, schedule, determine duties of, and dismiss the personal assistance worker in their home;

  (6) Notify the Department in writing at least 45 days in advance of any:

    (a) Voluntary closure;

    (b) Change of ownership;

    (c) Change of location;

    (d) Sale of the business;

    (e) Change in the name under which the provider is doing business; or

    (f) Change in provider tax identification number;

  (7) Include in the notice to the Department the method for informing participants and representatives of its intent to close, change ownership, change location, or sell its business;

  (8) Include in the notice to the Department, and inform participants and representatives, of the transition plan developed by the agency to ensure continuity of services to participants;

  (9) If applicable, apply for a new license whenever ownership is to be transferred from the person or organization named on the license to another person or organization in time to assure continuity of services;

  (10) Submit a Medicaid provider application to the Department if the new owner chooses to participate in the Program; and

  (11) Conduct a criminal history records check on all direct service workers including nurses, in accordance with the procedure for a State criminal history records check established under Health-General Article, Title 19, Subtitle 19, Annotated Code of Maryland.

B. A worker who performs delegated nursing services in accordance with COMAR 10.27.11 shall:

  (1) If required to administer medications in accordance with the plan of service, be a certified medications technician; and

  (2) If performing other delegated nursing functions, also be a certified nursing assistant.

C. A personal assistance provider agency may not assign the participant’s representative to provide services to that participant.