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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.61.01" title_num="10" subtitle_num="09" chapter_num="61" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Adult Evaluation and Review Services (AERS)” means an entity within the local health department which, in accordance with the waiver, this chapter, and COMAR 10.09.30, assesses waiver applicants and participants.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Authorized representative” means a spouse, legal guardian, parent, individual with power of attorney, or other individual designated in writing to the Department, authorized concerning the applicant's or recipient's eligibility under this chapter, to:</text>
      <paragraph num="(a)">
        <text>Act on an applicant's or recipient's behalf; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Assist with the application or redetermination process and in other communication with the Department.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>"Centers for Medicare and Medicaid Services (CMS)" means the federal agency responsible for administering Medicare, Medicaid, and several other health related programs.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Department” means the Maryland Department of Health.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Eligibility” means an individual's qualification for participation in the Medical Day Care Services Waiver, in accordance with the requirements of this chapter.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Eligible” means that an individual is determined to meet the requirements of this chapter for eligibility as a Medical Day Care Services Waiver participant.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Medicaid” means the Maryland Medical Assistance Program administered by the State of Maryland under Title XIX of the Social Security Act, which provides comprehensive medical and other health-related care for categorically eligible and medically needy recipients.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Medical day care” means medically supervised, health-related services provided in an ambulatory setting to medically handicapped adults, who, because of their degree of impairment, need health maintenance and restorative services supportive to their community living.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Medical Day Care Services Waiver” means the program implemented under this chapter in accordance with the CMS-approved application for this waiver and any amendments to it submitted by the Department and approved by CMS.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Multidisciplinary team” means the group consisting of members of the medical day care center’s professional staff, the participant, the participant’s authorized representative, healthcare professionals, and waiver case managers, as appropriate, that establishes and updates the participant’s service plan and plan of care.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Nursing facility” means a facility that is participating in the Maryland Medical Assistance Program as a nursing facility pursuant to COMAR 10.09.10.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Participant” means an individual who:</text>
      <paragraph num="(a)">
        <text>Meets the qualifications for participation in the waiver as specified in Regulations .02 through .04 of this chapter; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Is enrolled by the Department to receive waiver services.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(13)">
      <text>“Plan of care” means a written plan established by the multidisciplinary team in accordance with COMAR 10.12.04.22 and based on:</text>
      <paragraph num="(a)">
        <text>A medical order; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>An assessment of the participant’s health status and special care requirements.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(14)">
      <text>“Primary care provider” means a physician, physician assistant, or nurse practitioner who is the primary coordinator of care for the participant.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Program” means the Maryland Medical Assistance Program.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Provider” means a facility licensed under COMAR 10.12.04 furnishing medical day care services through an appropriate agreement with the Department, and identified as a Program provider by the issuance of an individual account number.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Recipient” means a person who is certified by the Department as eligible for, and is receiving, Medical Assistance benefits.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Service plan” means an approved document which specifies the type, amount, frequency, and duration of all waiver and other Medicaid services required to safely support the waiver participant in the community.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“State Plan” means a comprehensive, written commitment by a State Medicaid agency, submitted under §1902(a) of the Social Security Act, to administer or supervise the administration of the Medical Assistance Program in accordance with federal requirements.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Supplemental Security Income (SSI)” means a federally administered program providing benefits to needy aged, blind, and disabled individuals under Title XVI of the Social Security Act, 42 U.S.C. §1381 et seq.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Waiver” means the Medical Day Care Services Waiver as implemented through this chapter.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Waiver applicant” means an individual who is applying for participation in the waiver to receive the services covered under this chapter.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Waiver year” means the State fiscal year from July 1 through June 30.</text>
    </paragraph>
  </paragraph>
</regulation>