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<regulation prefix="Regulation" num=".02" citation="COMAR 10.11.04.02" title_num="10" subtitle_num="11" chapter_num="04" 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>“Administer a blood test for lead poisoning” means to:</text>
      <paragraph num="(a)">
        <text>Draw a blood specimen, by either venous or capillary methodology, and:</text>
        <paragraph num="(i)">
          <text>Send the specimen to a medical laboratory for blood lead analysis; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Conduct a blood lead analysis at a health care provider's office subject to licensing, certification, and approval by the Laboratories Administration of the Department; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Order a blood specimen to be drawn by a third-party health care provider, by either venous or capillary methodology, and sent to a medical laboratory for blood lead analysis.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>“At-risk area” means any geographic area within the State that has been designated by the Department as at-risk for lead exposure in the 2015 Targeting Plan for Areas at Risk for Childhood Lead Poisoning.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Blood lead analysis” means the analysis and determination by a medical laboratory of the blood lead level in a blood specimen.</text>
    </paragraph>
    <paragraph num="(3-1)">
      <text>“Blood lead reference value” means a blood lead level of 3.5 micrograms per deciliter.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“CDC” means the federal Centers for Disease Control and Prevention.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Child” means an individual younger than 18 years old.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Repealed.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Department” means the Maryland Department of Health.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Repealed.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“EPSDT” means the Early and Periodic Screening Diagnosis and Treatment program governed by COMAR 10.09.23.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Health care provider” means a person who is licensed, certified, or otherwise authorized to provide health care services under the Health Occupations Article, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>Repealed.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Immunization registry” means an immunization registry established and maintained by the Department.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Lead exposure risk questionnaire” means the set of questions used to determine an individual's risk for lead exposure and lead poisoning, as approved by the Department and based on the recommendations from the CDC.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>Repealed.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Medical laboratory” means a licensed medical laboratory as defined by Health-General Article, §17-201(b), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Nonprimary care” means health care that:</text>
      <paragraph num="(a)">
        <text>Is given or recommended by a health care provider that is not the individual's primary care provider; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Includes but is not limited to episodic health care for acute illness or injury or health care that is given in an emergency room or other urgent care setting.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(17)">
      <text>Prekindergarten Program.</text>
      <paragraph num="(a)">
        <text>“Prekindergarten program” means a public educational or public early intervention program that enrolls or serves children below the level of kindergarten.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Prekindergarten program” includes:</text>
        <paragraph num="(i)">
          <text>Programs that operate within a school and those that operate outside of a school;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Preschool special education programs governed by COMAR 13A.05.01;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Extended Elementary Education Programs governed by COMAR 13A.06.02.01;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Local Infant and Toddler Programs as defined in COMAR 13A.13.01;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Head Start and Early Head Start Programs as authorized under the Head Start Act, 42 U.S.C. §9801 et seq.;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Judith P. Hoyer Early Child Care and Education Centers established by Education Article, 5-217, Annotated Code of Maryland; and</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Any other educational or early intervention program as determined by the Department.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(18)">
      <text>“Primary care” means health care that:</text>
      <paragraph num="(a)">
        <text>Is continuous, comprehensive and coordinated;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Emphasizes prevention of illness and injury; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Includes but is not limited to the following services;</text>
        <paragraph num="(i)">
          <text>Age appropriate screenings;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Diagnosis and treatment of acute and chronic disorders;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Growth and developmental assessments;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Health care supervision;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Immunizations;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Patient and parent health and psychosocial counseling;</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Physical examinations; and</text>
        </paragraph>
        <paragraph num="(viii)">
          <text>Referrals to specialty health care providers.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(19)">
      <text>“Primary care provider” means a health care provider that provides primary care.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Targeting Plan” means the 2015 Targeting Plan for Areas at Risk for Childhood Lead Poisoning developed by the Department that includes but is not limited to:</text>
      <paragraph num="(a)">
        <text>Methodology for determining levels of risk for childhood lead poisoning;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Maps of the State designating at-risk areas;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Zip code and census tract lists indicating each zip code and census tract's designated level of risk; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Recommendations regarding the prevention of childhood lead poisoning.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(21)">
      <text>“12-month visit” means a well-child evaluation by a health care provider that occurs when a child is between 12 months old and 14 months old.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“24-month visit” means a well-child evaluation by a health care provider that occurs when the child is between 24 months old and 26 months old.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Well-child evaluation” means a periodic primary care assessment of a child by a primary care provider in accordance with the:</text>
      <paragraph num="(a)">
        <text>American Academy of Pediatrics' guidelines; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Periodicity schedule established under EPSDT requirements.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>