<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".12" citation="COMAR 10.21.16.12" title_num="10" subtitle_num="21" chapter_num="16" heading="Denial, Emergency Suspension of Approval, and Disciplinary Action.">
  <paragraph num="A.">
    <text>Denial of Approval.</text>
    <paragraph num="(1)">
      <text>If the Secretary proposes to deny approval to an applicant under the provisions of this chapter, the Secretary shall give written notice of the proposed denial to the:</text>
      <paragraph num="(a)">
        <text>Applicant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Program's CEO and president of the advisory committee or governing body, whichever applies;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Administration;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>CSA or lead CSA;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>ASO; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Medical Assistance Program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>In the notice under §A(1) of this regulation, the Secretary shall include:</text>
      <paragraph num="(a)">
        <text>The date on which the Secretary proposes to deny approval;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The facts that warrant the proposed denial of approval;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Citation of the regulation or regulations upon which the proposed denial is based; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Notification:</text>
        <paragraph num="(i)">
          <text>That before the denial of approval, the program may request a hearing under the provisions of Regulation .16 of this chapter; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>When feasible, of a case resolution conference.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Emergency Suspension of Approval.</text>
    <paragraph num="(1)">
      <text>Under State Government Article, §10-226, Annotated Code of Maryland, upon findings of conditions that pose an imminent risk to the health, safety, or welfare of an individual served by a program, the Secretary may order the immediate suspension of the approval of the program and the cessation of operation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the Secretary takes the action under §B(1) of this regulation, the Secretary shall promptly give written notice of the proposed emergency suspension to the:</text>
      <paragraph num="(a)">
        <text>Program director;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>President of the program's advisory committee, board of directors, or governing body, whichever is applicable;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Administration;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>CSA or lead CSA;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Department's designated approval unit;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>ASO; and</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Medical Assistance Program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>In the notice under §B(2) of this regulation, the Secretary shall include:</text>
      <paragraph num="(a)">
        <text>The proposed effective date of the emergency suspension;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>When feasible, the date of a pre-deprivation hearing and a case resolution conference prior to the Department's final action;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The findings under §B(1) of this regulation and the reasons that support the finding;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Notification that:</text>
        <paragraph num="(i)">
          <text>Following the emergency suspension, the program may request a hearing under the provisions of Regulation .16 of this chapter; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The emergency suspension may lead to revocation of the approval if the violation or violations are not corrected within the time period specified by the Department.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>If the Secretary suspends approval, the program director shall immediately:</text>
      <paragraph num="(a)">
        <text>Notify individuals or the guardians of individuals receiving services of the suspension;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Cooperate with the CSA or lead CSA and the Administration in accessing appropriate alternate services for individuals in the program; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Cease operations of the program.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Disciplinary Action.</text>
    <paragraph num="(1)">
      <text>The Secretary may propose to take any of the following disciplinary actions against a program:</text>
      <paragraph num="(a)">
        <text>Revocation of approval;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Suspension of approval;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Probation with conditions; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Banning new admissions.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The Secretary may propose to take one of the actions outlined in §C(1) of this regulation if the program:</text>
      <paragraph num="(a)">
        <text>Is out of compliance with the requirements of:</text>
        <paragraph num="(i)">
          <text>This chapter;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>COMAR 10.21.17; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>The chapter under this subtitle that outlines the requirements for the specific program;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Fails to maintain financial viability; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Obtains or attempts to obtain approval by fraud, misrepresentation, or the submission of false information to the Secretary.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Except under §B of this regulation, no less than 45 calendar days in advance of the proposed action taken under this regulation, the Secretary shall send written notice of the proposed action to the:</text>
      <paragraph num="(a)">
        <text>Program director;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>President of the program's advisory committee, board of directors, or governing body, whichever is applicable;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Administration; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>CSA or lead CSA.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>In the notice under §C(3) of this regulation, the Secretary shall include:</text>
      <paragraph num="(a)">
        <text>The date on which the Secretary proposes to take action, and when feasible, the date of a case resolution conference;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The facts that warrant the proposed action;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Citation of the regulation or regulations upon which the proposed action is based; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Notification that, before the action, the program has the right to request a hearing under the provisions of Regulation .16 of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>If, after notice and opportunity to be heard, the Secretary takes disciplinary action, the program director shall, within 10 working days:</text>
      <paragraph num="(a)">
        <text>Notify individuals or the guardians of individuals receiving services of the action; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If the program ceases operations:</text>
        <paragraph num="(i)">
          <text>Notify the CSA or lead CSA and the Administration of the cessation; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Cooperate with the CSA or lead CSA and the Administration in accessing appropriate alternate services for individuals in the program.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>