Chapter 15. Waiting List Equity Fund
Regulation .01 Scope.LinkCopy Citation
A.
These regulations address the management and use of money in the waiting list equity fund.
B.
The waiting list equity fund may not be used to supplant funds requested or appropriated for:
(1)
Emergency community placements; or
(2)
Transitioning students.
Regulation .02 Definitions.LinkCopy Citation
A.
In this chapter, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Administration” means the Developmental Disabilities Administration (DDA).
(2)
“Appropriate evaluation” means the assessment of an individual using accepted professional standards to determine the presence or absence of a developmental disability:
(a)
As defined in Health-General Article, §7-101(e), Annotated Code of Maryland; or
(b)
That qualifies the individual for individual support services only as defined in Health-General Article, §7-403(c), Annotated Code of Maryland.
(3)
“Community placement” means when an individual is discharged from a State residential center into the community and receives community-based services.
(4)
“Department” means the Maryland Department of Health.
(5)
“Developmental disability” means a severe, chronic disability of an individual that:
(a)
Is attributable to a physical or mental impairment other than the sole diagnosis of mental illness, or to a combination of mental and physical impairments;
(b)
Is manifested before the individual becomes 22 years old;
(c)
Is likely to continue indefinitely;
(d)
Results in an inability to live independently without external support or continuing and regular assistance; and
(e)
Reflects the need for a combination and sequence of special, interdisciplinary, or generic care, treatment, or other services that are individually planned and coordinated for the individual.
(6)
“Eligibility for support services only” means an individual has a severe chronic disability that is:
(a)
Attributable to a physical or mental impairment other than the sole diagnosis of mental illness, or to a combination of mental and physical impairments; and
(b)
Likely to continue indefinitely.
(7)
“Family caregiver” means any of the following who is residing with the eligible individual:
(a)
Spouse;
(b)
Biological, adoptive, or foster parent;
(c)
Guardian;
(d)
Sibling;
(e)
Grandparent; or
(f)
Other related next of kin.
(8)
Family Support Services.
(a)
“Family support services” means a program designed to enable a family to provide for the needs of a child with developmental disability living in the family home.
(b)
“Family support services” includes:
(i)
Individual and family counseling;
(ii)
Personal care;
(iii)
Day care;
(iv)
Specialized equipment;
(v)
Health services;
(vi)
Respite care;
(vii)
Housing adaptations; and
(viii)
Transportation.
(9)
“Individual” means the person for whom an application for services has been filed with the Administration.
(10)
Individual Support Services.
(a)
“Individual support services” means an array of services that are designed to increase or maintain an individual's ability to live alone or in a family setting.
(b)
“Individual support services” includes:
(i)
In-home assistance with meals and personal care;
(ii)
Counseling;
(iii)
Physical, occupational, or other therapies;
(iv)
Architectural modification; and
(v)
Other services that the Administration considers appropriate to meet an individual's needs.
(11)
“Individualized community integration day services” means any full-time or part-time program of habilitation, health-related services, scheduled training, or skills development activities conducted outside the individual's home.
(12)
Individualized Supported Living Arrangements Services.
(a)
“Individualized supported living arrangements services” means residential services provided in alternative living units (ALUs), community supported living arrangements (CSLA), and any other community residential arrangement which is individualized.
(b)
“Individualized supported living arrangements services” does not include group homes.
(13)
“Previous resident of a State residential center” means an individual who:
(a)
Was a resident of that facility on the first day of that fiscal year; and
(b)
Had resided at the facility at least 120 days during the 180 days immediately preceding placement in the community.
(14)
“Respite care” means short-term care not to exceed 14 consecutive days or 28 days in a 12-month period that is made available to provide relief for the individual with whom the developmentally disabled individual ordinarily lives.
(15)
“State residential center (SRC)” means a place that:
(a)
Is owned and operated by the State;
(b)
Provides residential services for an individual with an intellectual disability and who, because of an intellectual disability, requires specialized living arrangements and meets the criteria under Health-General Article, §§7-502 and 7-505, Annotated Code of Maryland; and
(c)
Admits nine or more individuals with intellectual disabilities.
(16)
“Supported employment” means paid competitive employment in an integrated work setting consistent with the federal Rehabilitation Act 1992 amendments.
(17)
“Waiting list” means those individuals who have:
(a)
Applied for services from the Administration in accordance with COMAR 10.22.12.04;
(b)
Been considered eligible for services in accordance with COMAR 10.22.12.06; and
(c)
Not yet received services for which they have applied from the Administration.
(18)
“Waiting list equity fund (WLEF)” means the fund established according to the requirements specified in Health-General Article, §7-206, Annotated Code of Maryland.
Regulation .03 Establishment of the Waiting List Equity Fund.LinkCopy Citation
A.
The waiting list equity fund is a nonlapsing fund established to ensure that when an individual leaves the State residential center to be served in the community, the net average cost of serving the individual in the SRC is applied to:
(1)
The individual's community placement;
(2)
Community services needed to sustain the individual's community placement; and
(3)
Provide community-based services to individuals not yet receiving services.
B.
The WLEF consists of funds that are equal to the cost of providing services to an individual in an SRC for a fiscal year, or part of a fiscal year in which the individual is:
(1)
No longer served in the SRC; and
(2)
Provided community-based services as specified in Regulation .04 of this chapter.
C.
In determining the contribution to the WLEF, the Administration shall calculate the cost of providing services to an individual in an SRC by:
(1)
Dividing the SRC's appropriation by the daily average census reported in the SRC's annual operating budget for the last full fiscal year the individual was served in the SRC, prorated over the number of months the individual is served in the community; and
(2)
Subtracting the following:
(a)
The average annual itemized expenses associated with institutional services and administrative overhead costs that are demonstrated to be directly attributable to the individuals remaining in the SRC,
(b)
The cost for new admissions certified with the provisions of Health-General Article, §§7-502 and 7-503, Annotated Code of Maryland,
(c)
The cost for respite care in accordance with Health-General Article, §7-509, Annotated Code of Maryland, which is based on the identification of the actual, specific costs directly attributable to serving individuals in the SRC with respite care services,
(d)
The cost for court-ordered commitments, and
(e)
Federal revenues under the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) attributable to direct client cost.
D.
The Administration shall allocate to the WLEF overhead savings derived from the closing of an individual cottage or cottages.
Regulation .04 Submission of Annual Budget.LinkCopy Citation
A.
When submitting its annual budget request for community services programs, the Administration shall include funds for the ongoing cost of services for the number of:
(1)
Previous residents placed from the SRC into the community in the previous fiscal year using the WLEF;
(2)
Individuals receiving emergency placements using the WLEF; and
(3)
Individuals receiving nonemergency placements using the WLEF.
B.
The Administration shall reduce the budget submission for the SRC by the net average cost of serving an individual in that center, as defined in Regulation .03C(2) of this chapter.
C.
The Administration shall calculate the net average cost on a prorated basis if an individual was placed in the community for less than the entire fiscal year.
D.
The Administration may increase or decrease the budget request for each SRC to account for the increased cost of services to the remaining residents of the SRC.
E.
If the Administration requests additional amounts for the purpose of funding community placements for current residents of SRCs, the Administration shall request that additional funding in a separate category from funds for the WLEF.
Regulation .05 Administration of Fund.LinkCopy Citation
A.
The Administration shall authorize the funding of services through the WLEF, administered as a nonlapsing revenue account, only to the extent that an appropriation has been made and that funds are available in the WLEF.
B.
The WLEF may be used to provide services to individuals who are:
(1)
In crisis and need emergency services; and
(2)
Not in crisis and do not need emergency services.
C.
The WLEF may not be used to supplant funds appropriated for:
(1)
Emergency community placements; or
(2)
Transitioning students.
D.
To determine the amount of funds available from the WLEF at any time during a fiscal year, the Administration shall project the cost for community services for that year for each individual whose services are funded through the WLEF.
E.
If approved by the Administration, the Administration shall include the following items in the projected costs:
(1)
The cost of the services provided to the individual;
(2)
Any increase in the cost of services being provided to the individual; and
(3)
Any increase in costs due to a change in the amount or type of services provided to the individual.
F.
The Administration shall account for all transactions into and out of the WLEF at the project level.
G.
The Administration shall ensure that all interest earned on the money in the WLEF remains with the fund.
H.
The availability of funding through the WLEF does not establish an entitlement to services.
Regulation .06 Eligibility Criteria.LinkCopy Citation
A.
To be eligible for services funded from the waiting list equity fund, an individual shall:
(1)
Be a resident of Maryland;
(2)
Have an appropriate evaluation that finds that the individual:
(a)
Has a developmental disability, or
(b)
Is eligible for support services;
(3)
Leave a State residential center on or after October 1, 1994, to be served in community-based services as specified in Regulation .05A of this chapter; or
(4)
Be in the community on the waiting list for community-based services in one of the following categories:
(a)
Crisis resolution,
(b)
Crisis prevention, or
(c)
Current request.
B.
A determination made under §A(2) of this regulation may be reopened on the provision of an additional evaluation after 1 year from the initial evaluation.
Regulation .07 Services.LinkCopy Citation
A.
The Administration shall ensure that the waiting list equity fund is used to provide the following community-based services to eligible individuals in accordance with the individual's needs:
(1)
Individual and family support services;
(2)
Respite care;
(3)
Supported employment;
(4)
Individualized community integration day services; and
(5)
Individualized supported living arrangements services.
B.
The Administration shall consider the following criteria when deciding priority for services:
(1)
80 percent of the WLEF monies are to be spent for individuals not in crisis and who do not need emergency services;
(2)
20 percent of the WLEF monies are to be spent for individuals in crisis and who need emergency services after all emergency funds have been expended on a regional basis;
(3)
Individuals who are not in crisis and who do not need emergency services are defined in COMAR 10.22.12;
(4)
Individuals who are in crisis and who need emergency services are defined in COMAR 10.22.12; and
(5)
For nonemergencies, individuals and their families shall receive services in the following priority order:
(a)
Oldest age of family caregiver, by the date of birth, in descending order, and
(b)
If there are two caregivers of the same age next to be served and funding is available to support only one, priority is given to the individual on the crisis prevention list.
Regulation .08 Review and Reporting Requirements.LinkCopy Citation
A.
On or before January 1 of each year, the Administration shall prepare a report to be submitted to the General Assembly and the Department of Fiscal Services on the waiting list equity fund.
B.
The Administration shall include in the report:
(1)
An accounting of all receipts and expenditures to and from the fund;
(2)
The number of individuals who left and entered State residential centers during the previous year;
(3)
The number of additional individuals who were on the waiting list for services from the Administration during the previous year; and
(4)
An accounting of each factor used to determine the cost of providing services to an individual in a State residential center in accordance with the provisions stated in Health-General Article, §7-206, Annotated Code of Maryland.
C.
The Administration shall:
(1)
Review the needs of individuals on the waiting list by July 1, 1998; and
(2)
Modify these regulations, as appropriate, to respond to the needs of the individuals on the waiting list.
Regulation .09 Administrative and Judicial Review.LinkCopy Citation
A.
An individual has the right to appeal an action or inaction with respect to this chapter in accordance with Health-General Article, §7-406, Annotated Code of Maryland, and COMAR 10.22.16.
B.
An individual may prevail at the appeal only upon a showing that the agency has violated statutory or regulatory provisions by its action or inaction.
Regulation .10 Eligibility for Other Services.LinkCopy Citation
A.
An individual's eligibility for services provided by any other public or private agency may not be affected by the individual's eligibility for services under this chapter.
B.
An individual who is eligible for services funded by the Administration may also be eligible for services provided by another agency.
Chapter annotations
Authority: Health-General Article, §7-206, Annotated Code of Maryland
History: Effective date:
History: Regulations .01 — .10 adopted as an emergency provision effective February 27, 1996 (23:6 Md. R. 470); emergency status extended to September 23, 1996 (23:14 Md. R. 1006); adopted permanently effective September 23, 1996 (23:19 Md. R. 1376)
History: COMAR 10.22.08 recodified to COMAR 10.22.15 effective July 26, 1999 (26:15 Md. R. 1148)
History: Regulation .02B amended effective November 25, 2013 (40:23 Md. R. 1934)