Chapter 05. Community Health Resources
Regulation .01 Qualification as Community Health Resource.LinkCopy Citation
A.
To qualify as a community health resource, a person shall demonstrate that the person meets the criteria set forth in Regulation .02, .03, or .04 of this chapter.
B.
Regardless of the community health resource category for which an applicant submits evidence of qualification, the Commission may determine that the applicant meets the criteria to qualify as a community health resource under either Regulation 02, .03, or .04 of this chapter.
Regulation .02 Qualification under Health-General Article, §19-2101(c)(1), Annotated Code of Maryland — Primary Health Care Services.LinkCopy Citation
A.
Criteria. To qualify as a community health resource pursuant to this regulation and Health-General Article, §19-2101(c)(1), Annotated Code of Maryland, a person shall demonstrate that the person:
(1)
Is a nonprofit or for-profit health care center or program;
(2)
Provides primary health care services:
(a)
In accordance with a sliding scale fee schedule payment policy that is consistent with the guidelines set forth in Regulation .05 of this chapter;
(b)
Without regard to an individual's ability to pay; and
(c)
Primarily to Maryland residents from service sites located within the State; and
(3)
Provides medical care to address a patient's general health needs, including:
(a)
Promotion and maintenance of the patient's health;
(b)
Treatment of illness;
(c)
Prevention of disease;
(d)
Maintenance of the patient's health records; and
(e)
Making referrals for medically necessary and appropriate specialty care services.
B.
Submission Requirements. To demonstrate qualification as a community health resource under this regulation, a person shall submit, on or before the date and time specified by the Commission, the information and documentation that the person meets the criteria set forth in §A of this regulation, including:
(1)
A written statement that includes the applicant's name, the addresses of all its service locations, and a description of how the applicant meets the requirements of §A of this regulation;
(2)
A copy of the applicant's written procedures for consistent application of the applicant's policies concerning:
(a)
Uncompensated care;
(b)
Its sliding scale fee schedule, consistent with the requirements of Regulation .05 of this chapter; and
(c)
Provision of services regardless of a patient's ability to pay;
(3)
A list of services offered by the applicant;
(4)
A calculation of the proportion of patients served by the applicant who are Maryland residents;
(5)
An explanation of how the services offered by the applicant are provided, specifying practitioners' licensure categories, such as physician, nurse-practitioner, or other; and
(6)
Upon the Commission's request, any additional information the Commission requires to complete its determination.
C.
The Commission shall determine that a person does not qualify as a community health resource pursuant to this regulation if:
(1)
Unless COMAR 10.45.08.01G applies, the person does not submit to the Commission, on or before the date and time specified by the Commission, the documentation required by §B of this regulation;
(2)
The Commission requests additional information or materials pursuant to COMAR 10.45.08.01G, and:
(a)
The person does not submit the information or materials requested by the Commission within the time allowed; or
(b)
The additional information and material submitted by the person do not establish the person's qualification as a community health resource; or
(3)
The Commission determines that the person does not meet the qualification criteria specified in §A of this regulation.
Regulation .03 Qualification under Health-General Article, §19-2101(c)(2), Annotated Code of Maryland — Access Services.LinkCopy Citation
A.
To qualify as a community health resource pursuant to this regulation and Health-General Article, §19-2101(c)(2), Annotated Code of Maryland, a person shall demonstrate that the person:
(1)
Is a nonprofit or for-profit health care center or program;
(2)
Offers access services that:
(a)
Directly assist low-income, uninsured, or underinsured individuals to gain access to reduced-price clinical health care services; and
(b)
May include, but are not limited to:
(i)
Coordination of patients' health care;
(ii)
Case management services; and
(iii)
Transportation of patients to and from medical appointments; and
(3)
Offers access services, as described in §A(2) of this regulation:
(a)
Without regard to an individual's ability to pay;
(b)
In accordance with a sliding scale fee schedule that is consistent with the guidelines set forth in Regulation .05 of this chapter; and
(c)
Primarily to Maryland residents from service sites located within the State.
B.
Nonqualifying Services.
(1)
Services not directly assisting patients to access clinical health care services are not access services and do not establish a person's qualification as a community health resource pursuant to this regulation and Health-General Article, §19-2101(c)(2), Annotated Code of Maryland.
(2)
Examples of services that do not qualify as access services include, but are not limited to:
(a)
Transportation to health fairs or wellness lectures;
(b)
Mass mailings of health educational materials; or
(c)
Promotional activities sponsored by health care providers.
C.
To demonstrate qualification as a provider of access services, a person shall submit, on or before the date and time specified by the Commission, the information and documentation that the person meets the criteria set forth in §A of this regulation, including:
(1)
A written statement that includes the applicant's name, the addresses of all its service locations, and a description of how the applicant meets the requirements of §A of this regulation;
(2)
A copy of the applicant's written procedures for consistent application of the applicant's policies concerning its:
(a)
Sliding scale fee schedule; and
(b)
Provision of services regardless of a patient's ability to pay;
(3)
A list of services offered by the applicant;
(4)
A calculation of the proportion of patients served by the applicant who are Maryland residents; and
(5)
Upon the Commission's request, any additional information the Commission requires to complete its determination.
D.
The Commission shall determine that a person does not qualify as a community health resource under this regulation if:
(1)
Except when the Commission requests additional information or materials pursuant to COMAR 10.45.08.01G, the person does not submit to the Commission, on or before the date and time specified by the Commission, the documentation required by §C of this regulation;
(2)
The Commission requests additional information or materials pursuant to COMAR 10.45.08.01G, and:
(a)
The person does not submit the information or materials requested by the Commission within the time allowed; or
(b)
The additional information and material submitted by the person do not establish the person's qualification as a community health resource; or
(3)
The Commission determines that the person does not meet the qualification criteria specified in §A of this regulation.
Regulation .04 Qualification under Health-General Article, §19-2101(c)(2), Annotated Code of Maryland — Designee Services.LinkCopy Citation
A.
To qualify as a community health resource designated pursuant to this regulation and Health-General Article, §19-2101(c)(2), Annotated Code of Maryland, a person shall establish that the person meets the definition in COMAR 10.45.01.02 of a:
(1)
Federally qualified health center;
(2)
Federally qualified health center “look-alike”;
(3)
Community health center;
(4)
Migrant health center;
(5)
Health care program for the homeless;
(6)
Primary care program for a public housing project;
(7)
Local nonprofit and community-owned health care program;
(8)
School-based health center;
(9)
Teaching clinic;
(10)
Wellmobile;
(11)
Health-center controlled operating network;
(12)
Historic Maryland primary care provider;
(13)
Outpatient mental health clinic;
(14)
Local health department;
(15)
Substance abuse treatment provider; or
(16)
DDA licensee for FY 2012 and FY 2013.
B.
To demonstrate that a person is a community health resource under this regulation, the person shall submit, on or before the date and time specified by the Commission, documentation establishing that the person meets the definitional criteria specified in COMAR 10.45.01.02 for a community health resource listed in §A of this regulation.
C.
Except as provided in §D of this regulation, a person listed in §A of this regulation qualifies as a community health resource without regard to the sliding scale fee schedule requirements specified in Regulation .05 of this chapter.
D.
The Commission shall determine that a person does not qualify as a community health resource under Regulation .04 of this chapter if:
(1)
Except when the Commission requests additional information or materials to aid in making a determination pursuant to COMAR 10.45.08.01G, the person does not submit to the Commission, on or before the date and time specified by the Commission, the documentation required by §B of this regulation;
(2)
The Commission requests additional information or materials pursuant to COMAR 10.45.08.01G, and:
(a)
The person does not submit the information or materials requested by the Commission within the time allowed; or
(b)
The additional information and material submitted by the person do not establish the person's qualification as a community health resource; or
(3)
The Commission determines that the person does not meet the definition, as specified in COMAR 10.45.01.02, of a provider category listed in §A of this regulation.
Regulation .05 Sliding Scale Fee Schedule Guidelines.LinkCopy Citation
A.
Applicability. The Commission shall apply the sliding scale fee schedule criteria set forth in §B of this regulation to determine whether:
(1)
An applicant meets the sliding scale fee schedule criterion to qualify as a community health resource under Regulation .02A(2) or .03A(3) of this chapter; and
(2)
An application submitted by a community health resource addresses the selection criterion specified in COMAR 10.45.07.01I.
B.
A community health resource shall offer primary health care services or access services to individuals whose annual family income is:
(1)
Below 100 percent of the federal poverty guidelines:
(a)
Free of charge; or
(b)
For no more than a nominal fee; or
(2)
At least 100 percent of the federal poverty guidelines but less than 200 percent of the federal poverty guidelines:
(a)
Free of charge; or
(b)
At a reduced price.
C.
A community health resource qualifying under Regulation .02 or .03 of this chapter may not require individuals with annual family income of less than 200 percent of the federal poverty guidelines to pay any charges for primary health care services or access services in addition to those specified in §B(1) or (2) of this regulation, as applicable.
D.
Notice and Documentation. At each of its care sites in the State, a community health resource qualifying under Regulation .02 or .03 of this chapter shall:
(1)
Provide notice to the public of its sliding scale fee schedule, including the display of a prominently posted sign indicating that free or reduced-price care is available; and
(2)
Collect documentation of income from individuals applying for reduced-price care pursuant to the community health resource's sliding scale fee schedule.
Chapter annotations
Authority: Health-General Article, §§19-2107, 19-2109, and 19-2201, Annotated Code of Maryland
History: Effective date:
History: Regulations .01 — .05 adopted as an emergency provision effective October 31, 2006 (33:24 Md. R. 1905); adopted permanently effective February 12, 2007 (34:3 Md. R. 299)
History: Regulation .04A amended effective July 23, 2012 (39:14 Md. R. 838)