Chapter 08. Workforce and Technology Center
Regulation .01 Scope.LinkCopy Citation
These regulations govern the operations of the Workforce and Technology Center, an organizational unit of the Division of Rehabilitation Services, Maryland State Department of Education, a facility which provides comprehensive rehabilitation services in support of the vocational and independent living goals of individuals with disabilities.
Regulation .02 Definitions.LinkCopy Citation
A.
In these regulations, the following terms have the meanings indicated.
B.
Terms Defined.
(1)
“Admission” means the date a person is formally admitted to the Center.
(2)
“Admission committee” means the management team delegated final responsibility to review and approve or deny applications for admission to the Center.
(3)
“Admission criteria” means the standards applied by the Center to determine its capacity and capability to provide the services requested by an applicant and the applicant's capability to benefit from services.
(4)
“Appeal hearing” has the same meaning as defined in COMAR 13A.11.07.02.
(5)
“Assistive technology” means the application of technological methods and principles and the provision of devices and aids to meet the needs of and address the barriers confronted by individuals with disabilities.
(6)
“Career assessment” means a systematic, organized study of a consumer that is made to identify vocational options, assets, limitations, and behaviors, considering the interests, capabilities, and priorities of the individual, in the context of work environments in which the individual might function.
(7)
“Case manager” means the staff person assigned primary responsibility for planning, initiating, coordinating, and monitoring a program of services in conjunction with the individual client.
(8)
"Center" means the Workforce and Technology Center, a facility operated by the Maryland State Department of Education, Division of Rehabilitation Services, for the purpose of providing vocational rehabilitation and independent living services to individuals with disabilities.
(9)
“Client” means an individual who is accepted for services and admitted to the Center.
(10)
“Client Assistance Program” has the same meaning as defined in COMAR 13A.11.01.03.
(11)
“Client's representative” has the same meaning as “individual's representative” as defined in COMAR 13A.11.01.03.
(12)
“Commission on Accreditation of Rehabilitation Facilities (CARF)” means the private, nonprofit organization formed in 1966 which has established standards of quality for rehabilitation services and which accredits those who provide these services.
(13)
“Department” means the Maryland State Department of Education.
(14)
“Director” means the chief administrator who is responsible for the operation of the Center.
(15)
“Discharge” means termination of a program of services being provided for a client of the Center.
(16)
“Division” has the same meaning as defined in COMAR 13A.11.01.03.
(17)
“Employer advisory board” means a group of citizens who voluntarily provide advice, consultation, and recommendations associated with vocational courses offered at the Center.
(18)
“Employment skills training” means a program offered by the Center designed to provide a client with these skills necessary to achieve employment in a specific occupation.
(19)
“Functional limitations” means conditions resulting from a disability which prevent or impair an individual's ability to perform independent living or vocationally related activities.
(20)
“Medical director” means the licensed physician who directs, manages, and coordinates medical services provided at the Center.
(21)
“Medical functional evaluation” means a systematic study of a person to assess and identify the need for physical restoration services, functional assets and limitations, and readiness for vocational rehabilitation or independent living services.
(22)
“Medical rehabilitation services” means the provision of one or more of the following services to clients:
(a)
Physical therapy;
(b)
Occupational therapy;
(c)
Audiology;
(d)
Speech-language therapy;
(e)
Rehabilitation nursing;
(f)
Medical management;
(g)
Psychiatric or psychological evaluation, or both, and psychiatric or psychological treatment, or both;
(h)
Therapeutic recreation; and
(i)
Related services.
(23)
“Medical staff” means those persons appointed to professional positions within the medical department of the Center in accordance with the credentialing process required by COMAR 10.07.01.24.
(24)
“Physiatrist” means an individual licensed to practice medicine in Maryland who, by virtue of training and experience, specializes in physical medicine and rehabilitation.
(25)
“Physician” means an individual licensed to practice medicine in Maryland who has been appointed to the medical staff of the Center.
(26)
“Program” means a structured set of activities designed to achieve specific objectives established for the client.
(27)
“Record” means the official repository of electronic and hard copy documentation concerning an individual served by the Center.
(28)
“Residential services” means the provision of room, board, recreation, and other support services in the dormitory of the Center or the supported residence dormitory.
(29)
“Restriction” means a procedure designed to reduce or eliminate maladaptive or inappropriate behavior as part of a progressive disciplinary action program.
(30)
“Risk management” means a program developed to identify, evaluate, and reduce the risks to clients in the provision of services at the Center.
(31)
“Vocational rehabilitation services” has the same meaning as defined in COMAR 13A.11.01.08.
Regulation .03 Referral.LinkCopy Citation
A.
Referral of a person to the Center may be made by a:
(1)
Division of Rehabilitation Services staff member on behalf of a client of the Division; or
(2)
Representative of a public or private organization or agency when an agreement has been established between the Center and the organization or program regarding direct referral of an individual.
B.
The referral source shall:
(1)
To the extent possible, make available to the admission office of the Center current medical, social, educational, psychological, psychiatric, and vocational rehabilitation information needed to make a determination regarding admission;
(2)
Indicate the services being requested for the applicant and whether the person seeks services as a resident of the Center, as a day client commuting to the Center, or as a client receiving Center services in the client's community; and
(3)
Assure that documentation required by the Center to process an application is complete and accurate and shall be responsible for providing any additional information which may be requested by the admission office.
Regulation .04 Admission Criteria.LinkCopy Citation
A.
A person may not be denied admission to the Center solely on the basis of the person's race, creed, religion, color, national origin, age, sex, disabling condition, residence, or political affiliation.
B.
The admission committee shall comply with the Division's Order of Selection for Services policy set forth at COMAR 13A.11.01.13.
C.
The assigned case manager shall review the application and supporting documentation and, based upon the criteria set forth in this regulation, make a decision to admit the applicant or to recommend to the admission committee denial of the applicant.
D.
The admission committee and case manager shall make the final decision to admit or deny an applicant to the Center based upon the following criteria:
(1)
The person is an applicant for or recipient of vocational rehabilitation services provided by the Division or by a public or private organization or agency with an established direct referral agreement with the Center;
(2)
The services and resources needed to address the functional limitations presented by the applicant are available at the Center;
(3)
There is evidence that the:
(a)
Applicant has the developmental, personal, and social skills necessary for self-directed activity and participation in a program of rehabilitation conducted in group settings;
(b)
Admission request is voluntary on the part of the applicant; and
(c)
Current health status of the applicant permits participation in a program of rehabilitation services; and
(4)
The applicant to an employment skills training program meets standards for admission and has a reasonable expectation of successfully completing the program and being employed in the field.
E.
An applicant may be admitted for residential services in the:
(1)
Supported residence dormitory (SRD) of the Center, if the admission committee, case manager, or residential supervisor determines that the applicant needs assistance with activities of daily living and/or requires supervision to be able to function in a residential setting; or
(2)
Dormitory of the Center, if the admission committee or case manager determines that the applicant is independent in the applicant’s activities of daily living and will be able to function in a residential setting with minimal supervision.
F.
Referral information confirms that the applicant who seeks admission for assessment or training services meets criteria specific to the service or program.
G.
An applicant who has been determined to have a communicable disease may not be admitted unless the Center's medical director approves admission on the grounds that the communicable disease is not transmissible through casual contact and the applicant's behavioral characteristics and history indicate that the applicant would not present a risk of transmitting the disease to other clients and staff of the Center.
H.
The admission committee may deny admission to an applicant who, in its determination, presents a danger to the health and safety of other clients and staff at the Center or presents a condition that the Center does not have adequate resources to care for appropriately, including, but not limited to, an applicant:
(1)
Who is behaviorally or psychiatrically unstable or dangerous to a degree which requires intensive supervision or a restrictive therapeutic environment as documented by a licensed physician or psychologist;
(2)
Who is acutely ill or medically unstable, as documented by a licensed physician, and requires medical, surgical, or nursing care beyond the resources of the Center;
(3)
Who is currently using or abusing illegal drugs or alcohol;
(4)
Who is a minor and who requires, in order to participate in a program of services, separate residential facilities for care or treatment as may be required by State law or regulation;
(5)
Who is incarcerated or required to be under the strict supervision of law enforcement officers; or
(6)
Who does not have established housing:
(a)
For weekends;
(b)
For other times when the Center is closed; or
(c)
Upon completion of the applicant's service or program.
Regulation .05 Admission Decision and Appeal Process.LinkCopy Citation
A.
WTC staff shall notify the applicant and referral source of the scheduled admission. If the applicant is being denied admission, the admission committee shall respond in writing and:
(1)
State its reasons for denial;
(2)
Inform the applicant and referral source of the Client Assistance Program and appeal process; and
(3)
When appropriate, provide alternative recommendations for addressing the functional limitations presented by the applicant.
B.
The referral source, the applicant for services, or the applicant's representative may request reconsideration of a decision denying admission within 30 days of receipt of the admission committee's decision by requesting, in writing, an opportunity to appear before the admission committee.
C.
If the admission committee, after reconsidering, confirms the decision to deny admission, the applicant may request an appeal hearing in accordance with COMAR 13A.11.07.03.
Regulation .06 Financial Participation.LinkCopy Citation
A.
The Center shall apply the policies, procedures, and schedule governing participation by the client or the client's representative in the cost of services set forth in COMAR 13A.11.01.10 and .15.
B.
Upon admission to the Center, the client or the client's representative shall complete and sign a financial agreement which details the client's or the client's representative's responsibilities for payment, if any, for services to be provided. The financial agreement shall authorize the assignment of costs to third parties if available and applicable.
Regulation .07 Services.LinkCopy Citation
The Center shall provide the following services, depending on the needs of the client and the individualized program of services developed with the client:
A.
Case management;
B.
Career assessment;
C.
Outpatient medical rehabilitation;
D.
Assistive technology (AT);
E.
Employment skills training;
F.
Work readiness services;
G.
Worksite services;
H.
Room, board, and recreation;
I.
Addiction assessment and addiction counseling for clients who are enrolled in other Center programs;
J.
Other services which may reasonably be expected to benefit the client and which may be needed to address the client's individualized rehabilitation needs or functional limitations; and
K.
Special programs for clients including:
(1)
Blindness and vision services;
(2)
Autism services;
(3)
Services for transitioning youth; and
(4)
Deaf and hard of hearing services.
Regulation .08 Discharge Planning.LinkCopy Citation
A.
For clients receiving medical functional evaluations, comprehensive assessments, and employment skills training, the case manager and the client shall initiate a discharge plan upon the client's admission to the Center and document the discharge plan in the record. The case manager shall include in the discharge planning process:
(1)
The client;
(2)
Family members or others who can provide support and assistance to the client;
(3)
Members of the interdisciplinary team who may be involved in the delivery of services to the client; and
(4)
The referral source.
B.
The case manager shall notify the client, the client's family, representative, the referral source, and rehabilitation team members of the proposed discharge date.
C.
The case manager for clients receiving medical functional evaluations, comprehensive assessments, and employment skills training shall hold a discharge conference with the client on or shortly before the day of discharge to summarize services, discuss issues, and outline the steps needed to facilitate transition to the next phase of the client's rehabilitation program. The client shall be informed that a written report will be submitted to the referral source in a timely fashion after the conclusion of the service.
Regulation .09 Discharge.LinkCopy Citation
A.
Workforce and Technology Center staff may discharge a client from the Center under any of the following circumstances and with the active participation of the client, the client's representative, and the referral source:
(1)
The client satisfactorily completes the rehabilitation program as presented in the client's service plan;
(2)
The client meets the requirements for graduation from an employment skills training program;
(3)
The client initiates voluntary termination of the program;
(4)
The client's medical condition prevents continued participation in a program of services;
(5)
The client exhibits behavior which is dangerous or harmful to the client or to others in accordance with Regulation .11 of this chapter;
(6)
The client is permanently suspended as a result of disciplinary action in accordance with Regulation .11; or
(7)
The client dies.
B.
The Center's Assistant Director may discharge a client from the Center under any of the following circumstances and with the active participation of the client, the client's representative, and the referral source:
(1)
The client fails to achieve satisfactory progress, based upon the service plan, and efforts to resolve the issues contributing to the lack of progress are unsuccessful; or
(2)
The client is absent for more than 3 full program days without providing an acceptable reason to the case manager.
C.
Appeal.
(1)
A client or a client's representative may request reconsideration by the Director of the decision to discharge of the Assistant Director within 3 days of being notified of the decision. The Director shall confirm or overturn the decision within 24 hours of the request.
(2)
If the discharge decision is confirmed pursuant to §C(1) of this regulation, at the time of discharge from the Center, the client, the client's representative, and the referral source shall be given written notification of the:
(a)
Reason for discharge;
(b)
Availability of the Client Assistance Program; and
(c)
Appeal process in accordance with COMAR 13A.11.07.03.
(3)
If the discharge decision is confirmed pursuant to §C(1) of this regulation and the client pursues an appeal hearing in accordance with COMAR 13A.11.07.03, the client may remain at the Center and receive services pending the appeal process.
D.
A copy of the discharge summary shall be forwarded to the referral source and included in the client's record.
Regulation .10 Disciplinary Action.LinkCopy Citation
A.
The Director or the Director's designee may take appropriate disciplinary action against any client who violates the Center's regulations and procedures, or whose behavior is disruptive to the operations of the Center's programs and services. The severity of the disciplinary action shall be based on the nature and scope of the client's behavior. Disciplinary action may range from imposing appropriate restrictions on the client's privileges at the Center to temporary or permanent suspension from the Center.
B.
Restrictions on Privileges. The case manager or residential services staff, or both, as appropriate, may impose appropriate disciplinary actions involving restrictions on privileges and shall inform the client of the disciplinary action and the reasons for the action. The case manager or residential services staff, or both, as appropriate, shall, in a timely manner, notify the referral source of the disciplinary action and reasons for the action.
C.
Temporary or Permanent Suspension.
(1)
The Center's Assistant Director, with the active participation of the referral source, shall implement the temporary or permanent suspension of a client from the Center.
(2)
The Assistant Director shall:
(a)
Give the client oral and written notice of the suspension and the reasons for the suspension;
(b)
Inform the client and the client's representative of the Client Assistance Program;
(c)
Inform the client and the client's representative that the client may request reconsideration of the Assistant Director's decision to the Director of the Center;
(d)
Inform the client and the client's representative that the client may appeal the decision in accordance with COMAR 13A.11.07.03; and
(e)
Notify the referral source in writing of the client's suspension.
(3)
A temporary suspension may not exceed 30 program days on the first occurrence.
D.
A client whose presence in the Center poses a continuing danger to self or others may be suspended from the Center immediately, pending the reconsideration and appeal process.
E.
The disciplinary action taken against a client shall be documented in the client's record.
F.
A client who has been temporarily suspended from a program of services may not be permitted to return to the Center until a case conference is held between the client or the client's representative, the case manager, the referral source, and any other Center staff who are providing services to the client. At the case conference, the case manager shall establish the conditions under which the client may return to the Center, including any restrictions which may be imposed, or whether the suspension should be extended or made permanent.
Regulation .11 Client Orientation.LinkCopy Citation
A.
Each client admitted to the Center shall be provided with orientation services addressing both general operations of the Center and specific matters associated with the client's enrollment into a program of services.
B.
The Center’s Admission Packet which includes the rules and regulations shall be presented in writing to the client during the admission process. The client or, as appropriate, the client and the client’s representative, shall acknowledge receipt of a copy of the regulations and procedures associated with participation in a program of services at the Center by signing the document.
C.
The orientation program shall also include, as appropriate and required:
(1)
Medical screening;
(2)
Interview and completion of financial forms by the Admissions Office;
(3)
Introduction to the specific program area or areas involved in the delivery of services; and
(4)
Development of the service plan as specified in Regulation .08.
D.
The client shall be informed of the attendance policies relating to the program of services in which the client is enrolled, and the consequences which may result if the client is absent without authorization.
E.
The Center’s Admission Packet which includes the Consumer Bill of Rights shall be presented in writing to the client during the admission process. The client or, as appropriate, the client and the client’s representative, shall acknowledge receipt of a copy of the Consumer Bill of Rights and confirm that they have been provided the opportunity for clarification of their rights at the Center and of the methods and procedures available to present a complaint, seek review or appeal of any decisions involving the provision or denial of services, or address any other matter which may be of concern while enrolled in the Center, by signing the document.
Regulation .12 Employment Skills Training.LinkCopy Citation
A.
The Director shall assure that written policies and procedures are maintained relating to the planning, development, and provision of employment skills training courses. These policies and procedures shall include but not be limited to written curriculum and course descriptions which shall describe the:
(1)
Training objectives;
(2)
Performance standards against which the client's progress shall be assessed and the methods of assessment; and
(3)
Requirements for course completion and extension of the program.
B.
The Director shall assure that an organized review of curriculum content, materials, and equipment is conducted at least once every 3 years in order to assure their continuing relevance. This review may be conducted as part of the activities conducted by the Employer Advisory Boards established for specific courses.
C.
Instructional personnel shall have active involvement in conferences and in service plan development, review, and modification for those clients served within their respective areas.
Regulation .13 Career Assessment Services.LinkCopy Citation
A.
The Director shall assure that policies and procedures are maintained relating to the planning, development, and provision of career assessment services to ensure that an array of assessment services are offered to meet the needs of the client and the referral source.
B.
Career assessment services shall be sufficiently comprehensive to obtain physical, intellectual, social, and work-related information necessary to identify a client's interests, knowledge, aptitudes, work skills and work-related capabilities and behaviors.
C.
The career assessment services shall employ work samples which shall be:
(1)
Representative of realistic competitive worker traits and skills;
(2)
Established by an analysis of job tasks or traits related to a specific area of work and standardized as to materials, layout, instructions, and scoring; and
(3)
Based upon competitive norms or industrial standards.
D.
Appropriate adaptive assessment tools and methods shall be used wherever possible with clients having sensory, physical, communication, or other functional impediments which might invalidate standardized procedures.
E.
The length of time a client remains in career assessment shall be based upon the type of assessment requested and the time necessary to accomplish the client's evaluation goals.
F.
Evaluation data shall include personal interviews and behavioral observations conducted by Center staff or consultants.
G.
Based on referral information, referral questions to be answered, questions from the person served, the initial interview, pre-evaluation assessment of potential modifications required to meet a person’s specific needs, and the stated purpose of the evaluation, a specific written evaluation plan shall be developed with each client which shall identify:
(1)
The specific type of career assessment requested;
(2)
The questions to be answered through the evaluation;
(3)
Methods to be used to address the referral questions; and
(4)
Reasonable accommodations and assistive technology needs and assistive technology strategies to be used.
H.
Career Assessment Services staff person will provide preliminary information about the assessment results at the conclusion of the service. A written evaluation report shall be prepared for each client served in career assessment, and disseminated to the referral source within 14 working days of discharge from the Center. The evaluation report may be disclosed to other appropriate agencies or individuals only in accordance with the standards of Regulation .17 of this chapter.
Regulation .14 Medical Services.LinkCopy Citation
The Medical Director shall be responsible for planning and managing the clinical services provided by the Center in accordance with appropriate federal and State law, and regulations and standards established by accrediting organizations, including the Commission on Accreditation of Rehabilitation Facilities.
Regulation .15 Records.LinkCopy Citation
A.
The Director shall assure that policies and procedures are developed and maintained to ensure that a confidential record, including electronic and hard copy, is established and maintained for each client admitted to the Center.
B.
The record for each client shall include:
(1)
Case identification data;
(2)
Pertinent history, diagnosis of disability, functional limitation or limitations, and goals;
(3)
Reports of assessment and individual program planning;
(4)
Reports from referring sources;
(5)
Reports of staff conferences;
(6)
The individual service plans;
(7)
Signed and dated service and progress reports from each Center department providing service;
(8)
Release forms;
(9)
Reports from outside consultation including laboratory, radiology, medical, or related services;
(10)
Designation of the case manager for the client;
(11)
Evidence of the client's, and when appropriate, the family's participation in the decision-making process of the client's program;
(12)
Discharge information; and
(13)
Other information relating to the planning, provision, and management of services to the client.
C.
The Center record shall be retained for a minimum of 5 years from the time the client is discharged from the Center.
D.
The record shall be maintained in a secure area and may be disclosed to the client, the client's representative, or others only in accordance with the standards set forth in COMAR 13A.11.06.
E.
The record may not be removed from the Center unless by court order or with the permission of the Director or Director's designee.
F.
Staff members of the Center or the Division who are involved in providing rehabilitation services to a client may maintain a working file relating to the client for their own use in planning, implementing, and managing the services, provided that these files are maintained in a secure place and are not accessible to or revealed to any other person, except in accordance with the standards of COMAR 13A.11.06.
Regulation .16 Protection, Use, and Release of Personal Information.LinkCopy Citation
A.
The Center shall apply the policies and procedures set forth in COMAR 13A.11.06 Records of Services.
B.
Personal information in the possession of the Center shall be used only for purposes directly connected with the planning, implementation, and management of rehabilitation services provided by the Center and the Division. The Center may obtain personal information from service providers and cooperating agencies under assurances that the information may not be further divulged except in accordance with this regulation.
Regulation .17 Accreditation and Licensing.LinkCopy Citation
A.
The Director shall assure that policies and procedures are maintained to comply with licensing and accrediting standards for career assessment, employment skills training, outpatient medical rehabilitation services, and any other services or programs for which the Center has or obtains accreditation or appropriate licensing as may be required by State law and regulations or by the Commission on Accreditation of Rehabilitation Facilities.
B.
The Director shall assure that the Monitoring Committee is established and maintained in accordance with applicable State laws and regulations and standards established by accrediting organizations.
C.
The Director of the Center shall assure that the policies and procedures are maintained for:
(1)
A risk management program;
(2)
An infection control program;
(3)
A physician credentialing procedure;
(4)
A program evaluation system; and
(5)
Policy development through the Division's Policy Review Committee.
Regulation .18 Administrative Operations.LinkCopy Citation
A.
The Director shall assure that policies and procedures are established and maintained in compliance with applicable federal, State, and local ordinances, laws, regulations, and orders as they apply to the use of facilities including, but not limited to, standards associated with health, welfare, sanitation, and safety.
B.
The Center shall be maintained in accordance with applicable fire code requirements set forth in State laws, regulations, and local ordinances. The premises shall be inspected annually and approved by the local fire authority.
C.
The Center shall maintain a fire and disaster plan in accordance with applicable State and local ordinances and shall regularly conduct fire drills during all shifts. A record of each fire drill shall be prepared and maintained.
D.
The Division of Rehabilitation Services Police may stop and conduct a frisk of a client, employee, visitor, or any other person on the premises if there is reasonable belief that the person possesses a weapon which presents an imminent danger to the safety of that person or other persons in the Center.
E.
The Director or the Director's designee may authorize searches of the physical plant including lockers and residential areas assigned to individual clients when there is a reasonable belief that the search is essential to prevent imminent danger to the safety or welfare of a client, an employee, or other persons on Center property, or that the search will produce evidence that the client has violated or is violating either the law or rules of the Center. A search of the physical plant may be undertaken without advance authorization if imminent danger to the health, welfare, or safety of clients or others exists. The Director or designee shall be immediately notified of any search that was conducted without advance authorization. All searches shall be made in the presence of a third party.
F.
The Director shall ensure that the Center is accessible to individuals with disabilities in accordance with the requirements of the:
(1)
Architectural Barriers Act of 1968, 42 U.S.C. 4151 et seq.; and
(2)
Uniform Federal Accessibility Standards, 41 CFR Subpart 101-19.6.
Chapter annotations
Authority: Education Article, §§21-301—21-304, Annotated Code of Maryland
History: Effective date: April 16, 1990 (17:7 Md. R. 850)
History: Regulation .01 amended effective October 1, 2001 (28:19 Md. R. 1687)
History: Regulation .02 amended effective October 1, 2001 (28:19 Md. R. 1687)
History: Chapter revised effective August 28, 2006 (33:17 Md. R. 1438)
History: Regulation .02B amended effective January 12, 2009 (36:1 Md. R. 23)
History: Regulation .04E amended effective January 12, 2009 (36:1 Md. R. 23)
History: Regulation .05A amended effective January 21, 2013 (40:1 Md. R. 21)
History: Regulation .07 amended effective January 12, 2009 (36:1 Md. R. 23)
History: Regulation .08A amended effective November 30, 2009 (36:24 Md. R. 1859)
History: Regulation .08G repealed effective January 12, 2009 (36:1 Md. R. 23)
History: Regulation .09C amended effective January 12, 2009 (36:1 Md. R. 23)
History: Regulation .09D repealed effective January 12, 2009 (36:1 Md. R. 23)
History: Regulation .10C amended effective November 30, 2009 (36:24 Md. R. 1859)
History: Regulation .12B, E amended effective January 21, 2013 (40:1 Md. R. 21)
History: Regulation .14G amended effective November 30, 2009 (36:24 Md. R. 1859)
History: Regulation .14H amended effective January 21, 2013 (40:1 Md. R. 21)
History: Regulation .15 amended effective January 12, 2009 (36:1 Md. R. 23); November 30, 2009 (36:24 Md. R. 1859)
History: Regulation .16B amended effective January 12, 2009 (36:1 Md. R. 23)
History: Regulation .18B amended effective November 30, 2009 (36:24 Md. R. 1859)
History: Regulation .19D, E amended effective January 12, 2009 (36:1 Md. R. 23)
History: Chapter revised effective July 20, 2015 (42:14 Md. R. 882)