<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".02" citation="COMAR 14.11.01.02" title_num="14" subtitle_num="11" chapter_num="01" 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>“Annual adjusted gross income” means the total taxable and nontaxable annual income, less 100 percent of total unreimbursed medical expenses as defined by COMAR 07.03.17.33, of:</text>
      <paragraph num="(a)">
        <text>The eligible applicant; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The applicant's spouse.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>“Applicant” means an individual who has submitted an application to participate in the Program in order to receive reimbursement of the cost of attendant care services or ongoing additional supports.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Attendant” means an individual or provider agency who provides attendant care services to a participant.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Attendant care agreement” means a written agreement developed by the Department that:</text>
      <paragraph num="(a)">
        <text>Provides:</text>
        <paragraph num="(i)">
          <text>The effective date for reimbursable services; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The terms for reimbursement under the Program; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Is signed by the participant and the Program Director at the time of initial enrollment and at the request of the Program Director if any circumstances change for the individual or the program.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>“Attendant care services” means any of the following services for an individual, which are deemed necessary by an attending physician or by a registered nurse or certified nurse practitioner serving the individual including:</text>
      <paragraph num="(a)">
        <text>Activities of daily living such as:</text>
        <paragraph num="(i)">
          <text>Dressing;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Preparing food and assisting with eating;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Bathing and personal hygiene;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Assisting with routine bodily functions, including bowel and urinary care; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Moving into, out of, or turning in bed; or</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Instrumental activities of daily living such as:</text>
        <paragraph num="(i)">
          <text>Laundering and other clothing care;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Cleaning house; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Performing other services of daily care, including shopping and transportation.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>“Attending physician” means an individual who is authorized to practice medicine in this State and who has provided medical treatment to an applicant.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Certification of service form” means a document designated by the Department that verifies the participant's receipt of attendant care services for billing purposes.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Department” means the Department of Disabilities.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Duplicative services” means comparable care services or ongoing additional supports provided through any other federal or State assistance programs, such as but not limited to the programs described in COMAR 07.06.12, 10.09.04, or 10.09.20.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Episodic” means when an impairment or medical condition varies in frequency, intensity and duration and renders the person unable to engage in major life activities when onset.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Financial assistance” means reimbursement by the Department of the eligible percentage of the cost paid by a participant for attendant care services or ongoing additional supports.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Fiscal payment schedule” means the list of 12 1-month periods, established annually by the Program Director, in which Attendant Care Program benefits are provided, and participants are required to submit certification of service forms and receipts for reimbursement processing.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“Home visit” means a visit by the Program Director or designee to the home of the Program participant.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Ongoing additional supports” means a continual support that increases an eligible individual’s independent performance of an essential activity of daily living, self-care, or mobility, and is requested by a Participant and approved by the Department.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Participant” means an eligible and enrolled individual in the Program.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Permanent physical disability” means a medical condition that substantially affects an individual's ability to perform physical activities such as walking, standing, transferring, seeing, or hearing.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Program” means the Attendant Care Program.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Program Director” means the individual designated by the Secretary to oversee the day-to-day operations of the Program.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“Review of financial or programmatic eligibility” means initiating verification that the participant remains eligible within 1 calendar year since the completion of the most recent review or more frequently if requested by the Department or the individual.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Severe chronic disability” means a recurring medical condition that substantially limits an individual's mobility or ability to perform activities of daily living, instrumental activities of daily living, or self-care:</text>
      <paragraph num="(a)">
        <text>Permanently; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>On an ongoing basis or episodically, as defined by Regulation .02B(10) of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(21)">
      <text>“Sliding reimbursement scale” means the percentage breakdown of maximum financial assistance afforded to a Program participant based upon adjusted gross income and household size.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Standard assessment of functional capability” means the document designated by the Department to evaluate an applicant's:</text>
      <paragraph num="(a)">
        <text>Ability to perform essential activities of daily living and self-care;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Mobility;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Need for assistance with instrumental activities of daily living; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Need for attendant care services or ongoing additional supports.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(23)">
      <text>“Receipts” means proof of payment made for an approved service designated by the Department.</text>
    </paragraph>
  </paragraph>
</regulation>