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<regulation prefix="Regulation" num=".03" citation="COMAR 14.31.06.03" title_num="14" subtitle_num="31" chapter_num="06" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the definitions in COMAR 14.31.05 apply, and the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Administration” means the licensing agency.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Behavior intervention plan” means a plan that is based on the functional behavioral assessment, designed to address challenging behaviors through the use of positive behavioral interventions, strategies, and supports, developed by a human services professional as defined in §B( 21) of this regulation, who has training and expertise in conducting a behavior functional assessment.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Behavioral consultation” means on-site observation, assessment, and evaluation of the child within the context of the child’s existing program. Behavioral consultation may include:</text>
      <paragraph num="(a)">
        <text>Recommendations regarding structure of the program;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Appropriate activities and services; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Consultation with human services professionals.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>“Behavioral health” means treatment of mental illness, emotional disorders, drug abuse, or alcohol abuse.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Behavioral respite” means relief services provided by a community-based residential program that meets a child’s behavioral needs.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Board” means the board of directors of a residential child care program responsible for the planning and oversight of the operation of the residential child care program.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Certified residential child and youth care practitioner” means an individual who is certified by the Maryland State Board for the Certification of Residential Child Care Program Professionals as defined in COMAR 10.57.01.02B(7).</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Challenging behavior” means those behaviors exhibited by a child which are harmful, destructive, or socially unacceptable and necessitate being addressed in the child’s individual plan of care and behavior intervention plan.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Chemical restraint” means the use of medication that is not the current treatment for a child’s condition to control behavior or restrict the child’s movement.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Chief administrator” means the individual, regardless of title, who is appointed by the Board as having responsibility for the overall administration of the organization.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Chief financial officer” means the program executive with the primary responsibility for overseeing the financial activities of the program including financial planning, budget preparation, monitoring cash-flow, record keeping, and reporting to the Board.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Children's Cabinet” means those agencies directed by Executive Order 01.01.2006.03:</text>
      <paragraph num="(a)">
        <text>To examine Maryland's system of services to children and their families; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>To facilitate ongoing improvements to this service delivery system.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(13)">
      <text>“Contractual and temporary staff” in this chapter are those human services professionals and direct care staff who work at the residential child care program on a contractual or temporary basis or who are placed by a staffing organization with whom the licensee has a contract to perform those duties specified in the job description.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Cordless window covering” has the meaning stated in Family Law Article, §5-505, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Custodial agency” means the agency having primary legal responsibility, which may result from an order of shelter, commitment, limited guardianship, full guardianship, or voluntary placement, time limited, for the child in placement, and may include a child with disabilities.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>Direct Care Staff.</text>
      <paragraph num="(a)">
        <text>“Direct care staff” means staff assigned to perform direct responsibilities related to activities of daily living, self-help and socialization skills.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Direct care staff” does not include human services professionals, except when a human services professional is specifically assigned to perform the duties of direct care staff as specified in Regulation .06B(1) of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(17)">
      <text>“Emergency placement” means residential services provided to a child who requires immediate placement in a residential child care program because the child is:</text>
      <paragraph num="(a)">
        <text>Abandoned;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>At risk of serious immediate danger; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>At risk for long-term, out-of-home placement without use of placement as a short-term intervention.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(18)">
      <text>“Family” has the meaning stated in Human Services Article, §8-101, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(19)">
      <text>“Functional behavior assessment” means the systematic process of gathering information to guide the development of an effective and efficient behavior intervention plan for the problem behavior.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Group home” means a residential child care program, including:</text>
      <paragraph num="(a)">
        <text>Shelter care, including:</text>
        <paragraph num="(i)">
          <text>Emergency; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Structured;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Mother-baby programs;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Programs for adolescent girls who are pregnant;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Psychiatric respite care;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Secure care;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Programs for children who are medically fragile;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Programs for children with developmental disabilities;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Residential crisis services;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Residential respite care services;</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Wilderness programs; and</text>
      </paragraph>
      <paragraph num="(k)">
        <text>Diagnostic evaluation treatment programs.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(21)">
      <text>“Human services professional” means:</text>
      <paragraph num="(a)">
        <text>A social worker licensed under Health Occupations Article, Title 19, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A psychologist licensed under Health Occupations Article, Title 18, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A professional counselor certified under Health Occupations Article, Title 17, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A nurse licensed under Health Occupations Article, Title 8, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>A psychiatrist licensed under Health Occupations Article, Title 14, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>A guidance counselor certified under COMAR 13A.12.03.02 or a school psychologist certified under COMAR 13A.12.03.10;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>A certified counselor meeting the requirements under COMAR 10.58.07 to practice alcohol or drug counseling; or</text>
      </paragraph>
      <paragraph num="(h)">
        <text>For programs serving children with developmental disabilities, an individual with a bachelor’s degree in a human services field who has a minimum of 1 year of full-time experience working directly with persons with developmental disabilities.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(22)">
      <text>“Individual plan of care” means an individualized written plan as detailed in Regulation .17C of this chapter.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Licensee” has the meaning stated in COMAR 14.31.05.03B(20).</text>
    </paragraph>
    <paragraph num="(24)">
      <text>“Mechanical restraint” means any mechanical device that restricts the free movement of an individual.</text>
    </paragraph>
    <paragraph num="(25)">
      <text>“Medication management” means the facilitation of the safe and effective use of prescription and over-the-counter medications. The management of medications encompasses the way medications are procured, delivered, prescribed, self-administered or staff-administered, documented, and monitored.</text>
    </paragraph>
    <paragraph num="(26)">
      <text>“Office” means the Governor’s Office for Children.</text>
    </paragraph>
    <paragraph num="(27)">
      <text>“Permanency plan” means a design for services articulated by the placing agency that specifies:</text>
      <paragraph num="(a)">
        <text>Where and with whom a child shall live; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The proposed legal relationship between the child and the child's permanent caretaker.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(28)">
      <text>“Physical restraint” means the use of physical force, without the use of any device or material, to restrict the free movement of all or a portion of a child's body, not including:</text>
      <paragraph num="(a)">
        <text>Briefly holding a child in order to calm or comfort the child;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Holding the child by the hand or arm to escort the child safely from one area to another;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Moving a disruptive child who is unwilling to leave the area when other methods such as counseling have been unsuccessful; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Breaking up a fight.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(29)">
      <text>“Policy” means a set of basic principles adopted by the Board used to enforce procedures and which are in accordance with the requirements for residential child care programs under this chapter.</text>
    </paragraph>
    <paragraph num="(30)">
      <text>“Positive behavioral interventions, strategies, and supports” means a therapeutic intervention that uses a broad range of systemic and individualized strategies for enhancing positive social and emotional results while preventing or reducing challenging behaviors.</text>
    </paragraph>
    <paragraph num="(31)">
      <text>“Procedure” means a detailed explanation of how policies will be implemented.</text>
    </paragraph>
    <paragraph num="(32)">
      <text>“Program administrator” means the individual, regardless of title, certified under Health Occupations Article, Title 20, Annotated Code of Maryland, who is designated by the Board as having the day-to-day responsibility for the overall administration and operation of a program and for assuring the care, treatment, safety, and protection of children.</text>
    </paragraph>
    <paragraph num="(33)">
      <text>“Prone restraint” means a specific type of restraint in which a child is placed face down on the floor or another surface and physical pressure is applied to the child’s body to keep the child in the prone position. Use of prone restraint is prohibited in Maryland.</text>
    </paragraph>
    <paragraph num="(34)">
      <text>Protective or Stabilizing Device.</text>
      <paragraph num="(a)">
        <text>“Protective or stabilizing device” means any device or material attached or adjacent to the child’s body for the purpose of enhancing functional skills, preventing unintentional harm to self or others, or ensuring safe positioning of an individual.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Protective or stabilizing device” is limited to:</text>
        <paragraph num="(i)">
          <text>Adaptive equipment prescribed by a health professional, if used for the purpose for which the device is intended by the manufacturer;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Seat belts; or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Other safety equipment to secure children during transportation.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(35)">
      <text>“Residential child and youth care practitioner (RCYCP)” has the meaning stated in Health Occupations Article, Title 20, Annotated Code of Maryland. An RCYCP is direct care staff as defined in COMAR 14.31.06.04B(15).</text>
    </paragraph>
    <paragraph num="(36)">
      <text>“Restraint” means a technique that is implemented to impede a child’s physical mobility or limit free access to the environment, including chemical, mechanical or physical restraints.</text>
    </paragraph>
    <paragraph num="(37)">
      <text>“Seclusion” means the confinement of a child alone in a room from which the child is physically prevented from leaving. Use of seclusion is prohibited in residential child care programs in Maryland.</text>
    </paragraph>
    <paragraph num="(38)">
      <text>“Self-administration of medication” has the meaning stated for “self-administer” in Education Article, §7-421(a)(4), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(39)">
      <text>Severe Injury.</text>
      <paragraph num="(a)">
        <text>“Severe injury” means a medical emergency that requires immediate assessment and intervention by a somatic health care provider.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Severe injury” includes, but is not limited to, fractures, dislocations, third-degree burns (destruction of tissue), electric shock, loss or tearing of body parts, all eye emergencies, ingestion of toxic substance or sharp or dangerous objects, and any injury with loss of consciousness or head injuries.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(40)">
      <text>“Somatic health care” means medical care that addresses an individual’s physical health care needs.</text>
    </paragraph>
    <paragraph num="(41)">
      <text>“Structural barrier” means any inanimate object.</text>
    </paragraph>
    <paragraph num="(42)">
      <text>“Time-out” means the removal of a child to a supervised area, which is unlocked and free of structural barriers that prevent egress for a limited period of time during which the child has an opportunity to regain self-control and is not participating in program activities.</text>
    </paragraph>
    <paragraph num="(43)">
      <text>“Trauma-informed care” means a person-centered approach which includes assessment, prevention of re-traumatization, and development and implementation of a safe environment plan. It is a system that reduces the risk of exposure, is strengths-based and resilience-focused, promotes respect, and supports cultural and developmental factors.</text>
    </paragraph>
  </paragraph>
</regulation>