STATE OF MARYLAND

DHMH Office of Health ServicesMedical Care Programs PT7 - 03

MARYLAND MEDICAL ASSISTANCE PROGRAMNursing Home Transmittal No. 176

October 7 I 2002

FROM:

Nursing Home =strsx:1u,---Susan J. Tucker, Exec~ive DirectorOffice of Health Services

Please ensure that appropriate staff members in your organization areinformed of the contents of this transmittal.

~~:

House Bill 752

House Bill 752

House Bill 752, passed during the 2002 legislative session, places new requirements onnursing homes. This transmittal is intended to explain the new legislative requirements.A copy of the bill is enclosed for your reference.

Information on Community-based Services

Effective October 1. 2002, the law requires that social workers in nursing homes presentresidents with information on home and community-based services waivers and otherprograms that might help them live in the community. Specifically, social workers mustshare a one-page document that describes Medicaid programs that could enable theresident to live in the community. The one-page information sheet must be madeavailable to residents "upon admission or discharge of the resident." and "at least onetime annually at the request of the resident."

The law further requires that the social worker request that the resident sign anacknowledgement of receipt of the one-page information sheet. This acknowledgementshould be kept in the resident's medical record.

DHMH has developed this one-pager and we hope that it is a helpful tool for educatingresident and their families. A copy is enclosed to help start this process. You will beresponsible for copying the one-pager as necessary. DHMH will update the one-page

Toll Free 1-877-4MD-DHMH. TTY for Disabled - Maryland Relay Service 1-800-735-2258Web Site: www.dhmh.state.md.us

201 W. Preston Street. Baltimore, Maryland 21201Parris N. Glendening, Governor - Georges C. Benjamin, M.D., Secretary

information sheet periodically, and any comments you may have to improve it are greatlyappreciated. Any updates to the one-page information sheet will be transmitted to youdirectly. In the near future, DHMH will also send educational materials to better equipsocial work staff to answer questions on Medicaid's home and community-basedprograms.

Access to Nursing HomesFor providers that accept Medicaid reimbursement, the new law also governs access tothe nursing home by certain outside groups. Effective October 1, 2002, "employees orrepresentatives of protection and advocacy agencies and of Centers for IndependentLiving shall have reasonable and unaccompanied access to residents... for the purposeof providing information, training, and referral" to community services and organizations

The purpose of this legislation is to ensure that these organizations are permitted to talkto residents about opportunities for moving to the community. Nursing homes mayrequire proof of employment or training before allowing access to employees orrepresentatives of protection and advocacy agencies and of Centers for IndependentLiving.

(Note: The protection and advocacy agency in Maryland is the Maryland Disability LawCenter. Centers for Independent Living (CILs) are organizations dedicated to helpingpeople of all ages with all types of disabilities to live in a home or apartment of their own.There are seven CILs across the State that go by different names. A list of CILs a.ndtheir geographic domains is enclosed.)

Any questions regarding this transmittal should be directed to the Nursing Home Sectionof the Division of Long Term Care Services at (410) 767-1444.

Enclosures

Centers for Independent LivingMaryland Disability Law CenterNursing Home Liaison Committee

cc:

1

If Medical Assistance pays for any portion of your nursing home care,you may be eligible for long-term care services in the communityinstead of a nursing home.

There are several programs that provide services in the community:

Waiver for Older AdultsThis program is for eligible people aged 50 and over. It covers manyservices including personal care in your home and services providedin a participating licensed assisted living facility. Call your localArea Agency on Aging or 1-800-AGE-DIAL for more information.

Living at Home: Maryland Community ChoicesThis program is for eligible people with disabilities aged 21 to 59. Itcovers many services including attendant care services in yourhome. Call 1-800-332-6347 for more information.

Adult Medical Day CareAdults of all ages may qualify for medical day care. Servicesinclude nursing, personal care, leisure activities, a noon meal, andtransportation to and from a licensed medical day care center.

Evaluations and case management may also be available to helpdetermine if these programs are right for you. There are restrictions forcertain programs on who may be eligible and how many services maybe provided. It is also important to note that these programs do not payfor ongoing housing expenses such as rent or mortgage payments.

Organizations called Centers for Independent Living may be able tohelp you if you would like to consider returning to the community.Centers for Independent Living are dedicated to helping people of allages and types of disabilities to live in homes/apartments of their own.

This document is produced by the Maryland Department of Health and Mental Hygiene. By law, nursinghomes must share this information with every nursing home resident at admission and upon request.

Please sign on the line belowpage information sheet on Ion

to certify that you have received the one-19 term care services in the community.

Signature Date

Print Name

(This form must be kept in th~~ resident's medical record.)

Resources for IndependenceLori Magruder, Executive Director708 Fayette StreetCumberland, MD 21502Voice: 301-784-1774Fax: 301-784-1776TTY: 711Toll Free: 800-371-1986EMail: phcil@hereintown.net

Eastern Shore Center for IndependentLivingPrice Baurn, Executive Director7 Sunburst CenterCambridge, MD 21613Voice: 410-221-7701TrY: 410-221-5140Toll Free: 800-705-7944Fax: 410-221-7714EMail: escil@comcast.net

Counties Served: Garrett, Allegany,Washington Counties Served: Dorchester. Talbot,

Caroline. Cecil. Kent. Queen Anne's.Somerset. Wicomico. WorcesterIndependence Now, Inc.

Catherine Raggio, Executive Director6811 Kenilworth Avenue, Suite 504Riverdale, MD 20737-1333Voice: 301-277-2839Fax: 301-277-4587EMail: craggio@innow.org

Center for L.I.F .E.Gene Potts, Executive Director30265 Oaks Road, Suite 3P.O. Box 657Charlotte Hall, MD 20622301-994-9397Voice: 301-884-4498Fax: 301-884-6099cflife@earthlink.net

Counties served: Montgomery ~ PrinCI

Georgese

Counties Served: Charles, St. Mary's,Calvert

MCILFrank Pinter, Executive Director3011 Montebell0 TerraceBaltimore, MD 21214Voice: 410-444-1400Fax: 410-444-0825TTY: 711Email: frankp@mcil-md.org

Counties served: Howard, Baltimore,Harford, Anne Arundel, Baltimore Ci1ty

The Freedom CenterJamey George, Executive DirectorRose Hill Plaza, Unit A-201560 Opossumtown PikeFrederick, MD 21702Voice: 301-846-7811Fax: 301-846-9070TTY 711iameyg~rge@Qrodigy .net

Counties I Served: Frederick, Carroll

Updated 05/30/02

HOUSE-BILL 75203

21r2221

By: Delegate HubbardIntroduced and read first time: Fe!Assigned to: Environmental Matte]

)ruary 6, 2002

's

Committee Report: Favorable withHouse action: AdoptedRead second time: March 21, 2002

amendmen ts

C]

AJ.~ ACT concerning

2 Health - Nursing Facilities3 CommuJ

- Information About Home-Ba~~ and

lity-Based Services

6

89

lQ11121314151617181920

FOR the purpose of requiring a ~tift eeep8!fte~ep social worker at a nursing facilityto provide certain infonnation to residents about home- or community-basedwaiver programs at ~fte ~iMe e--eep~eift esee99Meft~ is pe:-::Pmee certain times;requiring the information to ccntain certain infonnation or referrals; reQuirin2'ilie Qepartment of Health ~!!9.~Ient~1 Hy2ien~ ~ creoare ce aln info!:!!!~~n~requiring the eeep8tfte'ep SOCIal worker to ask the resident to sign a certaincknowledgment to be kept itl the resident's medical record; pe~6iftB&, 'he. . tift Pe~:ppel 'e eeAetft eeeie'eftee: requiring a

ertain case manager at a local department of social services to provide certainsistance and infonnation to 'esidents; requiring the case manager to make a

ertain referral within a qenain time period under certain circumstances;ro..;wng that employees or representatives of certain agencies and centershall be given access into qertain facilities to provide certain information toesidents under certain circ\1Dnstances; prohibiting employees or representativesf certain agencIes and centers from disclosing certain infonnation provided to

sident~; defini?g certain. ~n:1S; and g~nerall!.r.e~ting to information aboutmmuruty servIces for reslclen:s of nursIng facll1tle$.

21

22

23

amendmentsBY re ealing a4d reenacting, wit~outicle - ~ealth - General i

ection 15+-101(a) and (i) iI , I

notated I Code of Marylan~!i( 000 Repl~cement Volume .~ 2001 Supplement)

26 B"x' adting to- -

EXPL.1J ATION: CAPIT.-\LS L'o'DICATE j 1 [ ckets] indicate matter dele

U. erlinin indicates amendn-.e,. indic:1tes matter stric

by mendn1ent.

TER .-\DDED TO E.'(ISTrSG LAW.rom e.usting la\v.

I bill.from the bill by 3mendment or deleted from the la\v

2 HOUSE BIti. 7521

2

3

4

Article - Health - General

Section 15-134Annotated Code of Marylar(2000 Replacement Volume

ld

and 2001 Supplement)

5 SECTION 1. BE IT E16 MARYLAND, That the Laws of I

-lACTED BY THE GENERAL ASSEMBLY OF\ofa,ryland read as follows:

1. Article - Health - General

8 15-101.

9 (a) In this title the follow:ing words have the meanings indicated.

10 (i) "Program~ means the Maryland Medical Assistance Program.

15-134.

12 (A) (1)

13 INDICATED.IN THIS SECTIOr'1 THE FOLLOWING WORDS HAVE THE MEA.~NGS

14 ~ ".'.~S gQQ~:::9&...15 ~ I~ga.~: '.I.QiQ IS H~Q~~~~ ~Q ~

:'!'C'?-" ~.~-~~S -~ SQQR~9~.~~QR 9~ .~ ~~-:'~I~~S'~ Q~~ ~~ ~.19~.~~j ~.A_":_~ S~~ .~S~S."'~

II ~es~~: ~=~~=i ~GR ~.~~I~_'::'.B -~~ ~.~~I~_~ 81

~. """"~~"""r'!'" nn ",rr.n.. . ~ . ~.- --~ : - --- ;..e" :.~-.:.~ 11~

~I ~ (2) "NURSING~, 15-132(AXI0) OF nus SUBTITLE.

'ACnJTr HAS THE MEAJ.~G STATED IN §

~t Ee1 (3) "RESIDENT"~ CARE IN A NU"RSmG FACILITY.}[EA..~S A..~ L.'lDMDUAL RECEIVING LONG-TER.Y1

i (B) (1) Q~~PtG .~ ~.II~~C.~2 A SOCIAL WORKER S}L\LL PROY]2 SHEET I~~ b~G~. ~.\t:1I. ¥ b~Gmj2 B~S~~~~ THAT;

;-?:! Br~~.~ S!;~ .~S!;66:.~~+~. f~' .'..IB6 6QQ~:::~~...":Qa

[DE TO A RESIDE~'T A ONE-PAGE L.WOR..\iATION~ ~!; .~+B ~. ~Qa.'.L~~ .'.66~SSmL!; ~Q ~i~

2~ (I) EXP~Sn

2 COi\I~fUNlTY-BASED WAIVER ~ql

2 RESmE~ TO LIVE IN THE CO~L\ft

[E A V AILABll.1TY OF SER\'lCES u"NDER HO~IE- ORGRA4\11S IN THE STATE THAT COULD E~ABLE THEJNITY 1

BOUSE BILL 752 3

1 SERVICES. OR EVALUATION SERVICES RELATED TO HOME- AND COMMUNITY-BASED2 WAIVER PROGRAMS_O..B 011IElf. OPrIQNLFO:R ~CEIVm.-G_LO~~TERM CARE3 SERVICES IN THE GQM;.\illNm: ~

6 00 THE DEPARTMENT. IN CONS::uLTA~_~~~~~N~~7 THAT I~IPLEMENT THE HOME- Ao'lffi COMMUNm=:p~];R~~ ~~~~8 SHALL PREPARE. DISTRIBUrE. Ao'lffi UPDATE AS NECESSARY THE ONE-~~9 JNFO~TION SHEE~ REQ~ED UNIJERJAMGMPlU-l) OF j1JIS_S~Ec:n~

1011

!.!12

@RESIDE~"T.14

~~ ~~Qa~.Ir'.;IQ~; PBQ'.~~~Q e¥ .'-,. ~.~S ~QQ~~~;.'.;Qa S;,,-'.Y.!~

16 ffi ~v.:::'6~; ~~; ~ ~~ a~6~~~~ 6.W~ ~S P n.'";T-~~¥ Qa17 P:T..'Y.¥ ?~~:~T..~~~~ a¥ ~~ paQG?_~1, ~~ ~~6~~~~ ~.~..."! as .'t£~;Q ~~b~!'.~

l~

2t1 l:H1 PRQ'.~~ R~~R?_'~ +Q ~~S~~~~ ~..": ~.~A.,? PRQ'.~~2JI .

~II

a h ~ /4) THE ~.~6 ~9GRQ~;..."':QR SOCIAL WORKER SHALL REQL'ESTT THE RESmE~"T SIG~ A.,'t' ACK.'lOWLEDG~[E~"T OF RECEIPr OF THE

2 OR.\L-\TION' SHEET PROVIDED BY THE ~;~S ~QQaQI~;...:;Qa SOCIAL WORKER THAT2 BE KEPT L't' THE RESIDENTS }[EDICAL RECORD.

CC) IF A RESIDE~T IS UNABLE TO CONTACT OLlSIDE E~S WlTHOLiISTA.,"CE, OR A RESIDE~i REQL"ESTS ASSIST.-\.,"CE, THE ~.4~S GQQ?~I~..'.;9aIAL WORKER SIw.L REFER THE RESIDE~"T TO PERSONS FROM THE DEPART}IE~T CA.'l PROVIDE L\TFOR.'rL1,.TION OR CASE ~L\,.'lAGE~IENT SERVICES TH.o\T \~liL

LE THE RESmE~l TO LE.\R:-.l ABOli RECEIV"L'OG LONG-TERM CARE SERVICESHE CO~[)fiI"NI'fY.

34\\ II CD) THE LONG-TER.\[ CARE ,CASE MA.~AGER A'3~ sltL\L SERVICES SIL-\LL: !

CAL DEP.o\RT}[E~"T QF

~~i \ 1) PRO\1DE .-\SSISTk-..tCE TO RESmE~TS .~"D ~1AKE REFERR.-\LS TO

P O!\."S nL\T ~\y HELP .\DOrrIONAL INFOR.'L~TIpN, CASE ~L-\..'lAGE~IE~'TS \lCES. OR EVALL'ATIO~ SERVICES REL-\TEO TO ~IEDICAL :\SS1STA.'lCE W.-\IVER

4

1 PROGRAMS OR OTHER OP'I'IONS F2 C OM MUNITY ;

HOUSE Bn.L 752

'OR RECEIVING LONG-TERM CARE SERVICES IN THE

3 (2) PROVIDE THE So4 CARE REPRESENTATIVE OR LEGJ

A.ME INFORMATION TO THE RESillENTS REALTIi~ GUARDlAL'l; Al'lD

5 (3) S~'.Y. ENSURE ~6 KEPI' IN A RESmENT'S CLIENT FJ

mAT A COPY OF THE INFORMATION PROVIDED ISLE.

7 (E) WHEN A RESmENT IN8 CARE SERVICES IN THE COMMUZ9 LOCAL DEPARTMENT OF SOCIAL

10 DAYS TO PERSONS THAT Wll.L11 SERVICES THAT WllJ. ENABLE TH12 BE AVAILABLE AND APPLY FOR B

DICATES A;.'I' INTEREST IN RECEIVING LONG-TE~I~t THE LONG TE&\I CARE CASE MANAGER AT ASERVICES SHALL REFER THE RESillENT WITHIN 10PROVIDE INFOR.'tlATION OR CASE MANAGE~IENTE RESillENT TO CONSillER THE OPrIONS THAT ~ YENEFITS IF THE RESillENT CHOOSES.

13 (F) (1) SUBJECT TO P~:~<?~H (3) OF THIS SUBSECTION. EMPLOYEES OR14 REPRESENTATIVES OF PROTECTJ:ON AND ADVOCACY AGENCIES AJ.~ OF CENTERS15 FOR INDEPENDE~ LMNG SH\LL HAVE REASONABLE AJ.'ffi UNACCOMP~'lIED16 ACCESS TO RESmENTS OF PtJ"BLIC OR PRIVATE NU"RSING FACn.ITIES IN THE STATE17 THAT RECEIVE REL,\lBURSEMEN' UNDER THE PROGRA.."i FOR THE PURPOSE OF18 PROVIDING INFOR.\fATION, TRAINu~G, ~'ffi REFERRAL TO PROGRAMS AJ.'ffi SERVICES19 ADDRESSL.'lG THE NEEDS 0 PEOPLE WITH DISABILITIES, INCLUDING20 P.-\RTICIPATION IN PROGRAMS THAT WOULD ENABLE nmrvmuALS WITH21 DISABll.ITIES TO LIVE OUTSillE THE NURSING FACILITY.

22 ~ ~ -'_SS~SS ~23 S~~S~Sq:lg~~ f~j g~ ~gs S~~IQ~t24 ~g):~.~-~tlS.,-~ PR~.'_'_~I.¥ ~.~I~25 ~.'!:.~, ~~~g~~IS ~.I.~. .'~~ 9t

~ ~~-~S~~b ~.~S~~S ~~Q~~~a :~~~aS~\I,L ~~S~:~~ ~m QPPQg":"..;,,}JI~:~Q ~.~~~ .\.'~a~~SIaE~~ Q~~ .~ aEb~~ n. B.'~IS B¥ ~~PIIQ~~~.P~~~Q~+. .

26 ~ LJ. EMPLOYEES27 ADVOCACY AGENCIES AJ.~ OF28 MAmT.-\L'oi THE CONFmE~IALm29 INFORMATION PROVIDED TO A RE30 THE RESmE~T OR THE RESD31 REPRESENTATIVE.

OR REPRESE~"TATIV"ES OF PROTECTION A.'.'DCENTERS FOR fl{DEPENDENT LnnNG SHALL

, OF THE RESWENTS .-\J."1D MAY NOT DISCLOSE mE

SmE~"T. EXCEPT WITH mE EXPRESS CONSE~"T OF)ENTS LEG.U GUARDL\."1 OR HEALm CARE

;I-~G THE ACCESS REQUIRED -~ER P.~GRAPH

37 SECTION 2. .o\..'lD BE IT Etn38 October I, 2002. Ii

~THERENACTED. That this Act shall take effect