1. A. The local department shall screen an applicant's completed application for CARE services on forms prescribed by the Administration. A complete application comprises the following information:

   1. (1) A completed Project Home application form.
   2. (2) A health history and the applicant's most recent health assessments; and

   3. (3) Consent forms signed by the applicant for the release of information to the local department by:

      1. (a) Appropriate health professionals; and
      2. (b) Legitimate sources of financial information.
2. B. If the applicant has been found not eligible, the local department shall send written notice to the applicant which shall include the reason for the decision.

3. C. If a service slot is not available for an eligible applicant, the local department shall:

   1. (1) Rank the applicant according to §E(1) of this regulation; and

   2. (2) Notify the applicant in writing within 30 days of receipt of the complete application that the applicant:

      1. (a) Has been placed on a waiting list; and
      2. (b) May be eligible for referral to other services through the local department.

4. D. If an applicant is found eligible and a service slot is available the local department shall assign a case manager to:

   1. (1) Complete a comprehensive assessment of the applicant's capacities and needs in a community living situation;

   2. (2) Establish the level of care required by the applicant by considering the following characteristics of the applicant:

      1. (a) Illnesses and disabilities which may require medical or corrective treatment;
      2. (b) Ability to perform physical self-maintenance activities;
      3. (c) Ability to perform basic activities of daily life; and
      4. (d) Level of cognitive functioning, emotional and behavioral controls, and social competence;
   3. (3) Determine the amount of income and other resources available to pay for placement;
   4. (4) Determine the availability of an appropriate CARE home;
   5. (5) Decide with the applicant whether CARE service is appropriate;

   6. (6) Send a written notice to the applicant, within 30 days of the case manager's assignment of the case, of the application decision which shall include:

      1. (a) For acceptance:

         1. (i) Decision;
         2. (ii) Reason for the decision;
         3. (iii) Level of care to be provided;
         4. (iv) Fact that an appropriate CARE home is or is not available, or that the applicant agreed that the local department shall seek a placement for the applicant in another jurisdiction; and
         5. (v) The resident's right to appeal any part of the decision as provided in COMAR 07.01.04, and the method for obtaining a fair hearing; or

      2. (b) For denial:

         1. (i) Decision;
         2. (ii) Reason for the decision;
         3. (iii) Specific regulation supporting the decision; and
         4. (iv) Applicant's right to appeal the decision as provided in COMAR 07.01.04 and the method for obtaining a fair hearing; and
   7. (7) If the local department is unable to place an eligible applicant, refer to §E(1) of this regulation.

5. E. Priority for Service.

   1. (1) Based on the applicant's situation at the time of application, an applicant is ranked on the following descending point system:

      1. (a) Applicant is in an abusive situation, or is under public guardianship (15 points);
      2. (b) Applicant is at high risk of institutional placement or continued institutional placement without supervised housing (15 points);
      3. (c) Relative caregiver is 60 years old or older (15 points);
      4. (d) Applicant is dependent on an unreliable or overburdened caregiver for daily needs (10 points);
      5. (e) Applicant is homeless or facing homelessness and is unable to use independent housing (10 points);
      6. (f) Relative caregiver suffers from a physical or mental disability that is a barrier to caring for the applicant or the caregiver is caring for another disabled family member (10 points);
      7. (g) Applicant's income is below the poverty level (10 points);
      8. (h) Applicant is lacking family or community supports necessary for coping with daily living (5 points);
      9. (i) Applicant is a recipient of Supplemental Security Income (SSI) (5 points); or
      10. (j) Applicant's income is below the State median income as specified in COMAR 07.02.04.08 (5 points).
   2. (2) Applicants who have equal points under §E(1) of this regulation and are equally appropriate for an available slot shall be offered service in the order in which the local department received the applications for service.

Authority: Health-General Article, §§19-1801—19-1806; Human Services Article, §§6-508—6-513; Annotated Code of Maryland
(Agency Note: Federal Regulatory Reference: 45 CFR Part 1397)

Effective date: February 24, 1986 (13:4 Md. R. 395)

Regulations .02, .03, .07, and .08 amended; new Regulation .16 adopted; and existing Regulations .16 and .17 recodified to be .17 and .18 as an emergency provision effective February 24, 1986 (13:6 Md. R. 667); emergency status expired June 30, 1986

Regulations .02I, K; .03C; .07; .08A amended effective July 13, 1986 (13:14 Md. R. 1631)

Regulations .16 and .17 recodified to .17 and .18, and new Regulation .16 adopted effective July 13, 1986 (13:14 Md. R. 1631)

Chapter 20 “C.A.R.E. Program” revised as Chapter 20 “Certified Adult Residential Environment (C.A.R.E.) Program” effective October 3, 1988 (15:20 Md. R. 2333)

Regulation .10A amended effective November 1, 1990 (17:20 Md. R. 2424)

Recodified from COMAR 07.02.20 to 07.06.15, December, 1992

Regulations .01—.18, Certified Adult Residential Environment C.A.R.E.(CARE) Program repealed effective June 11, 2001 (28:11 Md. R. 1053)

Regulations .01—.17, Certified Adult Residential Environment (CARE) Program adopted effective June 11, 2001 (28:11 Md. R. 1053)

Regulation .01 amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .02B amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .03A amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .04 amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .05 amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .06C, D amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .07 amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .08 amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .10 amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .11 amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .12C amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .14A amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .15A amended effective July 17, 2008 (35:14 Md. R. 1245)

Regulation .16C amended effective July 17, 2008 (35:14 Md. R. 1245)

Chapter recodified from COMAR 07.06.15 to COMAR 07.02.19, effective June, 2009

Regulation .01C amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .02B amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .03A amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .04 amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .05A, L amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .06C amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .07 amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .08B amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .10B amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .12C amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .13A, B amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .14A amended effective April 10, 2017 (44:7 Md. R. 353)

Regulation .16B amended effective April 10, 2017 (44:7 Md. R. 353)