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eimbursement
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ate
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ommission

An independent commission within DHMH:
The Maryland Department of Health and Mental Hygiene

Martin O'Malley,
Governor

Jillian Aldebron, J.D., M.A.
Chairman

Commissioners: 

• Jillian Aldebron, J.D., M.A.
• Kia Brown, M.S.
• Jeff Richardson, M.B.A., LCSW-c
• Thomas Sizemore, C.P.A., M.B.A.
• Timothy Wiens, M.S.W.

 

Charter

Use this link to view the actual statute in the Maryland Annotated Code or view the statute below

HEALTH - GENERAL  
TITLE 13.  MISCELLANEOUS HEALTH CARE PROGRAMS  
SUBTITLE 8.  COMMUNITY SERVICES REIMBURSEMENT RATE COMMISSION.
Md. HEALTH-GENERAL Code Ann. § 13-801  (2011)

 


§ 13-801. Definitions [Subtitle subject to abrogation]
(a) In general. -- In this subtitle the following words have the meanings indicated.
(b) Commission. -- "Commission" means the Community Services Reimbursement Rate Commission.
(c) Provider. -- "Provider" means a community-based agency or program funded:
   (1) By the Developmental Disabilities Administration to serve individuals with developmental disabilities; or
   (2) By the Mental Hygiene Administration to serve individuals with mental disorders.
(d) Rate. -- "Rate" means the reimbursement rate paid by the Department to a provider from State general funds, Maryland Medical Assistance Program funds, other State or federal funds, or a combination of those funds.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

 

 

 

§ 13-802. Established; function [Subtitle subject to abrogation]
(a) Established. -- There is a Community Services Reimbursement Rate Commission.
(b) Function. -- The Commission is an independent unit that functions in the Department.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

 

 

 

§ 13-803. Members; requirements; terms; vacancies [Subtitle subject to abrogation]
(a) Members. -- The Commission shall consist of seven members appointed by the Governor with the advice and consent of the Senate.
(b) Requirements -- Connection with providers. -- Of the seven members, four shall be individuals who do not have any connection with the management or policy of any provider.
(c) Requirements -- Interest. -- Each member appointed to the Commission shall be interested in ensuring high quality community-based services for individuals with developmental disabilities or mental disorders.
(d) Term; vacancies. --
   (1) The term of a member is 3 years.
   (2) If a vacancy occurs during the term of a member, the Governor shall appoint a successor who will serve until the term expires.
   (3) Except as provided in paragraph (4) of this subsection, a member who serves two consecutive full 3-year terms may not be reappointed for 3 years after completion of those terms.
   (4) The Governor may, with the advice and consent of the Senate, appoint up to two members serving on the Commission as of January 1, 2008, to serve a fifth consecutive 3-year term beginning October 1, 2008.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

 

 

 

§ 13-804. Chairman; vice chairman [Subtitle subject to abrogation]
 Each year, from among the members of the Commission:
   (1) The Governor shall appoint a chairman; and
   (2) The chairman shall appoint a vice chairman.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

 

 

 

§ 13-805. Quorum; meetings; compensation and expenses; staff [Subtitle subject to abrogation]
(a) Quorum. -- A quorum of the Commission is four members.
(b) Meetings. -- The Commission shall meet at least four times a year at the times and places that it determines.
(c) Compensation and expenses. -- A member of the Commission:
   (1) May not receive compensation for duties performed as a member of the Commission; but
   (2) Is entitled to reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.
(d) Staff. -- The Commission may employ staff and expend funds to carry out its duties and responsibilities under this subtitle in accordance with the State budget.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

§ 13-806. Duties (Abrogation of amendment effective June 30, 2016.)
(a) Assessment. -- The Commission shall assess:
   (1) The extent and amount of uncompensated care delivered by providers;
   (2) The level of and changes in wages paid by providers to direct support workers, including the source of revenue for wages paid by providers;
   (3) The ability of providers to operate on a solvent basis in the delivery of effective and efficient services that are in the public interest;
   (4) The incentives and disincentives:
      (i) Incorporated in the rate setting methodologies utilized and proposed by the Mental Hygiene Administration and the Developmental Disabilities Administration; and
      (ii) In alternative methodologies;
   (5) How incentives to provide quality care can be built into a rate setting methodology; and
   (6) The impact of changes in regulations that impact on the costs of providers and whether the rates have been adjusted to provide for any increased costs associated with the regulatory changes.
(b) Development. -- The Commission shall:
   (1) Develop or refine methodologies for calculating rate update factors for rates paid by the Developmental Disabilities Administration and the Mental Hygiene Administration and recommend annual rate update factors that use the methodologies that are developed;
   (2) With respect to the Developmental Disabilities Administration, review the data reported in the Developmental Disabilities Administration annual cost reports and use the data to develop relative performance measures of providers; and
   (3) Evaluate proposed regulatory changes by the Department, the Developmental Disabilities Administration, and the Mental Hygiene Administration that affect the rates paid or the rate structure.

HISTORY: 2010, chs. 497, 498.

 

 

 

§ 13-807. Powers [Subtitle subject to abrogation]
(a) In general. -- In addition to the powers and duties provided elsewhere in this subtitle, the Commission may:
   (1) Recommend the adoption of regulations to carry out the provisions of this subtitle;
   (2) Create committees from among its members;
   (3) Appoint advisory committees that may include individuals and representatives of interested public and private organizations;
   (4) Publish and distribute information that relates to the financial aspects of community-based developmental disability or mental health services; and

   (5) Subject to the limitations of this subtitle, exercise any other power that is reasonably necessary to carry out the purposes of this subtitle.
(b) Access to information. -- The Commission shall have timely access to information from the Executive Branch required to fulfill the responsibilities of the Commission under this subtitle, including information from the Developmental Disabilities Administration and the Mental Hygiene Administration.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

 

 

 

§ 13-808. Authority of Secretary of Health and Mental Hygiene [Subtitle subject to abrogation]
(a) Decisions or determinations by Commission. -- The power of the Secretary over plans, proposals, and projects of units in the Department does not include the power to disapprove or modify a decision or determination that the Commission makes under authority specifically designated to the Commission by law.
(b) Transfer of staff, function or funds. -- The power of the Secretary to transfer by rule, regulation, or written directive any staff, function, or funds of units in the Department does not apply to any staff, function, or funds of the Commission.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

§ 13-809. Annual report (Abrogation of amendment effective June 30, 2016.)
   On or before October 1 of each year, the Commission shall issue a report to the Governor, the Secretary, and, subject to § 2-1246 of the State Government Article, the General Assembly that:
   (1) Describes its findings regarding:
      (i) The changes in wages paid by providers to direct care workers;
      (ii) The financial condition of providers and the ability of providers to operate on a solvent basis in the delivery of effective and efficient services that are in the public interest;
      (iii) The incentives and disincentives incorporated in the rate setting methodologies utilized and proposed by the Mental Hygiene Administration and the Developmental Disabilities Administration and how the methodologies might be improved;
      (iv) How incentives to provide quality of care can be built into a rate setting methodology; and
      (v) The recommended methodologies for the calculation of rate update factors and the rate update factors recommended for the next succeeding fiscal year;
   (2) Recommends the need for any formal executive, judicial, or legislative action;
   (3) Describes issues in need of future study by the Commission; and
   (4) Discusses any other matter that relates to the purposes of the Commission under this subtitle.

HISTORY: 2010, chs. 497, 498.

 

 

 

§ 13-810. Findings and recommendations [Subtitle subject to abrogation]
(a) In general. -- The findings and recommendations of the Commission shall be considered each year in the development of the budgets of the Department, the Developmental Disabilities Administration, and the Mental Hygiene Administration.
(b) Written response to recommendations. --

   (1) The Mental Hygiene Administration and the Developmental Disabilities Administration shall respond to the recommendations of the Commission in writing within 30 days after the report required in § 13-809 of this subtitle has been issued.
   (2) The written response of the Mental Hygiene Administration and the Developmental Disabilities Administration shall include:
      (i) An explanation of the actions being taken to implement the recommendations of the Commission; or
      (ii) An explanation of why no action has been taken on the recommendations of the Commission.
(c) Provision of new or revised regulations regarding payment rates. --
   (1) The Mental Hygiene Administration and the Developmental Disabilities Administration shall provide to the Commission, in advance of or at the same time as they are provided to the public, copies of any new or revised regulations regarding payment rates for community services.
   (2) The Board of Nursing shall provide to the Commission, in advance of or at the same time as they are provided to the public, copies of any new or revised regulations that would be expected to impact on the costs incurred by providers of community services that are paid for by the Mental Hygiene Administration or the Developmental Disabilities Administration.

HISTORY: 1996, ch. 593; 1999, ch. 566; 2002, ch. 370; 2005, ch. 401; 2008, chs. 572, 573.

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Glossary and Acronyms

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