ROBERT L. EHRLICH, JR., Governor                            S.B. 819

(3)     "SEVERE COGNITIVE IMPAIRMENT" MEANS A LOSS OR

DETERIORATION IN AN INDIVIDUAL'S INTELLECTUAL CAPACITY THAT IS;

(I) COMPARABLE TO AND INCLUDES ALZHEIMER'S DISEASE AND
SIMILAR FORMS OF IRREVERSIBLE DEMENTIA; AND

(II) MEASURED BY CLINICAL EVIDENCE AND STANDARDIZED TESTS
THAT RELIABLY MEASURE IMPAIRMENT IN AN INDIVIDUAL'S;

1. SHORT TERM OR LONG TERM MEMORY;

2. ORIENTATION AS TO PEOPLE, PLACES, AND TIME; AND

3. DEDUCTIVE OR ABSTRACT REASONING.

(4)     "STANDBY ASSISTANCE" MEANS THE PRESENCE OF ANOTHER
PERSON WITHIN ARM'S REACH OF AN INDIVIDUAL THAT IS NECESSARY TO PREVENT,
BY PHYSICAL INTERVENTION, INJURY TO THE INDIVIDUAL WHILE THE INDIVIDUAL
IS PERFORMING AN ACTIVITY OF DAILY LIVING.

(5) (I) "SUBSTANTIAL SUPERVISION" MEANS CONTINUAL

SUPERVISION BY ANOTHER PERSON THAT IS NECESSARY TO PROTECT AN
INDIVIDUAL WITH SEVERE COGNITIVE IMPAIRMENT FROM THREATS TO HEALTH OR
SAFETY.

(II) "SUBSTANTIAL SUPERVISION" INCLUDES CUING BY VERBAL
PROMPTING, GESTURING, OR OTHER DEMONSTRATIONS OR 21 HOUR SUPERVISION.

(B) AN INDIVIDUAL SHALL BE DETERMINED MEDICALLY ELIGIBLE TO
RECEIVE NURSING FACILITY SERVICES UNDER THE MARYLAND MEDICAL
ASSISTANCE PROGRAM IF THE INDIVIDUAL REQUIRES;

(1) SKILLED NURSING FACILITY CARE OR OTHER RELATED SERVICES;

(2) REHABILITATION SERVICES; OR

(3) HEALTH RELATED SERVICES ABOVE THE LEVEL OF ROOM AND
BOARD THAT ARE AVAILABLE ONLY THROUGH INSTITUTIONAL FACILITIES
INCLUDING, BUT NOT LIMITED TO, INDIVIDUALS WHO EITHER BECAUSE OF SEVERE
COGNITIVE IMPAIRMENTS OR OTHER CONDITIONS;

(I) 1. ARE CURRENTLY UNABLE TO PERFORM AT LEAST TWO
ACTIVITIES OF DAILY LIVING WITHOUT HANDS ON ASSISTANCE OR STANDBY
ASSISTANCE FROM ANOTHER INDIVIDUAL; AND

2. HAVE BEEN OR WILL BE UNABLE TO PERFORM AT LEAST
TWO ACTIVITIES OF DAILY LIVING FOR A PERIOD OF AT LEAST 90 DAYS DUE TO A
LOSS OF FUNCTIONAL CAPACITY; OR

(II) NEED SUBSTANTIAL SUPERVISION FOR PROTECTION AGAINST
THREATS TO HEALTH AND SAFETY DUE TO SEVERE COGNITIVE IMPAIRMENT.

(C) THE DEPARTMENT SHALL ADOPT REGULATIONS TO CARRY OUT THE
PROVISIONS OF THIS SECTION.

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