COMAR 10.63 Notice of Proposed Action: Major Rewrite of Community-Based Behavioral Health Regulations

The Maryland Department of Health has filed a Notice of Proposed Action substantially rewriting COMAR 10.63 — Community-Based Behavioral Health Programs and Services. The chapter sets the operating rules for nearly every licensed community behavioral health program in the state, so the proposed changes have wide reach.

What the NOPA covers

The proposed text reorganizes and clarifies requirements across the chapter, including:

• General requirements for all programs (definitions, governance, applicability).
• Programs requiring license versus programs that don't.
• Accreditation and accreditation-based licensure, including written notification to the Administration within 5 business days of any change in accreditation status.
• Grievance policy content and the requirement to share it with participants at admission.
• Governance and corporate compliance, including expectations for compliance officer access to corporate officers and board members.
• Critical incident definitions and reporting — explicitly including any suicide attempt by a current participant.
• Program director, clinical director, and allied health staff roles and qualifications.
• License application and issuance, site requirements, and discontinuation of operations (including a 7-year records retention requirement after a program closes).
• Assessments and participant records — relevant history across substance use, employment, and related domains.
• Integrated Behavioral Health (IBH) Program rules, including referral services and staffing.
• Seclusion and restraint requirements.
• Residential safety, including documented monthly safety drills and environmental safety expectations (door handles, curtains, hooks, shower rods).

Why this matters now

Because COMAR 10.63 is the operating rulebook for community behavioral health in Maryland, changes here cascade into policy manuals, job descriptions, intake and discharge workflows, incident reporting procedures, and audit preparation. Programs that wait until the final rule is published will have less time to update documents and brief staff.

What to do during the comment period

1. Read the full proposed reg text and flag every section that affects your program type.
2. Identify internal policies, templates, and job descriptions that will need updates.
3. Draft a formal comment letter if any proposed language creates operational problems for your program.
4. Brief your leadership team, compliance officer, and clinical directors so they're not surprised when the rule is finalized.
5. Build a tracker of "policy work to do once final" so you can move quickly when the effective date is set.

Timeline

This is a Notice of Proposed Action, not a final regulation. A public comment period follows, after which the Department may revise and adopt the final text. Watch the Maryland Register and the DSD COMAR search portal for the final action and effective date.