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Maryland · Hiring · Health-General §§19-1901 to 19-1912
Before a caregiver starts work at a Maryland Residential Service Agency, you apply for a State criminal history records check through CJIS, or ask a licensed private agency for a check covering every state they lived or worked in during the past 7 years, and you ask their most recent employer about any history of physical abuse. COMAR adds seven more screening steps, including an in-person interview and a skills demonstration before referral to clients.
Quick answer
For criminal history checks, a residential service agency is an adult dependent care program (Health-General §19-1901(b)(6)). "Before an eligible employee may begin work for an adult dependent care program, each adult dependent care program shall, for each eligible employee": apply for a State criminal history records check or request a private agency background check, and request a reference from the potential employee’s most recent employer (§19-1902(a)). That reference request "shall, at a minimum, seek information about any history of physical abuse on the part of the potential employee" (§19-1902(b)).
The statute asks for the application before work begins; it does not say the results must be back first. COMAR’s screening list adds license and certification checks, health and TB screening, references, employment history, the I-9, identity, an in-person interview and a skills assessment and demonstration, the last two before referral to clients (COMAR 10.07.05.10B(1)). Neither the statute nor the RSA rules list offenses that bar someone from the work.
Before work
apply for the criminal check and request the employer reference
Health-General §19-1902(a)Anyone who works for pay for your agency, has routine, direct access to clients, and is not licensed or certified under the Health Occupations Article. Most aides who are not certified fall here. The statute leaves out people who only deliver or collect medical equipment.
Health-General §19-1901(h)COMAR’s screening policy covers every prospective employee, independent contractor and contractual employee who will serve clients. The statute says "works for" without mentioning contractors; by our reading, check them exactly as you check employees.
COMAR 10.07.05.10AOutside the statute’s definition, but inside COMAR’s screening list. The routes for them are less settled; see the open questions.
Health-General §19-1901(h); COMAR 10.07.05.10AThe statute does not stop you checking any other applicant or volunteer, and DPSCS’s rule leaves it to you whether and when to apply for one.
Health-General §19-1912; COMAR 12.15.03.03B(2)The statute and the rule read differently. The statute’s duty is for each "eligible employee", who "is not licensed or certified under the Health Occupations Article" (§19-1901(h)). COMAR’s screening applies to "a prospective employee, independent contractor, or contractual employee who will provide services to clients" (COMAR 10.07.05.10A), and its first screening step is the check "as required under Health-General Article, Title 19, Subtitle 19" (.10B(1)(a)). By our reading, the cautious course is to check everyone who will serve clients. The hub guide says the same.
The statute, COMAR and DPSCS’s duties in hiring order. Where a source sets no timing we say so. Tick steps off as you go; progress is saved in this browser only.
Complete DPSCS’s Application to Receive Criminal History Record Information for Employment or Licensing Purposes, choosing Adult Dependent Care. DPSCS charges no fee to become authorized. If you will use a private agency instead, choose one that meets the statute’s definition. The two routes.
An in-person interview is one of COMAR’s nine screening steps, and it comes before the person is referred to clients.
State route: the worker signs the disclosure statement and has live scan fingerprints taken using your authorization number, and you submit them with the fee. Private route: you request the check covering every state the worker lived or worked in during the past 7 years. Either way, you pay.
The request must at least ask about any history of physical abuse. What to ask.
License or certification verification, basic health screening including TB, references, employment history, Form I-9, and identity and work eligibility.
A skills assessment and demonstration is the ninth screening step, before client referral. How skills are shown.
Neither the statute nor the RSA rules list barring offenses, so the decision is yours. Keep the results confidential and secure. Deciding about a record.
On the State route, DPSCS sends a revised printed statement when a new Maryland record appears, and at least once a year asks you to confirm who still works for you, within 15 working days.
The statute gives you a choice: "Apply for a State criminal history records check" or request a private agency to conduct a background check (Health-General §19-1902(a)(1)). Both meet COMAR’s first screening step. Pick one, write it into your screening policy, and use it for everyone.
| State check through CJIS | Private agency check | Source | |
|---|---|---|---|
| Who runs it | DPSCS’s Central Repository, on your application under your authorization number. | A private detective agency licensed in Maryland, with at least $1,000,000 of errors and omissions insurance, able to finish within 2 working days in Maryland and 5 outside it. | DPSCS; §19-1901(j) |
| What it searches | The criminal history record information held in the Central Repository. | Each state where you know or have reason to know the worker worked or lived during the past 7 years. | COMAR 12.15.03.02B(8); §19-1902(d) |
| Fingerprints | Yes. DPSCS says in-state employment checks use live scan; ink cards only for a bona fide medical reason. DPSCS may waive fingerprints after two failed attempts for a physical or medical reason. | The statute defines it as a check of court and other records by a private agency, and sets no fingerprint step. | DPSCS; §§19-1901(c), 19-1904(c) |
| State fee | DPSCS: $38 for a State-only check fingerprinted in person, including its $20 service fee. Private fingerprinting providers may add their own fee. These are DPSCS’s fees, not ours. | Set by the company you choose. | DPSCS fee schedule |
| Who pays | Your agency. | Your agency. | §19-1902(c) |
| Extra steps | The worker completes and signs a sworn disclosure statement of any conviction or pending charge. | You follow the federal Fair Credit Reporting Act, including a statement of your findings to the worker when adverse information precludes hiring them. | §§19-1905, 19-1906(b) |
| The worker can contest | Yes: a hearing within 20 workdays unless waived, and a decision within 5 workdays. | Yes: the worker has an opportunity to contest the findings. | §§19-1906(a), 19-1908 |
| After hire | Revised printed statements when new Maryland records appear (State Rap Back). | The statute provides no updates. By our reading, a private check is a snapshot on the day it is run. | §19-1907(a)(2); COMAR 12.15.01.19 |
Which reaches further. By our reading, the State check searches Maryland’s Central Repository (COMAR 12.15.03.02B(8)), while a private check must cover each state of the last 7 years. For a worker who recently moved to Maryland, the private route reaches records the State check may not. The State route, in turn, keeps sending updates after hire. Whether DPSCS would add an FBI check for an RSA is not stated in what we saved; the statute asks for a State check.
DPSCS’s rule also covers people who are not eligible employees: "An adult dependent care program shall decide if and when to submit an application for a printed statement for another individual." (COMAR 12.15.03.03B(2)) That includes volunteers, but not people licensed or certified under the Health Occupations Article (.02B(14)); more on that below.
DPSCS’s adult dependent care rule does not apply to private agency checks (COMAR 12.15.03.01B), so nothing in it limits who a private check may cover. The statute’s confidentiality rules still apply to the results (below).
Before an eligible employee begins work, you "request a reference from the potential employee’s most recent employer" (§19-1902(a)(2)), and the request "shall, at a minimum, seek information about any history of physical abuse on the part of the potential employee" (§19-1902(b)). Ask the question in writing, in plain words, and keep a copy of the request with the date sent.
CareRulebook
CareRulebook’s Maryland manual includes Policy 3.4 (Screening and criminal history records checks): your choice of CJIS or a licensed private agency, whether to wait for results before referral, whether to check certified staff, the nine COMAR steps as a screening checklist, a reference request that asks about physical abuse, a criminal record assessment record and a background check log. Policy 3.6 covers certification checks and Policy 3.2 the skills demonstration.
$199CareRulebook founding price for the first 50 Maryland agencies, then $249. Not an OHCQ fee.
The statute tells you how to check, not whom to turn away. We found no list of barring offenses in Health-General Title 19, Subtitle 19, in DPSCS’s rule or in COMAR 10.07.05 (§19-1902; COMAR 10.07.05.10). The decision is yours, and it should be made the same way every time.
CareRulebook’s manual does not invent a list. The person who runs the agency reviews every result personally and weighs the nature and seriousness of the offense (with particular attention to violence, sexual offenses, abuse or neglect, theft, fraud, exploitation and drug offenses), how it relates to the job, how long ago it was, what the person says about it and, for a pending charge, whether to wait for the outcome before any client contact. Before deciding not to hire, the person is told which record is the concern and given a chance to explain. These are the manual’s own steps (Policy 3.4), not OHCQ’s. Our suggestion: take employment law advice before withdrawing an offer because of a record.
The statute and the RSA rules set no fixed re-check. On the State route, the record keeps watch for you:
A private agency check has no follow-up in the statute. If you use one, decide in your policy whether and when you re-check; the rules leave that to you.
"Information obtained from the Department or a private agency under this subtitle shall be confidential" and may be shared only with the worker who is its subject and the program seeking to hire them. It "may not: (1) Be used for any purpose other than that for which it was disseminated; or (2) Be redisseminated." And "Information obtained from the Department or a private agency under this subtitle shall be maintained in a manner to insure the security of the information" (§19-1907(c)-(e)). DPSCS’s rule adds that the results "may only be disseminated to" the person checked and the program involved in hiring, kept so only authorized people can see them (COMAR 12.15.03.08).
The lists are our reading of the confidentiality sections above. By our reading, the evidence a subcontracting agency sends under COMAR 10.07.05.10H is a statement that each step was done, not the records themselves. Whether OHCQ surveyors expect to see printed statements at an inspection is not stated; it is on our list of questions for OHCQ. How surveys run is on Maryland RSA inspections. Screening records are kept at your business office (COMAR 10.07.05.10C), so keep the criminal history section of each file separate and locked.
This is the least settled part of Maryland’s hiring checks. The sources point in different directions:
Whether CJIS will process these checks, and which check OHCQ expects to see for certified staff, are on our list of questions for OHCQ. More on certification levels is on Maryland caregiver training.
"Screening shall include" nine items (COMAR 10.07.05.10B(1)). OHCQ’s FY 2018 list of most cited RSA rules was led by .10, this screening regulation (OHCQ slides, 2020, slide 21). That list is old, but it shows where surveyors have looked.
| Item | Screening includes | Note |
|---|---|---|
| .10B(1)(a) | State criminal history records check or private agency background check, as Title 19, Subtitle 19 requires | This page |
| .10B(1)(b) | Verification of current professional licensure or certification | Nurses, CNAs and medication technicians |
| .10B(1)(c) | A basic health screening, including tuberculosis screening | Also a written policy item (.08B(1)(b)(iii)) |
| .10B(1)(d) | Verification of references | The employer reference |
| .10B(1)(e) | Verification of employment history | The rule sets no number of years |
| .10B(1)(f) | Completion of I-9 forms for employment | A federal form for employees |
| .10B(1)(g) | Verification of identity and employment eligibility | For contractors too |
| .10B(1)(h) | An in-person interview before the person is referred to clients | Before referral |
| .10B(1)(i) | A skills assessment and demonstration before client referral | Caregiver training |
Records. "An agency shall maintain records of information described in §B of this regulation for each employee, independent contractor, or contractual employee and retain the information in the agency’s business office." (COMAR 10.07.05.10C) Health requirements for staff are also one of the 23 written policy items (.08B(1)(b)(iii)); the full list is on Maryland RSA policies and procedures.
Timing. COMAR puts only the interview and the skills demonstration expressly before referral. The rule gives no timing for the other steps; CareRulebook’s manual completes them all before a person’s first client visit, apart from the criminal history results if you choose not to wait for them.
It depends. The statute requires the agency to apply for the State check (or request a private check) and to request a reference from the most recent employer before the worker begins work. It does not say the results must be back first. COMAR adds an in-person interview and a skills assessment and demonstration before referral to clients. By our reading, waiting for the results before any client visit is the safer course; CareRulebook’s manual lets you choose either way and writes the choice into your policy.
"Before an eligible employee may begin work for an adult dependent care program, each adult dependent care program shall, for each eligible employee:"
It depends. The statute’s check before work covers "eligible employees", who by definition are not licensed or certified under the Health Occupations Article, so it does not reach nurses, nursing assistants or medication technicians. But COMAR’s screening list applies to everyone who will serve clients, and Medicaid’s Community First Choice program requires checks on all direct service workers, including nurses. DPSCS’s rule leaves licensed and certified staff out of the people CJIS checks for an adult dependent care program. By our reading, the cautious course is a check for everyone, with a private agency check where CJIS will not process one. Ask OHCQ which it expects.
"Who is not licensed or certified under the Health Occupations Article."
It depends. The RSA rules allow independent contractors, but the Attorney General’s guidance says hourly personal care aides are usually employees under Maryland wage, sick leave and unemployment law, Medicaid pays for personal assistance only when the aide is an employee, and every RSA certifies that it has read that guidance. Get employment advice before using contractors.
"This chapter does not preclude an agency from operating with independent contractors."
It depends. Not always. The default is a certified caregiver for clients who need ADL help or medication administration. By our reading of COMAR 10.07.05.10D, an uncertified aide may serve a client who needs no ADL help, a client whose supervising nurse judges there are no predictable adverse health consequences, or a cognitively capable adult who signs a waiver of skilled services. Ask OHCQ how it expects the nurse’s judgment to be recorded. Staff who administer medication must be licensed or certified unless the client has signed an informed consent form under COMAR 10.07.05.12D.
"An agency may not knowingly provide or refer a caregiver who is not certified to provide services to a client unless the client:"
Not always. Before an eligible employee starts work, the agency either applies for a State criminal history records check through the CJIS Central Repository, which uses live scan fingerprints, or asks a licensed private agency to run a background check covering every state the worker lived or worked in during the past 7 years, for which the statute sets no fingerprint step. A State-only check fingerprinted in person costs $38 at DPSCS; that is a state fee, not a CareRulebook price.
The statute requires the agency to apply for the check, and to request a reference from the most recent employer, before the worker begins work. It does not say the results must be back first. COMAR adds an in-person interview and a skills demonstration before referral to clients. By our reading, waiting for the results before any client visit is the safer course, and CareRulebook’s manual lets you choose either way.
Neither Health-General Title 19, Subtitle 19 nor the RSA rules (COMAR 10.07.05) list offenses that bar someone from working for a residential service agency. The hiring decision is the agency’s. Write down the factors you weigh so every decision is made the same way, and take employment law advice before withdrawing an offer because of a record.
No. DPSCS’s rule requires a new application, fingerprints and fees when a previously checked person goes to work for a program they have not worked for before, and results may not be passed on to anyone except the person checked and the hiring program. A worker who returns to your own agency does not need new fingerprints if you kept them on the Central Repository’s list.
The statute and the RSA rules set no fixed re-check. On the State route, DPSCS updates the check and sends you a revised printed statement when a new Maryland arrest, charge or conviction is added, and at least once a year sends a list of your previously processed workers to confirm within 15 working days. A private agency check has no such updates.
The RSA rules and the criminal history statute name none. The Board of Nursing publishes a CNA-I (formerly GNA) Abuse Registry of nursing assistants with findings, and its Look Up a License feature shows a certificate’s current status. By our reading, checking both for every nursing assistant you hire is a sensible extra step; it is not a rule requirement.
The agency. The statute says the adult dependent care program shall pay for each eligible employee’s State check or private agency check. By our reading, that means you cannot charge the applicant for it.
The Board of Nursing has proposed criminal history checks for all its certificate holders (26-127-P, comments by October 5, 2026; in force as emergency rules since August 25, 2026), and OHCQ has signalled a 2026 update to the RSA training rules. Leave your email and we will tell you when a Maryland change affects your hiring checks or your policies.
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