Understanding COMAR in Maryland: Focus on Social Work and Counseling
The Code of Maryland Regulations (COMAR) is the official compilation of all administrative regulations issued by Maryland state agencies. These regulations carry the force of law and govern everything from healthcare and education to licensing standards for mental health professionals.
What COMAR Is and Why It Matters
COMAR serves as the bridge between legislation and practice. For therapists, it defines the scope of practice, supervision requirements, ethical expectations, and licensing standards.
Key Features of COMAR
- Regulatory authority
- Created by state agencies under authority granted by Maryland law
- Has legal enforceability when adopted
- Organizational structure
- Divided into 36 titles, each representing a state agency
- Each regulation has a four-part code (e.g., Title.Subtitle.Chapter.Regulation)
- Dynamic and updated
- Updated regularly through the Maryland Register
- Online version updated frequently; print version is official
- Applies across systems
- Healthcare systems
- Behavioral health programs
- Licensing boards
- Medicaid and public services
COMAR and Behavioral Health
For mental health professionals, COMAR is especially relevant within:
- Title 10 – Maryland Department of Health
- Covers behavioral health services, Medicaid programs, and provider requirements
- Health Occupations Article (via COMAR references)
- Governs licensing boards for:
- Social workers
- Professional counselors
- Psychologists
- Governs licensing boards for:
COMAR defines not just who can practice, but also how services must be delivered.
COMAR and Social Work in Maryland
Social work regulations are closely tied to both COMAR and the Maryland Board of Social Work Examiners.
Core Areas Covered in COMAR for Social Workers
- Licensure definitions
- COMAR includes definitions of:
- Licensed Certified Social Worker (LCSW-C)
- Licensed Master Social Worker (LMSW)
- COMAR includes definitions of:
- Scope of practice
- Defines what services each license level can provide
- Differentiates between:
- Clinical practice
- Case management
- Macro-level work
- Supervision requirements
- Specifies:
- Number of supervised hours required
- Acceptable supervisors
- Documentation standards
- Specifies:
- Ethical and professional conduct
- Requires adherence to:
- Confidentiality laws
- Informed consent practices
- Recordkeeping standards
- Requires adherence to:
Practical Examples of COMAR in Action
Understanding COMAR becomes clearer when applied to real-world scenarios:
- Example 1: LMSW in an OMHC
- Must work under supervision
- Cannot independently diagnose without proper credentials
- Must follow COMAR documentation rules
- Example 2: LGPC providing therapy
- Requires board-approved supervision
- Must adhere to COMAR treatment and recordkeeping standards
- Example 3: LCSW-C or LCPC in private practice
- Can practice independently
- Must comply with:
- Billing regulations
- Ethical standards
- Client record requirements
Key Reasons to Understand COMAR
- Legal protection
- Practicing outside COMAR guidelines can lead to:
- License suspension
- Legal liability
- Practicing outside COMAR guidelines can lead to:
- Clinical clarity
- Defines what you can and cannot do at each license level
- Career advancement
- Outlines the pathway from:
- LMSW → LCSW-C
- LGPC → LCPC
- Outlines the pathway from:
- Program compliance
- Agencies must follow COMAR to maintain licensure and funding
Final Thoughts
COMAR is the law clinicians follow not just to ensure their own safety and compliance, but because it ensures the quality of care for clients. There is a lot of common sense in these regulations, but they mostly revolve around core principles of therapeutic work and mental healthcare, which is do no harm.