In Re Adoption/Guardianship of DUSTIN R.

WATTS, J. This case concerns whether the Court of Special Appeals erred in dismissing on its own initiative an appeal by the Department of Health and Mental Hygiene (“DHMH”), Respondent, and whether the Circuit Court for Anne Arundel County, sitting as a juvenile court (“the juvenile court”), had the authority to order DHMH to continue to provide services after age twenty-one to Dustin R. (“Dustin”), Petitioner, a medically fragile child who needed life-sustaining care. We hold that: (I) the Court of Special Appeals erred in dismissing DHMH’s appeal because the juvenile court’s order was immediately appealable at a minimum as an interlocutory order granting injunctive relief; (II) the juvenile court had jurisdiction and the statutory authority to order DHMH to develop and approve a written plan of clinically appropriate services in the least restrictive setting that ensured that Dustin would continue to receive services, where Dustin was not yet twenty-one years old when the juvenile court issued its order and where such services were required to protect Dustin’s health and welfare, and where the juvenile court’s order served to bridge the gap in services as Dustin transitioned from his juvenile guardianship case to adult guardianship care and the final outcome (meaning judicial review, including the appellate process) may be of any Medicaid fair hearing proceedings; and (III) the juvenile court did not violate the separation of powers. BACKGROUND On December 16, 1992, Dustin was born.

In February 1995, when he was two years old, Dustin entered foster care. In that year, the juvenile court terminated Dustin’s biological parents’ parental rights and granted guardianship to the Anne Arundel County Department of Social Services (“DSS”) with ⁵⁴¹ the right to consent to adoption or long-term care short of adoption. On March 28, 1995, DSS placed Dustin in a treatment foster care home with Jacqueline and Darrell P. (“Mrs. P.” and “Mr. P.,” respectively). 1 Dustin’s placement with Mr. and Mrs. P. was successful; Mr. and Mrs. P.’s home was designated by court order as Dustin’s permanent placement; and the juvenile court gave Mr. and Mrs. P. limited guardianship authority to make medical (including mental and dental health), educational, and out-of-State travel decisions on Dustin’s behalf.

Dustin has lived with Mr. and Mrs. P. since March 28,1995. There is no dispute that Dustin is medically fragile and has special needs. Dustin has, among other conditions, an intellectual disability, severe seizure disorder, cortical visual impairment, gastro-esophageal reflux, scoliosis, osteoporosis, ischemic encephalopathy, global orthopedic impairments, cerebral palsy, and an Unidentified Long Chain Fatty Acid Syndrome with a Mitochondrial Disease (a metabolic disorder). 2 Dustin has a tracheostomy, full glottal closure, 3 a colostomy, and a gastrostomy tube for feeding. DHMH administers the Maryland Medical Assistance Program (“Medicaid”), which has paid Dustin’s medical expenses in foster care.

As Dustin grew older, his condition worsened. On February 18, 2005, when Dustin was twelve years old, after an ⁵⁴² emergency hearing, the juvenile court ordered DSS to secure round-the-clock (twenty-four hours per day, seven days per week) nursing services for Dustin. 4 In response, DSS filed an emergency motion requesting to remove Dustin from the home of Mr. and Mrs. P. and to move him to another placement that would cost “substantially less[,]” as the cost of round-the-clock nursing services exceeded the Medicaid rates. Ultimately, DSS reached an agreement to provide the additional private nursing care to Dustin by supplementing the Medicaid rates through splitting the cost of the supplemental payments between the Developmental Disabilities Administration (“DDA”) (which DHMH administers) and the Department of Human Resources. In 2006, DSS contracted with Med-Source Community Services, Inc. (“MedSource”) to provide round-the-clock nursing services at an hourly rate that exceeded the Medicaid reimbursement rate.

Since that time, Dustin has had a rotating team of eight registered nurses providing round-the-clock services. As early as 2010, Dustin began to seek the provision of services for himself after age twenty-one. In March 2010, at age seventeen, Dustin filed a petition for co-commitment to DHMH and DSS. The juvenile court denied the petition without prejudice.

In June 2011, Dustin filed an amended petition for co-commitment to DHMH and DSS, requesting that the juvenile court require DHMH and DSS to “present a written plan to provide for the care of Dustin [ ] in the [ ] home [of Mr. and Mrs. P.], including 24 hour skilled nursing care, upon turning” twenty-one years old. Dustin described his medical condition at that time in the amended petition as follows: [ ] Dustin, now Wk years old, is a severely medically fragile child with special needs. He is diagnosed with Unidentified Long Chain Fatty Acid Syndrome with a Mitochondrial Disease (metabolic disorder), Mental Retardation, Severe ⁵⁴³ Seizure Disorder, Gastro-Esophageal Reflux, Cortical Visual Impairment, Scoliosis, Osteoporosis, Global Orthopedic Impairments, and Cerebral Palsy. Because Dustin has limited ability to metabolize long chain fatty acids, has severe protein allergies, and frequent dramatic fluctuations in his blood sugar levels, he is fed a reduced protein formula and must be assessed a minimum of every 4 hours to prevent a metabolic crisis which may impact multiple body systems.

He has a gastrostomy tube[,] as well as an intravenous port for antibiotic administration and blood sample draws. [On] March 8, 2011[,] his rectum was permanently[,] surgically closed[,] and the surgeons created a permanent colostomy. He has fragile skin with a history of pressure ulcers, a history of gastrointestinal bleeding, and urinary retention with a history of bladder infections. At the time of this [amended] petition, he has been diagnosed with Neutropenia, a condition that compromises the body’s ability to heal or fight infection due to an extremely low white blood cell count. This condition further complicates the metabolic disorder. [ ] He functions at the cognitive level of about a [six-]month[-]old.

He does not have the ability to control his movement[,] and is transferred throughout the day from bed to wheelchair to standing frame frequently. In each piece of equipment, he is repositioned frequently[,] with multiple soft pads to prevent pressure sores and to stimulate long bone growth. He can[ ]not make sound[,] so he must be within sight of the nurse at all times. He receives all nutrition and most of his medication through a gastrostomy tube into his stomach and receives all intravenous medications and nutrition through the surgically implanted BardPort that provides direct access to the heart through the Vena Cava.

He has doctor’s orders to receive 16 medications at specified times every day[,] and receives 5 additional medications on a “prn[,]” or as needed[,] basis. He receives oxygen through [a] tube in his trachea when his blood oxygen saturation is low. Because he can[ ]not swallow or clear his airway, he is suctioned through the trachea ⁵⁴⁴ tube when necessary, as determined by the nurse, to prevent aspiration of fluid into his lungs. He is also catheterized for urine every four hours and more frequently if he has an infection.

(Record references omitted). Eventually, in April 2013, DHMH consented to co-commitment, and the juvenile court ordered DHMH to “continue the planning process for the transition of [Dustin] from foster care under the guardianship of [DSS] to the guardianship of his current foster parents or other appropriate persons[.]” Significantly, between March 2010—when Dustin first filed a petition for co-commitment to DHMH and DSS—and August 2013, on multiple occasions, Dustin requested that the juvenile court order DHMH to fund and provide to him after his twenty-first birthday the same services that he was then receiving. DHMH consistently opposed those requests on the grounds that such requests exceeded the juvenile court’s authority. In Fall 2012, DHMH and DSS began planning for Dustin’s transition out of his juvenile guardianship and foster care.

On December 6, 2012, representatives of DHMH participated in a quarterly Treatment Team Meeting that DSS organized. A DDA representative, who was at the meeting to help plan for Dustin’s transition from foster care, stated that DDA was committed to working with Medicaid’s Rare and Expensive Case Management Program (“REM”) “to determine the recommended level of services.” The DDA representative agreed to follow up with a DDA nurse to complete an assessment of Dustin in coordination with REM before the next scheduled Treatment Team Meeting. On February 7, 2013, a DDA nurse assessed Dustin and observed that Dustin “has an extensive medical history with treatment needs that are not deleg[ ]able to unlicensed staff[,]” but the DDA nurse opined that “the licensed nursing service is able to be shared” because Dustin was “not receiving treatments at intervals that would disallow for shared service with another person of equal or lesser licensed nursing need.” On March 4, 2013, Dustin’s resource coordinator recommended a service change, in which she noted that the outcome desired was as follows: “Dustin ⁵⁴⁵ will be provided his current supports in order to continue living in his current residence when he turns 21.” The resource coordinator stated that, “for Dustin to continue living in his current residence, all funding [that] he is currently receiving needs to continue, with the budget being through [DDA] at the time that he turns [twenty-one] years old.” On March 7, 2013, DSS conducted a Treatment Team Meeting, which representatives of DHMH, Dustin’s resource coordinator, Mrs. P, and Dustin’s counsel attended. The notes from the meeting state that the group was “in the process of planning for Dustin’s transition to DDA when he turns [twenty-one years old] in December.” The notes from the meeting state that a request for service change had already been submitted to DDA, and that DDA was to respond by March 29, 2013.

During the meeting, Mrs. P. expressed her concern “for Dustin to continue with the current quality of nursing services[,]” which she believed to be “essential ... for Dustin to remain in the [P. family] home after he turns” twenty-one years old. The notes from the meeting indicate that “[t]here continue[d] to be disagreement about the rate of nursing care[,]” and reported DDA’s intent to distribute a plan for Dustin for care in the P. family home “[i]n the next 3 to 4 months,” and the need for an “alternative plan” if Mrs. P. was not comfortable with the plan for nursing care in the P. family home. In a letter dated June 5, 2013—after DHMH consented to co-commitment—DDA proposed a transition plan for Dustin. DDA stated that Dustin would remain eligible to participate in REM; that Medicaid would pay for Dustin’s medical care; and that Dustin would be eligible for a DDA waiver, 5 whether or not he remained in the home of Mr. and Mrs. P. DDA ⁵⁴⁶ stated that it would seek to move Dustin to a residential program if Mr. and Mrs. P. decided not to seek guardianship.

Mr. and Mrs. P. decided to seek guardianship of Dustin so that he could remain in their home; on July 26, 2013, Mr. and Mrs. P. submitted through Dustin’s resource coordinator a proposed service funding plan, in which they, in coordination with MedSource, proposed to “[c]ontinu[e] Dustin’s budget ‘as is[.]’ ” The budget for Dustin’s care would continue to cover items such as training and orientation for Dustin’s nursing team, case management, payment of non-covered medical supplies and prescriptions, partial payment of utilities within the home of Mr. and Mrs. P., and equipment maintenance. In a letter dated August 14, 2013, DHMH responded to the proposed service funding plan, stating that certain services provided to Dustin were “covered waiver services[,]” including Dustin’s nursing, medical equipment and supplies, medications, and other medical care, but that other services requested in the proposed service funding plan were not covered, and thus were denied. 6 On August 26 and 27, 2013, and September 27, 2013, the juvenile court conducted an annual guardianship review hearing. At the hearing, counsel for DHMH and DSS readily acknowledged that the dispute was over funding for Dustin’s services, which Mr. P. and Mrs. P. wanted to continue after Dustin’s twenty-first birthday. The juvenile court heard testimony from witnesses on Dustin’s behalf, including: Dr. Richard Kelley, a pediatrician specializing in metabolic diseases, accepted as an expert in biochemical genetics and the complex nature of metabolic disease and its impact on bodily systems of children and adults, who had been caring for Dustin for approximately fifteen years; Stefania Bockmiller, a registered nurse, who had been caring for Dustin for nearly ten years, accepted as an expert in registered nursing care of medically ⁵⁴⁷ complex and fragile patients in hospital and community settings; Mona Yudkoff, a registered nurse, accepted as an expert in registered nursing with a focus on rehabilitation and life care planning; Jay Balint, the executive director, president, and chief executive officer of MedSource; Sherry Davis, Dustin’s resource coordinator; Mrs. P.; Laura Kress, the assistant director of nursing for nursing practice at Johns Hopkins Hospital; and A’lise Williams, director of DHMH’s Board of Nursing, whose deposition testimony was admitted into evidence.

The juvenile court also heard testimony from witnesses on DHMH’s behalf and DSS’s behalf, including: Rosslyn Hill, Dustin’s DSS social worker; Vanessa Bullock, the deputy director of the central Maryland regional office of DDA; and Marie Adams, a DDA registered nurse. At the hearing, counsel for DHMH argued that the juvenile court lacked the statutory authority to order the relief that Dustin requested—namely, that services continue after his twenty-first birthday. Counsel for DSS argued that ordering the relief would violate the separation of powers. By contrast, Dustin’s counsel contended that the juvenile court had the statutory authority to order a plan of clinically appropriate services in the least restrictive setting.

At the conclusion of the hearing, the juvenile court orally ruled that DHMH’s plan was clinically inadequate, stating: I expressed my concern over the position of [DSS]. They are his current guardian, [ ] yet they stand next to [DHMH] in ... trying to convince [me] to cut benefits for Dustin. ... It’s a cutback of services and that’s what they’re proposing. And I’m not sure that’s consistent with their obligations as guardian of his person.

This is a life and death issue for me. And I’m afraid th[at] DHMH and DSS really [are] not looking out through the eyes of it being a life and death issue. ⁵⁴⁸ The juvenile court identified two issues, namely, “what services are necessary[ ] to obtain the ongoing care needed after the guardianship terminates ... at age” twenty-one, and whether DHMH’s plan offered “clinically appropriate services in the least restrictive setting.” The juvenile court stated that the following factual findings had been found to be proven “no matter what standard of proof’ applied: 1. Dustin has a disability and is a medically fragile child per the [Code of Maryland Regulations] definition[.] 2. He needs ongoing care[.] 3.

He needs clinically appropriate services, which is[,] ultimately, what I have to decide[.] 4. And that is keeping what he already has; it cannot be decreased, it’s life-threatening if it’s decreased, and his needs were the same and probably will get more complicated as he gets older[.] 5. I believe that the P. residence is the least restrictive setting; I’m not sure anybody’s going to dispute that he’s been there since age two— 6. There are emotional ties[.] 7.

We know a description of all the improvements done to that house[.] 8. Everyone that currently cares for him at the P. house knows what he needs[.] . I find clearly that 24/7 [registered nurse] care, which he’s already getting[.] And I’m not sure how anybody can dispute that finding because it’s already been agreed to. It’s already been acknowledged that’s what works and that’s what keeps him out of the hospital.

Anybody [who] suggests that it should be decreased, whether it’s motivated by money, just is not looking at this case objectively— . His needs will increased] . As I stated, maintaining the status quo, in my view, is a matter of life or death[.] ⁵⁴⁹ And you know the governmental agencies involved here, I guess I can say I’m a little annoyed, because to me, a deal is a deal. They made a deal with Dustin, they made a deal with the P.’s, and now they want to renege on that deal, and I just have a problem with that....

They just out-of-hand rejected the plan submitted, even though they knew it worked, and even though they knew it had been approved for the last six or seven years____ . The current arrangement works and should not be ehanged[.] . This case is a level-of-care issue[.] I find that it’s not only in the best interest of Dustin—and if we value life at all this is a life-and-death matter, in the view of this particular member of the bench.... . A group home is clearly not appropriate^] .

And all of the services that he’s currently getting, just so I’m clear[,] as defined by the statute[,] are “clinically appropriate services.” After making the factual findings above, the juvenile court addressed a two-page document that Dustin submitted entitled “Proposed Findings and Order,” and the following exchange occurred: [THE COURT:] So that’s my decision. I’ve looked at the order, Proposed Findings of Fact and Order, and before I place my signature on it, are there any other comments regarding the order? [COUNSEL FOR DHMH]: I would ask that the order list the specific services that the Court is ordering that [DHMH] fund. THE COURT: Counsel, I don’t need to do that. If you’ve been paying attention at this trial, you know what those services are.

They’re everything he’s getting now----[I]n my view[, they] are going to be necessary after he turns [twenty-one], [COUNSEL FOR DHMH]: Does that include payments to Mrs. P.? ⁵⁵⁰ THE COURT: It includes everything.... It includes ... exactly what he’s getting now.... There is no need to change any of that. The juvenile court signed the “Proposed Findings and Order,” which reads, in full, as follows: PROPOSED FINDINGS AND ORDER On August 26-27, 2013 and September 27, 2013[,] a Guardianship Review Hearing was held and Dustin [ ] requests that the Court make the following Findings: 1) Dustin requires 24/7[,] one-on-one skilled nursing care provided by registered nurses [who] have been fully oriented to his care needs and have demonstrated competence in all of the tasks on the Skills Checklist developed by the supervising nurse. 2) Dustin requires the continuation of all services that will ensure that the agency is able to retain the current nurses [who] have been fully oriented to continue to care for him[,] including[,] but not limited to[,] call-out pay, orientation, holiday pay, and vacation. 3) It is in Dustin’s best interest to remain in the least restrictive setting in the home of the P[.] family[,] who are willing to continue to provide a home to him after he turns [twenty-one]. 4) Dustin requires the continuation of all other services currently provided that enable Dustin to remain healthy and safe in the P[.] home. 5) DHMH has not provided a plan for Dustin of clinically appropriate services in the least restrictive setting. 6) That [another planned permanent living arrangement] is in Dustin’s best interest because of his ongoing[,] extensive[,] and extraordinary medical conditions and his profound physical and developmental disabilities.

Further, Dustin requests that this Court: 1) ORDER that DHMH develop and approve a written plan that ensures that Dustin will continue to receive all of the services and supports [that] he is currently receiving^] ⁵⁵¹ ineluding[,] but not limited to[,] all services that will ensure that Dustin will receive 24/7, one-on-one skilled nursing care provided by registered nurses [who] have been fully oriented to his care needs and have demonstrated competence in all of the tasks on the Skills Checklist developed by the supervising nurse. 2) ORDER that DSS[ 7 ] and DHMH each report to the [juvenile] court and all parties in writing monthly [ ] the specific steps taken to ensure that Dustin’s current level of services and supports will continue in the P[.] home. 3) ORDER that the Stipulation of the parties dated April 26, 2005, shall continue to remain in effect; 4) ORDER that this matter be scheduled for hearing within [two] months[ ] for a Guardianship Review to determine adequacy of the progress toward the goal of achieving a seamless transition that will ensure Dustin’s health and safety and maintain the continuity of his placement in the community in the P[J home. 5) ORDER that the Court continue to grant Mr. and Mrs. [ ] P. the authority to make medical (including mental, dental and vision health), educational,] and out[-]of[S]tate travel decisions on Dustin’s behalf.[ 8 ] At the bottom of the Proposed Findings and Order, the juvenile court judge signed on the signature line that had been provided. The judge announced: “The order is signed.” 9 After the guardianship review hearing, the clerk of the juvenile court made the following docket entries: ⁵⁵² Num/Seq 00168000 00169000 00170000 00171000 00172000 Description Filed Jdg Hearing Sheet 09/27/13 PFH No Pro Se Party at time of Pro- 09/30/13 TBA eeeding Reasonable Efforts Made by DSS 09/30/13 TBA Another Planned Permanent Liv- 09/30/13 TBA ing Arrangement Proposed Finding and order 09/30/13 PFH On October 24, 2013, DHMH noted an appeal to the Court of Special Appeals. On December 2, 2013, the juvenile court conducted another guardianship review hearing. 10 The juvenile court judge signed an order dated December 2, 2013, crossing out the word “Proposed,” so the title read “PROPOSED ORDER”; the order, as amended and signed by the juvenile court judge, provided, in pertinent part: PROPOSED ORDER Upon a Guardianship Review Hearing on December 2, 2013 and the Findings made by [the juvenile court] on September 27, 2013, this Court hereby issues the following: [ ] ORDER that DHMH develop[,] approved and] supply to counsel for other parties by 12/9, 2013 “close of business[,]” a written plan that ensures that Dustin will continue to receive the services [that] he is currently receiving^] including[,] but not limited to[,] all services that will ensure that Dustin will receive 24/7, one-on-one skilled nursing care provided by registered nurses [who] have been fully oriented to his care needs and have demonstrated competence in all of the tasks on the Skills Checklist developed by the supervising nurse. [ ] ORDER that this matter be scheduled for hearing 12/12, 2013, at 1:30 p.m. ... for a Guardianship Review to determine adequacy of the progress toward the goal of achieving ⁵⁵³ a seamless transition that will ensure Dustin’s health and safety and maintain the continuity of his placement in the community in the P[.] home. If there is a signed, approved Service Funding Agreement and there are no outstanding issues, the parties shall notify the court and the hearing will be canceled[.] After the December guardianship review hearing, the clerk of the juvenile court made the following docket entries: Num/Seq Description Filed Jdg 00180000 Hearing Sheet 12/02/13 PTC 00181000 No Pro Se Party at time of Pro- 12/02/13 TBA ceeding 00182000 Order of Court 12/03/13 PTC On December 11, 2013, DHMH entered into a contract with MedSource Community Services, Inc. for “MedSource to implement the [September 27, 2013] Order and the Plan, pending the outcome of [DHMH]’s appeal of the Order[.]” On appeal, although neither DHMH nor Dustin raised any issue as to the appealability of the juvenile court’s September 27, 2013 order, in an unreported opinion dated December 22, 2014, a three-judge panel of the Court of Special Appeals dismissed DHMH’s appeal on its own initiative, a majority holding that the September 27, 2013 order was not a final, appealable order; accordingly, the Court of Special Appeals did not reach the merits.

Specifically, the Court of Special Appeals determined that, although “[t]he hearing transcript le[ft] no doubt that the [juvenile] court subjectively intended to render an unqualified, final disposition of the claim[,]” “the document executed by the [juvenile court] did not adjudicate the claim, and, objectively speaking, it was not a final order”; and, “although the clerk made a record of the document that the [juvenile court] signed, the docket entry did nothing to indicate that anything had actually been determined.” Notably, the Honorable Andrea M. Leahy dissented, stating that the juvenile court signed the proposed order, consistent with its oral rulings on the record, and that the juvenile court and the parties intended the signed proposed order to be a final, appealable order. ⁵⁵⁴ On January 21, 2015, Dustin filed in this Court a petition for a writ of certiorari, raising the following three issues: 1. Does an alleged scrivener’s error in the form of an order and docket entry render the order invalid and require dismissal of an appeal, even if it might deprive an extraordinarily medically fragile youth of life-sustaining relief? 2. Did the juvenile court exceed its authority under the guardianship law by ordering DHMH to enter into a plan to obtain the same life-sustaining care for a youth aging out of the system that he has received for the last ten years? 3. Is a juvenile court order requiring a State agency to develop and approve a plan to obtain ongoing life-sustaining care for a ward of the court, entered pursuant to express provisions of the guardianship statute, unconstitutional under the separation-of-powers doctrine?

On February 5, 2015, DHMH filed an answer and cross-petition for a writ of certiorari, raising the following three issues: 1. Did the Court of Special Appeals err in dismissing [DHMHj’s appeal from an order granting an injunction? 2. Is Dustin [ ] required to use the available administrative remedy to challenge [DHMHj’s decision on funding for the services [that] he will receive after his [twenty-fir]st birthday? 3. Did the juvenile court exceed its authority in ordering [DHMH] to develop, approve, and implement a plan to provide specified services to Dustin [ ]?

On April 17, 2015, this Court granted the petition and denied the cross-petition. See In re: Adoption/Guardianship of Dustin R., 442 Md. 515 , 113 A.3d 624 (2015). STANDARD OF REVIEW “An appellate court reviews without deference a [lower] court’s interpretation of a statute[.]” Howard v. State, 440 Md. 427, 434 , 103 A.3d 572, 576 (2014) (citation omitted). ⁵⁵⁵ DISCUSSION I. Appealability Both Dustin and DHMH contend that the juvenile court’s order is appealable as an interlocutory order granting an injunction, and that the Court of Special Appeals erred in dismissing DHMH’s appeal on its own initiative. We agree.

The September 27, 2013 order was immediately appealable at a minimum as an interlocutory order granting injunctive relief. Md.Code Ann., Cts. & Jud. Proc. (1973, 2013 RepLVol.) (“CJP”) § 12-303(3)(i) provides that an order granting an injunction is an appealable interlocutory order, stating: A party may appeal from any of the following interlocutory orders entered by a circuit court in a civil case: ... [a]n order[ granting or dissolving an injunction, but if the appeal is from an order granting an injunction, only if the appellant has first filed his [or her] answer in the cause[.] (Paragraph breaks omitted).

Maryland Rule 15-501(a) defines an “injunction” as “an order mandating or prohibiting a specified act.” In State Comm’n on Human Relations v. Talbot Cnty. Det. Ctr., 370 Md. 115, 139 , 803 A.2d 527, 541 (2002), we explained: “An injunction is a writ framed according to the circumstances of the case commanding an act which the court regards as essential to justice, or restraining an act which it esteems contrary to equity and good conscience.” (Citation and internal quotation marks omitted). “Injunctive relief is relief prohibiting someone from doing some specified act or commanding someone to undo some wrong or injury ... generally, it is a preventive and protective remedy, aimed at future acts, and it is not intended to redress past wrongs.” Colandrea v. Wilde Lake Cmty. Ass’n, Inc., 361 Md. 371, 394-95 , 761 A.2d 899, 911 (2000) (ellipsis in original) (citation, internal quotation marks, and emphasis omitted).

Although the Maryland Rules do not define “order,” in Prince George’s Cnty. v. Vieira, 340 Md. 651, 661 , 667 A.2d 898, 903 (1995), we described an “order” as follows: “[A]n ‘order’ emanates from a court and, in fact, constitutes a ⁵⁵⁶ command or decree of the court.” For purposes of contempt of a court order, the Court of Special Appeals has stated that “the order must be sufficiently definite, certain, and specific in its terms so that the party may understand precisely what conduct the order requires.” Droney v. Droney, 102 Md.App. 672, 684 , 651 A.2d 415, 421 (1995) (citations omitted). If the order is sufficiently definite, then parties must comply with the dictates of the order, and a party may be held in contempt for “willful” noncompliance. Royal Inv. Grp., LLC v. Wang, 183 Md.App. 406, 448 , 961 A.2d 665, 689 (2008), cert. dismissed, 409 Md. 413 , 975 A.2d 875 (2009).

Here, it is plainly evident that the juvenile court’s September 27, 2013 order was an “order” as that term is understood, and that it was an order that at a minimum granted injunctive relief to Dustin. The record demonstrates that the juvenile court ordered DHMH to develop, approve, and implement a plan to provide ongoing services to Dustin. As such, the order granted injunctive relief because it was “a writ framed according to the circumstances of the case commanding an act which the court regarded] as essential to justice[.]” State Comm’n on Human Relations, 370 Md. at 139 , 803 A.2d at 541 . It is obvious that the order was, indeed, an order.

The juvenile court orally ruled and signed the “Proposed Findings and Order” submitted by Dustin; in its oral ruling, the juvenile court made factual findings, including findings consistent with those contained in Dustin’s proposed findings, and determined on the record that Dustin was entitled to the relief that he requested. The juvenile court then stated that it granted Dustin’s request that DHMH perform the acts specified in the “proposed” order. After some discussion about a requested alteration to the text of the “proposed” order, and the juvenile court’s resolution of that request, the juvenile court announced that “[t]he order is signed”; clearly, that the order was titled “Proposed Findings and Order” was of no significance at all. Put plainly, by signing the “proposed” order, the juvenile court made the “proposed” order into an actual order, and clearly intended the order as a binding command to the parties.

That the juvenile court did not strike out the word “Proposed” in the title, or otherwise alter the prefatory lan ⁵⁵⁷ guage (ie., “Dustin [ ] requests” and “Dustin requests”), is not dispositive of whether the order is, in fact, an order. 11 The record demonstrates that the juvenile court at a minimum granted mandatory injunctive relief to Dustin, as confirmed by: (1) the positions taken by the parties in the Court of Special Appeals and this Court, ie., the lack of any contest whatsoever as to the appealability of the order; and (2) more importantly, the juvenile court’s subsequent order of December 2, 2013, requiring DHMH’s compliance with the September 27, 2013 order by the close of business on December 9, 2013. Both parties had actual notice of the entry of the September 27, 2013 order and its terms, as both were present at the hearing. See Md. R. 15-502(d) (“An injunction is not binding on a person until that person has been personally served with it or has received actual notice of it by any means.”). That the docket entry simply noted entry of the order under the title of the order—“Proposed Finding[s] and Order”—is of no consequence; it is clear that the courtroom clerk simply entered the title of the document as the docket entry.

In sum, we hold that the Court of Special Appeals erred in dismissing the appeal because the juvenile court’s order was appealable at a minimum as an interlocutory order granting injunctive relief. See CJP § 12—303(3)(i). It is clear that, here, the juvenile court signed an order setting forth the relief requested by Dustin, and both parties understood the order to be the juvenile court’s command or decree. Having held that the appeal was erroneously dismissed, we address the merits of the issues presented to this Court. 12 ⁵⁵⁸ II.

Statutory Authority and Jurisdiction Dustin contends that the juvenile court was authorized to order DHMH to enter into a plan to obtain “life-sustaining services” for him to continue after he reached age twenty-one. Dustin argues that Md.Code Ann., Fam. Law (1984, 2012 RepLVol.) (“FL”) § 5-324(b)(l)(ii)(7)(B) and (8) protect children with disabilities transitioning to adult care and grant the juvenile court the power, before Dustin turned twenty-one, to order DHMH to obtain ongoing care for him that would be needed after he turned twenty-one, and to order DHMH to submit a plan of clinically appropriate services in the least restrictive setting for him. Dustin asserts that the statute’s plain language is unambiguous in this regard.

Dustin maintains that the juvenile court’s common law parens patriae powers enable it to protect him. DHMH responds that the juvenile court lacked the authority to order it to develop, approve, and implement a plan to provide services to Dustin after his twenty-first birthday because, under FL § 5—328(a)(2), the juvenile court had limited statutory jurisdiction extending only until Dustin attained the age of twenty-one, and, under FL § 5—324(b)(l)(ii), the juvenile court lacked the authority to order services after the conclusion of its jurisdiction. DHMH argues that the plain language and legislative history of the statutes confirm that the juvenile court lacked the authority to order it to provide services or funding after Dustin’s twenty-first birthday. For the following reasons, we agree with Dustin.

The statutes’ plain language leads to the conclusion that the juvenile court had the authority to order DHMH to provide services for Dustin to continue after he reached age twenty-one. “As a court of limited jurisdiction, the juvenile court may exercise only those powers granted to it by statute.” In re Ryan W., 434 Md. 577, 602 , 76 A.3d 1049 , 1064 ⁵⁵⁹ (2013) (citations omitted); see also Smith v. State, 399 Md. 565, 574 , 924 A.2d 1175, 1180 (2007) (“We have held that juvenile courts, as statutorily created courts of limited jurisdiction, may exercise only those powers expressly designated by statute.”). Pursuant to FL § 5-328(a), if a local department is a child’s guardian, as is the circumstance here, the juvenile court: (1) retains jurisdiction until: (i) the child attains 18 years of age; or (ii) the juvenile court finds the child to be eligible for emancipation; and (2) may continue jurisdiction until the child attains 21 years of age. In other words, the juvenile court’s jurisdiction extends only “until the child attains 21 years of age.” FL § 5-328(a)(2). FL § 5-324(b)(l), concerning the grant of guardianship and accompanying order, provides, in pertinent part: In a separate order accompanying an order granting guardianship of a child, a juvenile court: (ii) consistent with the child’s best interests: 7. shall direct the provision of any other service or taking of any other action as to the child’s education, health, and welfare, including: B. for a child with a disability, services to obtain ongoing care, if any, needed after the guardianship case ends; and 8. may co-commit the child to the custody of [DHMH] and order [DHMH] to provide a plan for the child of clinically appropriate services in the least restrictive setting, in accordance with federal and State law.[ 13 ] ⁵⁶⁰ We must construe FL § 5-328(a) and FL § 5-324(b)(l)(ii) to determine whether the statutes authorized the juvenile court to order DHMH to provide services to Dustin after his twenty-first birthday.

In doing so, we reiterate: “In interpreting a statute, a court first considers the statute’s language, which the court applies where the statute’s language is unambiguous and clearly consistent with the statute’s apparent purpose.” Hailes v. State, 442 Md. 488, 495 , 113 A.3d 608, 612 (2015) (citation and internal quotation marks omitted). Plain Language We unequivocally hold that the juvenile court had jurisdiction and the statutory authority to order DHMH to develop and approve a plan that ensured that Dustin would continue to receive services, where Dustin was not yet twenty-one years old when the juvenile court issued its order and where such services were required to protect Dustin’s health and welfare; in other words, the juvenile court had jurisdiction and statutory authority to issue the September 27, 2013 order to DHMH to provide services for Dustin after age twenty-one. By its plain language, FL § 5-328(a) provides that, in cases where the local department is a child’s guardian, the juvenile court “retains jurisdiction[ ] until the child attains 18 years of age[,]” but that it “may continue jurisdiction until the child attains 21 years of age.” (Paragraph break omitted). In other words, although the juvenile court’s jurisdiction ordinarily ends once a child turns eighteen years old, the juvenile court’s jurisdiction “may” extend until the child turns twenty-one years old.

FL § 5-328(a)(2). Indeed, when read in its logical order, FL § 5-328(a)(2) states, in its entirety: “If a local department is a child’s guardian under this subtitle, a juvenile court: [ ] may continue jurisdiction until the child attains 21 years of age.” (Paragraph break omitted). By contrast, FL § 5-328(a)(l)(i) states, in its entirety: “If a local department is a child’s ⁵⁶¹ guardian under this subtitle, a juvenile court: [] retains jurisdiction until[ ] the child attains 18 years of age[.]” (Paragraph breaks omitted). FL § 5-328(a)(2)’s use of the word “may” is significant because it indicates a legislative intent to provide the juvenile court with the discretion to extend its jurisdiction over a guardianship matter past the ordinary cut-off date of a child’s eighteenth birthday.

See, e.g., Anne Arundel Cnty. Ethics Comm’n v. Dvorak, 189 Md.App. 46, 83 , 983 A.2d 557, 579 (2009) (“[T]he word ‘may,’ when used in a statute, usually implies some degree of discretion.” (Citation and some internal quotation marks omitted)). In other words, under FL § 5-328(a)(2), if the juvenile court exercises its discretion to extend its jurisdiction in a guardianship proceeding past a child’s eighteenth birthday, the juvenile court is not thereafter divested of jurisdiction in that guardianship proceeding until the child turns twenty-one years old. Thus, the juvenile court has the authority to act, even if a child is twenty years and three hundred and sixty-four days old.

What this means is that the juvenile court in the instant case had jurisdiction to issue both the September 27, 2013 order and the December 2, 2013 order because Dustin was twenty years old at the time those orders were issued; indeed, Dustin did not turn twenty-one years old until December 16, 2013. FL § 5-328(a)(2)’s plain language leads to the conclusion that the juvenile court’s jurisdiction continues until a child turns twenty-one, not that the juvenile court’s order is no longer effective when a child reaches age twenty-one. Accordingly, we turn to FL § 5—324(b)(1)(ii)(7)(B) and (8) to determine whether the juvenile court had the statutory authority to order DHMH to develop and approve a written plan of clinically appropriate services in the least restrictive setting that ensured that Dustin would continue to receive the services that he was then receiving. FL § 5-324(b)(l)(ii)(7)(B) states: In a separate order accompanying an order granting guardianship of a child, a juvenile court: ... consistent with the ⁵⁶² child’s best interests: ... shall direct the provision of any other service or taking of any other action as to the child’s education, health, and welfare, including: ... for a child with a disability, services to obtain ongoing care, if any, needed after the guardianship case ends[.] By its plain language, FL § 5—324(b)(l)(ii)(7)(B) provides that, prior to termination of the guardianship case (ie., before the juvenile court is divested of jurisdiction), the juvenile court must order a party to provide any service or take any other action to obtain any ongoing care needed to protect the health of a child with disabilities after he or she turns twenty-one years old.

In other words, FL § 5-324(b)(l)(ii)(7)(B)’s purpose is to ensure that services are provided for, if needed, ie., that care is in place before a child turns twenty-one years old, so that there is no gap in care between the end of the juvenile guardianship case and transition into the adult guardianship system. Indeed, such judicial action is mandated by FL § 5-324(b)(l)(ii)(7)(B), which provides that the juvenile court “shall direct” the provision of such services. See, e.g., Dove v. State, 415 Md. 727, 738 , 4 A.3d 976, 982 (2010) (“[T]he word ‘shall’ indicates the intent that a provision is mandatory.” (Citations omitted)). Furthermore, FL § 5-324(b)(l)(ii)(7)(B)’s plain language—specifically, “any other service or taking of any other action”—encompasses a multitude and variety of services or actions. “Any” means, in relevant part, “one, some, or all indiscriminately of whatever quantity” and is “used to indicate a maximum or whole[.]” Any, Merriam-Webster (2015), http://www.merriam-webster.com/dictionary/any [http:// perma.cc/W9FK-M476]. “Service” means “help, use, benefit” or a “contribution to the welfare of others[,]” and can include “a facility supplying some public demand[.]” Service, Merriam-Webster (2015), http://www.merriam-webster.com/ dictionary/service [http://perma.cc/NA66-8PYS].

And, “action” means “[t]he process of doing something; conduct or behavior” or “[a] thing done[.]” Black’s Law Dictionary (10th ed.2014). Thus, FL § 5-324(b)(l)(ii)(7)(B) authorizes—indeed, ⁵⁶³ requires—the juvenile court to order any service or action, without limitation, consistent with the child’s bests interests. In the case of “a child with a disability,” FL § 5-324(b)(l)(ii)(7)(B) requires the juvenile court to direct the provisions of “services to obtain ongoing care, if any, needed after the guardianship case ends[.]” “Obtain” means “to gain or get (something) usually by effort” or “to gain or attain usually by planned action or effort[.]” Obtain, Merriam-Webster (2015), http://www.merriam-webster.com/dictionary/ obtain [http://perma.cc/UH42-KJLE]. “Ongoing” means “continuing to exist, happen, or progress” or