Md. Code Regs. 10.09.52.04

Current through Register Vol. 51, No. 12, June 14, 2024

Section 10.09.52.04 - Covered Services - IEP Service Coordination

A. The Program shall reimburse for the services in §§B-D of this regulation when the services have been documented, pursuant to the requirements of this chapter, as medically necessary.

B. Initial IEP.

(1) Definition. "Unit of service" means:

(a) A completed initial IEP, signed by all members of the IEP team; and

(b) At least one contact by the participant's service coordinator in person, in writing, via telehealth, or by telephone with the participant or the participant's parent, on the participant's behalf relating to development of the IEP.

(2) The covered services include convening and conducting an IEP team to:

(a) Perform a multidisciplinary assessment of the participant; and

(b) Develop an initial IEP.

C. Ongoing IEP Service Coordination.

(1) Ongoing IEP service coordination is provided by a participant's service coordinator.

(2) Definition. For purposes of this section, "unit of service" means:

(a) At least one contact per month by the service coordinator in person, via telehealth, by telephone, or by written progress notes or log with the participant or the participant's parent, on the participant's behalf relating to the child's ongoing IEP service coordination; and

(b) The provision of all other necessary services covered under these regulations.

(3) As necessary, the Program shall include as covered services the following:

(a) Acting as a central point of contact relating to IEP services for a participant;

(b) Maintaining contact with:

(i) The child's direct service providers, as applicable, which may include, but not be limited to, the child's Maryland Medicaid Managed Care Program provider or the Rare and Expensive case management provider; and

(ii) A participant or the participant's parent through in-person visits, written communication, telephone calls, telehealth, and follow-up service as necessary;

(c) Implementing the IEP by referring the participant to direct service providers, assisting the participant in gaining access to services specified in the IEP, and providing linkage to agreed-upon direct service providers of services;

(d) Discussing with direct service providers the services needed and available for the participant, assessing the quality and quantity of services being provided, following up to identify any obstacles to a participant's utilization of services, coordinating the service delivery, and performing ongoing monitoring to determine whether the services are being delivered in an integrated fashion as recommended in the IEP and meet the participant's current needs;

(e) Providing a participant or the participant's parent with information and direction that will assist them in successfully accessing and using the services recommended in the IEP;

(f) Informing a participant's parent of the participant's and the family's rights and responsibilities in regard to specific programs and resources recommended in the IEP; and

(9) Reviewing at least annually at a meeting or by other means acceptable to the participant's parent and others involved in the review process:

(i) The degree of a participant's progress toward achieving the goals established in the IEP; and

(ii) Whether the goals or recommended services need to be revised.

(4) Administrative, supervisory, and monitoring services associated with the ongoing service coordination, including coordinating with the child's primary care provider, are included as part of the service.

D. IEP Review.

(1) Definition. "Unit of service" means:

(a) A completed initial 60-day, interim, or annual IEP review as evidenced by a revised IEP or, if a revised IEP was not done, documented by the IEP team; and

(b) At least one contact by the IEP service coordinator or IEP team in person, by telephone, via telehealth, or by written communication with the participant or the participant's parent, on the participant's behalf.

(2) The covered services include convening and conducting an IEP team to:

(a) Perform a multidisciplinary reassessment of the participant's status and service needs; and

(b) Review and revise, as necessary, the participant's IEP.

Md. Code Regs. 10.09.52.04

Regulations .04 adopted as an emergency provision effective June 17, 1993 (20:14 Md. R. 1165); adopted permanently effective September 27, 1993 (20:19 Md. R. 1472)
Regulations .04 amended as an emergency provision effective March 23, 1998 (25:8 Md. R. 595); amended permanently effective June 29, 1998 (25:13 Md. R. 993):
Regulations .04 amended effective July 1, 2001(28:12 Md. R. 1107)
Regulation .04A amended effective August 27, 2007 (34:17 Md. R. 1507)
Regulations .04-1 and.04-2 adopted effective July 1, 2001(28:12 Md. R. 1107); amended effective 43:6 Md. R. 407, eff.3/28/2016; amended effective 50:22 Md. R. 973, eff. 11/13/2023