Md. Code Regs. 10.09.56.15

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.09.56.15 - Covered Services - Intensive Individual Support Services

A. Intensive individual support services:

(1) Are intensive, one-on-one interventions with the participant provided by a direct care worker;

(2) May be received by the participant on a long-term basis;

(3) Are authorized in the participant's Autism Waiver plan of care if the participant's behavior without this intervention would require a more restrictive residential or treatment setting;

(4) May be provided in the participant's home or another setting except a residential or youth camp facility;

(5) May be provided by more than one direct care worker necessitating ongoing coordination between the direct care workers;

(6) Are goal-oriented and task-oriented, with interventions developed on an individualized basis based on the participant's individualized treatment plan;

(7) Use the home and community environment as a learning experience and opportunity to illustrate and model alternative ways for the participant to behave;

(8) Assist the participant in achieving successful home and community living through structured support, reinforcement, modeling, and behavior management, as evidenced in written progress notes;

(9) Shall, when transportation is provided:

(a) Have individualized goals for transportation for the participant on the participant's treatment plan; and

(b) Document the start and stop times transportation is provided for each day that a participant is transported;

(10) Are intended to:

(a) Prevent or defuse crises;

(b) Promote developmental and social skills growth;

(c) Provide the participant with behavior management skills;

(d) Give the participant a sense of security and safety;

(e) Assist the participant with maintaining self-sufficiency and impulse control;

(f) Improve the participant's positive self-expression and interpersonal communication;

(g) Improve the participant's ability to function and cooperate in the home and community;

(h) Reverse negative behaviors and attitudes; and

(i) Foster stabilization; and

(11) Include:

(a) One-on-one support, assistance, oversight, and intervention;

(b) Time-structuring activities;

(c) Immediate behavioral reinforcements;

(d) Time-out strategies; and

(e) Crisis intervention techniques.

B. Direct care workers and supervisors rendering intensive individual support services shall collaborate with the participant's family, providers of other waiver services, and other professionals working with the participant in the home or other community settings, including the schools.

C. A professional who meets the provider qualifications of Regulation .04G(1)(a)-(f) of this chapter shall:

(1) Train and provide ongoing supervision to the direct care worker rendering intensive individual support services;

(2) Supervise the direct care worker when crisis intervention services are rendered, to evaluate the nature of the crisis and intervene as necessary to reduce the likelihood of reoccurrence;

(3) Plan and regularly review the participant's therapeutic activities and behavior plans;

(4) Meet regularly with the participant and family and observe the participant in the home setting;

(5) Develop intervention on an individualized basis and identify the interventions on an individualized treatment plan; and

(6) Identify in the treatment plan goals and tasks that the intensive individual support services direct care worker is implementing.

D. For dates of service before July 1, 2023, a unit of service is a 30-minute increment of service rendered to a participant by a qualified provider in the participant's home or a community setting.

E.For dates of service on or after July 1, 2023, a unit of service is a 15-minute increment of service rendered to a participant by a qualified provider in the participant's home or a community setting.

Md. Code Regs. 10.09.56.15

Regulation .15A, C amended as an emergency provision effective October 1, 2004 (32:1 Md. R. 24); amended permanently effective April 25, 2005 (32:8 Md. R. 741); amended effective 43:7 Md. R. 449, eff.4/11/2016; amended effective 51:18 Md. R. 809, eff. 9/16/2024.