Md. Code Regs. 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.
Notes
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.
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No prior version found.