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<regulation prefix="Regulation" num=".03" citation="COMAR 10.09.34.03" title_num="10" subtitle_num="09" chapter_num="34" heading="Covered Services.">
  <paragraph num="A.">
    <text>The Program covers the services listed in this chapter when the services are:</text>
    <paragraph num="(1)">
      <text>Diagnosed, identified, and prescribed by an EPSDT provider to be medically necessary;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Preauthorized by the Department or its designee; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Delivered in accordance with the behavioral plan.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The following services are covered:</text>
    <paragraph num="(1)">
      <text>Therapeutic behavioral assessment and reassessment that includes:</text>
      <paragraph num="(a)">
        <text>Development of a behavioral plan with the participant and parent, guardian, or individual who customarily provides care which specifically:</text>
        <paragraph num="(i)">
          <text>Identifies the target behaviors or symptoms that are placing the current living arrangement at risk or presenting a barrier to transition to a less restrictive living arrangement;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Defines specific interventions to be used to resolve the behaviors or symptoms, including how a therapeutic aide will implement therapeutic behavioral services;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Defines outcome measures that can be used to demonstrate the decreasing frequency of targeted behaviors;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Defines alternative behaviors;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Defines the clinically accepted techniques for behavior change, including where, when, and the frequency of the techniques to be used and the risks and benefits of each;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Details the strategies and skills for the participant and parent, guardian, or individual who customarily provides cares to provide continuity of care when therapeutic behavioral services are discontinued;</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Details emergency procedures to be implemented when the participant exhibits behaviors that pose harm to self or others;</text>
        </paragraph>
        <paragraph num="(viii)">
          <text>Contains written informed consent before implementation, of the parent or legal guardian, or if the participant is 18 years old or older, written informed consent of the participant; and</text>
        </paragraph>
        <paragraph num="(ix)">
          <text>Identifies the level or type of licensed healthcare professional responsible for monitoring the behavioral plan; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Determination if therapeutic behavioral services are needed;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Therapeutic behavioral services that:</text>
      <paragraph num="(a)">
        <text>Provide one-to-one intervention for a specified period of time at the appropriate site in accordance with the behavioral plan; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>May include, but are not limited to:</text>
        <paragraph num="(i)">
          <text>Assisting the participant to engage in or remain engaged in appropriate activities;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Minimizing the participant’s impulsive behavior;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Providing immediate behavioral reinforcements;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Providing time structuring activities; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Collaboration with and support for parent, guardian, or individual who customarily provides care in the effort to provide ongoing behavioral support.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>