<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.09.45.03" title_num="10" subtitle_num="09" chapter_num="45" heading="Participant Eligibility.">
  <paragraph num="A.">
    <text>A recipient is eligible for mental health case management services if the recipient:</text>
    <paragraph num="(1)">
      <text>Is in a federal eligibility category for Maryland Medical Assistance according to COMAR 10.09.24, which governs the determination of eligibility for the Maryland Medical Assistance Program; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Has a serious and persistent mental health disorder and is:</text>
      <paragraph num="(a)">
        <text>In, at risk of, or needs continued community treatment to prevent, inpatient psychiatric treatment;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>At risk of, or needs continued community treatment to prevent, being homeless; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>At risk of incarceration or who will be released from a detention center or prison.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Waiver of Specific Diagnostic Criteria. The specific diagnostic criteria may be waived if an individual is:</text>
    <paragraph num="(1)">
      <text>Committed as not criminally responsible and is conditionally released from a Mental Hygiene Administration (MHA) facility, according to the provisions of Health-General Article, Title 12, Annotated Code of Maryland; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>In a MHA facility, or is a MHA-funded individual in a psychiatric inpatient hospital who requires community services, excluding individuals who are eligible for Developmental Disabilities Administration's residential services.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Eligible individuals transitioning from institutions as described in either §B(1) or (2) of this regulation to a community-based setting may receive case management services for up to 180 consecutive days of the covered stay in the institution.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Levels of Care.</text>
    <paragraph num="(1)">
      <text>In addition to meeting the eligibility criteria outlined under §§A and B of this regulation, participants shall be classified according to the levels of care listed in §D(2) or (3) of this regulation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Level I—General. For a maximum of 2 units of service per month and based on the severity of the participant's mental illness, the participant shall meet at least one of the following conditions:</text>
      <paragraph num="(a)">
        <text>The participant is not linked to mental health and medical services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The participant lacks basic supports for shelter, food, and income;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The participant is transitioning from one level of care to another level of care; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The participant needs case management services to maintain community-based treatment and services.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Level II—Intensive. For a maximum of 5 units of service per month and based on the severity of the participant's mental illness, the participant shall meet two or more of the following conditions:</text>
      <paragraph num="(a)">
        <text>The participant is not linked to mental health and medical services;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The participant lacks basic supports for shelter, food, and income;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>The participant is transitioning from one level of care to another level of care; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The participant needs case management services to maintain community-based treatment and services.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>A participant may not be enrolled in Mental Health Case Management for Adults while receiving services under COMAR 10.09.90 or 10.09.33.</text>
  </paragraph>
</regulation>