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<regulation prefix="Regulation" num=".01" citation="COMAR 10.09.50.01" title_num="10" subtitle_num="09" chapter_num="50" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>“Audiological evaluation” means identification, evaluation, and treatment of auditory impairments necessary to develop and implement an IFSP or an IEP pursuant to COMAR 13A.13.01.03B and 13A.05.01.03B.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Audiologist” means an individual licensed by the Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech Language Pathologists to practice audiology in Maryland.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Audiology service” means treatment of auditory impairments necessary to develop and implement an IFSP or an IEP pursuant to COMAR 13A.13.01.03B and 13A.05.01.03B.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>“Dietitian-Nutritionist” means an individual who is licensed as a dietitian-nutritionist by the Maryland State Board of Dietetic Practice to practice dietetics in Maryland.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>“Aversive technique” means the use of painful or noxious stimuli to the body, which is intrusive to the individual's physical, mental, or emotional well-being, used to terminate challenging or maladaptive behavior.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Child's family” means those individuals with whom a participant resides, who are responsible for the participant, and who are the primary nurturing caregivers.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>“Crisis intervention services” means the therapeutic response that provides immediate care or referral for an individual with an urgent mental health need.</text>
    </paragraph>
    <paragraph num="(8)">
      <text>“Department” means the Maryland Department of Health as defined in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Early intervention services (EIS)” means services which are consistent with COMAR 13A.13.01.03B.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Individualized education program (IEP)” means a written description of special education and related services developed by an IEP team to be implemented to meet the individual needs of a child pursuant to COMAR 13A.05.01.03B and 13A.05.01.09.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“IEP team” means a group convened and conducted by a provider to develop a participant’s IEP, which is composed of a child’s parent or parents, the child’s teacher, and relevant service providers as indicated in COMAR 13A.05.01.03B and 13A.05.01.07.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Individualized Family Service Plan (IFSP)” means a written plan for providing early intervention and other services to an eligible child and the child’s family developed by an IFSP team pursuant to COMAR 13A.13.01.03B.</text>
    </paragraph>
    <paragraph num="(13)">
      <text>“IFSP team” means a group convened and conducted by a provider to develop a participant’s IFSP, which is composed of a child’s parent or parents, the child’s service coordinator, and relevant service providers as indicated in COMAR 13A.13.01.06.</text>
    </paragraph>
    <paragraph num="(14)">
      <text>“Infants and toddlers with disabilities” means children from birth to the beginning of the school year following the child’s 4th birthday who are eligible for early intervention services, as described in COMAR 13A.13.01.03B and documented by appropriate licensed personnel as defined in COMAR 13A.13.01.03B.</text>
    </paragraph>
    <paragraph num="(15)">
      <text>“Jurisdiction” means a state or the District of Columbia.</text>
    </paragraph>
    <paragraph num="(16)">
      <text>“Local School System (LSS)” means any of the 24 public school systems in Maryland responsible for providing public elementary or secondary education.</text>
    </paragraph>
    <paragraph num="(17)">
      <text>“Local lead agency” means the agency designated by the local governing authority in each county and Baltimore City to administer the interagency system of early intervention services under the direction of the State Department of Education in accordance with Education Article, §8-416, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(18)">
      <text>“Maladaptive behavior” means behavior that is:</text>
      <paragraph num="(a)">
        <text>Harmful to oneself or others;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Developmentally inappropriate; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Disruptive or dangerous.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(19)">
      <text>“Maryland State Department of Education” has the meaning stated in COMAR 13A.01.03.</text>
    </paragraph>
    <paragraph num="(20)">
      <text>“Medical Assistance Program” has the meaning stated in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(21)">
      <text>“Mental health professional” has the meaning stated in COMAR 10.21.17.02B.</text>
    </paragraph>
    <paragraph num="(22)">
      <text>“Nurse” means an individual who is licensed to practice as a registered nurse (RN) or licensed practical nurse (LPN) in the jurisdiction in which services are provided.</text>
    </paragraph>
    <paragraph num="(23)">
      <text>“Nursing care plan” means a plan developed by a registered nurse that identifies the patient’s diagnoses and needs, the goals to be achieved, and the interventions required to meet the patient’s medical condition as defined in COMAR 10.09.53.01B.</text>
    </paragraph>
    <paragraph num="(24)">
      <text>Nursing Services.</text>
      <paragraph num="(a)">
        <text>“Nursing services” means skilled nursing services performed by a licensed nurse for a participant, which are necessary for the participant to benefit from educational or early intervention services pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Nursing services” includes an initial assessment.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>“Nursing services” does not include:</text>
        <paragraph num="(i)">
          <text>Routine assessments of recipients whose medical condition is stable, unless the assessment leads to an intervention or change in the nursing care plan;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Administration of medications;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Supervision of interventions which the child is able to perform independently;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Health screens;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Health education, except one-on-one training regarding self-management of the child's medical condition;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>First aid interventions;</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Services not directly related to the nursing care plan; and</text>
        </paragraph>
        <paragraph num="(viii)">
          <text>Services not deemed medically necessary at the initial assessment or the most recent nursing care plan review.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(25)">
      <text>Nutrition Services.</text>
      <paragraph num="(a)">
        <text>“Nutrition services” means services delivered by a licensed dietitian nutritionist.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Nutrition services” includes:</text>
        <paragraph num="(i)">
          <text>Nutrition assessments and evaluations;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Developing and monitoring appropriate plans to address the nutritional needs of eligible children; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Making referrals to appropriate community resources to carry out nutrition goals in an IFSP pursuant to COMAR 13A.13.01.03B.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(26)">
      <text>“Occupational therapist” means an individual licensed by the Maryland State Board of Occupational Therapy Practice to practice occupational therapy in Maryland.</text>
    </paragraph>
    <paragraph num="(27)">
      <text>“Occupational therapy assistant” means an individual licensed by the Maryland State Board of Occupational Therapy Practice to practice limited occupational therapy in Maryland.</text>
    </paragraph>
    <paragraph num="(28)">
      <text>“Occupational therapy services” means occupational therapy evaluations or treatments delivered by a licensed occupational therapist, or treatments delivered by a licensed occupational therapy assistant, which are necessary to develop and implement an IEP or an IFSP pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.</text>
    </paragraph>
    <paragraph num="(29)">
      <text>“Parent” means the parent of a child and includes:</text>
      <paragraph num="(a)">
        <text>A biological or adoptive parent;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A legal guardian;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Another person responsible for a child's welfare; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A parent surrogate for those cases when:</text>
        <paragraph num="(i)">
          <text>A public agency, after reasonable efforts, cannot discover the whereabouts of a biological or adoptive parent,</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>An individual cannot be identified with responsibility for a child's welfare, or</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A child is a ward of the State.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(30)">
      <text>“Participant” means a Medical Assistance recipient who is eligible for and receives school-based health-related services.</text>
    </paragraph>
    <paragraph num="(31)">
      <text>“Physical therapist” means an individual licensed by the Maryland Board of Physical Therapy Examiners to practice physical therapy in Maryland.</text>
    </paragraph>
    <paragraph num="(32)">
      <text>“Physical therapist assistant” means an individual licensed by the Maryland Board of Physical Therapy Examiners to practice limited physical therapy in Maryland.</text>
    </paragraph>
    <paragraph num="(33)">
      <text>“Physical therapy services” means physical therapy evaluations or treatments, delivered by a licensed physical therapist, or treatments delivered by a licensed physical therapy assistant, which are necessary to develop and implement an IEP or an IFSP pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.</text>
    </paragraph>
    <paragraph num="(34)">
      <text>“Program” means the Medical Assistance Program as defined in COMAR 10.09.36.01.</text>
    </paragraph>
    <paragraph num="(35)">
      <text>“Provider” means a local school system, local lead agency, State-operated education agency, or State-supported education agency which meets the conditions for participation as defined in Regulation .03 of this chapter to provide school-based health-related services.</text>
    </paragraph>
    <paragraph num="(36)">
      <text>“Psychological services” means the delivery of services by a qualified licensed mental health professional, including administering psychological and developmental tests and other assessment procedures, interpreting assessment results, obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development, and planning and managing a program of psychological services including psychological counseling for children and families.</text>
    </paragraph>
    <paragraph num="(37)">
      <text>“Rehabilitative service” means the medical or remedial service recommended by a licensed physician or authorized practitioner under Health Occupations Article, Annotated Code of Maryland within the scope of the practice under §B(36) of this regulation, for the reduction of maladaptive behavior and restoration of a recipient to the best possible functional level.</text>
    </paragraph>
    <paragraph num="(38)">
      <text>“School psychologist” means an individual certified by the Maryland State Department of Education to provide psychological services in a school-based setting.</text>
    </paragraph>
    <paragraph num="(39)">
      <text>“Special health needs” means those temporary or long-term health problems arising from physical, emotional, or social factors, or any combination of these.</text>
    </paragraph>
    <paragraph num="(40)">
      <text>“Speech-language pathologist” means an individual licensed by the State Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists to practice speech language pathology in Maryland.</text>
    </paragraph>
    <paragraph num="(41)">
      <text>“Speech-language pathology assistant” means an individual licensed by the State Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists to assist in the practice of speech language pathology in Maryland.</text>
    </paragraph>
    <paragraph num="(42)">
      <text>“Speech-language pathology” means speech language evaluations, diagnoses or treatments delivered by a licensed speech-language pathologist, or treatments delivered by a licensed speech-language pathology assistant, which are necessary to develop and implement an IEP or an IFSP pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.</text>
    </paragraph>
    <paragraph num="(43)">
      <text>“Therapeutic behavioral aide” means an individual who has been trained to implement a behavior plan as specified in the IEP or IFSP under the supervision of a licensed physician or authorized practitioner pursuant to Health Occupations Article, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(44)">
      <text>“Therapeutic behavioral service” means a one-to-one individualized rehabilitative service, rendered by a therapeutic behavioral aide, using appropriate methods of preventing or decreasing maladaptive behaviors for a Medicaid recipient who is eligible for and receives health-related services in an IEP or health-related early intervention services in an IFSP.</text>
    </paragraph>
  </paragraph>
</regulation>