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<regulation prefix="Regulation" num=".06-1" citation="COMAR 10.09.56.06-1" title_num="10" subtitle_num="09" chapter_num="56" heading="Specific Conditions for Participation — Therapeutic Integration Services.">
  <text>To provide one or more of the services covered under Regulation .14 of this chapter, the provider shall:</text>
  <paragraph num="A.">
    <text>Have at least 3 years of experience in providing habilitation services to children with autism spectrum disorder or other developmental disabilities;</text>
  </paragraph>
  <paragraph num="B.">
    <text>Employ a full-time program director to assure adequate coordination and supervision of the covered services, who shall:</text>
    <paragraph num="(1)">
      <text>Hold a valid Maryland certificate as a special education supervisor, principal, or special educator, and have at least 3 years of successful teaching experience, as verified by former employers, in regular or special education, or both, as appropriate for the director's assignment; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Have at least 3 years of relevant experience with counseling or supervision, as appropriate for the director's assignment;</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Employ direct care workers who meet provider qualifications in accordance with Regulation .04E of this chapter;</text>
  </paragraph>
  <paragraph num="D.">
    <text>Have on site at least one direct care worker for every three participants on the waiver, with more staffing as necessary based on participants’ needs;</text>
  </paragraph>
  <paragraph num="E.">
    <text>Designate an on-site supervisor for the direct care workers who is:</text>
    <paragraph num="(1)">
      <text>A licensed psychologist;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>A certified school psychologist;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A certified special educator;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A licensed certified social worker;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>A licensed professional counselor;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>A board-certified behavioral analyst;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>A licensed or certified as a music, art, drama, dance, or recreation therapist; or</text>
    </paragraph>
    <paragraph num="(8)">
      <text>An individual with a master's or doctorate degree in special education or a related field and at least 5 years experience in providing training or consultation in the area of autism spectrum disorder or other developmental disabilities;</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Employ or contract with certain professionals for consultation in accordance with Regulation .04G(1) and (2) of this chapter;</text>
  </paragraph>
  <paragraph num="G.">
    <text>Have at least one professional on call at all times for crisis intervention in accordance with Regulation .04G(1) and (2) of this chapter;</text>
  </paragraph>
  <paragraph num="H.">
    <text>Demonstrate the capability and capacity of providing therapeutic integration services by submitting documentation of experience and a written implementation plan which includes at a minimum policies and procedures regarding:</text>
    <paragraph num="(1)">
      <text>Abuse, neglect, and exploitation;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Positive behavior interventions and restraints;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Implementation of treatment plans;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Emergency backup plans;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Transportation of participants;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Maintenance of required documentation;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Training and supervision of staff;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Quality assurance; and</text>
    </paragraph>
    <paragraph num="(9)">
      <text>HIPAA;</text>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>Provide documented evidence of services in the least restrictive environment in the community that is appropriate to a participant's needs;</text>
  </paragraph>
  <paragraph num="J.">
    <text>Provide documented evidence of integration of the covered services with other community-based services received by participants;</text>
  </paragraph>
  <paragraph num="K.">
    <text>Document arrangements to obtain medical services for participants in an emergency;</text>
  </paragraph>
  <paragraph num="L.">
    <text>For initial approval and as a condition of occupancy of any facility used by the program:</text>
    <paragraph num="(1)">
      <text>Submit written documentation from responsible agency or licensing authorities verifying that the facility is in compliance with applicable health, fire safety, and zoning regulations; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Allow an on-site review by the MSDE;</text>
    </paragraph>
  </paragraph>
  <paragraph num="M.">
    <text>For continued approval, maintain written documentation of compliance with applicable health, fire safety, and zoning regulations as a condition of occupancy of any facility used by the program;</text>
  </paragraph>
  <paragraph num="N.">
    <text>Provide the treatment plan to the participant's service coordinator within 30 calendar days of initiation of service and at least annually or more frequently if the treatment plan changes;</text>
  </paragraph>
  <paragraph num="O.">
    <text>Maintain daily contact logs completed on the same day the service is provided and reflective of individual plan goals and activities; and</text>
  </paragraph>
  <paragraph num="P.">
    <text>Maintain and make available for review by the State, documentation of the 6-month review and update of each participant’s status relative to each goal in the therapeutic integration treatment plan.</text>
  </paragraph>
</regulation>