# COMAR Title 10 — Maryland Department of Health

## Subtitle 09 — Medical Care Programs

### Chapter 56 — Home and Community-Based Services Waiver for Children with Autism Spectrum Disorder

#### Regulation .06 Specific Conditions for Participation — Intensive Individual Support Services.

*COMAR 10.09.56.06*

To provide the service covered under Regulation .15 of this chapter, the provider shall:

A. Have at least 3 years of experience in providing habilitation services to children with autism;

B. Employ a full-time program director, to assure adequate coordination and supervision of the covered services, who shall either:

  (1) 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

  (2) Have at least 3 years of relevant experience with counseling or supervision, as appropriate for the director's assignment;

C. Employ direct care workers who meet provider qualifications in accordance with Regulation .04E of this chapter;

D. Employ or contract with certain professionals for consultation as needed who meet provider qualifications in accordance with Regulation .04G(1) and (2) of this chapter;

E. Assure supervision of direct care workers by a:

  (1) Licensed psychologist;

  (2) Certified school psychologist;

  (3) Certified special educator;

  (4) Licensed certified social worker;

  (5) Licensed professional counselor;

  (6) Board Certified Behavioral Analyst; or

  (7) Individual with a masters 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;

F. Have at least one professional on call at all times for crisis intervention who meets provider qualifications in accordance with Regulation .04G(1) and (2) of this chapter;

G. Demonstrate the capability and capacity of providing intensive individual support services by submitting documentation of experience and a written implementation plan which includes at a minimum policies and procedures regarding:

  (1) Abuse, neglect, and exploitation;

  (2) Positive behavior interventions and restraints;

  (3) Implementation of treatment plans:

  (4) Emergency backup plans;

  (5) Transportation of participants;

  (6) Maintenance of required documentation;

  (7) Training and supervision of staff;

  (8) Quality assurance; and

  (9) HIPAA;

H. Assure the provision of services in the least restrictive environment in the community that is appropriate to a participant's needs;

I. Provide documented evidence of integration of the covered services with other community-based services received by Autism Waiver participants;

J. Document arrangements to obtain medical services for participants in an emergency;

K. Provide the treatment plan to the participant's service coordinator within 30 calendar days of initiation of service, and at least annually thereafter, or more frequently if the treatment plan changes;

L. Document goals related to transportation and the participant’s needs on the treatment plan when transportation will be provided;

M. Maintain daily contact logs completed on the same day the service is provided and reflective of treatment plan goals and activities; and

N. 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 intensive individual support services treatment plan.