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<regulation prefix="Regulation" num=".05" citation="COMAR 10.09.59.05" title_num="10" subtitle_num="09" chapter_num="59" heading="Eligibility.">
  <paragraph num="A.">
    <text>A participant is eligible for specialty mental health services if:</text>
    <paragraph num="(1)">
      <text>The individual meets the Department’s medical necessity criteria; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The service is appropriate to the specific provider type or community-based mental health provider listed in Regulation .04 of this chapter.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Individuals are eligible for Psychiatric Rehabilitation Programs for adults if the individual:</text>
    <paragraph num="(1)">
      <text>Has been referred for psychiatric rehabilitation program services by a licensed mental health professional who:</text>
      <paragraph num="(a)">
        <text>Is enrolled as a provider in the Program with an active status on the date of service;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Facilitates an informed choice of psychiatric rehabilitation program providers; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Currently provides inpatient, residential treatment center, or outpatient mental health services to the individual;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Has a diagnosis listed in COMAR 10.67.08.02N; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Is in need of program services in order to improve or restore independent living and social skills necessary to support the individual’s recovery, ability to make informed decisions and choices, and participation in community life.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Individuals are eligible for Psychiatric Rehabilitation Programs for minors if the individual:</text>
    <paragraph num="(1)">
      <text>Has been referred for psychiatric rehabilitation program services by a licensed mental health professional who:</text>
      <paragraph num="(a)">
        <text>Is enrolled as a provider in the Program with an active status on the date of service;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Facilitates an informed choice of psychiatric rehabilitation program providers; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Currently provides inpatient, residential treatment center, or outpatient mental health services to the minor;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Is currently in, and remains in, active mental health treatment;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Has the appropriate consent to participate in psychiatric rehabilitation program services;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Has a diagnosis listed in COMAR 10.67.08.02N and severe functional impairments in at least one life domain;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>With psychiatric rehabilitation program services, is expected to have reduced symptoms of their mental illness or functional behavioral impairment as a result of their mental illness based on the clinical evaluation and ongoing treatment plan; and</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Is at risk of requiring a higher level of care, or is returning from a higher level of care.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Individuals are eligible for Mobile Treatment Services if it is assessed that the individual will benefit from mobile treatment services and the individual is:</text>
    <paragraph num="(1)">
      <text>Experiencing homelessness;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Unable or unwilling to use, on a continuing basis, community-based mental health services that are prescribed for the individual; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>In an institution or inpatient facility and would be able to reside in a community setting if the individual received MTS and other appropriate support services.</text>
    </paragraph>
  </paragraph>
</regulation>