<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".34" citation="COMAR 10.09.81.34" title_num="10" subtitle_num="09" chapter_num="81" heading="Covered Services — Behavior Consultation Services.">
  <paragraph num="A.">
    <text>Definition. “Unit of service” means an hour of service rendered by a qualified individual during a home visit to a participant, not including:</text>
    <paragraph num="(1)">
      <text>The time spent on related activities before or after the home visit; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The time spent on supervisory or consultative services to the provider.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>A provider may bill for the length of a home visit to a participant, upon completion of the services specified in §D of this regulation.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Behavior consultation services may be preauthorized by a participant's plan of care as necessary and appropriate when:</text>
    <paragraph num="(1)">
      <text>A participant's behavior is:</text>
      <paragraph num="(a)">
        <text>Disruptive;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Potentially dangerous to the participant's or another person's health and functioning; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Placing the participant at risk of institutionalization due to health and safety concerns; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Advice is needed as to how to manage the disruptive behavior of a participant.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Behavior consultation services include a:</text>
    <paragraph num="(1)">
      <text>Home visit by an individual qualified to render services to:</text>
      <paragraph num="(a)">
        <text>Evaluate a participant's acute behavior change;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Assess the situation;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Determine the contributing factors; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Recommend interventions and treatments;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Written report prepared for review by the case manager and the assisted living services provider or the participant's family, which assesses the situation and makes recommendations; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Verbal review of the report with the case manager and the assisted living services provider or the participant's family to discuss:</text>
      <paragraph num="(a)">
        <text>The report's findings and recommendations; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>A course of action, including any related needed medical interventions.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>