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<regulation prefix="Regulation" num=".12" citation="COMAR 10.09.89.12" title_num="10" subtitle_num="09" chapter_num="89" heading="Covered Services — Intensive In-Home Services.">
  <paragraph num="A.">
    <text>Intensive In-Home Services (IIHS):</text>
    <paragraph num="(1)">
      <text>Are strengths-based interventions with the child and his or her identified family that includes a series of components, such as:</text>
      <paragraph num="(a)">
        <text>Functional assessments and treatment planning;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Individualized interventions;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Crisis response and intervention; or</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Transition support;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>May be provided to the child alone, to other family members, or to the child and family members together;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Are intended to support a child to remain in his or her home and reduce hospitalizations and out-of-home placements or changes of living arrangements through focused intervention in the home and community; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>May be used in situations such as the start of a child's enrollment in the 1915(i), upon discharge from a hospital or residential treatment center, or to prevent or stabilize after a crisis situation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Types of IIHS Providers. The Department may approve two types of IIHS providers:</text>
    <paragraph num="(1)">
      <text>Evidence-Based Practice (EBP)-IIHS providers, to include providers of EBPs as determined by the Department; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Promising Practice IIHS providers (non-EBP), to include providers of the In-Home Intervention Program for Children (IHIP-C) and other promising practices, as determined by the Department.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>An EBP-IIHS provider shall have a certificate or letter from the national or intermediate surveyor or developer of the particular evidence-based practice to demonstrate that the EBP-IIHS provider meets all requirements for Department-approved EBP-IIHS, to include participating in all fidelity monitoring activities.</text>
  </paragraph>
  <paragraph num="D.">
    <text>A Non-EBP IIHS provider shall:</text>
    <paragraph num="(1)">
      <text>Be a Department-approved IHIP-C provider or have a certificate or letter from a national or intermediate purveyor or developer of another promising practice; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Meet the requirements of §E of this regulation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>All non-EBP IIHS providers not approved by the Department as IHIP-C providers shall:</text>
    <paragraph num="(1)">
      <text>Ensure that there are Clinical Supervisors and staff who are responsible for creating, implementing, and managing the treatment plan with the child and family and the CFT;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide crisis response services for the participants on the IIHS provider's caseload and ensure that on-call and crisis intervention services are:</text>
      <paragraph num="(a)">
        <text>Provided by a licensed mental health professional trained in the intervention;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Available 24-hours per day, 7 days per week, during the hours the provider is not open to the individual enrolled in the treatment; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>In compliance with staffing, supervision, training, data collection, and fidelity monitoring requirements set forth by the purveyor, developer, or MDH and approved by the Department;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Employ Clinical Supervisors who:</text>
      <paragraph num="(a)">
        <text>Have a current license under the Health Occupations Article, Annotated Code of Maryland, as a:</text>
        <paragraph num="(i)">
          <text>Licensed certified social worker-clinical (LCSW-C);</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Licensed clinical professional counselor (LCPC);</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Psychologist;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Psychiatrist;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Nurse psychotherapist; or</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Advanced practice registered nurse/psychiatric mental health (APRN-PMH); and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Have at least 3 years of experience in providing mental health treatment to children and families;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Employ mental health professionals who:</text>
      <paragraph num="(a)">
        <text>Have a current license under the Health Occupations Article, Annotated Code of Maryland, as a:</text>
        <paragraph num="(i)">
          <text>Licensed certified social worker (LCSW);</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>LCSW-C;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>LCPC;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Psychologist;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Psychiatrist;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Nurse psychotherapist; or</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>APRN-PMH.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Are supervised by a clinical lead supervisor;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>See the child in-person at least once per 7 days while receiving IIHS services;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Employ in-home stabilizers who:</text>
      <paragraph num="(a)">
        <text>Support the implementation of the treatment plan, but are not responsible for creating it or modifying it;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Are at least 21 years old;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Have at least a high school diploma or equivalency; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Have completed relevant, comprehensive, appropriate training before providing services, as outlined by the purveyor, developer, or the Department and approved by the Department;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Provide a minimum of one face-to-face contact with the participant per week of service;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Ensure a minimum of 50 percent of the mental health professionals' contacts with the participant or family, or both, is face-to-face; and</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Ensure that a minimum of 50 percent of the mental health professionals' time is spent working outside the agency's office and in the participant's home or community, as documented in case notes.</text>
    </paragraph>
  </paragraph>
</regulation>