<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.09.90.03" title_num="10" subtitle_num="09" chapter_num="90" heading="Participant Eligibility.">
  <paragraph num="A.">
    <text>A participant shall be eligible for care coordination services if the recipient:</text>
    <paragraph num="(1)">
      <text>Is in a federal eligibility category for Maryland Medical Assistance according to COMAR 10.09.24, which governs the determination of eligibility for the Maryland Medical Assistance Program; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Meets the criteria of either §B(1) or (2) of this regulation.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The participant:</text>
    <paragraph num="(1)">
      <text>Shall:</text>
      <paragraph num="(a)">
        <text>Meet the diagnostic requirements of being either:</text>
        <paragraph num="(i)">
          <text>An individual younger than 18 years old with a serious emotional disturbance or co-occurring disorder; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A young adult with a serious emotional disturbance or co-occurring disorder enrolled in care coordination services continuously under this chapter since reaching age 18; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Require community treatment and support in order to prevent or address:</text>
        <paragraph num="(i)">
          <text>Inpatient psychiatric or substance use treatment;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Treatment in a RTC or residential substance use treatment facility;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>An out-of-home placement;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Emergency room utilization due to multiple behavioral health stressors;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Homelessness or housing instability, or otherwise lacking in permanent, safe housing; or</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Arrest or incarceration due to multiple behavioral health stressors; or</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Shall:</text>
      <paragraph num="(a)">
        <text>Meet the requirements of §B(1)(a); and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Need care coordination services to facilitate community treatment following:</text>
        <paragraph num="(i)">
          <text>Release from a detention center or correctional facility; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Discharge to the community from RTC placement or inpatient psychiatric unit.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A participant that disenrolls after reaching 18 years of age and wishes to re-enroll in care coordination services at a later date shall do so pursuant to COMAR 10.09.45 if more than 120 calendar days has passed since disenrollment.</text>
  </paragraph>
</regulation>