<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.09.90.07" title_num="10" subtitle_num="09" chapter_num="90" heading="Participant Eligibility — Level III — Intensive Care Coordination.">
  <paragraph num="A.">
    <text>The participant shall meet at least one of the following conditions:</text>
    <paragraph num="(1)">
      <text>The participant has been enrolled in the 1915(i) program for 6 months or less;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The participant is currently enrolled in Level I or Level II Care Coordination services under this chapter and has experienced one of the following adverse childhood experiences during the preceding 6 months:</text>
      <paragraph num="(a)">
        <text>Emotional, physical, or sexual abuse;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Serious emotional or physical neglect; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Significant family disruption or stressors;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>The participant meets the following conditions:</text>
      <paragraph num="(a)">
        <text>The participant has a behavioral health disorder amenable to active clinical treatment, diagnosed through a face-to-face psychosocial assessment by a licensed mental health professional;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>There is clinical evidence the minor has a SED and continues to meet the service intensity needs and medical necessity criteria for the duration of their enrollment;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A comprehensive psychosocial assessment performed by a licensed mental health professional finds that the participant exhibits a significant impairment in functioning, representing potential serious harm to self or others, across settings, including the home, school, or community;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The psychosocial assessment supports the completion of the Early Childhood Service Intensity Instrument (ECSII) for youth ages 0—5 or the Child and Adolescent Service Intensity Instrument (CASII) for youth ages 6—21, by which the participant receives a score of:</text>
        <paragraph num="(i)">
          <text>3 on the ECSII; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>3 or higher on the CASII;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(e)">
        <text>Youth with a score of 3, 4, or 5 on the CASII also shall meet the conditions outlined in §B of this regulation; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Youth with a score of 3 or 4 on the ECSII also shall meet the conditions outlined in §C of this regulation.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Youth with a score of 3, 4, or 5 on the CASII shall meet one of the following criteria to be eligible based on their impaired functioning and service intensity level:</text>
    <paragraph num="(1)">
      <text>Transitioning from a residential treatment center; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Living in the community, be 6 through 21 years old, and have:</text>
      <paragraph num="(a)">
        <text>Any combinations of 2 or more inpatient psychiatric hospitalizations or emergency room visits in the past 12 months; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Been in an RTC within the past 90 calendar days.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Youth who are younger than 6 years old who have a score of a 3 or 4 on the ECSII shall either:</text>
    <paragraph num="(1)">
      <text>Be referred directly from one of the following:</text>
      <paragraph num="(a)">
        <text>Inpatient or day hospital unit;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Primary care physician (PCP);</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Outpatient psychiatric facility;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Early Childhood Mental Health (ECMH) Consultation program in daycare;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Head Start program;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Judy Hoyer Center; or</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Home visiting program; or</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>If living in the community, meet one or more of the following criteria in the past 12 months:</text>
      <paragraph num="(a)">
        <text>Had one or more psychiatric inpatient or day hospitalizations;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Had one or more ER visits;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Exhibit severe aggression;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Display dangerous behavior;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Been suspended from school or childcare setting;</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Display emotional or behavioral disturbance prohibiting their care by anyone other than their primary caregiver;</text>
      </paragraph>
      <paragraph num="(g)">
        <text>Be at risk for out-of-home placement or placement disruption;</text>
      </paragraph>
      <paragraph num="(h)">
        <text>Have severe temper tantrums that place the child or family members at risk of harm;</text>
      </paragraph>
      <paragraph num="(i)">
        <text>Have trauma exposures and other adverse life events; or</text>
      </paragraph>
      <paragraph num="(j)">
        <text>Be at risk of family-related risk factors, including safety, parent-child relational conflict, and poor health and developmental outcomes.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>