<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".12" citation="COMAR 10.09.90.12" title_num="10" subtitle_num="09" chapter_num="90" heading="Covered Services — Plan of Care.">
  <paragraph num="A.">
    <text>The POC shall contain, at minimum:</text>
    <paragraph num="(1)">
      <text>A description of the participant’s strengths and needs;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The diagnosis or diagnoses established as evidence of the participant’s eligibility for services under this chapter;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The goals of care coordination services to address the behavioral health, medical, social, educational, and other services needed by the participant, with expected target completion dates;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>A crisis plan including the proposed strategies and interventions for preventing and responding to crises and the youth and family’s definitions of what constitutes a crisis;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Designation of the care coordinator with primary responsibility for implementation of the POC;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Signatures of the care coordinator and other CFT members, if appropriate;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Signatures of the participant and family indicating that the participant and family have:</text>
      <paragraph num="(a)">
        <text>Participated in the development of the POC; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Had choice in the selection of services, providers, and interventions when possible, in the care coordination process of building the POC; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>For 1915(i) participants, specified for each recommended service, the following information as appropriate or as required by the Department:</text>
      <paragraph num="(a)">
        <text>Description of the service;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Service start date;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Estimated duration;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Frequency and units of service as measured in 15 minute increments to be delivered;</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The specific need or goal that the service is related to; and</text>
      </paragraph>
      <paragraph num="(f)">
        <text>The provider name and contact information.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>If not included in the POC, an ongoing record of contacts made on the participant’s behalf, which includes all of the following, shall be included in the participant’s chart:</text>
    <paragraph num="(1)">
      <text>Date, start and end time, and subject of contact;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Individual contacted;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Electronic or scanned signature of care coordinator making the contact;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Nature, content, and unit or units of service provided;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Place of service;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Whether strategies and tasks specified in the POC have been achieved;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>The timeline for obtaining needed services;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>The timeline for reevaluation of the plan;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>The need for and occurrences of coordination with child- and family-serving agencies and providers;</text>
    </paragraph>
    <paragraph num="(10)">
      <text>The names and contact information for the participant’s primary care provider, dentist, and other health care providers;</text>
    </paragraph>
    <paragraph num="(11)">
      <text>The medications that the participant is currently taking and the dosage and frequency of the medications; and</text>
    </paragraph>
    <paragraph num="(12)">
      <text>Monthly summary notes, which reflect progress made towards the identified needs and outcome measures.</text>
    </paragraph>
  </paragraph>
</regulation>