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<regulation prefix="Regulation" num=".07" citation="COMAR 10.22.12.07" title_num="10" subtitle_num="22" chapter_num="12" heading="Eligibility Determination Process — Determination of Service Priority Category and Description of Categories.">
  <paragraph num="A.">
    <text>Determination of Service Priority Category.</text>
    <paragraph num="(1)">
      <text>The regional director shall base the recommendation regarding service priority on the determination that the individual meets the criteria for one or more of the following categories, which are listed in the order of priority in which applicants shall receive services:</text>
      <paragraph num="(a)">
        <text>Category I — Crisis Resolution;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Category II — Crisis Prevention; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Category III — Current Request.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Individuals shall be served according to their priority ranking as follows:</text>
      <paragraph num="(a)">
        <text>Individuals in Category I are to be served before those in Category II; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Individuals in Category II are to be served before those in Category III.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Service delivery is dependent upon levels of funding allocated for the fiscal year for the following discrete categories:</text>
      <paragraph num="(a)">
        <text>Category IV — Transitioning Youth;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Category V — Knott Class Member;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Category VI — Inappropriate Institutionalization; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Category VII — Innovation or Demonstration Projects.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Individuals may be in more than one priority category at the same time. For example, an individual in the transitioning youth priority category for a day program may also be in the crisis prevention priority category for a residential program if the individual is graduating or leaving a secondary school program and has no place to live after that program ends.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Description of Categories.</text>
    <paragraph num="(1)">
      <text>Category I — Crisis Resolution.</text>
      <paragraph num="(a)">
        <text>To qualify for this category, the applicant shall meet one or more of the following criteria. The applicant shall be:</text>
        <paragraph num="(i)">
          <text>Homeless or living in temporary housing with clear time-limited ability to continue to live in this setting with no viable non-DDA-funded alternative;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>At serious risk of physical harm in the current environment;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>At serious risk of causing physical harm to others in the current environment;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>In danger of losing DDA-funded residential services because of a lack of current day services;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>One who has lost DDA-funded day services; or</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Living with a caregiver who is unable to provide adequate care due to the caregiver's impaired health, which may place the applicant at risk of serious physical harm.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>To qualify for Category I under §B(1)(a)(ii), of this regulation, evidence such as the following shall be necessary. The applicant:</text>
        <paragraph num="(i)">
          <text>Has recently received severe injuries due to the behavior of others in the home or community;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Has recently been the victim of sexual abuse;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Has been neglected to the extent that the individual is at serious risk of sustaining injuries which are life threatening or which substantially impair functioning;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Engages in self-injurious behavior which puts the individual at serious risk of sustaining injuries which are life threatening or which substantially impair functioning; or</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Is at serious risk of sustaining injuries which are life threatening or which substantially impair functioning due to the physical surroundings.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>If the applicant qualifies for Category I under §B(1)(a)(v), of this regulation, the individual shall qualify for day services only.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>If the applicant is living in a situation where the applicant is the caregiver, §B(1)(a)(vi), of this regulation, shall apply to the applicant.</text>
      </paragraph>
      <paragraph num="(e)">
        <text>Individuals who qualify for services under this category shall, at a minimum, remain in this category until they have been provided with those services required to resolve the situation.</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Individuals become eligible to receive services as the need occurs.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Category II — Crisis Prevention.</text>
      <paragraph num="(a)">
        <text>To qualify for this priority category, the applicant:</text>
        <paragraph num="(i)">
          <text>Shall have been determined by the DDA to have an urgent need for services;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>May not qualify for services based on the criteria for Category I; and</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Shall be at substantial risk for meeting one or more of the criteria in §B(1)(a) of this regulation, within 1 year, or have a caregiver who is 65 years old or more.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Individuals who qualify for services under this category shall, at a minimum, remain in this category until they have been provided with those services required to resolve the situation.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Individuals become eligible to receive services from the date of approval of priority status, except when eligibility is determined by the age of the caregiver. In this case, priority is determined by the caregiver's date of birth so that individuals with caregivers born at an earlier date have priority over individuals with caregivers born at a later date.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Category III — Current Request.</text>
      <paragraph num="(a)">
        <text>To qualify for this priority category, the applicant shall indicate at least a current need for services.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Prioritization of Services.</text>
        <paragraph num="(i)">
          <text>Applicants shall be prioritized for services based on the number of fiscal years they have been on the waiting list, except as provided for in §B(3)(b)(iv) of this regulation.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Applicants on the waiting list for the longest period of time shall receive services before those who have been on the list for fewer years, except as provided for in §B(3)(b)(iv) of this regulation.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Applicants whose applications are received by the DDA access unit within a given fiscal year shall be ranked by the fiscal year of application, and the month and day of birth. Those applicants born at the beginning of the fiscal year have priority over those born later in the year.</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>For day programs only, the period of time that shall be counted toward prioritizing an individual shall begin with the year of departure from school or the year of application, whichever is later.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Category IV — Transitioning Youth.</text>
      <paragraph num="(a)">
        <text>To qualify for funding for services in this priority category the applicant shall be eligible:</text>
        <paragraph num="(i)">
          <text>For DDA-funded services in this category from the individual's 21st to the individual's 22nd birthday. If the date of graduation is after the individual's 21st birthday, the individual shall continue to be eligible for 1 year after the date of graduation.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>To receive day services only.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Individuals in this priority category shall also be in one or more of the other priority categories.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Individuals become eligible to receive services from the date of approval of priority status.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Category V — Knott Class.</text>
      <paragraph num="(a)">
        <text>To qualify for this priority category, the applicant shall have:</text>
        <paragraph num="(i)">
          <text>An intellectual disability; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Been determined inappropriately retained in a Department operated behavioral health facility as set forth in Knott vs. Hughes Civil Action No. Y-80-2832 (Fed. Dist. Ct. Md).</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Individuals become eligible to receive services based on the best clinical judgment of the professionals involved based on availability of allocated resources.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Category VI — Inappropriate Institutionalization.</text>
      <paragraph num="(a)">
        <text>To qualify for this priority category, the applicant shall be a:</text>
        <paragraph num="(i)">
          <text>Resident in a nursing facility and not meet the criteria for admission or retention for that facility;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Resident of an intermediate care facility for individuals with intellectual disabilities or persons with related conditions (ICF/IID) and not meet the criteria for admission or retention for that facility as determined by the hearing examiner;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Resident in a chronic hospital who does not meet the criteria for admission or retention for that facility;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Resident in a behavioral health facility operated by the Department who has a developmental disability but is not an individual with an intellectual disability and who does not meet the criteria for admission or retention in a State psychiatric hospital and whose primary need is not for a mental health service.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>An individual in this priority category shall also be in another priority category.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Funding may be allocated for one or more of the above groups in §B(6)(a)(i)—(iv) of this regulation.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Individuals become eligible to receive services based on the best clinical judgment of the professionals involved based on availability of allocated resources.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>Category VII — Innovation or Demonstration Projects.</text>
      <paragraph num="(a)">
        <text>To identify those individuals for whom this priority category is appropriate, the Administration, after consultation with interested parties, shall publish a request for proposal (RFP) for innovation or demonstration projects.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>To qualify for this priority category, an individual shall be identified in a proposal submitted to the Administration which is considered appropriate for funding by the Administration.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>An individual served in this priority category may continue to receive services, to the extent that funds are allocated, after the termination of the innovation or demonstration period.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>An individual in this priority category may also be in another priority category.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>Eligible applicants may receive family support services and low intensity support services on a first-come, first-served basis, regardless of service priority determination.</text>
    </paragraph>
  </paragraph>
</regulation>