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<chapter num="01" heading="Provision of Early Intervention Services to Infants and Toddlers and Their Families" title_num="13A" subtitle_num="13">
  <regulation prefix="Regulation" num=".01" heading="Purpose.">
    <text>The purpose of this chapter is to implement Part C of the Individuals with Disabilities Education Act (IDEA), 34 CFR 303, and Education Article, Title 8, Subtitle 4, Annotated Code of Maryland, which assure the provision of services for all eligible infants and toddlers, birth until the beginning of the school year following the child’s fourth birthday, and their families, in accordance with the child’s Individualized Family Service Plan (IFSP).</text>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Scope.">
    <text>This chapter applies to the Department and other State or local public agencies that participate in the local interagency system of services that provide early intervention services to eligible infants and toddlers, birth until the beginning of the school year following the child’s fourth birthday, and their families, in accordance with the child’s Individualized Family Service Plan (IFSP), consistent with the Act and 34 CFR §303.</text>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>“Act” means the Individuals with Disabilities Education Act as amended, 20 U.S.C. §1400 et seq.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>“Adjusted age” means, for children born before 37 weeks gestation, the number of weeks born prematurely subtracted from the infant’s chronological age. An infant’s adjusted age is used until the infant’s adjusted age is 12 months.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Annual evaluation” means the meeting conducted at least once a year to evaluate a child’s IFSP and to revise its provisions, as appropriate.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Appropriate professional requirements” means entry-level requirements for personnel providing early intervention services that:</text>
        <paragraph num="(a)">
          <text>Are based on the highest requirements in the State applicable to the profession or discipline in which a person is providing early intervention services; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Establish suitable qualifications for personnel providing early intervention services to eligible children and their families, who are served by State, local, and private agencies.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>“Assessment” means ongoing procedures used by qualified personnel throughout the period of a child's eligibility to identify the:</text>
        <paragraph num="(a)">
          <text>Child's unique strengths and needs;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Services appropriate to meet those needs;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Resources, priorities, and concerns of the family; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Supports and services necessary to enhance the family's capacity to meet the developmental needs of the child.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>Assistive Technology Device.</text>
        <paragraph num="(a)">
          <text>“Assistive technology device” means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Assistive technology device” does not include:</text>
          <paragraph num="(i)">
            <text>A medical device that is surgically implanted, including a cochlear implant; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>The optimization, maintenance, or replacement of that device.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(7)">
        <text>Assistive Technology Service.</text>
        <paragraph num="(a)">
          <text>“Assistive technology service” means a service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Assistive technology service” includes:</text>
          <paragraph num="(i)">
            <text>Evaluation of the needs of a child with a disability, including a functional evaluation of the child in the child's customary environment;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Training or technical assistance for a child with disabilities or, if appropriate, that child's family; and</text>
          </paragraph>
          <paragraph num="(vi)">
            <text>Training or technical assistance for professionals, including individuals providing education and rehabilitation services, or other individuals who provide services to or are otherwise substantially involved in the major life functions of infants and toddlers with disabilities.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>Audiology.  “Audiology” means services which include:</text>
        <paragraph num="(a)">
          <text>Identification of children with auditory impairment, using at-risk criteria and appropriate audiologic screening techniques;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Referral for medical and other services necessary for the habilitation or rehabilitation of children with auditory impairment;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Provision of auditory training, aural rehabilitation, speech reading and listening devices, orientation and training, and other services;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Provision of services for prevention of hearing loss; and</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Determination of the child's need for individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(9)">
        <text>Consent.</text>
        <paragraph num="(a)">
          <text>“Consent” means a parent:</text>
          <paragraph num="(i)">
            <text>Has been fully informed of all information relevant to the activity for which consent is sought, in the parent's native language or other mode of communication;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Understands and agrees in writing to the carrying out of the activity for which the parent's consent is sought, and the consent describes that activity and lists the early intervention records, if any, that will be released and to whom; and</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Understands that the granting of consent is voluntary on the part of the parent and may be revoked at any time.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Consent” includes consent given to an action before a parent revokes consent, so that revocation is not retroactive and does not negate an action that occurred after the consent was given and before the consent was revoked.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(10)">
        <text>“Day” means a calendar day unless otherwise specified.</text>
      </paragraph>
      <paragraph num="(11)">
        <text>“Department” means the Maryland State Department of Education.</text>
      </paragraph>
      <paragraph num="(12)">
        <text>“Developmental Delay” means the presence of:</text>
        <paragraph num="(a)">
          <text>A 25 percent delay, using a child’s adjusted or chronological age and as measured and verified by appropriate diagnostic instruments and procedures, in one or more of the following developmental areas:</text>
          <paragraph num="(i)">
            <text>Cognitive development;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Physical development, including vision and hearing;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Communication development;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Social or emotional development; or</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Adaptive development;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>Atypical development or behavior, which:</text>
          <paragraph num="(i)">
            <text>Is demonstrated by abnormal quality of performance and function in one or more of the above specified developmental areas; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Interferes with current development, and is likely to result in subsequent delay (even when diagnostic instruments or procedures do not document a 25 percent delay); or</text>
          </paragraph>
        </paragraph>
        <paragraph num="(c)">
          <text>A diagnosed physical or mental condition that has a high probability of resulting in developmental delay, with examples of these conditions including:</text>
          <paragraph num="(i)">
            <text>Chromosomal abnormalities;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Genetic or congenital disorders;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Severe sensory impairments;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Inborn errors of metabolism;</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Disorders reflecting disturbance of the development of the nervous system;</text>
          </paragraph>
          <paragraph num="(vi)">
            <text>Congenital infections;</text>
          </paragraph>
          <paragraph num="(vii)">
            <text>Disorders secondary to exposure to toxic substances, including fetal alcohol syndrome; and</text>
          </paragraph>
          <paragraph num="(viii)">
            <text>Severe attachment disorders.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(13)">
        <text>“Duration” means the period of time over which services will be provided, such as when the child is expected to achieve the results or outcomes in his or her IFSP.</text>
      </paragraph>
      <paragraph num="(14)">
        <text>“Early intervention record” means any personally identifiable information, as defined in §B(48) of this regulation, about a child or the child’s family generated by the early intervention system which pertains to:</text>
        <paragraph num="(a)">
          <text>Evaluation and assessment;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Development of an individualized family service plan; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The delivery of early intervention services.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(15)">
        <text>Early Intervention Services (EIS).</text>
        <paragraph num="(a)">
          <text>“Early intervention services” means continuous developmental services designed to meet the needs of an infant or toddler with a disability and the needs of the family to appropriately assist in the child’s development that:</text>
          <paragraph num="(i)">
            <text>Are selected in collaboration with the parents;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Meet the standards of the State;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Are provided at no cost; and</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Are under public supervision by qualified personnel.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Early intervention services” include, but are not limited to:</text>
          <paragraph num="(i)">
            <text>Assistive technology;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Audiology;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Family training, counseling, and home visits;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Health services;</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Medical services for diagnostic or evaluation purposes;</text>
          </paragraph>
          <paragraph num="(vi)">
            <text>Nursing services;</text>
          </paragraph>
          <paragraph num="(vii)">
            <text>Nutrition services;</text>
          </paragraph>
          <paragraph num="(viii)">
            <text>Occupational therapy;</text>
          </paragraph>
          <paragraph num="(ix)">
            <text>Physical therapy;</text>
          </paragraph>
          <paragraph num="(x)">
            <text>Psychological services;</text>
          </paragraph>
          <paragraph num="(xi)">
            <text>Service Coordination;</text>
          </paragraph>
          <paragraph num="(xii)">
            <text>Sign language and cued language services;</text>
          </paragraph>
          <paragraph num="(xiii)">
            <text>Social work services;</text>
          </paragraph>
          <paragraph num="(xiv)">
            <text>Special instruction;</text>
          </paragraph>
          <paragraph num="(xv)">
            <text>Speech-language pathology;</text>
          </paragraph>
          <paragraph num="(xvi)">
            <text>Transportation; and</text>
          </paragraph>
          <paragraph num="(xvii)">
            <text>Vision services.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(16)">
        <text>Early Intervention Service (EIS) Provider.</text>
        <paragraph num="(a)">
          <text>“Early intervention service provider” means a public, private, or nonprofit entity or individual that provides early intervention services, consistent with 34 CFR §303.12.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Early intervention service provider” may include the Department as the lead public agency responsible for providing early intervention services to infants and toddlers with disabilities in the State.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(17)">
        <text>“Elementary school” means a nonprofit institutional day or residential school, including a public elementary charter school that provides elementary education.</text>
      </paragraph>
      <paragraph num="(18)">
        <text>“Eligible child” or “eligible children” means infants or toddlers with a disability as defined in §B(28) of this regulation.</text>
      </paragraph>
      <paragraph num="(19)">
        <text>Evaluation.</text>
        <paragraph num="(a)">
          <text>“Evaluation” means the procedures used by qualified personnel to determine a child's initial and continuing eligibility for early intervention services as an infant or toddler with a disability as defined in §B(28) of this regulation.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Evaluation” includes determining the child’s status in each of the following developmental areas:</text>
          <paragraph num="(i)">
            <text>Cognitive development;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Physical development, including vision and hearing;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Communication development;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Social or emotional development; and</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Adaptive development.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(20)">
        <text>“Extended school year (ESY)” means the individualized extension of specific special education and related services as defined in COMAR 13A.05.01.03B(26).</text>
      </paragraph>
      <paragraph num="(21)">
        <text>“Family training, counseling, and home visits” means services provided, as appropriate, by social workers, psychologists, and other qualified personnel to assist the family of an infant or toddler with a disability in understanding the special needs of the child and enhancing the child's development.</text>
      </paragraph>
      <paragraph num="(22)">
        <text>“Free appropriate public education” (FAPE) has the meaning stated in 34 CFR §303.15 and COMAR 13A.05.01.03B(27).</text>
      </paragraph>
      <paragraph num="(23)">
        <text>“Frequency” means the rate at which services are provided, including the number of sessions over a particular period of time, such as daily, weekly, or monthly.</text>
      </paragraph>
      <paragraph num="(24)">
        <text>Health Services.</text>
        <paragraph num="(a)">
          <text>“Health services” means services necessary to enable a child to benefit from other early intervention services during the time the child is receiving early intervention services, consistent with 34 CFR §303.16.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Health services” include, but are not limited to:</text>
          <paragraph num="(i)">
            <text>Clean intermittent catheterization, tracheostomy care, tube feeding, the changing of dressings or osteotomy collection bags, and other health services; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Consultation by physicians with other service providers concerning the special health care needs of eligible children that will need to be addressed in the course of providing other early intervention services.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(c)">
          <text>“Health services” do not include:</text>
          <paragraph num="(i)">
            <text>Services which are surgical in nature such as cleft palate surgery, surgery for club foot, or the shunting of hydrocephalus;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Services purely medical in nature such as hospitalization for management of congenital heart ailments, or the prescribing of medicine or drugs for any purpose;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Services that are related to implementation, optimization (e.g., mapping), maintenance, or replacement of a medical device that is surgically implanted, including cochlear implant;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Devices necessary to control or treat a medical condition such as heart monitors, respirators and oxygen, and gastrointestinal feeding tubes and pumps; and</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Medical health services such as immunizations and regular well-baby care that are routinely recommended for all children.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(25)">
        <text>“Homeless children” has the meaning stated in section 725 of the McKinney-Vento Homeless Assistance Act, as amended, 42 U.S.C. 11431 et seq. for homeless children and youths.</text>
      </paragraph>
      <paragraph num="(26)">
        <text>“Include” means that the items named are not all of the possible items that are covered, whether like or unlike the ones named.</text>
      </paragraph>
      <paragraph num="(27)">
        <text>“Individualized education program (IEP)” means a written statement for a student with a disability that is developed, reviewed, and revised in accordance with 34 CFR §§300.320 —300.324 and COMAR 13A.05.01.08 and .09.</text>
      </paragraph>
      <paragraph num="(28)">
        <text>“Individualized family service plan” means a written plan for providing early intervention and other services to an eligible child and the child’s family, consistent with 34 CFR §303.344 that is:</text>
        <paragraph num="(a)">
          <text>Based on the multidisciplinary evaluation and assessment of the child, and the assessment of the child's family, in accordance with 34 CFR §303.321;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Written to include the content specified in 34 CFR §300.344;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Implemented as soon as possible, but not more than 30 days following receipt of parental consent, consistent with 34 CFR §303.420; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Developed jointly by the family and appropriate qualified personnel involved in the provision of early intervention services, in accordance with 34 CFR §§303.342, 303.343, and §303.345.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(29)">
        <text>Infant or Toddler with a Disability.</text>
        <paragraph num="(a)">
          <text>“Infant or toddler with a disability” means a child, birth through 2 years old, who is eligible for early intervention services, as documented by appropriate qualified personnel, as having a developmental delay as defined by §B(11) of this regulation; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A child, 3 years old until the beginning of the school year following the child’s fourth birthday, who:</text>
          <paragraph num="(i)">
            <text>Previously received early intervention services, in accordance with Part C of the Act and this chapter; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Is identified as a child with a developmental delay or disability, consistent with 34 CFR §300.8 and COMAR 13A.05.01.06.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(30)">
        <text>“Intensity” means whether a service is provided on an individual or group basis.</text>
      </paragraph>
      <paragraph num="(31)">
        <text>“Interim service coordinator” means the individual designated at the single point of entry to assist the referred child and family through the initial multidisciplinary evaluation and assessment and individualized family service plan process.</text>
      </paragraph>
      <paragraph num="(32)">
        <text>“Length” means the length of time a service is provided during each session of that service.</text>
      </paragraph>
      <paragraph num="(33)">
        <text>“Local governing authority” means the local elected official or officials with executive authority in each jurisdiction.</text>
      </paragraph>
      <paragraph num="(34)">
        <text>“Local lead agency” means the public agency designated by the local governing authority in each county and Baltimore City to administer the interagency system of early intervention services under the direction of the Department, in accordance with Education Article, §8-416, Annotated Code of Maryland.</text>
      </paragraph>
      <paragraph num="(35)">
        <text>“Local school system” means any of the 24 public school systems in the State responsible for providing public elementary or secondary education.</text>
      </paragraph>
      <paragraph num="(36)">
        <text>“Location” means the actual place or places where a service will be provided.</text>
      </paragraph>
      <paragraph num="(37)">
        <text>“Maryland Infants and Toddlers Program” means the program within the Department responsible for the planning, supervision, monitoring, and technical assistance for the implementation of Part C of the Act and this chapter.</text>
      </paragraph>
      <paragraph num="(38)">
        <text>“Medical services” means services provided by a licensed physician for diagnostic or evaluation purposes to determine a child's developmental status and need for early intervention services.</text>
      </paragraph>
      <paragraph num="(39)">
        <text>“Method” means how a service is provided.</text>
      </paragraph>
      <paragraph num="(40)">
        <text>“Multidisciplinary” means the involvement of two or more disciplines or professions in the provision of integrated and coordinated services, including evaluation and assessment activities and the development of the IFSP consistent with 34 CFR §303.24.</text>
      </paragraph>
      <paragraph num="(41)">
        <text>Native Language.</text>
        <paragraph num="(a)">
          <text>“Native language” means the language or mode of communication normally used by an individual who is limited English proficient, or the language normally used by the parent of the child, consistent with 34 CFR §303.25.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Native language” includes the language of the child, if determined developmentally appropriate for the child by qualified personnel conducting the evaluation or assessment.</text>
        </paragraph>
        <paragraph num="(c)">
          <text>“Native language” includes the mode of communication that is normally used by an individual:</text>
          <paragraph num="(i)">
            <text>Who is blind or visually impaired;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Who is deaf or hard of hearing; or</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>With no written language.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(42)">
        <text>“Natural environments” means settings that are natural or typical for a same-aged infant or toddler without a disability, including home or community settings, consistent with 34 CFR §303.126.</text>
      </paragraph>
      <paragraph num="(43)">
        <text>Nursing Services. “Nursing services” means services which include the:</text>
        <paragraph num="(a)">
          <text>Assessment of health status for the purpose of providing nursing care, including the identification of patterns of human response to actual or potential health problems;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Administration of medications, treatments, and regimens prescribed by a licensed physician.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(44)">
        <text>“Nutritional services” means services which include:</text>
        <paragraph num="(a)">
          <text>Conducting individual assessments in:</text>
          <paragraph num="(i)">
            <text>Nutritional history and dietary intake such as anthropometric, biochemical, and clinical variables;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Feeding skills and feeding problems; and</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Food habits and food preferences;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>Developing and monitoring appropriate plans to address the nutritional needs of eligible children based on the findings in(a) of this subsection; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Making referrals to appropriate community resources to carry out nutrition goals.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(45)">
        <text>Occupational Therapy.</text>
        <paragraph num="(a)">
          <text>“Occupational therapy” means services to address the functional needs of a child related to:</text>
          <paragraph num="(i)">
            <text>The performance of self-help skills;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Adaptive behavior and play; or</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Sensory, motor, and postural development.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Occupational therapy” is designed to improve the child's functional ability to perform tasks in home, school, and community settings, and includes:</text>
          <paragraph num="(i)">
            <text>Identification, assessment, and intervention;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Adaptations of the environment;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Selection, design, and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills; and</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(46)">
        <text>Parent.</text>
        <paragraph num="(a)">
          <text>“Parent” means:</text>
          <paragraph num="(i)">
            <text>A biological or adoptive parent;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>A guardian authorized to act as the child’s parent, or authorized to make early intervention, educational, health, or developmental decisions for the child;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>An individual acting in the place of a biological or adoptive parent including a grandparent, stepparent, or other relative with whom the child lives, or an individual who is legally responsible for the child’s welfare;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>A foster parent with whom the student lives, if the foster parent has been granted limited guardianship for educational decision-making purposes by the court that has placed the child in foster care; or</text>
          </paragraph>
          <paragraph num="(v)">
            <text>A surrogate parent who has been appointed in accordance with 34 CFR §303.422 and consistent with Regulation .13 of this chapter.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Parent” does not include:</text>
          <paragraph num="(i)">
            <text>An EIS provider or public agency responsible for the provision of any service to a child or any family member of the child; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>The State, if the child is a ward of the State.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(47)">
        <text>Participating Agency.</text>
        <paragraph num="(a)">
          <text>“Participating agency” means an individual, agency, entity, or institution that collects, maintains, or uses personally identifiable information to implement Part C of the Act and the regulations in this chapter with respect to a particular child.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Participating agency” includes the lead agency and EIS providers of services including service coordination, evaluations, and assessments.</text>
        </paragraph>
        <paragraph num="(c)">
          <text>“Participating agency” does not include primary referral sources, or public agencies that act solely as funding sources for Part C services.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(48)">
        <text>“Periodic review” means the multidisciplinary review of the IFSP, conducted every 6 months, or more frequently if conditions warrant, or at the family's request.</text>
      </paragraph>
      <paragraph num="(49)">
        <text>“Personally identifiable information” means information that includes:</text>
        <paragraph num="(a)">
          <text>The name of:</text>
          <paragraph num="(i)">
            <text>The child;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>The child’s parent; or</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Other family member;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>The address of the child;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A personal identifier such as the child's Social Security number or child identification number; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>A list of personal characteristics or other information that would make it possible to identify the child with reasonable certainty.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(50)">
        <text>Physical Therapy Services.</text>
        <paragraph num="(a)">
          <text>“Physical therapy services” means services to address the promotion of sensorimotor function through enhancement of:</text>
          <paragraph num="(i)">
            <text>Musculoskeletal status;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Neurobehavioral organization;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Perceptual and motor development;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Cardiopulmonary status; or</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Effective environmental adaptation.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Physical therapy services” includes:</text>
          <paragraph num="(i)">
            <text>Screening, evaluation, and assessment of infants and toddlers to identify movement dysfunction;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Providing individual and group services or treatment to prevent, alleviate, or compensate for movement dysfunction and related functional problems.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(51)">
        <text>Primary Referral Sources.</text>
        <paragraph num="(a)">
          <text>“Primary referral sources” means an individual, agency, entity, or institution that may suspect an infant or toddler as having a developmental delay who may benefit from EIS.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Primary referral sources” include:</text>
          <paragraph num="(i)">
            <text>Parents;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Physicians;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Child care programs;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Domestic violence shelters and agencies;</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Early learning programs;</text>
          </paragraph>
          <paragraph num="(vi)">
            <text>Health care clinics and providers;</text>
          </paragraph>
          <paragraph num="(vii)">
            <text>Homeless family shelters;</text>
          </paragraph>
          <paragraph num="(viii)">
            <text>Hospitals, including prenatal and postnatal care facilities;</text>
          </paragraph>
          <paragraph num="(ix)">
            <text>Public agencies;</text>
          </paragraph>
          <paragraph num="(x)">
            <text>Public health facilities; and</text>
          </paragraph>
          <paragraph num="(xi)">
            <text>Staff in the State child welfare system.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(52)">
        <text>“Profession” means a specific occupational category that:</text>
        <paragraph num="(a)">
          <text>Provides early intervention services to eligible children and their families;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Has been established or designated by the State; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Has a required scope of responsibility and degree of supervision.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(53)">
        <text>“Psychological services” means services that include:</text>
        <paragraph num="(a)">
          <text>Administering psychological and developmental tests, and other assessment procedures;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Interpreting assessment results;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Planning and managing a program of psychological services including:</text>
          <paragraph num="(i)">
            <text>Psychological counseling for children and parents;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Family counseling;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Consultation on child development;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Parent training; or</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Education programs.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(54)">
        <text>“Public agency” means:</text>
        <paragraph num="(a)">
          <text>The lead agency; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Any other agency or political subdivision.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(55)">
        <text>“Qualified personnel” means persons who have met State approved or recognized certification, licensing, registration, or other comparable requirements that apply to the area in which the personnel are conducting evaluations and assessments or providing early intervention services, including:</text>
        <paragraph num="(a)">
          <text>Audiologists;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Family therapists;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Nurses;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Occupational therapists;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Orientation and mobility specialists;</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Pediatricians and other physicians for diagnostic and evaluation purposes;</text>
        </paragraph>
        <paragraph num="(g)">
          <text>Physical therapists;</text>
        </paragraph>
        <paragraph num="(h)">
          <text>Psychologists;</text>
        </paragraph>
        <paragraph num="(i)">
          <text>Registered dieticians;</text>
        </paragraph>
        <paragraph num="(j)">
          <text>Social workers;</text>
        </paragraph>
        <paragraph num="(k)">
          <text>Special educators, including teachers of children with hearing impairments and teachers of children with visual impairments;</text>
        </paragraph>
        <paragraph num="(l)">
          <text>Speech and language pathologists;</text>
        </paragraph>
        <paragraph num="(m)">
          <text>Vision specialists, including ophthalmologists and optometrists; and</text>
        </paragraph>
        <paragraph num="(n)">
          <text>Other services and personnel as defined in §B(15) and (58) of this regulation.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(56)">
        <text>“Scientifically based research” has the meaning given in the term Section 9101(37) of the Elementary and Secondary Education Act of 1965, as amended.</text>
      </paragraph>
      <paragraph num="(57)">
        <text>Screening.</text>
        <paragraph num="(a)">
          <text>“Screening” means procedures or activities carried out by, or under the supervision of, the local lead agency or EIS provider to identify infants and toddlers suspected of having a disability and in need of early intervention services, at the earliest possible age, consistent with 34 CFR §303.320.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Screening” includes the administration of appropriate instruments by qualified personnel.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(58)">
        <text>Service Coordination.</text>
        <paragraph num="(a)">
          <text>“Service coordination” means activities to assist and enable an eligible child and the child's family to receive the rights, procedural safeguards, and services that are authorized to be provided under the State's system of early intervention services.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Service coordination” includes:</text>
          <paragraph num="(i)">
            <text>Assisting families in gaining access to, and coordinating the provision of, the early intervention services;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Coordinating the performance of evaluations and assessments;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Facilitating and participating in the development, review, and evaluation of individualized family service plans;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Coordinating, facilitating, and monitoring the delivery of service across agencies to ensure that the services are provided in a timely manner;</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Conducting follow-up activities to determine that appropriate early intervention services are provided;</text>
          </paragraph>
          <paragraph num="(vi)">
            <text>Informing families of their rights and procedural safeguards;</text>
          </paragraph>
          <paragraph num="(vii)">
            <text>Coordinating the funding sources for early intervention services;</text>
          </paragraph>
          <paragraph num="(viii)">
            <text>Facilitating the development of a transition plan to preschool, school, or other services, if appropriate;</text>
          </paragraph>
          <paragraph num="(ix)">
            <text>Informing families of the availability of advocacy services;</text>
          </paragraph>
          <paragraph num="(x)">
            <text>Coordinating with medical and health providers; and</text>
          </paragraph>
          <paragraph num="(xi)">
            <text>Assisting families to get required immunizations for eligible children, in compliance with COMAR 10.06.04.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(59)">
        <text>“Service coordinator” means the individual designated in the IFSP to carry out service coordination activities.</text>
      </paragraph>
      <paragraph num="(60)">
        <text>Sign Language and Cued Language Services.</text>
        <paragraph num="(a)">
          <text>“Sign language and cued language services” means teaching:</text>
          <paragraph num="(i)">
            <text>Sign language;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Cued language; or</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Auditory oral language.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Sign language and cued language services” includes providing:</text>
          <paragraph num="(i)">
            <text>Oral transliteration services;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Sign language interpretation; or</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Cued language interpretation.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(61)">
        <text>“Single point of entry” means the contact point in the local jurisdiction designated by each local lead agency to accept referrals from primary referral sources and others who suspect a developmental delay in an infant or toddler.</text>
      </paragraph>
      <paragraph num="(62)">
        <text>“Social work services” means services that may include:</text>
        <paragraph num="(a)">
          <text>Making home visits to evaluate a child's living conditions and patterns of parent-child interaction;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Preparing a psychosocial developmental assessment of the child within the family context;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Providing individual and family-group counseling with parents and other family members and appropriate social skill-building activities with the child and parents;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Working with those problems in a child's and family's living situation, such as home, community, and any center where early intervention services are provided that affect the child's maximum utilization of early intervention services; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Identifying, mobilizing, and coordinating community resources and services to enable the child and family to receive maximum benefit from early intervention services.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(63)">
        <text>“Special instruction” means services that may include:</text>
        <paragraph num="(a)">
          <text>The design of learning environments and activities that promote the child's acquisition of skills in a variety of developmental areas including cognitive processes and social interaction;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Curriculum planning including the planned interaction of personnel, materials, and time and space that leads to achieving the outcomes in the child’s individualized family service plan;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Providing families with information, skills, and support related to enhancing the skill development of the child; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Working with the child to enhance the child's development.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(64)">
        <text>“Speech-language pathology” means services which may include:</text>
        <paragraph num="(a)">
          <text>Identification of children with communicative, language, or oral pharyngeal disorders and delays in development of communication skills;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Diagnosis and appraisal of specific speech language disorders and delays;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Referral for medical or other professional attention necessary for the habilitation or rehabilitation of communicative, language, or oral pharyngeal disorders and delays in development of communication skills; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Provision of habilitative, rehabilitative, or preventative services for communicative or oral pharyngeal disorders and delays in development of communication skills.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(65)">
        <text>“Transportation” means the cost of travel that are necessary to enable an eligible child and the child's family to receive early intervention services and includes mileage, travel by taxi, common carrier, or other means, and other related costs, such as tolls and parking expenses.</text>
      </paragraph>
      <paragraph num="(66)">
        <text>Vision Services.</text>
        <paragraph num="(a)">
          <text>“Vision services” means services that include the evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>“Vision services” include referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>“Vision services” include:</text>
          <paragraph num="(i)">
            <text>Communication skills training;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Orientation and mobility training for all environments;</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Visual training;</text>
          </paragraph>
          <paragraph num="(iv)">
            <text>Independent living skills training; and</text>
          </paragraph>
          <paragraph num="(v)">
            <text>Additional training necessary to activate visual motor abilities.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(67)">
        <text>Ward of the State.</text>
        <paragraph num="(a)">
          <text>“Ward of the State” means a child:</text>
          <paragraph num="(i)">
            <text>For whom a State or county agency or official has been appointed legal guardian; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Who has been committed by a court of competent jurisdiction to the legal custody of a State or county agency or official with the express authorization that the State or county agency or official make educational decisions for the child.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Ward of the State” does not include a foster child who has a foster parent who meets the definition of a parent as defined in §B(45) of this regulation.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Referral and Screening.">
    <paragraph num="A.">
      <text>Referral.</text>
      <paragraph num="(1)">
        <text>A local lead agency shall identify a single point of entry which shall:</text>
        <paragraph num="(a)">
          <text>Coordinate all major child find efforts, consistent with 34 CFR §303.302 and COMAR 13A.13.02.04B; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Be available for use by primary referral sources and others who suspect developmental delay in an infant or toddler.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>A local lead agency shall require the referral of a child younger than 3 years old who:</text>
        <paragraph num="(a)">
          <text>Is the subject of a substantiated case of child abuse or neglect; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Is identified as directly affected by illegal substance abuse or withdrawal symptoms resulting from prenatal drug exposure.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>A local lead agency shall seek parental consent for referral of a child younger than 3 years old who directly experiences a substantiated case of trauma due to exposure of violence, as defined in Section 320 of the Family Violence Prevention and Services Act, 42 U.S.C. 10401, et seq.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>A local lead agency shall ensure primary referral sources refer an infant or toddler as soon as possible, but in no case more than 7 days after the child has been identified.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Screening Procedures.</text>
      <paragraph num="(1)">
        <text>A local lead agency or EIS provider may screen a child younger than 3 years old to determine whether the child is suspected of having a disability, consistent with 34 CFR 303.320.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If a local lead agency or EIS provider proposes to screen a child, it shall:</text>
        <paragraph num="(a)">
          <text>Provide the parent notice of the intent to screen the child to identify whether the child is suspected of having a disability, consistent with 34 CFR §303.421;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Provide the parent a description of the parent’s right to request an evaluation at any time during the screening process, in accordance with 34 CFR §303.32; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Obtain consent before conducting the screening procedures, in accordance with as required in 34 CFR §303.420(a)(1) and Regulation .12 of this chapter.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>If the result of screening or other available information indicates that the child is suspected of having a disability, the local lead agency shall:</text>
        <paragraph num="(a)">
          <text>Provide the parents notice of the results consistent with 34 CFR §303.421 and Regulation .11 of this chapter;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Obtain parental consent for evaluation and assessment consistent with 34 CFR §303.420 and Regulation .12 of this chapter; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Conduct an evaluation and assessment of the child in accordance with 34 CFR §303.321 and Regulation .05 of this chapter.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>If the result of screening or other available information indicates no suspicion of a disability, the local lead agency or EIS provider shall provide the parents notice of that determination and the parent’s right to request an evaluation, consistent with 34 CFR §303.421.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Parents may request and consent to an evaluation at any time during the screening process.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>The evaluation of the child must be conducted within 45 days from the date of referral, even if the local lead agency or EIS provider has determined the child is not suspected of having a disability in accordance with §B(4) of this regulation.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>A local lead agency is not required to provide:</text>
        <paragraph num="(a)">
          <text>An evaluation of the child unless:</text>
          <paragraph num="(i)">
            <text>The child is suspected of having a disability; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>The parent requests an evaluation; or</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>Early intervention services unless the child is determined to be an infant or toddler with a disability as defined in 34 CFR §303.21 and Regulation .03B(29) of this chapter.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Evaluation and Assessment.">
    <paragraph num="A.">
      <text>Evaluation Procedures.</text>
      <paragraph num="(1)">
        <text>A local lead agency shall ensure:</text>
        <paragraph num="(a)">
          <text>A child receives a timely, comprehensive, multidisciplinary evaluation, consistent with 34 CFR §§303.321, 303.322, and 303.420(a)(2);</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A parent provides consent before conducting each evaluation and assessment of a child, consistent with 34 CFR §303.321(1) and Regulation .12 of this chapter; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Evaluations are administered by qualified personnel.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>In conducting an evaluation, no single procedure may be used as the sole criterion for determining a child’s eligibility.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Procedures shall include:</text>
        <paragraph num="(a)">
          <text>Administering an evaluation instrument;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Taking the child’s history, including interviewing the parent;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Identifying the child’s level of functioning in each of the developmental areas identified in Regulation .03B(12) of this chapter;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Gathering information from other sources such as family members, other caregivers, medical providers, social workers, and educators to understand the full scope of the child’s unique strengths and needs, if necessary, as required in 34 CFR §303.420(a)(1); and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Reviewing medical, educational, and other records.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>Evaluations and assessments of a child must be conducted in the native language of the child, unless clearly not feasible to do so.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Nondiscrimination. Local lead agencies shall conduct nondiscriminatory evaluation and assessment of children and families, consistent with 34 CFR §303.321(a)(4).</text>
    </paragraph>
    <paragraph num="C.">
      <text>Written Report.</text>
      <paragraph num="(1)">
        <text>The written report shall include:</text>
        <paragraph num="(a)">
          <text>A statement of the child's current health status based on a review of pertinent records and medical history;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A statement which describes the child's levels of functioning in each developmental area and the dates of the evaluation and assessment procedures;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A statement of criteria, including tests, evaluation materials, and informed clinical opinion; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>The signatures and titles of the qualified personnel who administered the evaluation and assessment.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Written reports of evaluations and assessments described in §C(1) of this regulation shall be included in the child’s early intervention record to:</text>
        <paragraph num="(a)">
          <text>Document the results of evaluations and assessments conducted by qualified personnel; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Determine initial eligibility of a child referred for evaluation.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Individuals who may have the opportunity to participate in the multidisciplinary evaluation process may include:</text>
      <paragraph num="(1)">
        <text>The child's parent or parents;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Other family members; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The interim service coordinator.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Eligibility Determination.</text>
      <paragraph num="(1)">
        <text>Qualified personnel directly involved in the diagnosis of the child or in conducting the evaluation and assessment of the child shall determine the child's eligibility for early intervention services by comparing evaluation results with the criteria for an infant or toddler with a disability as defined in Regulation .03B(29) of this chapter.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Qualified personnel shall use informed clinical opinion when conducting an evaluation and assessment of a child.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A local lead agency shall ensure informed clinical opinion:</text>
        <paragraph num="(a)">
          <text>May be used as an independent basis to establish a child’s eligibility for the EIS when the other instruments do not establish eligibility; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>May not be used to negate the results of evaluation instruments used to establish eligibility.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>A written statement shall document the eligibility decision and be included in the child's early intervention record. The written statement shall include:</text>
        <paragraph num="(a)">
          <text>The names and titles of the qualified personnel determining the child's eligibility;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The date of the determination; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The basis for eligibility determination.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>A child’s medical and other records may be used to establish eligibility without conducting an evaluation of the child if:</text>
        <paragraph num="(a)">
          <text>The records indicate that the child’s level of functioning in one or more developmental areas constitutes a developmental delay; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The child otherwise meets the criteria for an infant or toddler with a disability as defined in Regulation .03B(29) of this chapter.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>If the local lead agency determines a child is not eligible, the local lead agency shall provide the parent with prior written notice consistent with 34 CFR §303.421, including the parent’s right to dispute the eligibility determination through dispute resolution mechanisms in accordance with 34 CFR §303.430 and Regulation .14 of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="F.">
      <text>Assessments.</text>
      <paragraph num="(1)">
        <text>If a child is eligible for EIS as an infant or toddler with a disability, the child and family shall have:</text>
        <paragraph num="(a)">
          <text>A multidisciplinary assessment of the unique strengths and needs of the child and the identification of services appropriate to meet those needs; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A family-directed assessment of concerns, priorities, and resources of the family and the identification of the supports and services necessary to enhance the family’s capacity to meet the developmental needs of the child. These assessments may occur simultaneously with the evaluation.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Family assessments shall be conducted in the native language of the family member being assessed, unless clearly not feasible to do so.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The assessment of the child shall include:</text>
        <paragraph num="(a)">
          <text>A review of the results;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Personal observations of the child; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The identification of the child’s needs in each of the developmental areas.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>The family assessment shall:</text>
        <paragraph num="(a)">
          <text>Be voluntary for each family member participating in the assessment;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Be based on information obtained through:</text>
          <paragraph num="(i)">
            <text>An assessment tool; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>An interview with those family members who elect to participate in the assessment; and</text>
          </paragraph>
        </paragraph>
        <paragraph num="(c)">
          <text>Include the family’s description of its concerns, priorities, and resources related to enhancing the child’s development.</text>
        </paragraph>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".06" heading="Individualized Family Service Plan (IFSP) Team.">
    <paragraph num="A.">
      <text>IFSP Team Members.</text>
      <paragraph num="(1)">
        <text>A local lead agency shall ensure the initial IFSP team meeting and the annual IFSP team meeting to evaluate the IFSP of an infant or toddler with a disability shall be multidisciplinary and include the following participants:</text>
        <paragraph num="(a)">
          <text>The parents of the child;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The service coordinator who:</text>
          <paragraph num="(i)">
            <text>Has worked with the family since the initial referral of the child; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Was designated by the public agency to be responsible for implementation of the IFSP;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(c)">
          <text>Individuals directly involved in conducting the evaluations and assessments in accordance with Regulation .05 of this chapter;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Individuals who will provide services to the child or the family, as determined appropriate;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Other family members, as requested by the parent, if feasible to do so; and</text>
        </paragraph>
        <paragraph num="(f)">
          <text>An advocate or individual outside the family, if the parent requests that the individual participate.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>At a minimum, the IFSP team shall include:</text>
        <paragraph num="(a)">
          <text>The parent; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Two or more individuals from separate professions.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>One of the individuals listed in §A(2)(b) of this regulation shall be the child’s service coordinator.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>If an individual listed in §A(1) of this regulation is unable to attend a meeting, arrangements shall be made for the individual's involvement through other means, including:</text>
        <paragraph num="(a)">
          <text>Participating in a telephone conference call;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Having a knowledgeable authorized representative attend the meeting; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Making pertinent records available at the meeting.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>IFSP Team Meetings.</text>
      <paragraph num="(1)">
        <text>The IFSP team meeting shall be conducted:</text>
        <paragraph num="(a)">
          <text>In a setting and at a time that is convenient to the family; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>In the native language of the family or other mode of communication used by the family, unless it is clearly not feasible to do so.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>Written notification of the IFSP team meeting shall be provided to the family and other participants early enough before the meeting date to ensure invited individuals will be able to attend.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".07" heading="Development and Review of the IFSP.">
    <paragraph num="A.">
      <text>The initial meeting to develop an IFSP for a child evaluated for the first time and determined to be eligible shall be conducted within the 45 days of the referral consistent with 34 CFR §303.310 and Regulation .05 of this chapter.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Maryland IFSP Process.</text>
      <paragraph num="(1)">
        <text>The Maryland Infants and Toddlers Program shall provide each local lead agency electronic access to the Maryland IFSP.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Each local lead agency shall:</text>
        <paragraph num="(a)">
          <text>Use the Maryland IFSP, consistent with 34 CFR §303.344; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Ensure the development of a child’s initial IFSP, in accordance with §A of this regulation, at an IFSP team meeting unless:</text>
          <paragraph num="(i)">
            <text>The child or parent is unavailable to complete the screening, the initial evaluation, the initial assessment of the child and family, or the initial IFSP due to exceptional family circumstances; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>The parent has not provided consent for the screening, the initial evaluation or the initial assessment of the child despite documented, repeated attempts by the local lead agency or EIS provider to obtain parental consent.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>In the event the circumstances described in §B(2)(b) of this regulations exist, the local lead agency shall:</text>
        <paragraph num="(a)">
          <text>Document in the child’s early intervention record the exceptional family circumstances or repeated attempts by the local lead agency or EIS provider to obtain parental consent;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Complete the screening, the initial evaluation, the initial assessment, and the initial IFSP meeting as soon as possible after the documented exceptional family circumstances described in §B(2)(b) of this regulation no longer exist or parental consent is obtained for the initial evaluation and initial assessment of the child;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Develop and implement an interim IFSP to the extent appropriate and consistent with §B of this regulation;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Provide for the signature of the parent and other parties as required on the Maryland IFSP document;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Ensure that early intervention services are provided consistent with 34 CFR §§303.13(a)(8), 303.26, and 303.344:</text>
          <paragraph num="(i)">
            <text>In natural environments, including the home and community settings in which children without disabilities participate, to the maximum extent appropriate; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>In a setting other than the natural environment that is most appropriate, as determined by the IFSP Team, only when early intervention services cannot be achieved satisfactorily in a natural environment;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(f)">
          <text>Implement the EIS as specified in the IFSP as soon as possible, but not later than 30 days from the date of parent consent, except as provided under 34 CFR §303.345;</text>
        </paragraph>
        <paragraph num="(g)">
          <text>Ensure the provision of service coordination to an eligible child and the child's family, consistent with 34 CFR §§303.12 and 303.31, that includes the:</text>
          <paragraph num="(i)">
            <text>Designation of a service coordinator from the profession most immediately relevant to the child's or family's needs, or who is otherwise qualified to carry out all applicable responsibilities; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Assignment of responsibility for the implementation of the IFSP and coordination with other agencies and persons; and</text>
          </paragraph>
        </paragraph>
        <paragraph num="(h)">
          <text>Identify the actions to be taken to support the transition of children receiving early intervention services to preschool or other appropriate services, consistent with 34 CFR §§303.209, 303.344(h), and Regulation .09 of this chapter.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Interim IFSP.</text>
      <paragraph num="(1)">
        <text>The EIS for an eligible child and the child’s family may commence before the completion of the evaluation and assessments, as described in Regulation .05 of this chapter, if:</text>
        <paragraph num="(a)">
          <text>It is determined that EIS are needed immediately by the child and the child’s family;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Parental consent is obtained; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>An interim IFSP is developed that includes the name of the service coordinator who will be responsible for:</text>
          <paragraph num="(i)">
            <text>Implementing the interim IFSP; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Coordinating with other agencies and persons.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>An evaluation and assessment shall still be completed within the 45 days of the referral consistent with 34 CFR §303.310 and Regulation .05 of this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Periodic IFSP Review.</text>
      <paragraph num="(1)">
        <text>Periodic review shall provide for the participation of individuals identified in Regulation .06A of this chapter.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>When necessary, provisions shall be made for the participation of other representatives identified in Regulation .06A of this chapter.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A periodic review of an IFSP for a child and the child's family shall be conducted every 6 months, or more frequently if conditions warrant, or if the family requests such a review to determine:</text>
        <paragraph num="(a)">
          <text>The degree to which progress toward achieving the outcomes is being made; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Whether modification or revision of the outcomes is necessary.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>The periodic review may occur:</text>
        <paragraph num="(a)">
          <text>At an IFSP team meeting; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>By another means that is acceptable to the parents and other participants.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Annual IFSP Review.</text>
      <paragraph num="(1)">
        <text>An IFSP team meeting shall be conducted at least annually to evaluate the IFSP for a child and the child's family, and to revise the provisions of the IFSP, as appropriate.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>During the annual IFSP team meeting, the results of any current evaluations conducted in accordance with Regulation .05 in this chapter and other information available from the ongoing assessment of the child and family shall be used to determine what EIS are needed and what EIS will be provided.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".08" heading="Individualized Family Service Plan (IFSP) Document.">
    <paragraph num="A.">
      <text>The IFSP shall include:</text>
      <paragraph num="(1)">
        <text>A statement of the child’s present levels of physical development, including:</text>
        <paragraph num="(a)">
          <text>Vision;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Hearing;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Health status;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Cognitive development;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Communication development;</text>
        </paragraph>
        <paragraph num="(f)">
          <text>Social or emotional development; and</text>
        </paragraph>
        <paragraph num="(g)">
          <text>Adaptive development;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>A statement of the family’s concerns, priorities, and resources related to enhancing the development of the child as identified through assessment, with the concurrence of the family;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A statement of the measurable results or outcomes considered developmentally appropriate and expected to be achieved for the child and family, consistent with 34 CFR §303.344(c), including:</text>
        <paragraph num="(a)">
          <text>Preliteracy;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Numeracy;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Language skills; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Criteria, procedures, and timeline used to determine:</text>
          <paragraph num="(i)">
            <text>The degree to which progress toward achieving the results or outcomes identified in the IFSP is being made; and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Whether modifications or revisions of the expected results or outcomes, or early intervention services identified in the IFSP are necessary;</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>The projected date for the initiation of each early intervention service;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>The anticipated duration of each service;</text>
      </paragraph>
      <paragraph num="(6)">
        <text>The name of the service coordinator from the profession most relevant to the child’s or family’s needs who is responsible for:</text>
        <paragraph num="(a)">
          <text>Implementing the early intervention services identified in a child’s IFSP;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Transition services; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Coordination with other agencies and individuals;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(7)">
        <text>The steps and services to be taken to support the smooth transition of the child from EIS to:</text>
        <paragraph num="(a)">
          <text>Preschool services, in accordance COMAR 13A.05.01, to the extent that those services are appropriate;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The Extended IFSP Option, consistent with 34 CFR §303.209; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Other appropriate services; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>The steps to support the smooth transition, including:</text>
        <paragraph num="(a)">
          <text>Discussions with, and training of, parents, as appropriate, regarding future placement as other matters related to the child’s transition;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Procedures to prepare the child for changes in service delivery, including steps to help the child adjust to, and function in, a new setting;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Confirmation that:</text>
          <paragraph num="(i)">
            <text>Child find information about the child has been transmitted to the local school system or other relevant agency, in accordance with 34 CFR §303.209(b); and</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>With parental consent, if required under 34 CFR §303.414, transmission of additional information needed by the local school system to ensure continuity of services from the Part C program to the Part B program, including a copy of the most recent evaluation and assessments of the child and family and most recent IFSP; and</text>
          </paragraph>
        </paragraph>
        <paragraph num="(d)">
          <text>Identification of transition services and other activities that the IFSP Team determines are necessary to support the transition of the child.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>EIS Providers. EIS providers shall:</text>
      <paragraph num="(1)">
        <text>Participate in the development of an initial IFSP within 45 days from receipt of referral for an eligible child and the child's family;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Implement and conduct periodic reviews and annual evaluations of a child’s IFSP consistent with 34 CFR §§303.342—303.343 and established local policies and procedures;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Participate in the ongoing multidisciplinary assessment of the child and the family-directed assessment of the resources, priorities and concerns of the family, as it relates to the needs of the child in the development of integrated outcomes for the IFSP;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Provide early intervention services in accordance with the IFSP of the infant or toddler with a disability; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Consult with and train parents and others regarding the provision of the early intervention services described in the IFSP of the infant or toddler with a disability.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>IFSP Services.</text>
      <paragraph num="(1)">
        <text>The IFSP shall address the needs of an infant or toddler with a disability and the needs of the family to assist appropriately in the child’s development, as identified by the IFSP team, in one or more of the following areas, including:</text>
        <paragraph num="(a)">
          <text>Physical development;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Cognitive development;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Communication development;</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Social or emotional development;</text>
        </paragraph>
        <paragraph num="(e)">
          <text>Adaptive development.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>The IFSP shall include, to the extent practicable a statement of the specific early intervention services based on peer-reviewed research that are necessary to meet the unique needs of the child and the family to achieve the results or outcomes identified in §A(3) of this regulation, including:</text>
        <paragraph num="(a)">
          <text>The length, duration, frequency, intensity, and method of delivering the early intervention service, as defined in Regulation.03B of this chapter;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A statement that an early intervention service is provided on a year-round basis in the natural environment of the child or service, to the maximum extent appropriate, or a justification as to why an early intervention service will not be provided in the natural environment;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The determination of the appropriate setting for providing an early intervention service, including any justification for not providing a particular early intervention service in the natural environment shall be:</text>
          <paragraph num="(i)">
            <text>Made by the IFSP Team;</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Consistent with the provisions of 34 CFR §§303.13(a)(8), 303.26, and 303.126; and</text>
          </paragraph>
          <paragraph num="(iii)">
            <text>Based on the child’s outcomes identified by the IFSP Team;</text>
          </paragraph>
        </paragraph>
        <paragraph num="(d)">
          <text>The location of the early intervention services; and</text>
        </paragraph>
        <paragraph num="(e)">
          <text>The agency fiscally responsible for the service.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>To the extent appropriate, the IFSP shall:</text>
        <paragraph num="(a)">
          <text>Identify medical and other services that the child or family needs or is receiving through other sources, but that are neither required nor funded in accordance with Part C of the Act; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Include a description of the steps the service coordinator or family may take to assist the child and family in securing the services above, if those services are not currently being provided.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>A public agency or EIS provider who has a direct role in the provision of early intervention services is responsible for making a good faith effort to assist each eligible child in achieving the outcomes in the child’s IFSP.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>A public agency or EIS provider cannot be held accountable if a child does not achieve the growth projected in the child’s IFSP, consistent with 34 CFR §303.346.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>The local lead agency shall ensure appropriate early intervention services are based on scientifically based research and are available to infants and toddlers with disabilities and their families, including infants and toddlers with disabilities who are homeless and their families consistent with 34 CFR §303.112.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".09" heading="Transition.">
    <paragraph num="A.">
      <text>Notification to the Local School System.</text>
      <paragraph num="(1)">
        <text>The Maryland Infants and Toddlers Program shall inform a local school system of potentially eligible children, 2 years old or older, who reside in the jurisdiction served by the local school system.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The notification shall be provided electronically on the secure server, within a given timeframe determined by the Maryland Infants and Toddlers Program.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A local lead agency is not required to conduct an evaluation, assessment, or an initial IFSP team meeting for the toddler referred to a local lead agency less than 45 days before the toddler’s third birthday.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>A local lead agency shall refer the toddler to the local school system for the jurisdiction in which the toddler resides, with parental consent as required under §303.414, if a toddler is referred to a local lead agency less than 45 days before the toddler’s third birthday.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Transition Procedures.</text>
      <paragraph num="(1)">
        <text>A local lead agency shall ensure steps and services are identified to support a toddler’s smooth transition, consistent with 34 CFR §§303.209 and 303.344(h) to:</text>
        <paragraph num="(a)">
          <text>Preschool special education;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The Extended IFSP Option; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Other appropriate services.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>The local lead agency shall:</text>
        <paragraph num="(a)">
          <text>Develop transition outcomes on a child’s IFSP at the IFSP meeting closest to the child’s second birthday; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Convene an IFSP team meeting for transition planning, consistent with requirements in 34 CFR §§303.342(d) and (e) and 303.343(a), with the approval of the parents of the toddler, not less than 90 days, and at the discretion of all parties, not more than 9 months before the toddler’s third birthday, to discuss services the toddler may be eligible to receive.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>If a toddler with a disability may be eligible for preschool special education services, consistent with COMAR 13A.05.01, the local lead agency, with the approval of the toddler’s family, shall convene an IFSP team meeting, as described in §B(2)(b) of this regulation, with:</text>
        <paragraph num="(a)">
          <text>The toddler’s family;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A representative of the local school system; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The toddler’s service coordinator.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(4)">
        <text>If the local lead agency determines that a toddler with a disability is not potentially eligible for preschool special education services, the local lead agency, with the approval of the toddler’s family, shall make reasonable efforts to convene an IFSP team meeting, as described in §B(2)(b) of this regulation with:</text>
        <paragraph num="(a)">
          <text>The toddler’s family;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The toddler’s service coordinator; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Providers of other appropriate services.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>The IFSP team meeting described in §B(2)(b) of this regulation may occur less than 90 days before the toddler’s third birthday, with clear written documentation, if:</text>
        <paragraph num="(a)">
          <text>The toddler is unavailable;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The family requests a delay because of other family reasons; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The toddler was referred after 33 months of age.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>If the IFSP team meeting described in §B(5) of this regulation occurs less than 90 days before the toddler’s third birthday, the local lead agency shall make reasonable attempts to conduct the IFSP team meeting as soon as possible to allow for appropriate transition planning.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>The IFSP team shall develop a transition plan as part of the child’s IFSP that includes:</text>
        <paragraph num="(a)">
          <text>Steps for the toddler with a disability and the toddler’s family to exit from the Part C program; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The identification of transition services the toddler or the toddler’s family needs.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(8)">
        <text>The local lead agency shall provide the toddler’s parents with:</text>
        <paragraph num="(a)">
          <text>An annual notice consistent with 303.211(b)(1); and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Information regarding community options and service delivery models if a toddler:</text>
          <paragraph num="(i)">
            <text>Continues to receive early intervention services in accordance with an Extended IFSP; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Begins to receive preschool special education services in accordance with an IEP.</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="(9)">
        <text>If a toddler with a disability may be eligible for preschool special education services, the local school system shall convene an IEP team meeting to determine the child’s eligibility for Part B preschool special education services, consistent with COMAR 13A.05.01.</text>
      </paragraph>
      <paragraph num="(10)">
        <text>The local school system IEP team meeting described in §B(9) of this regulation shall:</text>
        <paragraph num="(a)">
          <text>Be convened in a timely manner such that eligibility is determined before the toddler’s third birthday; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The toddler’s service coordinator or other Part C representative as a required team member, to participate in the review of existing data on the child’s progress and performance on IFSP outcomes, unless the family requests, in writing, that a Part C representative not participate in the IEP team eligibility meeting.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(11)">
        <text>If a toddler is determined eligible for Part B preschool special education services, and parents wish for their child to receive services, the parents shall provide informed written consent, consistent with Regulation .12 of this chapter and COMAR §13A.05.01.13 to:</text>
        <paragraph num="(a)">
          <text>Continue early intervention services through an Extended IFSP, including an educational component, as required by §303.344(c); or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Receive preschool special education services through an IEP as a student with a disability in accordance with 34 CFR §300.324 and COMAR §13A.05.01.08, and no longer receive Part C services.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Extended IFSP Option. If the parent chooses the Extended IFSP Option the local lead agency shall:</text>
      <paragraph num="(1)">
        <text>Acknowledge the parent’s choice and their child’s eligibility by providing the parent prior written notice, in accordance with 34 CFR §300.503 and COMAR §13A.05.01.12; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Ensure that early intervention services identified on a toddler’s IFSP includes an educational component that promotes school readiness and incorporates:</text>
        <paragraph num="(a)">
          <text>Preliteracy;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Language; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Numeracy skills.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Termination of Extended IFSP Option Services.</text>
      <paragraph num="(1)">
        <text>A parent may choose to terminate participation in early intervention services through an IFSP, at any time after the Extended IFSP Option is chosen, and choose preschool special education services through an IEP.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The parent shall notify the local lead agency, in writing, of the choice to terminate early intervention services under the Extended IFSP Option.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The local lead agency shall notify the local school system of the parent’s decision to request preschool special education services through an IEP.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>If a child’s family chooses to terminate early intervention services under an Extended IFSP and initiate services through an IEP, a redetermination of the toddler’s eligibility for special education services in accordance with COMAR 13A.05.01 is not required.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Within 45 days of receiving written notification, as described in §D(3) of this regulation, the local school system shall convene an IEP team meeting to develop an IEP and determine the educational placement, in accordance with §F of this regulation.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Once a child’s parent makes the choice to terminate early intervention services through an Extended IFSP and pursue services through an IEP, through written notification to the local lead agency, as described in §D(2) of this regulation, the parent cannot continue services through an Extended IFSP beyond the date that IEP services are to begin; or the beginning of the school year following the child’s fourth birthday, whichever occurs sooner.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>In order to ensure a seamless delivery of services, the local lead agency shall continue to provide early intervention services under an Extended IFSP until the IEP services are to begin or until the beginning of the school year following the child’s fourth birthday, whichever occurs sooner.</text>
      </paragraph>
    </paragraph>
    <paragraph num="E.">
      <text>Transition Planning Before the Beginning of the School Year Following a Toddler’s Fourth Birthday.</text>
      <paragraph num="(1)">
        <text>The Maryland Infants and Toddlers Program, local lead agencies, and public agencies shall ensure a smooth transition of a toddler from Part C EIS to preschool, in accordance with 34 CFR §303.211(b)(6)(ii).</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The local lead agency shall convene an IFSP team transition planning meeting, consistent with requirements in 34 CFR §§303.342(d) and (e) and 303.343(a), with the approval of the child’s family to discuss any preschool special education services that the child may receive and other community options.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The IFSP transition planning meeting described in §E(2) of this regulation shall occur not fewer than 90 days, or at the discretion of all parties, not more than 9 months before the toddler will no longer be eligible to receive EIS.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>The participants of the IFSP team meeting shall include:</text>
        <paragraph num="(a)">
          <text>The toddler’s service coordinator;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The child’s family; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>A representative of the local school system.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>The IFSP team meeting described in §E(2) of this regulation may be held less than 90 days before the beginning of the school year following the child’s fourth birthday, if there is written documentation that:</text>
        <paragraph num="(a)">
          <text>The child is unavailable because of illness; or</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The family requests a delay because of other family reasons.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>If the IFSP transition planning meeting described in §E(2) of this regulation is held less than 90 days before the beginning of the school year following the child’s fourth birthday, reasonable attempts must be made to conduct the meeting as soon as possible to allow for appropriate transition planning.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>The local school system shall convene an IEP team meeting for the purpose of IEP development, consistent with COMAR 13A.05.01.07—.10, before the beginning of the school year following the child’s fourth birthday if the parent wishes to consider preschool special education services.</text>
      </paragraph>
    </paragraph>
    <paragraph num="F.">
      <text>Preschool IEP Services. If the parent chooses to receive preschool special education services through an IEP, the local school system shall:</text>
      <paragraph num="(1)">
        <text>Convene an IEP team meeting for the purpose of IEP development;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>At the request of the family, invite the toddler’s service coordinator or other representatives of the local lead agency to attend the IEP team meeting;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Develop an IEP, taking into consideration the IFSP, in accordance with 34 CFR §§300.323(b), 300.324 and COMAR §13A.05.01.07—.10; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Consider Extended School Year services for a toddler transitioning to preschool special education services through an IEP whose third birthday falls after the end of one school year and before the beginning of the next school year, consistent with COMAR §13A.05.01.08B(2); and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Ensure the IEP is in effect at the beginning of the school year, in accordance with COMAR 13A.05.01.09D(2).</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".10" heading="Procedural Safeguards — General Provisions.">
    <paragraph num="A.">
      <text>Procedural Safeguards Notice.</text>
      <paragraph num="(1)">
        <text>The local lead agency shall provide a copy of the procedural safeguards to the parents of an infant or toddler with a disability, with prior written notice, in accordance with 34 CFR §303.421(b)(3).</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The procedural safeguards notice shall include:</text>
        <paragraph num="(a)">
          <text>Confidentiality of personally identifiable information and early intervention record, in accordance with 34 CFR §§303.401—303.417;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Parental consent and notice, in accordance with 34 CFR §§303.420—303.422;</text>
        </paragraph>
        <paragraph num="(c)">
          <text>Surrogate parents, in accordance with 34 CFR §303.422; and</text>
        </paragraph>
        <paragraph num="(d)">
          <text>Dispute Resolution options, in accordance with 34 CFR §§303.430—303.434, and 303.440—303.449.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Confidentiality of Information. A local lead agency shall ensure the confidentiality of personally identifiable information, in accordance with 34 CFR 99, 34 CFR §§303.401—303.417, and COMAR 13A.08.02.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Opportunity to Examine Records. In accordance with the confidentiality procedures of 34 CFR 99, 34 CFR §§303.405, and COMAR 13A.08.02, the parent of an infant or toddler with a disability shall be given the opportunity to inspect and review their child’s early intervention records collected, maintained, or used by the local lead agency.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The local lead agency shall provide parents an initial copy of their child’s early intervention record at no cost to the parents, in accordance with 34 CFR §303.400(c).</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".11" heading="Procedural Safeguards — Prior Written Notice.">
    <paragraph num="A.">
      <text>General. Consistent with 34 CFR §303.421, a local lead agency shall provide a parent prior written notice a reasonable time before the local lead agency or an EIS provider proposes, or refuses, to initiate or change the identification, evaluation, or placement of their infant or toddler, or the provision of early intervention services to the infant or toddler with a disability and that infant’s or toddler’s family.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Prior Written Notice Content. The notice shall be in sufficient detail to inform the parent of:</text>
      <paragraph num="(1)">
        <text>The action that is being proposed or refused;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The reasons for taking the action; and</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The procedural safeguards, as described in Regulation .10A of this chapter, including:</text>
        <paragraph num="(a)">
          <text>A description of mediation, consistent with 34 CFR §303.431;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>How to file a State complaint, in accordance with 34 CFR §§303.432 through 303.434; and</text>
        </paragraph>
        <paragraph num="(c)">
          <text>How to file a due process complaint, consistent 34 CFR §303.430(d), including any timelines.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Native Language.</text>
      <paragraph num="(1)">
        <text>The notice shall be written in language that is understandable to the general public, and provided in the native language of the parent, unless it is clearly not feasible to do so.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If the native language used by the parent is not a written language, the local lead agency shall ensure that the notice is translated orally or by other means to the parent, and the parent understands the content of the notice.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>A public agency shall maintain written documentation that the requirements of §C(1) and (2) of this regulation have been met.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".12" heading="Procedural Safeguards — Consent.">
    <paragraph num="A.">
      <text>The local lead agency shall ensure parental consent is obtained before:</text>
      <paragraph num="(1)">
        <text>Administering screening procedures under 34 CFR §303.320 that are used to determine whether a child is suspected of having a disability;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>All evaluations and assessments of a child are conducted, consistent with 34 CFR §303.321 and Regulation .05 of this chapter;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>Early intervention services are provided to the child;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Public benefits or insurance or private insurance is used if such consent is required under § 303.520; and</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Disclosure of personally identifiable information consistent with 34 CFR §303.414.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>If a parent does not give consent, consistent with §A(1), (2) or (3) of this regulation, the local lead agency must make reasonable efforts to ensure that the parent:</text>
      <paragraph num="(1)">
        <text>Is fully aware of the nature of the evaluation and assessment of the child or early intervention services that would be available; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Understands that the child will not be able to receive the evaluation, assessment, or early intervention service unless consent is given.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>The local lead agency shall not use the due process hearing procedures described in Regulation .14C of this chapter to challenge a parent’s refusal to provide any consent that is required in accordance with §A of this regulation.</text>
    </paragraph>
    <paragraph num="D.">
      <text>The parents of an infant or toddler with a disability:</text>
      <paragraph num="(1)">
        <text>Determine whether they, their infant or toddler with a disability, or other family members will accept or decline any early intervention service at any time; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>May decline a service after first accepting it, without jeopardizing other early intervention services.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".13" heading="Procedural Safeguards — Surrogate Parents.">
    <paragraph num="A.">
      <text>General.</text>
      <paragraph num="(1)">
        <text>A local lead agency shall ensure the rights of a child are protected when:</text>
        <paragraph num="(a)">
          <text>No parent can be identified;</text>
        </paragraph>
        <paragraph num="(b)">
          <text>The lead agency or other public agency, after reasonable efforts, cannot locate a parent; or</text>
        </paragraph>
        <paragraph num="(c)">
          <text>The child is a ward of the State.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>A lead agency shall consult with the public agency assigned care of the child for children who are wards of the State or placed in foster care.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>If a child is a ward of the State, the surrogate parent may be appointed by the judge overseeing the infant’s or toddler’s case , instead of being appointed by the local lead agency in accordance with §A(1) of this regulation, provided the surrogate parent meets the requirements of §A(5) of this regulation.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Criteria for Selecting Surrogates. The local lead agency shall ensure that a person recommended as a surrogate parent:</text>
        <paragraph num="(a)">
          <text>Has no personal or professional interest that conflicts with the interests of the child the surrogate parent represents; and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Has knowledge and skills that ensure adequate representation of the child.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(5)">
        <text>Nonemployee requirement; Compensation.</text>
        <paragraph num="(a)">
          <text>A person assigned as a surrogate parent may not be an employee of the local lead agency or an employee of any service provider involved in the provision of early intervention or other services to the child or the child's family.</text>
        </paragraph>
        <paragraph num="(b)">
          <text>A person who otherwise qualifies to be a surrogate parent is not an employee of an agency solely because the person is paid by a public agency to be a surrogate parent.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(6)">
        <text>Surrogate Parent Responsibilities. The surrogate parent has the same rights as a parent for all purposes of Part C of the Act and this chapter.</text>
      </paragraph>
    </paragraph>
    <paragraph num="B.">
      <text>Surrogate Parent Appointment.</text>
      <paragraph num="(1)">
        <text>The local lead agency shall appoint a surrogate parent no more than 30 days after the local lead agency determines that the child needs a surrogate parent, consistent with §A(1) of this regulation.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The written notification in §B(1) of this regulation shall include the name or names of an individual or individuals appropriately qualified to fulfill the role of a surrogate parent, consistent with §A(4) and (5) of this regulation.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The local lead agency shall notify State Superintendent of Schools, or the Superintendent's designee, in writing, of the surrogate parent appointment not more than 10 days after the appointment.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>The notification described in §B(3) of this regulation shall include the child’s name, the name of the surrogate parent, and any other information deemed applicable.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Limited Civil Liability.</text>
      <paragraph num="(1)">
        <text>A child entrusted to a surrogate parent shall be represented by that surrogate parent in the early intervention services decision making process.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>A surrogate parent is not liable to the child entrusted to the surrogate parent or to the parent of that child for any damages that result from acts or omissions of that surrogate parent constituting ordinary negligence.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The immunity does not apply to liability covered by any applicable insurance, to the extent of that coverage, or to acts or omissions constituting gross, willful, or wanton negligence.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".14" heading="Procedural Safeguards — Dispute Resolution.">
    <paragraph num="A.">
      <text>Written State Complaint Procedures. The Department shall receive and resolve any early intervention State complaint filed by any party regarding any violation of Part C of the Act in accordance with 34 CFR §§303.432—303.434, and COMAR 13A.05.01.15A.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Mediation. Any party may request mediation to resolve a dispute involving any matter related to the provision of early intervention services, including matters arising prior to the filing of a due process complaint, in accordance with 34 CFR §303.431, and COMAR 13A.05.01.15B.</text>
    </paragraph>
    <paragraph num="C.">
      <text>Due Process Hearing Procedures.</text>
      <paragraph num="(1)">
        <text>The Department shall provide for impartial resolution of individual child complaints concerning any matter related to the provision of early intervention services in accordance with 34 CFR §§303.440—303.449, 34 CFR §§300.507—300.518, and COMAR 13A.05.01.15C.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>If a parent files a due process complaint to dispute a determination that the child does not meet the criteria for identification as a student with a disability under Part B, the local lead agency is not required to provide the child with early intervention services after the child’s third birthday during the pendency of the due process hearing.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Education Article, §8-416, Annotated Code of MarylandFederal Regulatory Reference: 34 CFR 99, 300, 303</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: June 24, 1991 (18:12 Md. R. 1327)</annotation>
    <annotation type="History" subtype="Administrative History">Regulations .02, .03, .05, .07—.09, and .11—.13 amended as an emergency provision effective October 26, 1993 (20:23 Md. R. 1793); emergency status extended at 21:8 Md. R. 664; adopted permanently effective July 4, 1994 (21:13 Md. R. 1154)</annotation>
    <annotation type="History" subtype="Administrative History">COMAR 01.04.01 transferred to COMAR 13A.13.01 effective November 1997</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .02B amended effective January 20, 2003 (30:1 Md. R. 27)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .08A amended effective January 20, 2003 (30:1 Md. R. 27); November 8, 2004 (31:22 Md. R. 1596)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .11A, B amended effective January 20, 2003 (30:1 Md. R. 27)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .11B amended effective October 5, 2009 (36:20 Md. R. 1531)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .12 amended effective January 20, 2003 (30:1 Md. R. 27)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .12B amended effective October 5, 2009 (36:20 Md. R. 1531)</annotation>
    <annotation type="History" subtype="Administrative History">Regulation .13 amended effective January 20, 2003 (30:1 Md. R. 27)</annotation>
    <annotation type="History" subtype="Administrative History">Regulations .01—.13 repealed and new Regulations .01—.14 adopted effective August 5, 2013 (40:15 Md. R. 1230)</annotation>
  </annotations>
</chapter>