The purpose of this chapter is to: Define the roles and responsibilities of the State Coordinating Council and the local care teams in fostering the development of resources necessary to serve children with intensive needs in the State of Maryland; Promote interagency coordination in the provision of such services; and Ensure that State funds for the out-of-State placement of children with intensive needs are allocated in accordance with relevant State and federal laws. In this chapter, the following terms have the meanings indicated. Terms Defined. “Appropriate service or placement” means a service, placement, or plan of care provided in accordance with the requirements of applicable federal and State laws, including: 20 U.S.C. §1400 et seq.; 42 U.S.C. §§620 and 670 et seq.; The Child Abuse Prevention and Treatment Act, 42 U.S.C. §5102 et seq.; The Adoptions and Safe Families Act of 1997 (P. L. 105-89); Courts and Judicial Proceedings Article, §3-820, Annotated Code of Maryland; COMAR 13A.05.01 and 13A.05.02; Health-General Article, Title 15, Annotated Code of Maryland; Applicable regulations in COMAR 10.09; and The reauthorization of the Elementary and Secondary Schools Act of 2001, P.L. 107—110 (January 8, 2002). Child in Need of Out-of-State Placement. “Child in need of out-of-State placement” means a child who is recommended for or placed in an out-of-home placement outside of the State by a public agency. “Child in need of out-of-State placement” does not include a child: Placed in foster care, as defined in Family Law Article, §5-501, Annotated Code of Maryland; or Who is in a hospital for 30 continuous days or less. “Child with intensive needs” means a child who has behavioral, educational, developmental, or mental health needs that cannot be met through available public agency resources because: The child’s needs exceed the resources of a single public agency; or There is no legally mandated funding source to meet the child’s needs; or A child is in need of out-of-State placement. “Children’s Cabinet” means those agencies directed by Executive Order: To examine Maryland’s system of services to children and their families; and To facilitate ongoing improvements to this service delivery system. “Cost sheet” means a document which details the cost of needed services. “Family” means an eligible child’s natural, adoptive, or foster parents, and includes: A guardian; A person acting as parent of a child; and A relative or stepparent with whom a child lives. “Funding agency” means the State or local agency designated by State or federal law as responsible for funding or cofunding educational, residential, or treatment services identified in a child’s plan of care. “Funding letter” means a document generated by the Governor’s Office for Children detailing the cost of educational, residential, or treatment services and the designated funding agencies. “Hospital” has the meaning stated in Health-General Article, §19-301, Annotated Code of Maryland. “Local agency” means the local school system, the local management board, and any local or regional departments, divisions, or offices of the State agencies identified in §B(19) of this regulation. “Local Care Team (LCT)” means the interagency body established in each local subdivision in the State for the purpose of providing a forum for interagency discussions and problem solving and offering referrals and information for families of children with intensive needs. “Local Management Board (LMB)” means the interagency body established by each local jurisdiction in the State for the purpose of overseeing and ensuring the implementation of a local interagency delivery system for children, youth, and families in that jurisdiction. “Notification” means the submission of completed documents as determined and required by the State Coordinating Council. “Out-of-State placement” means the placement of a child with intensive needs in a residential facility outside of the State for which State funding is sought, including: Alternative living units; Group homes; Hospitals; Residential facilities for children with disabilities; Residential treatment centers; Wilderness programs; and Other out-of-home settings as needed or appropriate to meet the intensive needs of a child. “Parent advocate” means an individual who is trained by and actively participates in a parents’ support or advocacy organization whose purpose is to support families of children with intensive needs. “Parent or guardian” means the parent, guardian, or person with legal authority to make decisions regarding the placement or other services provided by public agencies to a child with intensive needs.. “Plan of care” means the plan developed for the out-of-home placement of a child with intensive needs consistent with: The child’s individualized education program, if the child is a student with disabilities; Any court-ordered services; Services covered and authorized under the Maryland Medical Assistance Program if the child is eligible for medical assistance under Health-General Article, Title 15, Annotated Code of Maryland; or Any other service or program mandated by federal or State law with respect to the individual child. “Review” means the SCC discussion of aggregated data compiled by GOC from the notifications submitted by the State placing agencies. “State agency” means the: Maryland Department of Health; Department of Human Services; Department of Juvenile Services; Governor’s Office for Children; and Maryland State Department of Education. “State Coordinating Council (SCC)” means the State interagency body established as a committee of the Children’s Cabinet and which is responsible for: Reviewing and tracking the types, costs, and effectiveness of services required to meet the needs of children who are recommended for out-of-State placements; Coordinating the monitoring of out-of-State placement services to children with intensive needs; and Performing additional functions in accordance with the directives of the Children’s Cabinet. SCC Membership and Organization. The members of the SCC are the following State officials, or their designees: The Secretary of the Maryland Department of Health; The Secretary of the Department of Human Services; The Secretary of the Department of Juvenile Services; The Executive Director of the Governor’s Office for Children; and The State Superintendent of Schools. The Secretary of Budget and Management, or a designee, shall serve as a non-voting, ex officio member of the SCC. The Secretary of the Department of Disabilities, or a designee, shall serve as a non-voting, ex officio member of the SCC. The Children’s Cabinet shall designate up to 3 individuals to serve on the SCC on a rotating basis to represent: Family members or family advocates; and Youth or youth advocates. The Governor’s Office for Children shall provide staff support for the SCC. The SCC shall be chaired by a voting member as follows: The chairman shall serve a term of 12 months; and The chairmanship shall rotate among all voting members. The SCC shall establish and develop procedures to: Review notifications for state funding for the out-of-State placement of individual children with intensive needs; Make recommendations regarding the review of such notifications to the SCC; and Perform other functions as identified by the Children’s Cabinet or the SCC. LCT Membership and Organization. Each LCT shall consist of at least one designee of each of the following bodies: The Alcohol and Drug Administration; The Department of Juvenile Services; The Developmental Disabilities Administration; The local school system; The Mental Hygiene Administration or the local core service agency; The local department of social services; The local health department; and The local management board. The LCT membership shall include a parent of a child with intensive needs from the community, or parent advocate, or both, appointed by the chairman of the LCT in consultation with the local child advocacy community. The LCT membership shall include a non-voting representative of the local office of the Division of Rehabilitative Services to represent individuals who are 16 years old and older. Although each LCT member agency may designate staff to represent it on the LCT, all designees shall possess authority to the extent permitted by federal and State law to commit the resources of the agency that they represent. For all matters decided by a vote of the LCT: Each member agency listed in §B(1) of this regulation has a single vote; and The parent and parent advocate member represented on the LCT each have a single vote. The LCT shall select its chair by: Rotating the chairmanship among the members of the agencies represented on the LCT; or Appointing the LMB’s designee to the LCT as its chair. Each LCT: Shall determine which of its members will have responsibility for its administrative functions; and If 2 or more members will share the responsibility, shall determine the rotation of the administrative functions. General Responsibilities. The SCC shall encourage the implementation of the State’s policies to: Promote the development of a continuum of quality educational, treatment, and residential services in Maryland which will enable children with intensive needs to be served in the least restrictive setting appropriate to their individual needs; and Identify any additional treatment, educational, and residential resources, opportunities, or supports which may provide children with appropriate services in the least restrictive environment. Oversight of Resources for Children with Intensive Needs. The SCC shall oversee the resources available to serve children with intensive needs through the following activities: Establishment, support, and maintenance of a data tracking protocol to support agency accountability and State level service planning capability; Maintenance of a list of all residential facilities for children with intensive needs, which are approved or licensed by State agencies; Coordination of the monitoring of out-of-State facilities for compliance with applicable laws, regulations, and standards; Recommendations to State and local agencies regarding the use of existing community-based services and the development of new and enhanced community-based programs to serve children with intensive needs; Reviewing notifications for State funding of the individual placement of a child in need of out-of-State placement; Tracking the types, costs, and effectiveness of services required to meet the needs of children who are placed in an out-of-State facility; and Providing training and technical assistance to local agency and community partners. Each LCT shall develop policies and procedures to govern the: Conduct of regular meetings of the LCT; and Discussion of any requests for assistance by member agencies of individual children with intensive needs, including procedures for: Timely discussion of all requests for assistance; Expedited discussion of any request for assistance designated as an emergency matter by the referring agency; and Assurances of parental participation, or documentation of the LCT’s diligent efforts to assure parental participation, in the discussion of a child’s care. The LCT shall meet a minimum of four times per calendar year for the purposes stated in Human Services Article, §8-407, Annotated Code of Maryland. The Executive Director of the Governor’s Office for Children may grant waivers to the number of meetings required under §B of this regulation if: The LCT requests a waiver in writing prior to January 1 of the applicable calendar year; The LCT explains the reason for the waiver request; The request does not violate any applicable statute, law, regulation, ordinance, or bylaw; and The request is reasonable under the circumstances. Waivers under this chapter may be granted for a 1-year period, are renewable, and are subject to reconsideration at any time. The denial of a waiver may not be appealed. The placing agency shall submit a notification of State funding for the costs, or a portion of the costs, of the placement, as provided by applicable State laws. Prior to notification of out-of-State placement to the SCC, the placing agency shall notify all appropriate local agencies, the local school system and family members of the placement decision and expected admission date. Prior to notification of out-of-State placement to the SCC, the placing agency shall ensure that funding discussions have included input from all appropriate local agencies, the local school system and family members. The notification shall be on a form specified by the SCC and shall include the following: Information deemed necessary by the SCC to identify the child, the child’s intensive needs, and the nature and costs of the recommended placement; Documentation of the placing agency’s efforts to serve the child in the least restrictive environment appropriate to the child’s needs, including: A description of efforts to identify appropriate community-based services to meet the child’s needs; Reasons why community-based options were considered inadequate to meet the child’s needs or were otherwise rejected; A description of additional supports and services which would be required to provide appropriate services in an in-State facility, a community-based program, or the child’s home; The lack of availability of appropriate in-State facilities and services to meet the needs of the child; and A plan for the child’s return from the out-of-State placement, including: Time frame for the child’s return; Description of services and resources needed to facilitate the child’s return; and As appropriate, identification of a strategy for developing resources needed to facilitate the child’s return which are not currently available in the community. Exception Criteria for Out-of-State Placements. The SCC may review a notification from a placing agency for State funding of an out-of-State placement under one of the following exception criteria: The out-of-State placement is closer to the child’s home than any alternative in-State placement; The plan for the child’s permanent placement includes residence with a caregiver in proximity to the proposed out-of-State placement; The individualized needs of the child cannot be met through available, appropriate in-State resources at a total cost less than or equal to 100 percent of the average cost per placement for all appropriate out-of-State programs for which application would be made for the child; The child is currently in detention, shelter care, or committed to the Department of Juvenile Services pending placement under a court order; Compliance with the federal Individuals with Disabilities Education Act requires out-of-State placement; or The child is hospitalized in an acute care psychiatric hospital under the following circumstances: The child is committed to the Department of Juvenile Services, a local department of social services, or a division of the Maryland Department of Health; The child’s treatment team has determined that the child is ready for discharge. The only available, appropriate placement is out-of-State. The referring agency shall indicate which of the above exceptions is applicable with regard to the placement of the child for whom it has made notification to the SCC. The SCC will meet at least 6 times a year to conduct business meetings and provide trainings and technical assistance. Attendance at LCT. A child’s parents and the child’s legal counsel shall be invited to attend a meeting of the LCT or any portion of the meeting during which the child’s care is discussed. The child’s parents and legal counsel may present information to the meeting participants regarding their position as to the child’s needs and care. Notices to Parents. At least 10 calendar days before a meeting at which a child’s care is to be discussed, the parents and the child’s advocate or counsel shall receive a written invitation to the meeting, including the: Date, time, and location of the meeting; Intent to discuss the child’s care at the meeting; and Child’s right to be represented by an advocate or counsel. The SCC shall develop and implement a process to coordinate the monitoring of out-of-State facilities where Maryland children are being served at State expense. The SCC shall review any monitoring reports of site visits of out-of-State facilities that have been conducted by placing agency monitoring teams. Based upon the findings of a placing agency monitoring team, the SCC shall consult with the monitoring team to determine whether remedial actions are necessary. Each SCC member shall notify appropriate agency staff of any reports of monitoring of out-of-State residential services. The SCC shall review licensing and monitoring reports from each state in which a facility under contract with a placing agency is located. The Department of Human Services, Department of Juvenile Services, Department of Education, and Maryland Department of Health will share official monitoring reports with the SCC within 2 weeks of report being finally approved by the relevant agency head or designee. Before being submitted for publication, any proposed amendments to this chapter shall be reviewed and approved by the Office for Children and the Children’s Cabinet. Education Article, §§8-103—8-303 and 8-401—8-417; Health-General Article, §§2-102, 2-104, 2-105, 4-305—4-307, 7-1007, 10-204, 10-712, 10-1203, and 15-102.1; Human Services Article, §§2-202, 2-203, 2-209, 4-204, 4-205, 4-207, 9-202, 9-204, and 9-221; Annotated Code of Maryland Effective date: September 3, 2001 (28:17 Md. R. 1552) Chapter revised effective April 12, 2004 (31:7 Md. R. 581) COMAR 01.04.01 revised and recodified to COMAR 14.31.01 as an emergency provision effective June 30, 2005 (32:15 Md. R. 1314); revised and recodified permanently effective November 28, 2005 (32:23 Md. R. 1828) Regulations .01—.04 and .06—.14, Local and State Coordinating Councils, repealed and new Regulations .01—.04 and .06—.09, Local Care Teams and State Coordinating Council, adopted effective March 31, 2014 (41:6 Md. R. 381) Regulation .05 repealed and new Regulation .05 adopted effective October 13, 2014 (41:20 Md. R. 1113)