Md. Code Regs. 10.09.89.12

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.89.12 - Covered Services - Intensive In-Home Services

A. Intensive In-Home Services (IIHS):

(1) Are strengths-based interventions with the child and his or her identified family that includes a series of components, such as:

(a) Functional assessments and treatment planning;

(b) Individualized interventions;

(c) Crisis response and intervention; or

(d) Transition support;

(2) May be provided to the child alone, to other family members, or to the child and family members together;

(3) Are intended to support a child to remain in his or her home and reduce hospitalizations and out-of-home placements or changes of living arrangements through focused intervention in the home and community; and

(4) May be used in situations such as the start of a child's enrollment in the 1915(i), upon discharge from a hospital or residential treatment center, or to prevent or stabilize after a crisis situation.

B. Types of IIHS Providers. The Department may approve two types of IIHS providers:

(1) Evidence-Based Practice (EBP)-IIHS providers, to include providers of EBPs as determined by the Department; and

(2) Promising Practice IIHS providers (non-EBP), to include providers of the In-Home Intervention Program for Children (IHIP-C) and other promising practices, as determined by the Department.

C. An EBP-IIHS provider shall have a certificate or letter from the national or intermediate surveyor or developer of the particular evidence-based practice to demonstrate that the EBP-IIHS provider meets all requirements for Department-approved EBP-IIHS, to include participating in all fidelity monitoring activities.

D. A Non-EBP IIHS provider shall have a certificate or letter from the national or intermediate purveyor or developer of the particular promising practice or from the Department to demonstrate that the Non-EBP IIHS provider meets all requirements for IHIP-C or other Department-approved non-EBP IIHS.

E. All IIHS providers shall:

(1) Ensure that there are Clinical Leads, Supervisors, and Therapists on staff who are responsible for creating, implementing and managing the treatment plan with the child and family and the CFT;

(2) Provide crisis response services for the participants on the IIHS provider's caseload and ensure that on-call and crisis intervention services are:

(a) Provided by a licensed mental health professional trained in the intervention;

(b) Available 24-hours per day, 7 days per week, during the hours the provider is not open to the individual enrolled in the treatment; and

(c) In compliance with staffing, supervision, training, data collection, and fidelity monitoring requirements set forth by the purveyor, developer, or DHMH and approved by the Department;

(3) Employ Clinical Leads and Supervisors who:

(a) Have a current license under the Health Occupations Article, Annotated Code of Maryland, as a:

(i) Licensed certified social worker-clinical (LCSW-C);

(ii) Licensed clinical professional counselor (LCPC);

(iii) Psychologist;

(iv) Psychiatrist;

(v) Nurse psychotherapist; or

(vi) Advanced practice registered nurse/psychiatric mental health (APRN-PMH); and

(b) Have at least 3 years of experience in providing mental health treatment to children and families;

(4) Employ therapists who:

(a) Have a current license under the Health Occupations Article, Annotated Code of Maryland, as a:

(i) Licensed certified social worker (LCSW);

(ii) LCSW-C;

(iii) LCPC;

(iv) Psychologist;

(v) Psychiatrist;

(vi) Nurse psychotherapist; or

(vii) APRN-PMH.

(b) Are supervised by a clinical lead supervisor;

(c) See the child in-person at least once per 7 days while receiving IIHS services;

(5) Employ in-home stabilizers who:

(a) Support the implementation of the treatment plan, but are not responsible for creating it or modifying it;

(b) Are at least 21 years old;

(c) Have at least a high school diploma or equivalency; and

(d) Have completed relevant, comprehensive, appropriate training before providing services, as outlined by the purveyor, developer, or the Department and approved by the Department;

(6) Provide a minimum of one face-to-face contact with the participant per week of service;

(7) Ensure a minimum of 50 percent of the therapist's contacts with the participant or family, or both, is face-to-face; and

(8) Ensure that a minimum of 50 percent of the therapist's time is spent working outside the agency's office and in the participant's home or community, as documented in case notes.

Md. Code Regs. 10.09.89.12

Regulations .12 adopted effective 41:19 Md. R. 1077, eff.10/1/2014 ; amended effective 43:21 Md. R. 1166, eff. 10/24/2016; amended effective 45:1 Md. R. 13, eff. 1/15/2018; amended and recodified from .14 effective 46:17 Md. R. 725, eff. 8/26/2019; amended effective 47:10 Md. R. 517, eff. 5/18/2020; amended effective 48:12 Md. R. 473, eff. 6/14/2021; amended effective 49:7 Md. R. 466, eff. 4/4/2022; amended effective 50:22 Md. R. 974, eff. 11/13/2023