Sec. 10.09.50.01. Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Audiological evaluation” means identification, evaluation, and treatment of auditory impairments necessary to develop and implement an IFSP or an IEP pursuant to COMAR 13A.13.01.03B and 13A.05.01.03B.

(2) “Audiologist” means an individual licensed by the Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech Language Pathologists to practice audiology in Maryland.

(3) “Audiology service” means treatment of auditory impairments necessary to develop and implement an IFSP or an IEP pursuant to COMAR 13A.13.01.03B and 13A.05.01.03B.

(4) “Dietitian-Nutritionist” means an individual who is licensed as a dietitian-nutritionist by the Maryland State Board of Dietetic Practice to practice dietetics in Maryland.

(5) "Aversive technique" means the use of painful or noxious stimuli to the body, which is intrusive to the individual's physical, mental, or emotional well-being, used to terminate challenging or maladaptive behavior.

(6) "Child's family" means those individuals with whom a participant resides, who are responsible for the participant, and who are the primary nurturing caregivers.

(7) "Crisis intervention services" means the therapeutic response that provides immediate care or referral for an individual with an urgent mental health need.

(8) "Department" means the Maryland Department of Health as defined in COMAR 10.09.36.01.

(9) “Early intervention services (EIS)” means services which are consistent with COMAR 13A.13.01.03B.

(10) “Individualized education program (IEP)” means a written description of special education and related services developed by an IEP team to be implemented to meet the individual needs of a child pursuant to COMAR 13A.05.01.03B and 13A.05.01.09.

(11) “IEP team” means a group convened and conducted by a provider to develop a participant’s IEP, which is composed of a child’s parent or parents, the child’s teacher, and relevant service providers as indicated in COMAR 13A.05.01.03B and 13A.05.01.07.

(12) “Individualized Family Service Plan (IFSP)” means a written plan for providing early intervention and other services to an eligible child and the child’s family developed by an IFSP team pursuant to COMAR 13A.13.01.03B.

(13) “IFSP team” means a group convened and conducted by a provider to develop a participant’s IFSP, which is composed of a child’s parent or parents, the child’s service coordinator, and relevant service providers as indicated in COMAR 13A.13.01.06.

(14) “Infants and toddlers with disabilities” means children from birth to the beginning of the school year following the child’s 4th birthday who are eligible for early intervention services, as described in COMAR 13A.13.01.03B and documented by appropriate licensed personnel as defined in COMAR 13A.13.01.03B.

(15) "Jurisdiction" means a state or the District of Columbia.

(16) “Local School System (LSS)” means any of the 24 public school systems in Maryland responsible for providing public elementary or secondary education.

(17) "Local lead agency" means the 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 State Department of Education in accordance with Education Article, §8-416, Annotated Code of Maryland.

(18) "Maladaptive behavior" means behavior that is:

(a) Harmful to oneself or others;

(b) Developmentally inappropriate; and

(c) Disruptive or dangerous.

(19) "Maryland State Department of Education" has the meaning stated in COMAR 13A.01.03.

(20) "Medical Assistance Program" has the meaning stated in COMAR 10.09.36.01.

(21) “Mental health professional” has the meaning stated in COMAR 10.21.17.02B.

(22) “Nurse” means an individual who is licensed to practice as a registered nurse (RN) or licensed practical nurse (LPN) in the jurisdiction in which services are provided.

(23) “Nursing care plan” means a plan developed by a registered nurse that identifies the patient’s diagnoses and needs, the goals to be achieved, and the interventions required to meet the patient’s medical condition as defined in COMAR 10.09.53.01B.

(24) Nursing Services.

(a) “Nursing services” means skilled nursing services performed by a licensed nurse for a participant, which are necessary for the participant to benefit from educational or early intervention services pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.

(b) "Nursing services" includes an initial assessment.

(c) "Nursing services" does not include:

(i) Routine assessments of recipients whose medical condition is stable, unless the assessment leads to an intervention or change in the nursing care plan;

(ii) Administration of medications;

(iii) Supervision of interventions which the child is able to perform independently;

(iv) Health screens;

(v) Health education, except one-on-one training regarding self-management of the child's medical condition;

(vi) First aid interventions;

(vii) Services not directly related to the nursing care plan; and

(viii) Services not deemed medically necessary at the initial assessment or the most recent nursing care plan review.

(25) Nutrition Services.

(a) “Nutrition services” means services delivered by a licensed dietitian nutritionist.

(b) "Nutrition services" includes:

(i) Nutrition assessments and evaluations;

(ii) Developing and monitoring appropriate plans to address the nutritional needs of eligible children; and

(iii) Making referrals to appropriate community resources to carry out nutrition goals in an IFSP pursuant to COMAR 13A.13.01.03B.

(26) “Occupational therapist” means an individual licensed by the Maryland State Board of Occupational Therapy Practice to practice occupational therapy in Maryland.

(27) “Occupational therapy assistant” means an individual licensed by the Maryland State Board of Occupational Therapy Practice to practice limited occupational therapy in Maryland.

(28) “Occupational therapy services” means occupational therapy evaluations or treatments delivered by a licensed occupational therapist, or treatments delivered by a licensed occupational therapy assistant, which are necessary to develop and implement an IEP or an IFSP pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.

(29) "Parent" means the parent of a child and includes:

(a) A biological or adoptive parent;

(b) A legal guardian;

(c) Another person responsible for a child's welfare; or

(d) A parent surrogate for those cases when:

(i) A public agency, after reasonable efforts, cannot discover the whereabouts of a biological or adoptive parent,

(ii) An individual cannot be identified with responsibility for a child's welfare, or

(iii) A child is a ward of the State.

(30) “Participant” means a Medical Assistance recipient who is eligible for and receives health-related services in an IEP or health-related early intervention services in an IFSP.

(31) “Physical therapist” means an individual licensed by the Maryland Board of Physical Therapy Examiners to practice physical therapy in Maryland.

(32) “Physical therapist assistant” means an individual licensed by the Maryland Board of Physical Therapy Examiners to practice limited physical therapy in Maryland.

(33) “Physical therapy services” means physical therapy evaluations or treatments, delivered by a licensed physical therapist, or treatments delivered by a licensed physical therapy assistant, which are necessary to develop and implement an IEP or an IFSP pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.

(34) "Program" means the Medical Assistance Program as defined in COMAR 10.09.36.01.

(35) “Provider” means a local school system, local lead agency, State-operated education agency, or State-supported education agency which meets the conditions for participation as defined in Regulation .03 of this chapter to provide health-related services in an IEP or health-related early intervention services in an IFSP.

(36) “Psychological services” means the delivery of services by a licensed mental health professional, including administering psychological and developmental tests and other assessment procedures, interpreting assessment results, obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development, and planning and managing a program of psychological services including psychological counseling for children and families which are necessary to develop and implement an IEP or an IFSP pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.

(37) “Rehabilitative service” means the medical or remedial service recommended by a licensed physician or authorized practitioner under Health Occupations Article, Annotated Code of Maryland within the scope of the practice under §B(36) of this regulation, for the reduction of maladaptive behavior and restoration of a recipient to the best possible functional level.

(38) "Special health needs" means those temporary or long-term health problems arising from physical, emotional, or social factors, or any combination of these.

(39) “Speech-language pathologist” means an individual licensed by the State Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists to practice speech language pathology in Maryland.

(40) “Speech-language pathology assistant” means an individual licensed by the State Board of Examiners for Audiologists, Hearing Aid Dispensers, and Speech-Language Pathologists to assist in the practice of speech language pathology in Maryland.

(41) “Speech-language pathology” means speech language evaluations, diagnoses or treatments delivered by a licensed speech-language pathologist, or treatments delivered by a licensed speech-language pathology assistant, which are necessary to develop and implement an IEP or an IFSP pursuant to COMAR 13A.05.01.03B and 13A.13.01.03B.

(42) “Therapeutic behavior aide” means an individual who has been trained to implement a behavior plan as specified in the IEP or IFSP under the supervision of a licensed physician or authorized practitioner pursuant to Health Occupations Article, Annotated Code of Maryland.

(43) “Therapeutic behavior service” means a one-to-one individualized rehabilitative service, rendered by a therapeutic behavior aide, using appropriate methods of preventing or decreasing maladaptive behaviors for a Medicaid recipient who is eligible for and receives health-related services in an IEP or health-related early intervention services in an IFSP.