Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 2. |
Subtitle 09. MEDICAL CARE PROGRAMS |
Chapter 10.09.56. Home and Community-Based Services Waiver for Children with Autism Spectrum Disorder |
Sec. 10.09.56.14-1. Covered Services — Intensive Therapeutic Integration Services
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A. Intensive therapeutic integration services under this regulation:
(1) Are provided at a nonresidential setting separate from the home or facility where the participant lives;
(2) Shall have an on-site direct care worker for every participant receiving one-to-one interventions for intensive therapeutic integration;
(3) Shall include expressive therapies and therapeutic recreational activities;
(4) Shall include the development of socialization skills, enhancement of self-esteem, and behavior management;
(5) Are for participants who require one-to-one interventions and also have problems with socialization, isolation, hyperactivity, impulse control, and behavioral or other related disorders;
(6) Are not solely educational or recreational in nature, but have a therapeutic habilitative orientation, as evidenced in written progress notes;
(7) Shall be culturally competent and congruent with the participants cultural norms;
(8) Shall assure coordination with the participants other service providers, service coordinator, and multidisciplinary team;
(9) Shall be based on the participants individualized written treatment plan that identifies goals of the specific therapeutic activities provided;
(10) Shall provide:
(a) General therapeutic and therapeutic recreational services;
(b) Behavioral management;
(c) Planning for crises with the participant during a session;
(d) Socialization groups; and
(e) One or more of art, music, dance, or activity therapies, as appropriate for participants;
(11) Shall have a supervisor who has been trained in accordance with Regulation .04E(3) of this chapter that:
(a) Trains and provides ongoing supervision to the direct care worker rendering therapeutic integration services;
(b) Supervises the direct care worker when crisis intervention services are rendered to evaluate the nature of the crisis and intervenes to reduce the likelihood of reoccurrence;
(c) Plans and regularly reviews the participants therapeutic activities and behavior plan;
(d) Meets regularly with the participant and family and observes the participant in the community setting;
(e) Develops intervention on an individualized basis and identifies the interventions on an individualized treatment plan; and
(f) Identifies, in the treatment plan, the goals and tasks that the intensive therapeutic integration direct care worker is implementing; and
(12) Shall, when transportation is provided:
(a) Have individualized goals for transportation for the participant on the participants treatment plan; and
(b) Document the start and stop times transportation is provided for each day that a participant is transported.
B. A unit of service is a 30-minute increment of service rendered to a participant by a qualified provider in the community setting.