Sec. 10.09.90.06. Participant Eligibility — Level II — Moderate Care Coordination  


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  • The participant as described in Regulation .03A of this chapter shall meet three or more of the following conditions:

    A. The participant is not linked to behavioral health services, health insurance, or medical services;

    B. The participant lacks basic supports for education, income, food, or transportation;

    C. The participant is homeless or at-risk for homelessness;

    D. The participant is transitioning from one level of intensity to another level of intensity including transitions out of the following levels of service:

    (1) Inpatient psychiatric or substance use services;

    (2) RTC; or

    (3) 1915(i) services under COMAR 10.09.89;

    E. Due to multiple behavioral health stressors within the past 12 months, the participant has a history of:

    (1) Psychiatric hospitalizations; or

    (2) Repeated visits or admissions to:

    (a) Emergency room psychiatric units;

    (b) Crisis beds; or

    (c) Inpatient psychiatric units;

    F. The participant needs care coordination services to obtain and maintain community-based treatment and services;

    G. The participant:

    (1) Is currently enrolled in Level III Care Coordination services under this chapter; and

    (2) Has stabilized to the point that Level II is most appropriate;

    H. The participant:

    (1) Is currently enrolled in Level I Care Coordination services under this chapter; and

    (2) Has experienced one of the following adverse childhood experiences during the preceding 6 months:

    (a) Emotional, physical, or sexual abuse;

    (b) Emotional or physical neglect; or

    (c) Significant family disruption or stressors.