Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.50 - EPSDT School Health-Related Services or Health-Related Early Intervention Services › Section 10.09.50.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
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 Department of
				  Health and Mental Hygiene as defined in COMAR
				  10.09.36.01B.
(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
				  10.09.36.01B.
(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 10.09.53.0IB.
(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
				  10.09.36.01B.
(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.