To be eligible as a health home, a provider shall:

1. A. Meet the conditions for provider participation in the Medical Assistance Program, as set forth in COMAR 10.09.36.03;
2. B. Meet the approval requirements set forth in Regulation .02 of this chapter;
3. C. Be accredited by, or demonstrate evidence of having started the accreditation process from, an approved accrediting body as a health home;
4. D. For PRP and MTS health homes serving minors, demonstrate a minimum of 3 years of experience serving minors, which may be achieved as an independent practice or as a member of a broader agency, with exceptions designated by the Department;
5. E. At the time of enrollment as a health home, be registered or be able to provide documentation of starting the process of registration with CRISP in order to receive hospital encounter alerts;

6. F. At the time of enrollment as a health home, be registered or be able to provide documentation of starting the process of registration with one of the following organizations in order to receive access to real-time pharmacy data for participants:

   1. (1) CRISP; or
   2. (2) The State’s ASO;
7. G. At the time of enrollment as a health home, have an internal protocol for reviewing and responding to hospital encounter alerts and pharmacy use data;
8. H. Directly provide, or subcontract for the provision of, health home services to all participants;

9. I. Maintain an electronic database with the ability to, at minimum:

   1. (1) Maintain an up-to-date list of all health home participants and their contact information; and
   2. (2) Record and review clinical appointments;

10. J. Maintain a file for each participant that includes:

    1. (1) A form signed by the participant consenting to participate in the health home, including the program’s data-sharing elements;
    2. (2) An initial assessment of the participant’s health and social services needs, as described in Regulation .06B(1)(a) of this chapter; and

    3. (3) A care plan, updated every 6 months, which may be combined with the existing MTS, PRP, or OTP care plan, and includes, at a minimum:

       1. (a) The participant’s health home goals;
       2. (b) Time frames for meeting the health home goals;
       3. (c) Proposed interventions for meeting the health home goals;
       4. (d) Relevant community networks and supports;
       5. (e) Optimal clinical outcomes for the participant; and

       6. (f) Signatures of:

          1. (i) The participant or the participant’s parent or guardian; and
          2. (ii) The nurse care manager to whom the participant has been assigned in the health home;
11. K. Safeguard the confidentiality of the participants’ records in accordance with State and federal laws and regulations;
12. L. Provide on-call and crisis intervention services by telephone 24 hours a day, 7 days a week to participants and, as appropriate, their caregivers, or if the participant is a minor, the minor’s parent or guardian;
13. M. Be responsible for meeting all health home service requirements, including services performed by a business or individual subcontracted to provide such services;
14. N. Convene health home staff meetings every 6 months, at minimum, to plan and implement goals and objectives of functioning as a health home;
15. O. Collaborate with MCOs and the ASO to improve participant outcomes; and

16. P. Agree to participate in federal and State-required evaluation activities, including:

    1. (1) Using the ASO system to:

       1. (a) Submit encounters documenting participants’ services at least monthly;

       2. (b) Generate monthly reports documenting:

          1. (i) Health home service delivery; and
          2. (ii) Participants’ health and social outcomes; and
       3. (c) Update participant diagnoses and outcomes every 6 months; and

    2. (2) Completing and submitting to the Department a program assessment every 6 months to demonstrate that:

       1. (a) All staffing and other regulatory requirements are being met; and
       2. (b) A quality improvement plan is being implemented.

Authority: Health-General Article, §§2-104(b), 7.5-204, 7.5-205(d), 7.5-402, 8-204(c), 15-103, and 15-105(b), Annotated Code of Maryland

Effective date: September 30, 2013 (40:19 Md. R. 1544)

Regulation .01B amended effective July 7, 2014 (41:13 Md. R. 752); November 13, 2023 (50:22 Md. R. 973); May 11, 2026 (53:9 Md. R. 412)

Regulation .02 amended effective November 13, 2023 (50:22 Md. R. 973)

Regulation .04 amended effective November 24, 2014 (41:23 Md. R. 1372)

Regulation .04P amended effective May 11, 2026 (53:9 Md. R. 412)

Regulation .06B amended effective November 13, 2023 (50:22 Md. R. 973)

Regulation .06C, H amended effective May 11, 2026 (53:9 Md. R. 412)

Regulation .07 amended effective May 11, 2026 (53:9 Md. R. 412)

Regulation .07A amended effective November 13, 2023 (50:22 Md. R. 973)

Regulation .08C amended effective April 4, 2022 (49:7 Md. R. 465), May 11, 2026 (53:9 Md. R. 412)

Regulation .08D amended effective May 11, 2026 (53:9 Md. R. 412)

Regulation .09 amended effective April 4, 2022 (49:7 Md. R. 465)

Regulation .09B amended effective May 11, 2026 (53:9 Md. R. 412)

Regulation .09C amended effective October 24, 2016 (43:21 Md. R. 1166); January 1, 2018 (44:26 Md. R. 1215); December 30, 2019 (46:26 Md. R. 1164); November 13, 2023 (50:22 Md. R. 973); September 16, 2024 (51:18 Md. R. 808); November 10, 2025 (52:22 Md. R. 1095)