1. A. Intensive In-Home Services (IIHS):

   1. (1) Are strengths-based interventions with the child and his or her identified family that includes a series of components, such as:

      1. (a) Functional assessments and treatment planning;
      2. (b) Individualized interventions;
      3. (c) Crisis response and intervention; or
      4. (d) Transition support;
   2. (2) May be provided to the child alone, to other family members, or to the child and family members together;
   3. (3) Are intended to support a child to remain in his or her home and reduce hospitalizations and out-of-home placements or changes of living arrangements through focused intervention in the home and community; and
   4. (4) May be used in situations such as the start of a child's enrollment in the 1915(i), upon discharge from a hospital or residential treatment center, or to prevent or stabilize after a crisis situation.

2. B. Types of IIHS Providers. The Department may approve two types of IIHS providers:

   1. (1) Evidence-Based Practice (EBP)-IIHS providers, to include providers of EBPs as determined by the Department; and
   2. (2) Promising Practice IIHS providers (non-EBP), to include providers of the In-Home Intervention Program for Children (IHIP-C) and other promising practices, as determined by the Department.
3. C. An EBP-IIHS provider shall have a certificate or letter from the national or intermediate surveyor or developer of the particular evidence-based practice to demonstrate that the EBP-IIHS provider meets all requirements for Department-approved EBP-IIHS, to include participating in all fidelity monitoring activities.

4. D. A Non-EBP IIHS provider shall:

   1. (1) Be a Department-approved IHIP-C provider or have a certificate or letter from a national or intermediate purveyor or developer of another promising practice; and
   2. (2) Meet the requirements of §E of this regulation.

5. E. All non-EBP IIHS providers not approved by the Department as IHIP-C providers shall:

   1. (1) Ensure that there are Clinical Supervisors and staff who are responsible for creating, implementing, and managing the treatment plan with the child and family and the CFT;

   2. (2) Provide crisis response services for the participants on the IIHS provider's caseload and ensure that on-call and crisis intervention services are:

      1. (a) Provided by a licensed mental health professional trained in the intervention;
      2. (b) Available 24-hours per day, 7 days per week, during the hours the provider is not open to the individual enrolled in the treatment; and
      3. (c) In compliance with staffing, supervision, training, data collection, and fidelity monitoring requirements set forth by the purveyor, developer, or MDH and approved by the Department;

   3. (3) Employ Clinical Supervisors who:

      1. (a) Have a current license under the Health Occupations Article, Annotated Code of Maryland, as a:

         1. (i) Licensed certified social worker-clinical (LCSW-C);
         2. (ii) Licensed clinical professional counselor (LCPC);
         3. (iii) Psychologist;
         4. (iv) Psychiatrist;
         5. (v) Nurse psychotherapist; or
         6. (vi) Advanced practice registered nurse/psychiatric mental health (APRN-PMH); and
      2. (b) Have at least 3 years of experience in providing mental health treatment to children and families;

   4. (4) Employ mental health professionals who:

      1. (a) Have a current license under the Health Occupations Article, Annotated Code of Maryland, as a:

         1. (i) Licensed certified social worker (LCSW);
         2. (ii) LCSW-C;
         3. (iii) LCPC;
         4. (iv) Psychologist;
         5. (v) Psychiatrist;
         6. (vi) Nurse psychotherapist; or
         7. (vii) APRN-PMH.
      2. (b) Are supervised by a clinical lead supervisor;
      3. (c) See the child in-person at least once per 7 days while receiving IIHS services;

   5. (5) Employ in-home stabilizers who:

      1. (a) Support the implementation of the treatment plan, but are not responsible for creating it or modifying it;
      2. (b) Are at least 21 years old;
      3. (c) Have at least a high school diploma or equivalency; and
      4. (d) Have completed relevant, comprehensive, appropriate training before providing services, as outlined by the purveyor, developer, or the Department and approved by the Department;
   6. (6) Provide a minimum of one face-to-face contact with the participant per week of service;
   7. (7) Ensure a minimum of 50 percent of the mental health professionals' contacts with the participant or family, or both, is face-to-face; and
   8. (8) Ensure that a minimum of 50 percent of the mental health professionals' time is spent working outside the agency's office and in the participant's home or community, as documented in case notes.

Authority: Health-General Article, §2-104(b), Annotated Code of Maryland

Effective date: October 1, 2014 (41:19 Md. R. 1077)

Regulation .15B amended effective July 4, 2016 (43:13 Md. R. 712)

Regulation .10F amended October 24, 2016 (43:21 Md. R. 1166); January 15, 2018 (45:1 Md. R. 13)

Regulation .11E amended October 24, 2016 (43:21 Md. R. 1166); January 15, 2018 (45:1 Md. R. 13)

Regulation .12C amended October 24, 2016 (43:21 Md. R. 1166); January 15, 2018 (45:1 Md. R. 13)

Regulation .13D amended October 24, 2016 (43:21 Md. R. 1166); January 15, 2018 (45:1 Md. R. 13)

Regulation .14F amended October 24, 2016 (43:21 Md. R. 1166); January 15, 2018 (45:1 Md. R. 13)

Chapter revised effective August 26, 2019 (46:17 Md. R. 726)

Regulation .02B amended effective June 14, 2021 (48:12 Md. R. 473)

Regulation .03C, E, H amended effective June 14, 2021 (48:12 Md. R. 473)

Regulation .04A amended effective June 14, 2021 (48:12 Md. R. 473)

Regulation .09D, E amended effective November 13, 2023 (50:22 Md. R. 974)

Regulation .09F amended effective May 18, 2020 (47:10 Md. R. 517); June 14, 2021 (48:12 Md. R. 473); April 4, 2022 (49:7 Md. R. 466)

Regulation .09F repealed effective November 13, 2023 (50:22 Md. R. 974)

Regulation .10C, D amended effective November 13, 2023 (50:22 Md. R. 974)

Regulation .10E amended effective May 18, 2020 (47:10 Md. R. 517); June 14, 2021 (48:12 Md. R. 473); April 4, 2022 (49:7 Md. R. 466)

Regulation .10E repealed effective November 13, 2023 (50:22 Md. R. 974)

Regulation .11C amended effective May 18, 2020 (47:10 Md. R. 517); June 14, 2021 (48:12 Md. R. 473); April 4, 2022 (49:7 Md. R. 466)

Regulation .11C repealed effective November 13, 2023 (50:22 Md. R. 974)

Regulation .12F amended effective May 18, 2020 (47:10 Md. R. 517); June 14, 2021 (48:12 Md. R. 473); April 4, 2022 (49:7 Md. R. 466)

Regulation .12F repealed effective November 13, 2023 (50:22 Md. R. 974)

Regulation .14 amended effective September 16, 2024 (51:18 Md. R. 809)

Regulation .14E—I adopted effective November 13, 2023 (50:22 Md. R. 974)