1. A. A participant shall be eligible for care coordination services if the recipient:

   1. (1) Is in a federal eligibility category for Maryland Medical Assistance according to COMAR 10.09.24, which governs the determination of eligibility for the Maryland Medical Assistance Program; and
   2. (2) Meets the criteria of either §B(1) or (2) of this regulation.

2. B. The participant:

   1. (1) Shall:

      1. (a) Meet the diagnostic requirements of being either:

         1. (i) An individual younger than 18 years old with a serious emotional disturbance or co-occurring disorder; or
         2. (ii) A young adult with a serious emotional disturbance or co-occurring disorder enrolled in care coordination services continuously under this chapter since reaching age 18; and

      2. (b) Require community treatment and support in order to prevent or address:

         1. (i) Inpatient psychiatric or substance use treatment;
         2. (ii) Treatment in a RTC or residential substance use treatment facility;
         3. (iii) An out-of-home placement;
         4. (iv) Emergency room utilization due to multiple behavioral health stressors;
         5. (v) Homelessness or housing instability, or otherwise lacking in permanent, safe housing; or
         6. (vi) Arrest or incarceration due to multiple behavioral health stressors; or

   2. (2) Shall:

      1. (a) Meet the requirements of §B(1)(a); and

      2. (b) Need care coordination services to facilitate community treatment following:

         1. (i) Release from a detention center or correctional facility; or
         2. (ii) Discharge to the community from RTC placement or inpatient psychiatric unit.
3. C. A participant that disenrolls after reaching 18 years of age and wishes to re-enroll in care coordination services at a later date shall do so pursuant to COMAR 10.09.45 if more than 120 calendar days has passed since disenrollment.

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

Effective date: October 1, 2014 (41:19 Md. R. 1078)

Regulation .02B amended effective August 26, 2019 (46:17 Md. R. 726)

Regulation .03B amended effective August 26, 2019 (46:17 Md. R. 726)

Regulation .07 amended effective August 26, 2019 (46:17 Md. R. 726)

Regulation .07C amended effective November 14, 2022 (49:23 Md. R. 996)

Regulation .09B amended effective August 26, 2019 (46:17 Md. R. 726)

Regulation .12A amended effective August 26, 2019 (46:17 Md. R. 726)

Regulation .13D amended effective August 26, 2019 (46:17 Md. R. 726)

Regulation .16D amended effective April 13, 2015 (42:7 Md. R. 568)