Mental Health Services in Maryland IEPs
What mental health services are available through an IEP in Maryland?
Maryland provides for school-based mental health services both as IEP-related services and through general school behavioral health frameworks. Under COMAR 13A.05.01.02 and 34 CFR 300.34, counseling services (including individual and group counseling by qualified professionals), psychological services (including assessments, consultation, and direct intervention), and social work services (including home visits, crisis intervention, and coordination with community agencies) are recognized related services that must be included in a student's IEP when necessary for the child to benefit from special education. The IEP must document each mental health related service with its frequency, duration, location, and projected start date (COMAR 13A.05.01.09(A)(7)). Maryland has invested significantly in school-based mental health through the Expanded School Mental Health (ESMH) Services program, formerly known as ESBH, codified under Md. Code Ann., Health-Gen. § 7.5-201 et seq. (as amended by HB 548/SB 529, Mental Health — School-Based Behavioral Health Services — Expansion, effective 2023), which funds licensed behavioral health clinicians (LCSWs, LCPCs, psychologists) in public schools across all 24 LEAs. These school-based services may be coordinated with the IEP but are also available to general education students. Students with mental health conditions that adversely affect educational performance may qualify for special education under the 'Emotional Disability' category (COMAR 13A.05.01.03(A)(4)) or 'Other Health Impairment' if the condition results in limited strength, vitality, or alertness (COMAR 13A.05.01.03(A)(9)). When behavior impedes learning due to mental health concerns, the IEP team must consider positive behavioral interventions and supports (COMAR 13A.05.01.08(A)). Maryland's Medicaid School Programs (MSP) initiative allows LEAs to bill Maryland Medicaid for mental health and behavioral health services delivered to Medicaid-eligible students through the IEP, provided parental consent is obtained and the service is documented as medically necessary; this does not relieve the LEA of its FAPE obligation (Md. Code Ann., Ed. § 8-418). Maryland also established the Maryland School Mental Health Alliance to coordinate school mental health resources statewide.
What Maryland Requires
Counseling, psychological, and social work services are recognized IEP-related services when necessary for the child to benefit from special education (34 CFR 300.34; COMAR 13A.05.01.02).
Students with mental health conditions adversely affecting educational performance may qualify under 'Emotional Disability' (COMAR 13A.05.01.03(A)(4)) or 'Other Health Impairment' (COMAR 13A.05.01.03(A)(9)).
When behavior impedes learning due to mental health concerns, the IEP team must consider positive behavioral interventions and supports (COMAR 13A.05.01.08(A)).
Mental health related services must be documented in the IEP with frequency, duration, location, and projected start date (COMAR 13A.05.01.09(A)(7)).
Maryland's Expanded School Mental Health (ESMH) program funds licensed behavioral health clinicians in all 24 LEAs; services may be coordinated with the IEP (Md. Code Ann., Health-Gen. § 7.5-201 et seq.).
Medicaid-eligible mental health services may be billed to Maryland Medicaid with parental consent, but this does not reduce the LEA's FAPE obligation (Md. Code Ann., Ed. § 8-418).
Maryland School Mental Health Alliance coordinates statewide school mental health resources and best practices across LEAs.
Key Timelines
Mental health related services must begin on the projected start date in the IEP (COMAR 13A.05.01.09(A)(7)).
Services must be reviewed at least annually at the IEP meeting (COMAR 13A.05.01.08(B)).
If a student's mental health needs change significantly, the IEP team should reconvene promptly to revise services (COMAR 13A.05.01.08(B)(1); 34 CFR 300.324(b)).
Mental health evaluations as part of special education assessment must be completed within the 60-day evaluation timeline (COMAR 13A.05.01.06(A)).
Sources
Related IEP Guides
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